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Weight loss before surgery

suzannethemom

suzannethemom

Member
When I met with the surgeon the other day, he requested that I lose 5 pounds before surgery. That would be a drop from 223 to 218 pounds. My BMI would drop from 38.3 to 37.4 (still within the required BMI by my insurance company). However, I was reading about the pre-op liquid diet required for two weeks before surgery. Most patients lose between 10 to 15 pounds due to the liquid diet. If so, that would put me below the required BMI of 35. I need to find out which of my weigh-ins will be sent to the insurance company. I’m assuming once I get insurance approval, I’m locked in. So if they weigh me on the day of surgery, it is not sent to the insurance company. Anyone have any insight on this?
 
Hello Suzanne,
That is a good question, I am well beyond the required BMI so it is not a concern of mine. But I would assume once approved then you are good to go. I mean, if they weigh you at the hospital before surgery and then you have surgery it would be too late by the time they found out anyway. Insurance sucks, so who knows what loop holes they have though.
 
My doc had to send a letter to Medicaid and Medicare including my weight and BMI on exam day, in order to get approval. Then, the affiliated hospital issued me a scholarship to cover the 20% that wasn't covered.

I was told to "try to lose some weight" before the surgery. This was for a few reasons, including changing habits and protecting post-op results. Nowadays I hear people saying it's to shrink the liver, but I don't buy that, since I haven't seen any accompanying science on it. If you can shrink one organ by eating less... Well, it's just a weird concept to me, typical of so many other myths women are fed about body image.

Your BMI is locked in when your doc examines you and issues the surgical order. Not to worry!
 
The liver shrinking phenomenon is real! When I had my pre op abdominal ultrasound, the report mentioned presence of hepatic steatosis (fatty liver), a common finding in obese folks. After my VSG surgery, the surgeon told me it was apparent I had adhered to the 2 week liquid diet, because my liver was nice and small. I am a veterinary pathologist and have seen fatty, enlarged livers. In addition to being enlarged, they are friable (easily torn), so it is understandable a surgeon would want to avoid the potential pitfalls of a fatty liver!
 
You're too nice! But please, I honestly never had a clue about the real impact of fatty liver until you explained it. I had hepatitis 40 years ago and all my thoughts about the liver relate to that. I really appreciated your info!

This group just keeps getting better and smarter. Thanks for your contributions!
 
dianeseattle said:
My doc had to send a letter to Medicaid and Medicare including my weight and BMI on exam day, in order to get approval. Then, the affiliated hospital issued me a scholarship to cover the 20% that wasn't covered.

I was told to "try to lose some weight" before the surgery. This was for a few reasons, including changing habits and protecting post-op results. Nowadays I hear people saying it's to shrink the liver, but I don't buy that, since I haven't seen any accompanying science on it. If you can shrink one organ by eating less... Well, it's just a weird concept to me, typical of so many other myths women are fed about body image.

Your BMI is locked in when your doc examines you and issues the surgical order. Not to worry!
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Would the surgical order be made at the initial exam or later? I have a required six-month wait and my first meeting with the surgeon is next week.
 
missyinacage said:
Once your surgery is approved by your insurance, it's approved. They don't "take it back". Surgery date weigh-in is for medical, not insurance, purposes.
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That’s not how it was for me. My surgeon didn’t have me do the preop diet because he’d experienced people who were approved and then denied after the surgery because they’d gone under the BMI. He explained that it was because they felt the person could do it on their own at that point. Yeah, like a pre op liquid diet is a reasonable long term solution :rolleyes:
 
3momchaos said:
That’s not how it was for me. My surgeon didn’t have me do the preop diet because he’d experienced people who were approved and then denied after the surgery because they’d gone under the BMI. He explained that it was because they felt the person could do it on their own at that point. Yeah, like a pre op liquid diet is a reasonable long term solution :rolleyes:
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Lucky you not having to do a pre-op diet.
 
Kcuster83 said:
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ohh I thought the cut off was 35 (if you had medical issues also). Maybe it changes from insurance to insurance though. Everything else does, why not. At least it worked out for you!
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I didn’t have comorbidities, so for my insurance it was 40 BMI, 35 BMI with 2 out of three comorbidities (diabetes, sleep apnea, or high blood pressure) that are being medically treated.
 
3momchaos said:
I didn’t have comorbidities, so for my insurance it was 40 BMI, 35 BMI with 2 out of three comorbidities (diabetes, sleep apnea, or high blood pressure) that are being medically treated.
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Yes, and you know why they make us jump through so many hoops before surgery? It's just a sneaky way of getting us to exercise; ya know, lots of hoop jumping raises the heart rate and burns lots of calories. Lol!
 
Only thing my surgeon said at our first consult was do not gain more weight he said that would disqualify anybody. So I initially weighed in at 353 a year ago March second. Dropped to 336 in 6 months just improving my eating habits. Final weigh in day of surgery was 311. I’m pretty sure I’m below 300 now. I don’t have a scale at home because I just obsess if I do. So I last was weighed 2/3 and I’ll be weighed again 3/8.
 
Leiabeedoh said:
Only thing my surgeon said at our first consult was do not gain more weight he said that would disqualify anybody. So I initially weighed in at 353 a year ago March second. Dropped to 336 in 6 months just improving my eating habits. Final weigh in day of surgery was 311. I’m pretty sure I’m below 300 now. I don’t have a scale at home because I just obsess if I do. So I last was weighed 2/3 and I’ll be weighed again 3/8.
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Hi Leia. You have made amazing progress with your weight loss so far. Congrats to you! I know what you mean about obsessing about the scale. I used to feel that way in the past when I was "dieting."

Now that I'm living my post-surgery healthier life, I have developed a whole new relationship with the scale. I only weigh myself 1 time weekly, on my surgery day, and I record my current weight, amount lost or gained from last week, and total weight loss since surgery.

Instead of fearing the numbers, I look forward to seeing them. The scale no longer is a judgment of my self-worth. If I lost since last week, woohoo! If I gained a little, I think about the past week's journey and make a few adjustments if necessary. But by looking weekly at my total weight loss, it puts those numbers in perspective.

After all, even if I'm up a little from one week to the next, I always will weigh less than my pre-surgery weight. Never on any diet that I was on could I be sure that I will never be that unhealthy eater again. A slip-up is NOT going to derail my progress.

Ok, I'm off of my soapbox now. I would recommend weighing yourself on an occasional basis if that could work for you, maybe weekly or every other week. Then hide your scale the rest of the time - under your bed, in your closet, in the attic, wherever you won't be tempted to check it daily. Best of luck to you!
 
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