Six Month Diet Question

[Who'sThere 331]

Okay...here is the exact wording from my health insurance policy. (This is one of the requirements, but it's the only one I'm worried about.)

(2) History of failure of medical/dietary therapies (including low calorie diet, increased physical

activity, and behavioral reinforcement). This attempt at conservative management must be

within two years prior to surgery, and must be documented by an attending physician who

does not perform bariatric surgery. (Failure of conservative therapy is defined as an inability

to lose more than ten percent of body weight over a six-month period and maintain weight

loss.)

I have done lots of other things in the past, but not necessarily doctor supervised. I was on Fentermine earlier this year for about three months along with a reduced calorie diet (that's as long as my PCP will prescribe it), and I did lose 10% of my weight. However, I did not keep it off for three months, let alone six months. Do you think this would count, or should I be starting a 6 month diet now? My initial consult isn't until Dec., and I certainly don't want to wait until then to start if I have to. I really want to have this done ASAP!

[RestlessMonkey 7]

Call the diet center and ask them what they recommend. A 6-month preop diet isn't an uncommon requirement for many ins companies. Good luck!

[karook54 0]

My ins. required a 6 mo supervised diet even thought I had 16 mo of documented records of Weight Watchers. I started my supervised dr. visits that mo. and I used my yearly gyn visit as one month. I had to go to the dr. for a total of 7 visits, so I would start as soon as possible and make sure you don't skip a month because the ins. co. will make you start over. Good luck

[crzytchr 3]

If you had a couple of more visits to the doctor after the prescribed medication earlier this year that documented your weight, that may work. Get that information together and check with the insurance company.

[Who'sThere 331]

Call the diet center and ask them what they recommend. A 6-month preop diet isn't an uncommon requirement for many ins companies. Good luck!

I'm not sure what you mean by diet center. Is there a special department at my insurance or at the surgeon's office or something else?

[RestlessMonkey 7]

Call the office of the surgeon (for me, that's a "bariatric diet center" and ask them what they recommend their patients do to fulfill that 6-month requirement. They may know a physician, or tell you to go to WW and check in w/your PCP, or some such. I didn't have to fulfill a 6-month preop diet requirement but I'd think your surgeon's staff can give you some tips on what YOUR insurance company will accept.

[Who'sThere 331]

Call the office of the surgeon (for me, that's a "bariatric diet center" and ask them what they recommend their patients do to fulfill that 6-month requirement. They may know a physician, or tell you to go to WW and check in w/your PCP, or some such. I didn't have to fulfill a 6-month preop diet requirement but I'd think your surgeon's staff can give you some tips on what YOUR insurance company will accept.

Oh, okay....thanks. I did email the question to the surgeon's office, but I haven't heard anything back yet.

[LABBY08 0]

I am in the process of doing my 6 month visits. It is required by my insurance. What it is, is that you have to show a 6 consective months of doctor supervised visits. You can ask your personal pcp, or NP, or the doctor that is doing your surgery, they usually have a 6 mth program. My doctor told me it's really not if you lose weight or not, it's to show the insurance that you can, or have tried to lose the weight, and can stick with something for 6 consective months.

Good Luck

[pstroud100 1]

My insurance required that I do the same thing. All I had to do is type a brief history of my diet failures for the past two years. I then backed that up with four years of doucmented weight history. I just got the last four visits from my gyno guy. I was told that was all I needed. Good luck in your journey. Hopefully I will have a date by the end of the month.

[Ditkadog1 0]

I would start with a call to your insurance carrier. I called mine, and despite what a lot of people have said here, I HAVE to lose 5% of my total weight in 6-12 months or they will deny coverage for the surgery. I went for my initial consult with my PCP and they had a form to send in to the insurance co that gave them my current (starting) weight and that's the weight they will use to determine coverage after 6 months. Each insurance is different and you don't want to get too far into this process and find out that you missed one little detail that your coverage requires. It would suck to jump through a bunch of hoops and then in 6 months find out you have to start over! Good luck!!