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

[Big Momma is Shrinking 0]

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

WOW Farmgirl!!!

You are VERY LUCKY to have found a Dr who will fight for you!!!

[FarmGirl7 0]

Yes, I am! Since my thyroid started going crazy 4 years ago, I've been slowly gaining weight. Luckily my doctor didn't want to wait until I did weight enough to qualify, and insurance seemed to agree with him. All it would mean is more skin! So I am REALLY looking forward to this surgery!

[Gerberdayzee 0]

I'm awaiting approval from the insurance (request submitted tuesday), but there's a chance that I might be denied. Low BMI of 37.8 and the insurance coordinator at my dr's office said my hypertension didn't seem bad enough even though I'm on daily meds.

I visited the dr on 4/1 and that's when they told me that I might be denied. Since then I have been so stressed out about what I'd do if I were deined that I've already gained about five pounds--which puts me around 10 pounds away from a BMI of 40. And even though I've never done it on purpose, I believe I could quickly gain the weight if I had to.

My question is ... does anyone know how soon I could resubmit the request the insurance company?

Thanks!

[FarmGirl7 0]

I was denied on a Wednesday, my doctor was notified on Friday morning, called my insurance company and talked to the doctor that denied me, and I was approved Friday afternoon. You just have to have a doctor willing to do that. But I don't think there is any "time limit", unless your insurance specifies one.

[CantB2noty 0]

Ook so it is stupid.. But if I was you, I would enjoy myself immensely eating all that you want, kinda like one last hooray before dieting and not eating that much ever again..... Use it as an opportunity to say good-bye..

[NiceWillSuffice 0]

You could have some good tasting meals the next couple weeks to meet approval weight. Yum.

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.

[savannahsmommie 0]

Sadly enough I was 9 pounds underweight limit. I stuffed BB's in my bra, which helped me gain 4 hours. Then I did the two three pound fishing weights in each pocket. Wore a baggy shirt and I qualified. Thank goodness! You can do, just be creative. I also drank half a gallon of Water while I was in the waiting room and then pee-d like a race horse after weigh in!

[lilith 6]

Sadly enough I was 9 pounds underweight limit. I stuffed BB's in my bra, which helped me gain 4 hours. Then I did the two three pound fishing weights in each pocket. Wore a baggy shirt and I qualified. Thank goodness! You can do, just be creative. I also drank half a gallon of Water while I was in the waiting room and then pee-d like a race horse after weigh in!

I'm dying over the BB's in the bra! That's gotta be a first!

[WDW Luver 0]

Ook so it is stupid.. But if I was you, I would enjoy myself immensely eating all that you want, kinda like one last hooray before dieting and not eating that much ever again..... Use it as an opportunity to say good-bye..

I have been!! Good bye Girl Scout Cookies, good bye ice cream, good bye favorite Mexican meal, Good bye favorite Chinese food, Good Bye bbq potato chips. .

Hello 5 more pounds!!! I can barely button my jeans and my undies are feeling quite tight so I am thinking that I am really about there. The scale only shows about 2-3 pounds on but I am hoping with strategic dressing I can make up the rest. I am actually going to weigh my jeans and figure out which pair is the heaviest!

Sadly enough I was 9 pounds underweight limit. I stuffed BB's in my bra, which helped me gain 4 hours.

Way too funny! Hubby has lead shot that is very heavy so I may "borrow" some of that to go in my bra. I just need to find something to put it in. I weighed a roll of quarters as was suggested but they are only about a half a pound each. I want more weight in a small space--although in my bra is no small space! I could probably hide a 20 pound turkey in there and no one would notice! Hmmmmm:idea:

[39andholding 0]

You can buy leg weights in the workout department of many stores. They strap to your ankles. Usually 2-3 lbs each. Can be worn under your clothes.

Edited April 23, 2009 by 39andholding

[WDW Luver 0]

I may have to get the weights! I was doing fine and had gained a few pounds but I have had a stomach bug for 3 days. But I have made appointments to go in and see the dietician on Monday so I have a few days to rehydrate and have a few milkshakes :rolleyes2: That will be my official starting weight.

I am planning on a big Breakfast and a grande/venti/tall biggumest Starbucks Mocha before I go in! Hopefully it will all go well.

The funny thing is with all the talk of hiding things under the clothes, I usually wear a cam walker on my leg--sucker is big and at least 15 pounds or so! I tried to get them to let me leave it on to weigh in (pain in the butt to take off and hard to stand without it) but they said it had to go.

[talkalot1981 5]

What weight is the one they go by? I mean, is it my weight from my PCM, dietician or when I go see the surgeon? I have to do a seminar before I even get to see the surgeon. I have to wait 1 1/2 more months because I have to be smoke free for 2 months. I haven't picked one up in 2 weeks.:rolleyes2: Well I am at the lower end of the scale(so I have been told 5'4" 230) Well I thought I would gain weight from not smoking, but I have actually lost 3 lbs. I can't lose anymore because I am affraid I won't weigh enough. I might do the bra thing but poor me isn't well endowed up there and I am affraid the stuff would fall out. My luck right in front of the important people. LOL That would be bad...LOL I have to keep a food and excersise log. I feel bad cause I am actually lying about how much excersise cause I don't really wanna lose weight until I do my first weigh in.

[WDW Luver 0]

My WLS drs. office did the weigh in the night we went for the informational seminar. They use their weight for your "official" weight. But they told me that I could come back and reweigh any time since I was "looking a bit dehydrated" that night :rolleyes2::wink::tongue: . It sounds like some offices are way more strict than others. Mine lets you leave your shoes and clothes on and won't ask you to empty your pockets (or bra. . ) I have read that some will make you take off extra stuff and may even put you in a gown to weigh :tt1:. Then you have to stuff the weights in your undies I guess!

You and are the same size. I am 5'4 and about 230. To be at 40 BMI they told me I have to get to 236. They don't "round" the numbers up so you have to hit it exactly. If you use some online BMI calculators they round up so I think 231 or so comes out to 40, but that won't cut it with the WLS.

Good for you for quitting smoking! If nothing else that will greatly increase your health and life span. Are you working with your Dr to make it easier? There are some great products and prescriptions available on the market these days to help you quit for life.

Call your WLS and ask them if you can get an "official" starting weight on the record so that you can then go ahead with your diet and exercise program. Do you have any comorbidities? If you do then getting to the magic 40 BMI isn't as important as long as you stay above 35.

[talkalot1981 5]

I have one comorbity. Hypertention. I also have depression/anxiety but my insurance(TriCare) doesn't consider those as a comorbity. I have heard Tricare denying people just for being under 3 or 4 lbs. I think I would just die if that happened to me. My surgeon's office won't even put me in as a patient until I as smoke free for 2 months. So I can't have them record my weight. I had to quit cold turkey because I have to take a nicotien test at the siminar. I can't chew gum or use Patches. It hasn't really been as hard as I thought it would be. I looked on line and the high end of my BMI is 136 so I guess I need to make sure I gain 6 lbs before I go to weigh in. Thanks Jennifer

[WDW Luver 0]

Yep, it more important to make your weight for qualifying than to lose at this point. It could set you back a few months if you have to do a supervised weight loss program before surgery but it is better to wait a few more months than to be denied.

If you think you need some help with the smoking talk with your Dr. There are some things they do that don't involve the nicotene. A friend of mine was put on a specific low dose anti depressant that helped him out a lot.

Keep in touch! Since we are the same size we are good support buddies! Maybe we will end up banded around the same time.