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I don't Qualify-- Need to gain 5 pounds



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:blink: So frustrated. I am at 39 BMI but am the healthiest darn obese person around apparently. I don't have any of the serious comorbidities--diabetes, high bp, cholesterol, or heart probs. What I do have is a complete disability in my feet. My insurance has already paid for several years of podiatrist appts, months of physical therapy, several medical devices, and 3 surgeries. I am unable to walk for more than about 5 minutes at a time. Currently my future is bleak and my insurance could end up paying for more foot surgeries, and my inactivity is putting me at risk for clotting. Insurance has already also paid for an ER visit and multiple tests for a suspected lung clot related to this. 2 podiatrists and my PCP agree that weight loss is really the best thing to help my feet and I will probably see about a 75% improvement if I do (there are also genitic issues involved)

But NOOOOOO! That isn't enough. If I don't have one of the big five then I don't qualify, YET. But if I can gain 5-7 pounds then I will be at 40 BMI and then qualify automatically. I have to gain 5 pounds in order to lose 100! Insurance stupidity at its finest.

I was prepared to start with a dietician this week and already had made a menu to alter my diet to high Protein and low fat etc... Instead it will be pizza, ice cream, soda, and my favorite Mexican place. It just seems so wrong.:(

Did anyone else have to do this? Any actual "healthy" ideas for gaining a few pounds. I really do prefer at this point to not do it with junk.

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just a thought just wear some heavier clothes and those some heavy keys in your pockets and some coins that will get you 5 lbs if you do it right

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Yea, I will be in heavier clothes, hiking boots, with my pockets (and my stomach!) stuffed next time!:thumbdown:. The 5 I need to gain takes that in account. There is only so much clothes I can wear!

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One gallon of Water weighs eight pounds. So you should at least be able to drink half of that right before your weigh in. Also, I hate to be the person to mention this, but a five pound fishing weight would be about the size of a pack of cigarettes and could fit in the bra cup! I know I sneaked some stuff into concerts in there! I would consider just putting a three-pound weight in each side! I would hesitate to do the pockets and boots in case you have to get in a gown or anything.

Well I considered all of this but it would have been around 15 for me so I am going to self pay...I feel lucky that I can! Insurance companies are evil! God luck! Cali

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I have heard of people being denied for one pound...

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Amazing.....I cannot believe that they would not qualify you for 5 lbs. Crazy!!

Isn't it though! Especially since weight can vary 5 pounds from 8am to 5pm. I was just at my PCP's office and I weighed 4 pounds more there than I did at the WLC yesterday at about the same time. The difference? Different shoes, I had eaten before I went, and needed to go to the bathroom.:smile:

PCP thinks it is rediculous also, but not much we can do about. I did realize that I will be being visited by Aunt Flo next week which always gives me a good boost of a few pounds so I may be able to do this!

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It sucks that you have to find a route to get by the insurance company. Been there done that.

I'd go with the Water and a high sodium meal (i.e. Chinese or Italian) the night before and right before weigh in. Also wear a girdle and stuff some flat weights inside (in your bra too, under your breast) trust me, they won't move.

Walmart has 5lb steel wrist/leg weights that are flat and easy to conceal.

After you weigh in, excuse yourself to the bathroom and remove the weight in the event you are examined.

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Absolutely absurd! I went in for my WLS consultation in 2003 and, you guessed it, wasn't fat enough by 6lbs. Back then the lap-band was just "coming into it's own". So much so, that the surgeon was leaving the next week to "check into it".

Now, 2009, oddly enough, I weighed JUST enough (by 1lb) to get the lap band. Except during those 6 years I had managed to lose 40lbs and gain it all back..:smile:

Needless to say, whatever you need to do to weigh in that extra weight, just do it. The surgery is the best thing I've ever done for myself. Very frustrating it could have been done in 2003:cursing:

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I'll admit it.....my BMI was 38, I gained the weight in order to qualify, and there is another thread on here if you find it you will find alot of others have done the same.

I agree it is stupid that the insurance co want to make things so difficult, but I just didn't feel it was fair to create a $14,000 for myself and family when I was sooo close as it was.

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I agree it is stupid that the insurance co want to make things so difficult, but I just didn't feel it was fair to create a $14,000 for myself and family when I was sooo close as it was.

Absolutely! DH has said that worst case we can use a home equity loan to pay for it, but I hate for us to spend that if we can avoid it.

Hardest damn 5 pounds I have ever gained! The irony is that I really don't gain that fast and don't "binge" eat. I have been eating all I can and just feel blech. I feel so bloated and piggy. I was going to reweigh tomorrow but so far it looks like I will fall short so I will probably wait until next week when I have my medical records from my drs office for the insurance.

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I know it seemed like it took me forever to gain the weight in order to qualify....

But the good news for you is that the insurance bases your weight off of that initial weigh-in so eat all you want and were the heaviest clothes you have....a word to the wise I had to weigh barefoot so don't worry about heavy shoes just clothes. You only have to weigh that much for that one time weigh-in.

Good luck let us know what you find out.

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Yea, I remember the first time i went to semenar, right off the back i wasn't qualified because I was under 5lbs or so... i was so mad, well............ a year later, i was like 25lbs over! lol... banned 4/2... and lost about 33lbs so far hehe...

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me too! actually frustrated cuz a dr. in town said I had to do the 6-month dr. supervised diet FIRST before I could come in for a consult. So I did it. They said they'd consider the pre-diet weight. good. well - 6 months later, they are losing the BCBS contract and maybe the Center of Excellence designation. Called a dr. referred to me and good write-ups here. they won't see me until I gain the 7 pounds. seriously? good grief! went to another surgeon last Friday ---- with a bag of BB's in my pocket and a bag of loose change with a cloth to keep the sound down in the other pocket (so I was even). Whew - I made the weight. Actually - i've always said I'm 5'8", which is stretching it just a half inch I think, but of course I want the 5'7" height cuz it is 11 pounds less to reach the BMI 35. sigh!

how wrong is this that we must resort to gaining to lose? I'll do it though. I had a lot of salt and junk - and like you, I'd been eating so healthy (had lost 23 lbs) and it felt SO BAD and gross. Then Flo arrived and it's been a hard craving this month.

oh - and in my BCBS TX policy ---- it says they look at the STARTING weight/BMI when you go on a 6-month diet. aaahhhh!

My hard part is finding the 5 year proof in medical records now! i don't know that I have it recorded. I know I've hit that weight 4 or 5 times, but do you think THAT was when I wanted to go see the dr. and get weighed? um, NO!

LOL

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I also don't "qualify". I'm pretty healthy despite a messed up thyroid, and I'm not 100lbs overweight. But my doctor called the insurance company after they denied me and worked some magic, and they are now paying half :)

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