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Question that probably has no answer but I am still asking

JennK85

JennK85

Member
Hello! I am in the approval process and planning to get bypass surgery. I am hoping to be approved by December from the dietician. I have been approved by the surgeon and psychiatrist already. I do have a question that might not be answerable. I started the program at 41.1 BMI. I know that is on the lower side. But I am always tired and very short. My weight has gone up and down and I just have never been able to keep it off. I am not diagnosed but my blood work is equal to that of a prediabetic. That is not helpful in allowing me to go below 40 BMI. I am losing slowly which is perfectly fine. I am eating how the dietician wants me to eat and drinking my water. I am right on track. Here is the question. Once I am approved by my insurance and have the surgery date. Do I still have to be concerned about the BMI staying at 40 or above or is this not a concern any longer because I am approved? I don’t have any other health issues and maybe I could have waited as I am sure I will continue to gain weight but I want to stop myself from becoming a diabetic as it runs in my family. I want to stop myself from developing weight related health issues if possible. Please don’t tell me to ask the dr. I will try again but the dr said if you fall below the 40 then you are no longer eligible in the program. That is the hospitals Bariatric program. So I need to clarify this with the doctor I already am aware of this. They said this at the very beginning so I need to clarify if that is all the way till the day of surgery?! I don’t know how the insurance part works? The doctor doesn’t want me thinking about falling below 40 if I do then I do to them. To me though I am spending money and would like to have an idea at least. Can this question be answered and if not that is ok. It can’t hurt to ask. Thanks so much!!
 
Wow, 40! that's high, IMO. I think the cutoff BMI is usually in the 30s, like 35.

I'd just keep eating the way you've been eating, because that's normal for you. If you see a doctor who says your BMI is too low, you can always adjust your eating upward, especially because honestly, you're borderline. You're probably not going to improve without the surgery.

But if your insurance okays your surgery, you can do anything you want after that. I remember my surgeon okayed me, and then suggested I try to LOSE a few pounds before the surgery, which would be just about a week or so away. Once my surgeon put it in writing, I was on my own.

Your doctor sounds kinda sadistic: unreasonable BMI, tight-ass about whether or not you can have the surgery if you gain a few points. As you said, your weight has gone up and down all your life, and that's the story most of us here will tell you. In any event, there was surely a fluctuation in weight that was so concerning, we decided to look into WLS. Can you ask your doctor (I'm assuming this is a GP, not a bariatric surgeon) to refer you to a bariatric space, like a dedicated clinic or department in a hospital? Those experts will make sure things work out for you, unless you're not being accurate about your perceptions and you SHOULDN'T lose 100 pounds. If you only weigh 50 pounds above your ideal weight, bariatric surgery is not for you. You can diet that off. But if you are CHRONICALLY spiking 50+ pounds, or 100 pounds, or more than that, you're heading for a permanent problem with heart disease and a dozen comorbidities that go along with obesity.

I might be wrong, but based on my perception of your story, you should find an expert surgeon or clinic that specializes in bariatrics and only let them treat you. Regular doctors, even great doctors, don't always take obesity seriously to the point of supporting surgery.

What do other group members here think?
 
Once your requirements are met, all the paperwork has been submitted and your insurance has approved the upcoming surgery the insurance company never looks at your weight/BMI again.

Your bariatric program may have different rules and I cannot speak to that.

Its obscene that they want you to lose weight at a BMI of 41 AND to stay at a BMI of above 40. I'd be sure to ask .. Which is it?!? Both cannot be done.

Good luck!!
 
Kris_B_Q said:
Wow - I was going to reply it depends on your insurance. Mine will go down to 35 (might be less) BMI if you have Diabetes. If you do not, then they hold firm at 40.
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I'm sure you're right; it does depend on your insurance.

I didn't have insurance per se--medicare and medicaid only, and they didn't pay at that time. But at Virginia Mason Hospital here in Seattle, they had a scholarship fund which covered most of it. I also was asked to enroll in a University of Washington study for seven years, which was awesome. They even paid related costs like meals and hotel stays if I had to come from out of town for a couple of days.

So my message dovetails onto your message: ASK what's included, then ask if there are resources that will pay whatever balance you can't afford to pay. It may seem like this is some kind of luxury you're getting, but believe me, you're a guinea pig for them. Every patient's information contributes to the wealth of research multiple agencies get from you. You're doing THEM and all who come after you a favor.

I don't remember my BMI at the moment but it was under 40. Ask your hospital ombudsman for a list of resources, or physical research tests you can do for the department to help them in their research.
 
BMI is a guid line, but when combined with other health issues as yours, they should approve it, you may want to get in touch with the insurance company, and see if that is the case, I have seen in my reading that a few doctors have not taken in the other health issues, and reported the accurately to the insurance company, this may be your case. But chat with the insurance company and try to get all the information. Best of luck
 
JennK85 said:
Hello! I am in the approval process and planning to get bypass surgery. I am hoping to be approved by December from the dietician. I have been approved by the surgeon and psychiatrist already. I do have a question that might not be answerable. I started the program at 41.1 BMI. I know that is on the lower side. But I am always tired and very short. My weight has gone up and down and I just have never been able to keep it off. I am not diagnosed but my blood work is equal to that of a prediabetic. That is not helpful in allowing me to go below 40 BMI. I am losing slowly which is perfectly fine. I am eating how the dietician wants me to eat and drinking my water. I am right on track. Here is the question. Once I am approved by my insurance and have the surgery date. Do I still have to be concerned about the BMI staying at 40 or above or is this not a concern any longer because I am approved? I don’t have any other health issues and maybe I could have waited as I am sure I will continue to gain weight but I want to stop myself from becoming a diabetic as it runs in my family. I want to stop myself from developing weight related health issues if possible. Please don’t tell me to ask the dr. I will try again but the dr said if you fall below the 40 then you are no longer eligible in the program. That is the hospitals Bariatric program. So I need to clarify this with the doctor I already am aware of this. They said this at the very beginning so I need to clarify if that is all the way till the day of surgery?! I don’t know how the insurance part works? The doctor doesn’t want me thinking about falling below 40 if I do then I do to them. To me though I am spending money and would like to have an idea at least. Can this question be answered and if not that is ok. It can’t hurt to ask. Thanks so much!!
Click to expand...
I was 4 Ibs short and they proceeded regardless
 
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