Beginning Stages

[kim_aba 0]

I have just started looking into the lap band procedure. I attended a seminar about a year ago but have not been sure about if I wanted to go this route. I have always felt like I was giving up on myself if I had the surgery. I have had some problems with my knees and am facing another arthoscopic surgery int he next month probably and my doctor has of course looked at the "weight" factor. I am considering the Lap Band now ....but worry about if my insurance (Aetna POS) will cover it and if this is the right decision. I hope this site will be helpful in making this decision and going through the process.

Kimberly

[Humming Bird 275]

I don't know much about the different insurance plans that cover lapband. I was self pay.

I don't think getting the band is giving up on yourself in any way. It is just the opposite! It is helping yourself!

I know I would not have taken off the weight I already have without the band. Lets face it, I have tried most of my life and been on every diet in the world. The weight always comes back plus some. I find that the nice difference about the band is that I feel full from very small portions. I don't feel like I am starving like I did with other weight loss methods.

[isaviolinist 11]

I agree with the above poster. Trust me, its not giving up. The LapBand is not an easy or quick fix. You definitely have to do your part to get the weight off. This site is a great resource. Good luck with whatever you decide to do!

[kiz 1]

Welcome to LBT, Kimberly.

I couldn't agree with Humming Bird more. There is no way that getting a gastric band or other WLS is giving up on yourself. I was self pay as well, and my band is worth every penny, and I'm worth it as well. I think it's a rare individual who makes the decision for WLS without trying multitudes of diets before making this decision. To me, it was accepting the fact that I needed help, and there's no shame in that. The recidivism rate of regaining weight after dieting for the morbidly obese is staggering. Some studies show it as high as 98%.

You'll read this over and over again on LBT that the band is a tool, but you have to work with your tool. It's not a free pass to indulge in high calorie foods, for one thing. Although it might be possible to get to your goal weight without exercise, I haven't heard anyone say they've done it. Gastric banding is not a passive WLS option.

With the band, to lose weight, I make very healthy food choices (my meals consist of 1/2 cup servings three time/day plus 1/2 cup snack), so making healthy choices is a must. I had to break the habit of grazing (which is how I ended up obese). Others had to learn not to eat huge meals.

So, this is not to say that WLS is the right answer for you if you're not committed to it heart, mind and body, but it can be the best investment in yourself and for your family that you can make.

Edited October 8, 2009 by kiz

[outside*looking*in 0]

I am also in the early stages. I know that my ins does not cover it so I will be self-pay. My husband is okay with it but would be more okay if ins covered it. I feel like I have been dieting to just NOT gain weight in the past few years! I have been overweight starting at 8y/o. I can't imagine myself below 240?? I weighed that much by the time I was 12y/o. The one time I was smaller, I was a senior in HS and weighed 170ish. That lasted for about a minute and I got there by being "love" sick.

I too wonder why we feel ashamed to ask for help? I am guilty of it. Or are we afraid of what others will think about our asking for help? I just figure I have got to do this for me. The people who are not supportive of it were/are probably not supportive of my being this fat either. So :sneaky:'em!

[ParrotheadCathy 0]

Kimberly, call Aetna. There should be a customer service phone number on your insurance card. They will need your policy number and they can tell you if you have coverage for weight loss surgery. If you do, ASK some questions:

1. Is there a minimum BMI I must reach?

2. Must my BMI have been at that level for a specific period of time?

3. Do you require a pre-op diet? If yes, for what period of time?

4. What doctors/hospitals/surgery centers are approved for this surgery?

If you DO NOT have coverage, pick a surgeon (there are threads on here about surgerons and you can get an idea about different docs in your area). When you go for the first consultation (not seminar), find out what pre-operative testing they require. Then go to your PCP and have him/her make the referrals for those tests and have the results sent to your PCP and have your PCP forward the results to the surgeon. This way, at least all the testing will be covered by insurance.

One suggestion -- if a sleep study is required, schedule that as soon as possible! Because it involves spending the night at the doc's facility, the availability is tight. I had a hard time getting an appointment and that actually postponed my surgery by almost 2 weeks.

[kim_aba 0]

Thank you for the encouragement and information. I am doing my research...trying to figure out what to do now. I just got my date for knee surgery whichi s Nov 5th. Right now because of my knee problems I cannot exercise at all. I have been overweight basically all my life. I am currently 339 lbs I know so many things would be different in my life if I was a "normal" size. I would do more things and not be hindered like I am now. I know I have to do something...

If my insurance says they do not cover it, don't some eventually get it covered by appeals? I have not had the courage to call or make an appt with a surgeon or my PCP yet.

Kimberly :thumbup:

[outside*looking*in 0]

I know for a fact that our ins. does not cover it. I called the ins. and even had my husband (policy holder) speak to his HR dept, about the other ins. offered through his company (to to re-up anyway). They used to offer it but since so many people had it done, they were losing money on the policies. They decided to take it out of the policies (the company he works for did). Even with medically neccasry, co-morbidities, appeals, - it won't matter in my case. You should call your member services and just ask! I waited a long time to call mine over fertility issues and it turns out they paid to see a specialist and to have testing done, a month after my last visit with the specialist, I was pregnant! If I had not been so scared to start that conversation, my two kids would not be 10 years apart!

I will be selfpay and I have not talked to my PCP yet either. It is worth it to me! You are right with me on the issue of being over weight since a child. I have no idea what I will look like as a thin person. To be honest, if I only get down to 200-220, I will still be happy - just knowing I will more than likely not gain it back. Best of luck to you:thumbup: MAKE THAT CALL!