So begins the journey... (Pittsburgh PA)

[Colleywobbles30 0]

Hello everyone,

My name is Amanda - 30 years old from Pennsylvania. I'm about 30 miles south of Pittsburgh and have high hopes to get the lap-band at Magee Hospital. I've been overweight for as long as I can remember, I've gained about 60 pounds since I got married in 2001. I've tried the diets, tried the whole "not eating" and every time I lose the weight comes back. I did try WW in 2006 and lost 28lbs over 3 months which I managed to keep off but I'm still unhappy with myself. I recently turned 30 in July and I realized how uncontrollable my weight has gotten, things are hurting that never hurt before and my energy levels are decreasing. I have a 4 year old daughter that I want to see grow up, I want to be able to DO things with her, like ride on roller coasters and RUN after her when we remove the training wheels from her bike. I'm ready for this journey because I now know that I can't do it alone, no matter how hard I have tried. Thankfully I don't have any ailments at this time ( except for PCOS, which I've had since 13) but my BMI is 44.5 and that alone is enough to get me banded.

I have Highmark BCBS and they will pay for 100% of the surgery ( minus my 250.00 deductible) but I have to go through 6 months of nutritional counseling before they'll approve me. This seems common with the insurance companies, they want a doctor to follow my progress for 6 months, have me meet with a dietician and have a psychological evaluation before they'll authorize the surgery. My question is this.. do I do this 6 month "diet" with my PCP or I do I need to find a surgeon first?!? How does ths process work? I want to start ASAP in hopes of having the surgery next Spring or Summer... any help in the right direction would be greatly appreciated. I look forward to getting to know some of you and traveling this rocky road together.

Sorry so long ... I tend to go on and on and on and on....................

[MacMadame 81]

Welcome to LBT.

Most insurance companies want your PCP to do the 6 month supervised diet. Sometimes the nutritionist at the surgeon's office can do it, but you should make sure your insurance company is okay with that because some are but some aren't.

[ShiraSimcha 0]

Hi!!! I went to the seminar at Magee last night. The woman who heads the program said that insurance doesn't cover Magee doing the nutritional classes...she said they will cover your pcp doing them. She also said once you start the classes you cannot gain ANY weight and in fact have to show either a steady no-loss or steady losses or you may not get approved. I wasn't sure if this was for Highmark or not. I talked to Highmark a few weeks ago and like you said, they seem pretty easy to deal with. I am on the cusp...35 BMI but I have comorbidities so I am hopeful. I have an appointment with my pcp on the 25th and just hope he agrees as well!

Stay in touch!!!! I am also on the PA support thread in the Pgh section.

Shira

[Brandy~ 2]

Hello! I took started my lapband journey at about the same age as you :rolleyes2:

I have BCBS and also had to have a 6 month diet. It was CAKE... other than having to wait 6 months it was easy. I picked a nutritionist seperate from the surgeon. I would check in with her 1 x per month for about 15 minutes. She was very kind and just said ok youre doing good or watch out your eating too much of this kind of food etc.

In the end I only lost about 5lbs over the 6month... because I didn't try. If I had it to do over again I would of worked harder to lose some weight. Turns out my insurance wont deny you for getting under a 40bmi after the diet.. So I would of had a head start lol.

Oh well now im blabbering on and on.

Good luck with your journey :thumbup: