BMI 39

[kimberb 323]

Hi I'm new to this forum. I've been on a Rollercoaster ride with my weight for about 15 years. My heaviest was 260. I went on WW and dropped 60 pounds in a year. 3 years later I'm at 240 again. My step daughter had the sleeve surgery 15 months ago and looks fantastic. My sister -law had the sleeve surgery 3 months ago and has dropped 65 pounds. I'm with Kaiser. They require a BMI of 40 without health issues and 35 BMI with health issues. I went to the orientation. Then talked with my primary doc. He thinks the sleeve would be great for me and referred me to Bariatrics. They called today and let me know I barely miss meeting the 40 BMI requirement . I do have high cholesterol. Asthma and chronic lower back pain. The nurse said she'd speak to the surgeon and call me. So this afternoon the nurse called back and said the surgeon wanted a phone consult with me on Sept 13th. I asked why and she said to discuss my health.

So should I gain the weight to reach the 40 BMI before 9/13? That would be about 7 pounds. It feels crazy thinking gain weight to have WLS. I've fought for so many years to lose.

What are your opinions about gaining weight to have surgery? Should I wait and see what the surgeon says? It's crazy to think my fat is not fat enough to qualify.

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[cindym44 75]

My BMI was just 35.2 and I got approved because I have high blood pressure and coronary heart disease. My surgeon's office did tell me not to lose any weight until I was approved though. Usually if you have other issues besides a BMI less than 40, you can get approved. In addition to high blood pressure and coronary heart disease, they will also consider sleep apnea and gerd.

Some insurance companies also require a structured 6 month diet plan and want to see at least a 5% weight loss. This plan must be done within the last year too. I got lucky -- my insurance (BCBS) required the structured diet plan, but did not have a weight loss requirement.

Pick a surgeon who has experience in submitting to your insurance because denials can be difficult to overturn. My surgeon's assistant has never had a claim denied and that was reassuring to me. She studies the guidelines for each insurance company and submits when they are all met.

Good Luck.

[Bufflehead 6,358]

If it were me I would gain the 7 lbs.

[kelliev2015 136]

I hate to say it but I agree on gaining the 7 pounds. Insurance companies make it so difficult that if you didn't qualify based on your comorbidities (it's a limited list), they could deny you even if you got to a 40 BMI and applied again. I just wouldn't risk it. Of course, it sounds ridiculous to do that but sadly, that is what insurance companies are forcing people to do by being so outrageous with their requirements.

[KristenLe 5,979]

@@kimberb They may want a history of a BMI over 40. Are you sure you are as tall as you said? Many of us have realized we are actually shorter than we though. No joke!

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[ella37 455]

Gain the 7 lbs and see if they approve you. 7 lbs isn't much to lose if they don't. Insurance can be a nightmare. I'm BMI 37 with no "serious" co-morbidities and they wouldn't approve me unless I got diabetes or severe sleep apnea or something. I would've had to gain 20+ lbs for my insurance and then dieted for 6 months and if you dip below 40 they won't do the surgery (most insurance co's take your weight from BEFORE the supervised diet, not mine), and if you gain even one lb the 6 month clock starts over. i decided to just self pay but if it was a matter of 7 lbs I definitely would've gained it.

Not the healthiest but they're kind of backing you into a corner. You either do that or wait until you have more serious health issues.

[nickisleeve 127]

Gaining the weight to meet 40 bmi has been a nightmare for me. It's so hard to gain it. I ate and ate and ate. I finally made wt rt before my appt. now I can't stop the over eating cycle. I was feeding my face so much to lose wt it's gotten out of control.

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[marchmellow 36]

My suggestion is either: Gain 7 lbs or wear 10 lb ankle weights or both. I wore ankle weights just be sure I was 40 bmi. I was still only 39 bmi with the ankle weights so the doctor went ahead and put that I weighed 250 (40 bmi). My surgery will be November. Good luck!

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[kimberb 323]

marchmellow my husband suggested the ankle weights. I rolled my eyes. I chuckled when I read your post. Told the hubby and his reply was "I told you' So they don't make you strip down for the official weigh in? This would be good to know.

KristenLe we checked my height last night have lost another 1/2 inch in 3 years. Why can't we get skinner as we age? Lol

Kaiser will accept any weigh in at your doctor office from the previous year to qualify for the BMI.

I had an appointment with my Primary today. Somehow I am I am now 41 BMI. It wasn't ankle weights So next week I'm going to call the bariatric department and mention this to them and see if I still need a phone consult with the surgeon.

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[fancypants67 162]

next time you go in....wear ankle weights and loose fitting pants. or put rolls of quarters in your pocket. That's what my friend did!!

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[nickisleeve 127]

On my first visit I kinda didn't straighten my knees for the height check. Hint hint

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[kimberb 323]

Hi all its me again. I'm currently sitting in the Bariatrics department waiting to have my official weight and height taken. Keep your fingers crossed for me. Reminding myself to not straighten my knees and I have a little help with reaching 40 bmi ????????

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[kimberb 323]

My official weight is 242.7 and my height is 5'3 ????

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[KristenLe 5,979]

That's a qualifying BMI isn't it @@kimberb?

[kimberb 323]

That's a qualifying BMI isn't it @@kimberb?

Yes it is. 42.7 bmi. Now I have to worry about the Mental health program I have been in since 2013. I was told today I may not qualify because of anxiety and depression issues I have been working on. I have a phone consultation with surgeon on the13th. Anxious about what he says.

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