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Too much pre-op weightloss?

mergatroid

mergatroid

Member
My Dr. said not too lose more than 10lbs. pre-op. I've lost 16, and while I am thrilled, I am scared
I may lose my operation. Any suggestions, other than gain some weight back?
 
Mergatroid-Welcome to the best bariatric forum on the planet :) I have never heard of anyone being told not to lose more than 10 pounds on their pre-surgical diet. By all accounts, the purpose of this diet is to shrink the liver to make your stomach more accessible for laproscopic surgery. Did you ask your surgeon why? I'm interested in what his answer was as I'm sure other's on this forum are too. I have even read a couple of posts here that said once the inital paperwork is sent in for approval they never see what your weight is once you complete the pre-op diet. You might want to call and speak to the insurance coordinator at your surgeon's office and ask if your weight loss of greater than 10 pounds will impact your insurance approval. The coordinators are the people who know the rules inside and out. Try not to be too concerned until you speak to the coordinator, I have a feeling that everything will work out OK :) :) :) Please let us know what you are told.
 
Hi Mergatroid, Welcome. Your Doctor must be concerned about you dropping below the minimum BMI for the surgery, do you have any other co morbidity factors such as high BP and/or cholesterol, sleep apnea? You can try putting on muscle weight and balancing your calories so you are not burning more calories in a day than you are taking in, you will need to work with a nutritionist and physical trainer to accomplis this though. I sure everything will work out. :cool: Tom
 
Thanks for the welcome aboard Pat99. I've been stalking this site for awhile. I am 5'2'' and currently 203lbs. When I finally went to see a surgeon I was at 219lbs. I'm guessing he didn't want me to go below a certain BMI point. I do have high cholesterol, hypertension and am hypothyroid. I have immediate family members with diabetes, which is my main concern, I want to avoid diabetes at all cost. I am awaiting results from a recent sleep study for sleep apnea before all the paperwork can be submitted to the insurance company. I am not on a "pre-surgery" diet, per se, I've just managed on my own. I'm afraid of falling back into my old eating habits and this is why I feel the surgery will help. Thank you, and Tom, for answering. I hadn't thought about the "muscle weight" thing. Good idea. I was afraid it would help me lose weight,of all things to be worried about, right? I'll let you know how it goes.
 
Welcome, Mergatroid. I have heard 2 different things-- that it's your weight and BMI you start with at the first surgeon visit, and second, that it's the weight and BMI you are at when insurance papers are filed. I don't know which one is true, or maybe both are true for different insurance companies.
Just think about the control you have gained over your eating habits to be able to lose 16 pounds on your own. to me that indicates that you will be successful after surgery and not go back to your old eating habits. I wouldn't try to gain any weight right now, just try to maintain what you have. And if the coordinator says you must weigh more, strap some 5 pound weights to your ankles!
 
I saw my surgeon today. They moved the offices so all of my paperwork was sent to their old fax number. Grrrr. I ran to my primary care physician right away and wouldn't
leave without all the paperwork in my hands AND sent to the new fax number. So now,...I wait. I am not good at waiting. I will be calling them tomorrow morning to see if
they got it. If they haven't, guess I'll just have to make another trip out there. Oh, sleep study - positive for sleep apnea. Good for me, right?
 
I have been tested for sleep arena and was told I have it my problem is that my insurance Blue Cross doesnt pay for bariatic surgery but they will pay for back ,knees and depression dont they realize that bariatric would be cheeper
 
Hi Linda, Welcome. Blue Cross must be different every where, that was my insurance carrier and the prosses was simple and I was able to have my surgery 3 to 4 months from the day I went to the seminar. Keep trying, you may just need to meet all the co morbidity weight requirements. I was able to get a referal from my primary doctor to the weight loss seminar and from there the bariatric team set everything up with the insurance company to get me approved. Have you done that aready? :cool: Tom
 
Linda, Do you have a choice of insurance where you work? I actually waited almost a year so that I could change from BC/BS to Cigna during open enrollment and then plan to have WLS. Also, my surgeon has a pretty good self-pay plan. I realize that doesn't help much, but just throwing ideas out there. Good luck.
 
That does not sound correct. BC/BS is one of the best insurances and have not heard "they do not cover bariatric surgery" but they have rules so you may have to be BMI greater than 40 or have some serious comorbidities and slightly lower BMI. Many insurances require a 6 mos waiting period during which you do Nutrition courses and support groups, psyche appts, etc. and if one does not want to abide by those rules they will not pay for the surgery. I would suggest you call yourself to Blue Cross and find out what their rules are for your plan. Best of Luck, this surgery saves the insurance companies lots of money if people are disiplined enough to go along with the rules and the 2 or more weeks of pre op protein etc. IT is not an easy way out, it is a hard way out but at the end of that rainbow there is a thinner, healthier you. Fight them if you need to!!!
 
I also had BC/BS and weight loss surgery of any kind was not a covered benefit. Employers can now customize their insurance plans to delete or add what is covered and what is not covered. Even with multiple co-morbidities and many, many letters of medical necessity from several doctor's I was denied WLS approval. I appealed the rejections over and over again without success. I even hired an attorney to review my terms of coverage and to help draft my appeal letters. To no avail I even offered to pay an additional premium to have WLS added to my policy. This went on for over 6 years. Very sad but very true. It wasn't until I was on SS disability and became eligible for Medicare that I was able to have my gastric bypass.
 
Wow, that is terrible, seems the insurance companies would want you to have the surgery if you are morbidly obese since it will save them money in the long run. I have seen people have the surgery for vanity only reasons and can see if insurance wants to deny it for those reasons but Diabetes, and other comorbid reasons are reasons to have this surgery. Sadly, when and if Obamacare goes in, this operation may be something that will never be covered if you are on govt insurance but if private insurance(obamacare makes it mandatory to have insurance and private insurance will be what you get unless very poor) it will be up to the insurance company like now.
Sorry to hear you went through all that to get this necessary surgery. IT is now being touted by people like Dr Oz, so docs are getting lots of requests and some are not going to fit the rules that the insurance companies have at this time. I know Medicaid people in MA have to go for 6 mos of nutrition counseling and support groups etc in and effort to make sure they are committed and see if they can really lose with nutritional means instead of surgery. There are other insurances that require a 3 month period, some require mulitple clases to be attended and some just one of each and psych consult. It is not easy being obese for sure and then not easy to make the life changing decision to change all eating habits and lose weight due to restriction or malabsorption, NOT an easy decision! Pick your surgeon wisely, lots of surgeons will now get on the bandwagon once there are lots of people requesting it but there needs to be a team approach or the patients will lose in that transaction. Pick a doc who is very experienced, in the surgery and in the approval network.
 
Going back to the docs tomorrow. I hope all the other docs sent in the required paperwork. I have my own copies just in case. I'm hoping that tomorrow we will set the date.
 
Good luck today. Sometimes with all the letters they have to get the insurance ok before they give you a date for operation. Let us know how it went.
 
Thanks Sandi. I actually called their insurance department today. I asked if all the doctors sent in the required paperwork. She said she wasn't sure because she didn't have my file with her because they took it for my appointment tomorrow, but, that she had sent it to my insurance company. I asked how long before they would know if it is approved or not. She said they're pretty quick about it. She was very non-commital. I hope that is not a bad sign. I've worked very long and hard for this and don't know how much more disappointment I can take. By the way, I've managed to get down to 192 lbs on my own. I'll be wearing lots of clothes to my appointment tomorrow.;)
 
Sometimes it is to see how much you can do on your own to show committment etc. I say, If I could lose considerable weight on my own, I would not be doing Bariatric Surgery!!!!
 
My surgery is November 1, 2012. I have been on a liquid diet for 8 days now and have lost over 10 pounds with 5 days to go. Only allowed 5 protein drinks a day, water and sugar free jello. I'm doing ok but it's like everyother day I am a B.....I decided to do the surgery because of the on set of diabetes, I was told 90 % chance it will disapear after surgery. Good luck ...keep in touch..would love to hear how your surgery goes..
Cindy
 
Went to my ortho . dr yesterday he told me if I didnt get the weight off soon I would be looking at knee replacement so I called the Insurance dept. where my hub works he told me it was selective that was why it was not included in our plan but he would look in to it since it is medically necessary my primary dr is also going to help and my theripest just waiting
 
Hang in there Linda. The squeaky wheel gets the grease is what we use to say in the Navy. Make lots of noise, continuously! If you need pointers I'm sure Pat99 could point you in the right directions. She's fought long and hard for this journey. I finally gave up with the VA. They would put me on all kinds of diets and see nutritionists/dieticians, you name it. I got a different insurance and VIOLA! Surgery is slated for the 28th of November. I worked real hard to lose the required pre-surgery weight. I've lost 24lbs on my own, and while proud of myself for doing so, realistically, history proves it wont stay off. You all know how that goes or you wouldn't be on this site to begin with. So, best of luck to you and please keep us posted.
 
Linda-Mergatroid is right about making a lot of noise. Your best bet is to have multiple doctors send letters of medical necessity to the insurance company. Better yet, have the doctors give you their letters and you send them to the insurance company and give copies to your bariatric surgeon for their files. This way you can keep a copy for yourself and you know the letters have been written and sent instead of wondering if the doctors got around to doing what you asked. If your medical insurance has an iron clad exclusion for WLS it might not work but it certainly doesn't hurt to keep trying. It takes minimal time and the only cost is the price of a stamp :) :) :)
 
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