Alexandra

Carolyn, that is so frustrating! Sounds like a classic example of the left hand not knowing what the right hand is doing. The "not medically necessary" line is probably their catch-all denial phrase. Do your diet and when it's over appeal again. Make sure that in the appeal the question of medical necessity is addressed by your doctor in addition to providing the notes/evidence of the diet that your carrier wants. It's just an obstacle, not a defeat. You'll get there!!

Mandy, insurance companies are indeed often wishy-washy. The form letter you got sounds like something that's outdated. Good luck with your appeal and I just KNOW you're going to be successful!!

I'm curious what you mean by this?

Nykee, I really do sympathize with your difficulties, believe me. Just want to submit that no amount of fill is going to "cure" you of a junk-food habit. What will help are the things that you can start doing right now. Remind your brain that YOU are in charge. And you ARE!! For each day, you are in charge of what goes into your mouth. And if you concentrate on adding Protein to your diet and drinking calorie-free liquids, then whatever else you do the pounds will begin to come off. And when you get to a good level of restriction...hoo-boy, watch out! You'll fall in love with your band all over again.

I thought this problem was long behind me, but it never really goes away. In the early days I had no problem keeping it quiet; it was easy to decide who to tell and who not to, keeping the line between close-people-I-see-every-day-and-who-care-about-me and everyone else. So that means there were two people in my office who knew, and everyone else didn't. My immediate family knew, while more distant people I only told much later. Of course, as time goes by and it becomes obvious that something is changing, we have to address this question again and again. Just this past weekend I was at a local coffee house and the staff came right out and asked me about my weight loss. I've been seeing these women weekly for years, and only now did they feel moved to say anything. One was just complimentary, but the other one (the heavy one) wanted to know all about how I did it. So now I'm faced all over again with that issue of telling the truth and possibly invoking a negative reaction, or telling only half the truth. I told her the truth, and could immediately see that she wasn't too interested. She has 106 lbs to lose (she tells me) and is all excited about her latest WW experience. She lost 50 lbs and gained 35 back and is just now rejoining. I'm standing there listening to this, getting impatient, regretting that I engaged in this conversation--I mean, other people are standing around, paying for their coffee! I've always hated talking about my weight and now is no different. (Except in support groups, of course.) The fact that relative strangers feel free to comment on how I look is not making me happy. What do I say, for example, to the hairdresser? The neighbor? The preschool teacher?

I'm a health insurance broker but my job consists mostly of administrative work. It's not my preferred career, by a long road, but hey something has to pay the bills. I used to be the executive director of a major professional writers' organization. THAT was fun.

Wow, that is the most narrow-minded thing I've ever heard. Holy cow! I agree, I sure hope that isn't what the doctor is saying to people. Oy vey!! BTW, welcome to LBT, Nita!!

Congratulations, Crystal!! What a blast to be done with school for another term. I've forgotten, if I ever knew, what degree you're going for. Can you share?

This is a real concern (well, it's not likely to kill you, I'd think) and the reason Benefiber is so popular. It doesn't thicken, gel up, or expand in the body so it's totally safe to take for bandsters. I've heard some pretty unpleasant stories involving Metamucil, so if you're going to take a fiber supplement be VERY sure it's one that dissolves totally and does not thicken.

I just noticed this. If you don't think you can stop eating the junk, then don't try. But DO try to START eating better food IN ADDITION to the junk. Add Protein to your diet and just try to eat that first before heading for the Cheetos. You'll be amazed how much less appealing junk food is when you really are full. Our bodies know what's good for them, and if you've given your body nutritious food to use it really will ease up on sending you those signals that junk is desirable. Don't tell yourself you can't have it at all. Just tell yourself you'll be having something else first. Trust me, it works! Try it!

Mandy, it sounds like you have a lot of options. Don't give up!! What you do will quite possibly help a lot of people down the road. As far as which state has jurisdiction, check your contract. Some out-of-state policies abide by the state where the employer is sited, but in some cases carriers write contracts separately for employees in other states. There's no hard-and-fast rule about this. Good luck and please keep us posted on your appeal!

Nykee, this is not a LOT of food at all!! What are you talking about? What it is is the wrong kind of food, though. To get to the point where you're satisfied between meals, you need to kick up the Protein and get totally rid of the crunchy Snacks. Cheetos do absolutely nothing to fill you up, they're 99% air and 100% empty calories. You didn't have any real food until 2:00 p.m. and then not again until 10:00 p.m. And you're surprised you're hungry?!? You're not eating any real FOOD!! Try having a Protein Bar for Breakfast, eaten whenever you feel able to eat. Put another one in your purse for the next time you're tempted to buy Cheetos. Get some cold cuts and sliced cheese and have that for lunch or supper. I know the 7-11 near me sells Protein Bars, hard-boiled eggs, and pre-made sandwiches. Does yours? Buy a turkey sub and eat it from the inside out, leaving the bread for last. You may not even want the bread once you're done with the insides. Psychological counseling is a great idea, and if your doc's office is going to insist you might as well get what you can from it. In the meantime, there is a lot you can do about what you're eating that really will help you use the band to its best advantage. Don't get frustrated, get busy!

When I look back on the first six months of banded life, I remember being GLAD about the slow onset of restriction. It's totally unrealistic to think that we can change our habits overnight with nothing but the knowledge there's a band inside to help us! If you're not feeling restriction, there is no point in beating yourself up about not being satisfied on the tiny amounts you've heard other people talk about. Finding the right fill is a process. Talk to your doctors! When you get to the point that three bites is your entire meal, you'll be glad you had this interim time to accept that 15 bites is a meal. Pre-op your meals were probably 50-75 bites! It's not easy being faced with a plateful of food you are physically incapable of eating, so don't rush the experience. Think of it as going down a ladder. You're eating less than you were pre-op, somewhere near the top of the ladder. As you descend a little more with each adjustment, there's time to accept the changes you're making. Then with the next fill your meals will get a little smaller, and you'll stay at that level for a while learning how to manage that. The whole POINT is that it's gradual! Don't think that just because you're not feeling it now that the whole project is a loss!!! Take notes about what you're eating and how long you're hungry. Often adding Protein will help in keeping us satisfied longer between meals. But if that doesn't work maybe another adjustment is in order. So call your docs. Good luck, and don't lose hope!! Your banded life is proceeding exactly as it's supposed to.

Hi Karen, Your experience is not at all unusual. Before banding I had a similar experience, in a preop seminar with something like 500 people there may have been 5 pre-bandsters in the audience. :rolleyes But like you, all the disdain people have for banding only make me more determined to have it and to make it work for me. I hope your doc's office has separate support-group meetings for bandsters and RNYers; it's utterly pointless to meld the two in post-op sessions. If he doesn't have one yet, offer to start one. All it takes is someone showing up every single time and letting the other bandster patients know about it. If you build it, they will come!

Congratulations, Ron, welcome to Bandland!! :D

Zoe, congratulations!!! That border to onederland is very well guarded, I know. You must have been a determined refugee to break through! Save me a place there, ok?

I think your PCP is right, Donna. Thyroid dysfunction is (supposedly) easy to control with meds, once you find the right level. So once you have that done you'll be on your way. Good luck with the new PCP!!

Kathy, one of the reasons they were visiting was to help clean our attic out of things they might want to keep. (Long story, but my attic is full of family photos and stuff.) So I've been looking for a photo of my mom when she was about my age. When I find one you can bet I'll be scanning it. I did find one of her in her early 20s, in a studio shot of the early 1950s. She certainly was beautiful! I wonder if that how I might have looked at that age, had I not weighed 250+ lbs.

Well, some would say that malabsorption is desirable because it is what guarantees weight loss for RNY patients. Along with dumping to provide negative behavioral reinforcement, malabsorption can seem like the holy grail to someone who just feels so completely out of control they need something to take over for them. RNY patients lose weight so fast because much of what they DO eat is simply not absorbed by their bodies. Of course WE see that as a bad thing, but presented in a certain light I can see why some would find it attractive. It is, however, temporary. After a couple of years the body adjusts to the new protocol and the malabsorption of calories ceases. The malabsorption of nutrients, however, never ends. Weird how anyone would consider this a good thing. I just don't get it.

Mandy, it is NOT pointless to appeal!! This is exactly why I was denied and here you are two years later hearing the same B.S. that I did. The band has been approved by the FDA for almost four years--it is NOT experimental and all you need is an outside opinion. Does your state offer third-party appeal rights? New Jersey does and I know it's not alone in doing so. Call your state department of insurance or health (whichever has jurisdiction over HMO decision) and ask what your recourse is if you don't agree with your carrier's decision. Maybe there's nothing you can do. But maybe there is, and if you win you'll not only save yourself thousands of dollars but you just might make it easier for the next person. Appeal!!!

Jodie, excess weight can't be the culprit for your hands hurting! The kind of pain you describe sounds like arthritis. Really, at your young age and with a BMI of "only" 41 I can't imagine that weight is the only reason for your pain. Your PCP may be caring but her successful weight loss may be blinding her. Please do yourself the favor of talking with a different PCP. Oh, and if the one person who had weight-loss surgery has now left the company under a dark cloud, maybe that has something to do with their current exclusion.

Appeals always have to address the specific reason for denial. If your mother's company's policy excludes weight loss surgery for everyone, your appeal would have to somehow convince them that they shouldn't apply that universal rule to you. And that's what I think would be hard to accomplish. They've doubtless turned down other people who have tried to get bariatric surgery. Do you know if anyone has won an exception? If so, that person would be great to get advice from. But the hard truth is that companies who have deliberately excluded this or any other procedure from their self-funded plans have done so for considered reasons. They have no incentive to do your mother a favor, and no obligation either. I can totally sympathize with not wanting to go into debt for this, Jodie. I didn't either, and wouldn't have. If I hadn't been able to beat my insurer on appeal I'd probably still be over 300 lbs right now. Debt is a serious load and not to be taken on lightly. Your tone is distressing; I hate to think of you in so much pain with nowhere to turn.

So yesterday I'm on the treadmill, cruising along at a brisk 3.8, 3.9 mph, when the music picked up. I made the speed a little higher, about 4.2, and suddenly found myself in a sort of jog! I kep that up for oh, wow, a whole 90 seconds and then I had to go. But I'm eager to try it again! I've never been able to run and have always been scared of what it might do to my knees. But that 90-second experience showed me I could do it, that the treadmill won't break, and that my knees won't give way immediately. It would have been no big achievement for anyone else, but holy cow! I couldn't believe I went more than a few steps at a jogging pace and didn't immediately get winded. You have to start somewhere, my wise friends said. If there are any formerly MO people here who now run for fun, please share the stories of how you started. And when! Is it absurd to think that at this weight I might actually be able to run a little?

LOL!!! You're making me cry with laughter!!! If I ever go near a triathlon they'll be ice skating in the hot place. What an idea!! :D

Regandy, there is no magic bullet. You know that. In 1981 your stomach stapling may have felt like it was, but you have probably just forgotten the behavioral hoops you had to jump through. Banding is a tool, like all the others, but what it does is keep us on the behavioral wagon we must stay on to lose weight and keep it off. The "problems" are not universal and are not even, to my mind, problems. They are learning experiences and I have to accept them as such because MY control over my intake was obviously not working. If I want to be a more normal size for the rest of my life I'll have to accept that I can't eat for three people, and my band continually reminds me of that. That's what I NEED it to do, and it works. I would not consider RNY if I had to lose my band, unless I was truly desperate and sick from excess weight. The effects of being banded are exactly the behavioral kick that I needed to reverse the trend of my life and start losing weight. I wouldn't trade it for the world.