Preop weight loss-too much?

[blackcatsandbaddecisions 848]

Hi All,

I am coming up next month on 6/6 appointments for my required six month waiting for insurance. I didn’t have much success with weight loss during the first few months, but since early July I’ve been pretty successful with dieting and have lost 40 lbs. I am still above 40 BMI, and would have to lose another 20+ lbs to get under 40 BMI, which I know is the cutoff without other comorbidities. My last appointment is 2.5 weeks away so I think I’m pretty safe for not falling below that cutoff before I’m done with the waiting period, but is it possible to lose too much weight in the qualification period if you are still above the BMI cutoff?

and side note, depending on how long it is between the submission to insurance/surgery day I think it’s pretty likely I’d fall below at that point. Can they rescind your approval after the fact if you show up for survey or a pre op appointment below the cutoff BMI?

sorry for all the paranoid questions, and thank you in advance!

[Pandemonium 515]

Congrats on the stellar pre-surgery weight loss!

Ultimately, it all depends on your insurance companies guidelines for approval. As you've said, you're unlikely to get below 40 BMI in the next 2.5 weeks. Provided that that appointment is your final one before your surgeon submits to the insurance company, you should be fine. Your surgeon will use your weight and BMI from that appointment when submitting for approval.

Once the approval is given, you should also be all set. When my surgeon submitted for approval, I was at 42 BMI, The request was initially denied due to my surgeon failing to submit some key data from my endoscopy, so he appealed and the approval went through about a month after the initial submission. By the time the approval came through, I was down to 40.2 BMI. On my surgery date, I was down to 37.7 BMI. Since the approval was already given, I was still very much in the clear. So, you shouldn't have anything to worry about once your surgeon has the go-ahead from the insurance company.

Again, great job on the weight loss and best of luck on getting a quick approval from your insurance company!

[ksgypsy 52]

I asked this question of the Patient Coordinator and was told that the insurance goes by the weight of my first Surgeon appointment. Of course you may have different requirements... Your Patient Coordinator may be able to advise you. I believe my 'packet' will be submitted to my insurance (Aetna) next week. To be certain, I ensured that I didn't go below at any point in the process. Started the process in Nov '19.

Best of luck to you!!

[Cheeseburgh 3,078]

My insurance went by first (highest) weight also. I qualified by 1 or 2 pounds. I was encouraged to lose weight before surgery and lost 23 pounds (4 months) by my surgery date. It makes sense, you adapt your eating habits and get mentally prepared.

I have read some insurance plans require you are above the magic BMI number. I’d check to be sure.

[blackcatsandbaddecisions 848]

I really appreciate all your responses, thank you! I want to take advantage of this time to set some new habits and lose as much weight as possible before surgery. I’ll keep up my dieting and try to get as low as I can so I have less to lose after surgery.

[Ann777 16]

On 9/27/2020 at 10:10 PM, Cheeseburgh said:

My insurance went by first (highest) weight also. I qualified by 1 or 2 pounds. I was encouraged to lose weight before surgery and lost 23 pounds (4 months) by my surgery date. It makes sense, you adapt your eating habits and get mentally prepared.

I have read some insurance plans require you are above the magic BMI number. I’d check to be sure.

@Cheeseburgh I noticed that our weight and height are very similar and would like your advice. I was 236 lbs highest weight but surgery weight was 227 at 5' 4 at the end of May. Now I'm 195 but the pounds come off so slowly! I'm 4 months out. Was it the same for you? Did you eat certain things that helped with weight loss? Yes, I Get my Protein and Water requirements daily. Help anybody!

[Cheeseburgh 3,078]

4 hours ago, Ann777 said:

@Cheeseburgh I noticed that our weight and height are very similar and would like your advice. I was 236 lbs highest weight but surgery weight was 227 at 5' 4 at the end of May. Now I'm 195 but the pounds come off so slowly! I'm 4 months out. Was it the same for you? Did you eat certain things that helped with weight loss? Yes, I Get my Protein and Water requirements daily. Help anybody!

Yes indeed. I copied and pasted this from another thread 9/10.I’ll follow up with more details later.

I never did the math on this before. 8/18-8/19 I lost an average of 6.1 pounds per month. I had surgery at 204 and I lost s.l.o.w. I think one month I only lost 2-3 pounds eating less than 900 calories a day. I did lose it though!

Edited October 4, 2020 by Cheeseburgh

[Cheeseburgh 3,078]

@Ann777 Here are my numbers 3-4 months post surgery. I lost 33 pounds in the first 4 months. You lost 32 so yep we are close. Instead of throwing in the towel, I tightened up my diet (less processed food, less calories) and started posting/lurking here. I still lost weight slow, and it came to a screeching halt around 6 months so I joined a gym and increased my activity level while still averaging 700-800 calories a day. It got crazy frustrating but I refused to give up. Logic kept nagging and reassuring me. I knew with the calorie deficit I was maintaining I was going to lose weight at some point. I’m a stubborn person, I didn’t even indulge and go over 900 calories that I recall.

Heads up, I just recalled that a medication I was on for high blood pressure during half that year is notorious for slowing your metabolism. It’s a beta blocker, Metoprolol, (although there are many drugs in that family) I researched it and asked to get switched to a new med. (unfortunately my blood pressure isn’t tied to my weight) getting off that medication and switching to a different one helped me a lot too.

It paid off, I’m into year 2 of post op and so far it’s second nature for me to be mindful of what I eat and I stay super active.

Edited October 4, 2020 by Cheeseburgh

[Ann777 16]

15 hours ago, Cheeseburgh said:

@Ann777 Here are my numbers 3-4 months post surgery. I lost 33 pounds in the first 4 months. You lost 32 so yep we are close. Instead of throwing in the towel, I tightened up my diet (less processed food, less calories) and started posting/lurking here. I still lost weight slow, and it came to a screeching halt around 6 months so I joined a gym and increased my activity level while still averaging 700-800 calories a day. It got crazy frustrating but I refused to give up. Logic kept nagging and reassuring me. I knew with the calorie deficit I was maintaining I was going to lose weight at some point. I’m a stubborn person, I didn’t even indulge and go over 900 calories that I recall.

Heads up, I just recalled that a medication I was on for high blood pressure during half that year is notorious for slowing your metabolism. It’s a beta blocker, Metoprolol, (although there are many drugs in that family) I researched it and asked to get switched to a new med. (unfortunately my blood pressure isn’t tied to my weight) getting off that medication and switching to a different one helped me a lot too.

It paid off, I’m into year 2 of post op and so far it’s second nature for me to be mindful of what I eat and I stay super active.

Wow, thank you, thank you... I'm not crazy-lol. I like your comment 'but I was still losing'. I tend to forget that my one and two pounds per week will add up. I'm not cheating but I get 1200 cals a day. I was bearly losing at my 2 month check up so my Nut increased me to 1200 since I was walking 3 miles 5 days a week. But..for the next two weeks, I'm cutting back on calories while the scale is slowly moving. thanks for the suggestion! You are my inspiration (2 year post op and 124!) Congratulations on your hard work and defeating that dreadful 6 month stall!

[Cheeseburgh 3,078]

5 hours ago, Ann777 said:

Wow, thank you, thank you... I'm not crazy-lol. I like your comment 'but I was still losing'. I tend to forget that my one and two pounds per week will add up. I'm not cheating but I get 1200 cals a day. I was bearly losing at my 2 month check up so my Nut increased me to 1200 since I was walking 3 miles 5 days a week. But..for the next two weeks, I'm cutting back on calories while the scale is slowly moving. thanks for the suggestion! You are my inspiration (2 year post op and 124!) Congratulations on your hard work and defeating that dreadful 6 month stall!

1200 calories is way too high. That’s a normal diet on Weight Watchers. I don’t understand some nutritionists. I maintain on about 1350-1400 a day

Edited October 5, 2020 by Cheeseburgh