So. Cal Kaiser "low" BMI approval?

MissKate · August 3, 2016

I have struggled with my weight my entire life. 3 years ago I hit my breaking point when I weighed in at 290 [44 BMI]. I'm 5'8. My PCP recommended WLS but I was too scared and was convinced that I didn't need it. Well, 3 years later and now I'm begging for it. No matter what I do, I can't seem to stay below 200. I was able to get to 190 with starvation and ridiculous amounts of cardio, but of course as soon as I reintroduced food, it came back.

I've tried every diet under the sun. 3 rounds of nutrisystem, herbalife, Meal Replacements, medically supervised diets, HCG, and my PCP even had me on phentermine for a while. Over the past year I went from 190lbs to 212lbs and nothing I've done to try to stop the gain has helped.

I am done being obese/overweight. I want to have the ability to actually live my life the way it is meant to be lived. I am so ready that I actually told my doctor that if she is unwilling to refer me to Kaisers weight loss department, I will gladly gain the 20lbs necessary to bump me up from a 32BMI to 35 and reminded her that I would be required to lose 20% of my weight before the surgery anyways [therefore making the weight gain absolutely pointless]. I also let her know that my gain has been steady even with proper foods/portions AND exercise. I have high blood pressure, am being tested for sleep apnea, and have family history of heart disease, diabetes, and cancer.

She gave me the phone number for the WL department and they are sending me a packet to fill out.

Has anyone here had to convince their insurance that they need approval? If so could you give me some pointers on convincing them? I am desperate to gain control of my life.

KristenLe · August 3, 2016

Try looking at the Obesity Action Coalition website for some guidance.

khoktzen · September 26, 2016

Hi Katie-

I happened to come across your post as I'm in a very similar situation. I'm 5'2" and hovering between 190-200 lbs. My bmi is currently right at 35 however, I haven't been officially diagnosed with any co-morbities. I've asked my dr on multiple occasions about weight loss surgery but she won't give me a referral. I did the Kaiser Medical Weight loss program and got down to about 187 but have since crept back up. I've adopted a healthy active livestyle and feel that I'm a great candidate for the surgery but my PCP just won't listen. I just asked if I could do a sleep study to rule out sleep apnea. Now I'm worried that if I do have sleep apnea, they'll say I don't have "severe" sleep apnea and not consider that a comorbity that would qualify me for WLS.

Did you end up having a sleep study done? What results did you get and where are you now in the process?

Hope you've made more progress than me!