Puju10 0 Posted July 24, 2008 My 2 Dr. recommend I get Lap band surgery for medical reasons and right now I'm 5'8" and 272lb. (I'm always 280 and can get to 250 but always spring back to 280). We are doing our own biggest loser at work and I have to admit til I get approved I been almost sabatoging myself on this diet contest. I didn't want to admit that cause I'm trying to keep my BMI up there. My point is I now know I'm not alone. Thank you! Share this post Link to post Share on other sites
myfunlife32 0 Posted July 25, 2008 All I have to say is I was willing to do anything and did - corrected my weight, changed hospitals. I'm just waiting for my insurance approval - they finally submitted today. We got pre-approval a month ago so they "say" its going to be quick. I'm with the other posters - worry about your health. Its not like you weigh under 200lbs and you're trying to cheat your way into the surgery. Keep us posted. Share this post Link to post Share on other sites
debgoodman 0 Posted July 25, 2008 (edited) I knew I was going to come up a little short and I had to be a 40 BMI. My ins only counts comorbs that are significant like BP or cholesterol, diabetes, ect. I ate like a pig for a month before weigh in and checked my weight daily to see where I was. I also wore the heaviest clothes and shoes I owned. Kinda hard in summer, but it worked. No way was I going to let 10 lbs mess up this opportunity.:smile2: Edited July 25, 2008 by debgoodman spelling Share this post Link to post Share on other sites
aprilapple 1 Posted July 25, 2008 Thanks mommieof4!I'm just starting to freak because the dr. I got my referral from was telling me I don't qualify because I don't have any co-morbidities. And I was like I do and he kept telling me they didn't qualify as a comorbidity.GRR! So of course I'm second guessing and freaking out. My ins.will not cover a bmi below 40 w/o comorbids. however,they are very specific about what conditions they will consider comorbids. check your policy. I had to have a bmi of 40 b/c i did not have comorbids that they would consider. Share this post Link to post Share on other sites
cobrien78 0 Posted July 25, 2008 The family practice dr. said that my insulin resistance wouldn't count cause I have PCOS and that's a fertility issue. He said my BP wasn't that high 136/86 even though I told him I've been treated for it in the past and it is consistently that elevated. He said he didn't have my cholesterol results so he couldn't be sure I have high chol. even though I told him it was tested high. He also said they wouldn't give me the surgery because my BMI wasn't 40 or above and I didn't have any co-morbidities although, in my opinion I do. He told me they don't do surgeries on people who have BMIs under 40 so as you can tell he really doesn't know much about WLS. Needless to say he really frustrated me and made me mad. I just want to gain a few lbs. to make sure I do qualify and be on the safe side it can't hurt to have a higher BMI. Share this post Link to post Share on other sites
aprilapple 1 Posted July 25, 2008 The family practice dr. said that my insulin resistance wouldn't count cause I have PCOS and that's a fertility issue. He said my BP wasn't that high 136/86 even though I told him I've been treated for it in the past and it is consistently that elevated. He said he didn't have my cholesterol results so he couldn't be sure I have high chol. even though I told him it was tested high. He also said they wouldn't give me the surgery because my BMI wasn't 40 or above and I didn't have any co-morbidities although, in my opinion I do. He told me they don't do surgeries on people who have BMIs under 40 so as you can tell he really doesn't know much about WLS. Needless to say he really frustrated me and made me mad. I just want to gain a few lbs. to make sure I do qualify and be on the safe side it can't hurt to have a higher BMI. I can only suggest what worked for me. So here goes: call the wait loss center or practice that u want to do your surgery. Ask for the patient coordinator. If u attend a seminar this person may be there also. Tell him or her that u are interested in wls but u don't have a pcp to do your supervised diet ( it may b req. by ins.) ask her to suggest one that is a " friend to the process" or one they get successful referrals from. Drop your current pcp like a hot potato. Also make sir u have done two things: read your policies guidelines and have the correct BMI. Arm yourself with info. that way people won't be able to tell u just anything. Keep us posted. Share this post Link to post Share on other sites
Mommie_of_4 0 Posted July 28, 2008 Cobrien ~ Do you have Tricare?? If so, the PCM doesn't have anything to do with it once you have been referred to the bariatric surgeon. The surgeon puts in the request for the surgery and lists all of your comorbids (that you tell them you have). I didn't provide any medical records from my PCM to the surgeon. They went off of what I told them. I was approved by Tricare in 5 days (2 of those days were the weekend). Your PCM really doesn't seem to support your choice. So you might want to find a PCM that is more understanding of your needs. Share this post Link to post Share on other sites
froggie456834 0 Posted July 28, 2008 I have a friend who gained weight to qualify for surgery. This was after six years of WW membership (with losing, gaining, losing, then gaining). She was near her heaviest ever (a weight which would have qualified her), but not there, and she didn't want to wait until she just magically became that weight again to qualify, so she gained about 14 pounds in time for her assessment to qualify. She totally doesn't regret it, as her issue with food is every bit as real as someone twice her weight. If you know this surgery is right for you because you've exhausted all options, do what you need to do to qualify, because in a perfect world there would be no hoops to jump through. Share this post Link to post Share on other sites