Low BMI no comorbidities - should I worry?

[KaiserKid 81]

Hi all,

I have my appointment with the weight center psych/dietician/MD in August - they have three options for people which include either diet/exercise w/ personal trainer, weight loss medication or surgery. After thinking HARD about it, I think I'm considering surgery if it's on the table. Reason being my BMI is exactly 40, I'm 4' 10.5" and fluctuate 195-200lbs. I DO exercise 3x/ week and have counted calories for several years, so I'm not sure how more of the same could help. Then again, maybe I'm wrong. I also read medications aren't super effective and I'd have to basically take them forever in order for them to continue to work.

Would it be wrong of me to go in and request surgery as my preferred option from the get-go? I don't want to go in and presume anything since they are the experts, but after doing some research I think surgery would be a good option.

However, being only 28 years old, no (qualifying) comorbidites and having a BMI JUST meeting the cutoff, should I worry about qualifying for any type of surgery? My insurance basically says I need to meet BMI of at least 40 and agree to the program (BCBS-MA).

What are some things that they might ask me at my first appointment? Will my height (or lack thereof) be a disadvantage to me? Part of the reason I was referred to the weight center was because my PCP said if my husband and I want to have a baby someday, it's not advised I get pregnant at this weight/height.

My appt isn't until next month so I just want to be as prepared as possible!

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[OKCPirate 5,323]

Yeah, you probably should. WLS seems to give us a new "set point" that leads to permanent weight loss. http://theweightofthenation.hbo.com/themes/obesity-research. The earlier you can get a handle on this, the less excess skin you are going to have to deal with. (in your 50's, it is an issue). You will save wear and tear on your joints. Many can attest that happy knees are great. I can't say with certainty that this is for you, but these are a few areas I'd look into.

[Bufflehead 6,358]

I don't think it's wrong at all to have surgery as your preferred option. Anyone who cares to read the medical literature can see it is by far the most effective way to lose weight -- why not have that as a preferred option?

As far as your BMI goes, certainly don't try to lose weight before your first appointment. You may even want to pack on a few pounds just to be safe.

[James Marusek 5,244]

I am 3 years post-op RNY gastric bypass surgery. My main goal was to eliminate several of my co-morbidities including high blood pressure, diabetes, severe acid reflux (Gerd) and sleep apnea. Those conditions went into remission within 2 weeks after surgery. So I am pleased with the results of this operation.

Since one of the reasons why you are considering this type of surgery is to better prepare your body to conceive and give birth to a child consider the following.

* It is important to not conceive immediately after surgery. You should probably wait until after you have lost the weight and stabilized. My program guidelines read:

- Avoid pregnancy. It is recommended to wait at least 12-18 months following surgery.

- Low caloric intake cannot support a pregnancy.

- If you have been told by a doctor that you cannot get pregnant... DO NOT COUNT ON THAT.

* In general, after surgery your body will become more fertile. [Which is your main goal]

So when you go to your first appointment, this is probably one of the issues that you should discuss.

[WitchySar 244]

You're going to need to find the specifics for your insurance. Some insurance requires a BMI over a certain point for a certain number of years, and dipping under that BMI could cause your insurance to deny you. Some insurances are a lot less strict.

[needtorecover 574]

You should qualify for insurance but like others said, don't try to lose any more weight. WLS has proven to be the most effective treatment for obesity and insurance companies are starting to see that the costs of comorbidities of obesity exceed the expense of a 1 time surgery. In days of yore it was considered a cosmetic surgery (lose weight and look good!) but now it's an excellent choice for better health (lose weight and dramatically decrease your chances of serious health problems!).

It is wise to have the surgery while you're young. I'm not much older than you (34) but the wear and tear from obesity has hurt my joints already. My knees get sore easily. My dad had to have knee replacement surgery in his late 50's and that would be my fate in my late 30's if I didn't get a handle on it now!

[KaiserKid 81]

Thank you! Yes my mom actually passed away last year at 54 from a heart attack. It was mostly related to her COPD from a lifetime of smoking but she was also probably around 275lbs when she passed (at 5'2"). I do not want that to be me so I'm scared I'll get denied because, as backwards as it sounds, I'd be "too healthy" in the eyes of the insurance company. I'm told BCBS-MA is good, but I'm still a nervous nelly!

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[AmberMc03 59]

I went through the same decision myself. 5"1' exactly 40bmi and 1 comorbidity which didn't qualify me under 40bmi. To be safe and ensure my qualification I gained a few more pounds before my initial consult and ended up starting at 41bmi. My surgery date BMI was 39.4 weight of 198.6 and my insurance covered.

[KaiserKid 81]

I went through the same decision myself. 5"1' exactly 40bmi and 1 comorbidity which didn't qualify me under 40bmi. To be safe and ensure my qualification I gained a few more pounds before my initial consult and ended up starting at 41bmi. My surgery date BMI was 39.4 weight of 198.6 and my insurance covered.

How did you feel about having to gain weight prior to your appt? I'm considering stopping my regular "diet" altogether and stop counting calories, etc. I'd hate to lose my progress but I guess a few weeks of feeling bloaty and gross is worth it if I can qualify for this procedure.

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[KaiserKid 81]

I went through the same decision myself. 5"1' exactly 40bmi and 1 comorbidity which didn't qualify me under 40bmi. To be safe and ensure my qualification I gained a few more pounds before my initial consult and ended up starting at 41bmi. My surgery date BMI was 39.4 weight of 198.6 and my insurance covered.

How did you feel about having to gain weight prior to your appt? I'm considering stopping my regular "diet" altogether and stop counting calories, etc. I'd hate to lose my progress but I guess a few weeks of feeling bloaty and gross is worth it if I can qualify for this procedure.

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[nickisleeve 127]

I went through the same decision myself. 5"1' exactly 40bmi and 1 comorbidity which didn't qualify me under 40bmi. To be safe and ensure my qualification I gained a few more pounds before my initial consult and ended up starting at 41bmi. My surgery date BMI was 39.4 weight of 198.6 and my insurance covered.

How did you feel about having to gain weight prior to your appt? I'm considering stopping my regular "diet" altogether and stop counting calories, etc. I'd hate to lose my progress but I guess a few weeks of feeling bloaty and gross is worth it if I can qualify for this procedure.

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Omg!!! My first appt is Aug 4. I've been trying to stuff my face to get more lbs on. Yes, I feel sluggish, bloated, and gross. Idk how much more of this I can take. It's so hard to put on extra weight fast.

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