Need Advice, please help.

[chargers56 0]

Hello everyone, I have been browsing these parts for some time now and I am learning so much about this process each day. I am 29/m 6'0 280lbs and I have been dieting for years losing weight only to slowly gain it all back and more. And I have spent more money than I care to admit on diets and medifast, and HMR and I am no longer interested in dieting anymore.

I have decided that lap-band is the right thing for me after talking to some people about it. I like the fact that it a a tool that works with me, and I am not interested in changing the inner workings of my body, gastric bypass and such.

I am scheduled to see my PCP on Monday morning and I have not discussed this option with her before. I am at Kaiser Permanente in San Diego California. I am interested in any advice for when I talk to my doctor on Monday. I have called kaiser to find out if they cover the band, and they tell me if my PCP says it is medically necessary then they do. I am scared that they are going to turn me down, and try to get me to diet again.

I have high blood pressure that i am medicated for and sleep apnea, as well as high cholesterol.

Anyone here have Kaiser in southern california?

Any advice you could give me for this visit would be excellent. I'm afraid of how to approach my doctor for this.

Thank you so much.

Edited September 18, 2009 by chargers56

[RestlessMonkey 7]

I'm not familiar with Kaiser so I can't address them. But with a BMI of 38 and the comorbidity of sleep apnea, you may qualify (I don't think they count BP if it is controlled with medication, and high cholesterol is considered a risk factor, not a medical disease)

The best you can do is talk to your PCP and see what she says. Info can be spun, too, remember...so if you and she feel like it is medically indicated for you, you have a good chance.

I am not a doc and at my high weight I didn't need to sell anything. You may want to be ready with what diet exercise programs you've tried, and why they (or you) failed to be a long term solution.

That's the big thing; why would you need surgery instead of just doing it "on your own". If you are a volume eater then the lap band was made for you, just FYI. Grazers, snackers, emotional eaters either don't do as well or have to really put out the effort (they can be very successful, but that emotional or head hunger must be dealt with and the band doesn't address it). So pondering all that, if you feel the band is your ticket, then be prepared to tell your PCP why you think so.

Good luck!

[should_be_working 0]

I don't know anything about Kaiser either but I also had a lower BMI and I qualified with BCBS with sleep apnea and high cholesterol as my co-morbidities. Good luck to you!

[RestlessMonkey 7]

I stand (well, I'm sitting) corrected...I didn't know ins. companies count high cholesterol as a comorbidity! That's great!

Then, you're golden!

[kwright 0]

Good luck with Kaiser in San Diego. I went to their information seminar in May and decided to go with my other insurance. While I was at the seminar I learned that you had to have a bmi of 50 which clearly I didn't have and that you have to go through their weight loss program which takes about a year. Back in May they didn't have a contract signed yet with Pacific Bariatric since their surgeons didn't do lapband at that time.

Best of luck to you and hopefully the process doesn't take as long.