6 Month Pre-Op Diet Question

[NurseJaci13 11]

So, I found out I can use the fact that I've been on WW for the last three-ish months to start "the clock" on my pre-op diet requirements...but, I'm concerned. I actually gained about 8 pounds during those three months making my BMI go up from below 40 to just over. It wasn't on purpose, and honestly, without WW I think I would have gained more due to the quarantine.

My question is...will this make those three months "not count"? Especially since they are all virtual right now? Has anyone had any experience with this?

Thanks for any advice! This site has been so affirming and helpful!

[Hop_Scotch 1,633]

I guess it would depend on your surgeon's/clinic pre-op guidelines/specifications. Are you on a specific program and if so when is your next check in/weigh in? Do you have time to lose some weight before the next weigh in?

Past few months have been trying for a lot of people hopefully they will understand.

[New&Improved 1,780]

Some programs don't care if you lose or gain they just want evidence

[WishMeSmaller 1,274]

My program (Insurance) required three months of medically managed weight loss. They normally have you go through a twelve week course, but I was unable to attend the classes due to work. I ended up seeing my primary doctor once a month and a nutritionist once a month to meet the goal. I did not lose any weight, but was approved for surgery. My insurance requires BMI > 40 or BMI 35-40 with co-morbities like hypertension, diabetes 2, high cholesterol, or sleep apnea, to cover the surgery. I have co-morbidities and my BMI bounces right around 39-41. My surgeon is not particularly concerned about my pre-surgery weight as long as there are no huge changes in weight and I follow the two week liquid pre-op diet. I expect to lose 10-15 pounds on the diet, which will put my BMI at about the 39 level. If I did not have co-morbidities my insurance would not pay for the surgery with the lower BMI. It is kind of ridiculous, really.

[NurseJaci13 11]

As far as I can tell they don't really care if I gain or lose, at least from what my BRS nurse said. It's more about the "education" I receive. I'm more concerned that they will think I gained on purpose to get over 40, which I didn't. I also have to be over 40 or be over 35 and have co-morbidities @WishMeSmaller and I agree. I'm only 5' 3" so a pretty small weight gain or loss changes my BMI but 5-10 pounds doesn't really change my health issues. I don't think my doctor even cares that much. They want you to meet with a nutritionist twice before surgery and do two psych evals, but they don't have a minimum time to do it in. They will get you in as quickly as you meet those two requirements and insurance approves. I was just wondering if anyone else had this situation.

[Knk710 2]

I am 203 pounds. 5ft 3 inch.

I, fall just under the requirements of having over 40 bmi. However, I have type 2 diabetes and high cholesterol. My Nurse told me that I must maintain my weight for the 6 months of nutritionist appts/visits if not the insurance company will not approve the surgery. Therefore, I can't gain weight (As it will show that im unable to follow an appropriate healthier eating plan now they won't want to risk dangers of side effects if that occurred after) I completed the 6 months of nutritionist visits and my psychological eval.

Edited June 14, 2020 by Knk710

[WishMeSmaller 1,274]

3 hours ago, NurseJaci13 said:

As far as I can tell they don't really care if I gain or lose, at least from what my BRS nurse said. It's more about the "education" I receive. I'm more concerned that they will think I gained on purpose to get over 40, which I didn't. I also have to be over 40 or be over 35 and have co-morbidities @WishMeSmaller and I agree. I'm only 5' 3" so a pretty small weight gain or loss changes my BMI but 5-10 pounds doesn't really change my health issues. I don't think my doctor even cares that much. They want you to meet with a nutritionist twice before surgery and do two psych evals, but they don't have a minimum time to do it in. They will get you in as quickly as you meet those two requirements and insurance approves. I was just wondering if anyone else had this situation.

I have to think your time counts lose or gain. I would hope that weight gain would be at the surgeon’s discretion as you will have fulfilled the insurance obligation.

I am right with you, nothing but a significant weight loss is going to change my health issues. I am also a nurse (assuming that is what your name implies) 😊. It is so frustrating that insurance is always driving health care instead of medical need.

i hope everything works out for you, @NurseJaci13! I am just hoping this new wave of COVID cases doesn’t hijack my surgery date again. I gained about 7 pounds when my first date was canceled🤦🏼‍♀️🤦🏼‍♀️🤦🏼‍♀️

Edited June 14, 2020 by WishMeSmaller

[Knk710 2]

I agree about the insurance driver and true they shouldn't hold it against. I pray the date is solid. This Covid-19 def doesn't help with weight stability... Good luck ...

[NurseJaci13 11]

19 hours ago, WishMeSmaller said:

I have to think your time counts lose or gain. I would hope that weight gain would be at the surgeon’s discretion as you will have fulfilled the insurance obligation.

I am right with you, nothing but a significant weight loss is going to change my health issues. I am also a nurse (assuming that is what your name implies) 😊. It is so frustrating that insurance is always driving health care instead of medical need.

i hope everything works out for you, @NurseJaci13! I am just hoping this new wave of COVID cases doesn’t hijack my surgery date again. I gained about 7 pounds when my first date was canceled🤦🏼‍♀️🤦🏼‍♀️🤦🏼‍♀️

I'm in nursing school! I'm set to graduate in 2022 (hopefully). Part of what finally got me to commit to surgery was going through clinicals and realizing how much my weight impeded me. I want to be the best nurse I can be .

I wish you luck @WishMeSmaller and I pray for ALL of our sakes that COVID doesn't make this already frustrating process even worse.

[NurseJaci13 11]

19 hours ago, Knk710 said:

I agree about the insurance driver and true they shouldn't hold it against. I pray the date is solid. This Covid-19 def doesn't help with weight stability... Good luck ...

My doctor said over and over again in our informational meeting that diet and exercise alone have a less than 2% success rate for obese people, so he doesn't really have pre-surgery weight loss goals for us unless there is some kind of risk factor they are trying to minimize. I'm relatively "small" so I doubt that will be my issue. And, good luck to you too!!

[WishMeSmaller 1,274]

17 minutes ago, NurseJaci13 said:

I'm in nursing school! I'm set to graduate in 2022 (hopefully). Part of what finally got me to commit to surgery was going through clinicals and realizing how much my weight impeded me. I want to be the best nurse I can be .

I wish you luck @WishMeSmaller and I pray for ALL of our sakes that COVID doesn't make this already frustrating process even worse.

Weight loss will make a tough job a bit easier. Good luck with nursing school! It is miserable, but you will use most of what you learn, even if you do it unconsciously. I love nursing, but am currently working in a clinic rather than a hospital, in part because my weight was making it harder on some of challenging days. Sometimes I think I might want to go back to working in the hospital when I am more fit 😊