Jump to content
×
Are you looking for the BariatricPal Store? Go now!

BMI of 38, hoping I don't get denied...



Recommended Posts

Hi everyone.

I have an appointment for a consult with a surgeon in 3 weeks. I've decided after this past year of diligently working out (5 or 6 days a week), and sorta-kinda eating okay, to only lose a grand total of almost nothing, I am about to give up.

I'm afraid I'm not overweight enough for my insurance to approve it. I told a friend this the other day. She had gastric bypass surgery years ago. I told her, "I almost want to stop working out and just start eating so that I can be a BMI of 40 by the time I see him (where it would be approved).

She said, "oh, that is so common. People do that all the time."

Do they?

I am so sick and tired of trying so hard to get nowhere.

Share this post


Link to post
Share on other sites

My insurance company approved payment for the sleeve with a BMI of 37 and one comorbid condition of dyslipidemia (a.k.a. elevated cholesterol).

Do you have any comorbidities such as high cholesterol, diabetes, heart disease, osteoarthritis, sleep apnea, or high blood pressure?

If you're a "healthy" person with a BMI of 38, my politically incorrect suggestion is to gain the 25 to 30 pounds to ensure your BMI is 40 by the time of your consultation.

Share this post


Link to post
Share on other sites

My ankles are always sore, and my right knee crackles loudly. Neither of those things have a diagnosis to go along with them.

My husband says I used to have sleep apnea, but the working out has made it go away. I never did have that officially diagnosed, either.

I do get acid reflux, and that is on my chart.

I have a gyne appointment tomorrow to check on a thing that might qualify (vaginal childbirth messes you up! Lol).

I didn't think about having heavy things *on* me...

Edited by WonderWhat

Share this post


Link to post
Share on other sites

I went into the program with a BMI of 40 but was required to lose 15 pounds, I lost 30, so my BMI going into insurance approval for surgery was 37 and I have no co-morbidities. I was approved with no issues but that may have been since I went into the program at a 40 BMI.

Share this post


Link to post
Share on other sites

I would talk to your insurance company first before doing anything drastic. I gained a few lbs (harder than it sounds) to meet their criteria. Then, I found out I had to have a 3 year history of bmi over 35 with comorbidities or 40 without. Plus, I couldn't drop below 35 during the 4 month supervised diet or they'd deny me.

So, I basically wasted time gaining, then had to go self pay and lose what I had just gained.

Sent from my XT1254 using BariatricPal mobile app

Share this post


Link to post
Share on other sites

This is the issue i am having. i loose 5 pounds i get below BMI of 40. My stomach is all messed up from going back to eating what ever. I have no problem eating healthy i actually prefer it except around my menstrual lol. but im always stuck at in the 240's if im in the 250's im in the bmi of 40 it is so easy for me to get the the 240's but i get absolutely no where once i am there it is so frustrating that is why i decided to get the sleeve. So i did the seminar and i have my consultation appointment scheduled i cant wait until that appointment.

Share this post


Link to post
Share on other sites

My appointment is tomorrow. I'm going in fully loaded (with a full tummy and lots of Water. And pockets of change, lol).

I have no idea how much I weigh. I don't have a home scale, so I guess I'll find out tomorrow!

Just a little nerve-wracking.

Share this post


Link to post
Share on other sites

This seems to be an area (like the pre-op diet) where there are different approaches from practice to practice. Mine made it clear to me that if my BMI went below 35 before they filed that insurance wouldnt approve me.

Share this post


Link to post
Share on other sites

Full belly, lots of Water, layers of clothes, heavy shoes. Oh! And see if you can make yourself a bit shorter on the bari doctor’s chart.

My BMI with comorbidity was a bit over 35. When I made myself 2 inches shorter, my BMI jumped to almost 39.

To be on the safe side, I intentionally didn’t lose any weight (drank water, wore heavy shoes) during my 6 mo diet period.

Insurance didn’t challenge my shorter height, but if they had, I would have probably measured about 1.5” shorter than my file stated.




Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
    • Bugg

      Hi everyone! I’m brand new here. I just went through all my pre-op requirements per my insurance company and now everything has been submitted and I’m just waiting for final approval and my surgery date. I’ve been doing research, watching YouTube videos, TikTok’s, ect.. trying to prepare my mind and what to expect so I’ll be ready for the surgery. I was so sure and so set and so ready and excited. However, now that I’ve done everything & it’s almost here, I am sooooooo scared! I know why I want it bc I’ve tried everything and I just don’t feel like I can lose weight by myself. I’m tired of being overweight my entire life. I’m miserable, but I keep psyching myself out afraid of GERD bc I know how that can be and I don’t want to have to get a bypass after already gaining the courage to even get VSG. I’m scared of complications like I’mgoing to regret doing it and be depressed that I didn’t just be more disciplined and try again to lose the weight on my own even sitting here typing this knowing in my mind i just can’t and don’t possess the discipline. I’m also afraid I won’t be able to handle the restrictions of the sleeve. What do I eat? I don’t know how to eat healthy really and don’t enjoy healthy food. I don’t know how to do this! I feel so defeated!Someone tell me they felt anything similar to this or am I not ready? I thought I was. I am so tired of being sick and tired and so tired of myself and so tired of being stuck and stuck in this body and somebody different on the outside from what I feel inside. I just want to ball up and cry.
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      over 20 lbs down since4 the pre surgery diet and surgery on the 14th
      · 1 reply
      1. Selina333

        Yay!! Congrats. I know how good that feels. 🤩

    • Jenopolis

      Had a sleeve in 2017, lost over 100 pounds. Had a DS surgery this year (2025) for more sustainable weight loss. 🤞
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      The 14th was my day. I am home and recovery is going pretty smooth. They even let me walk out of the hospital. Picture of me in recovery curtesy of my boyfriend lol. 

      · 3 replies
      1. DaisyChainOz

        Glad it went well!! Wishing you a speedy recovery and wonderful success!! 🤗

      2. buildabetteranna

        Thank you ❤️

      3. Selina333

        Neat you have a pic of this day! I was sooo happy to get my surgery. It was well worth it! And I'm not even near my goal. I had surgery Dec. 2!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×