BigSue

Thanks for the advice, everyone! My insurance requires my medically supervised diet to be outside of the bariatric group. I do have to meet with a nutritionist in the bariatric group, but that's a few weeks from now and I get the impression that it's a one-time thing. I also have to take an online nutrition class and a pre-op surgery prep class. I switched from regular soda to diet several years ago, and I was kind of proud of that because it was hard (I loved regular soda and hated the taste of diet, but I gradually made myself switch and now I prefer the taste of diet, and even unsweetened flavored seltzer). I have a personal rule of no snacking at work, but that's not so easy at home, although the intermittent fasting has helped. I've been entering my food in MyFitnessPal, which is required in my bariatric program for the week before meeting with the nutritionist, but I went ahead and started early, so that is helping me to choose lower-calorie foods, but I am having scary flashbacks to my years of yo-yo dieting because I always do well at the beginning but I can never keep it up for the long term.

I had my initial consultation for weight loss surgery last week and I think it went well! For some reason -- and it seems silly in hindsight -- I expected to have to explain myself and justify why I need this surgery, but that wasn't the case at all. I had filled out a bunch of paperwork and sent it in ahead of time, but they still had a few more forms for me to fill out. A nurse took my vitals and asked me about a few things on my paperwork, and then I met with the surgeon. I was undecided about which surgery to get, and the surgeon said he thinks gastric bypass would be best for me because I have a BMI on the high end. He wants me to lose at least 20 pounds before the surgery. He told me that my insurance provider recently reduced their requirements, and now they only require a 3-month supervised diet instead of 6 months. Finally, I met with a surgery coordinator, who went over all of the requirements I will have to complete before the surgery. She said they want a 5-year weight history and I explained that I don't have it because I went 7-8 years without going to a doctor, and she didn't seem too concerned and didn't think it would be an issue for my insurance. She sounded very confident that they will be able to get insurance approval. The next thing I have to do is an upper GI barium swallow test, which at first sounded like no big deal, but the more I look into it, the more I realize that it is a little scary. I've been reading about other people's weight loss surgeries and watching YouTube videos, and not many people have mentioned this part of it. Overall, I am feeling good about this. I have a long journey ahead of me, but I've taken the first step and it's starting to feel real now.

I recently decided to start the process of getting weight loss surgery. I have an appointment for an initial consultation with a surgeon later this month. I’ve been trying to figure out the insurance requirements (BCBS of Tennessee) for covering my surgery, and I know the standard requirements of having a BMI over 40 and maybe having to do a 6-month supervised diet program, but I’m having a hard time finding any information on some of the other details. My biggest concern is that I’ve seen some people here mention a requirement for documentation of weight history. I have been morbidly obese all my adult life, but I rarely go to doctors. I went to get a checkup and bloodwork a couple of months ago, but before that, I hadn’t been to a doctor in 7 or 8 years, so I basically have no documentation of my weight history. I don’t even have many pictures of myself because I am careful to avoid being in pictures due to embarrassment about my weight. What is typically required for weight history documentation? Also, I’ve been on all kind of diets (Atkins, South Beach, Weight Watchers, Slimfast, Cabbage Soup, calorie counting, etc.), some of which were given by a registered dietitian, but they were a long time ago, in my teens/early 20s. I stopped doing fad diets over 10 years ago because I realized that yo-yo dieting always resulted in regaining everything I lost and more. So, I’m also worried that I won’t have sufficient documentation of my previous dieting efforts. It took me a long time to get to the point that I feel not only that I need weight loss surgery, but that I am ready to put in the work and make the changes that I will need to make, but I’m afraid that I’m going to have to wait years for my insurance to approve the surgery just because I don’t have official records of my weight and diet history. I know my surgeon’s office will have to get the details from my insurance company, but I’d really appreciate any info anyone can give me so I know what to expect. Thanks!

No, not on BP meds (or any meds) right now. PCP said my BP is borderline, not high enough to warrant meds yet. Work physical does not include any bloodwork (except the pre-employment physical when I started the job), and the only urine testing they do is for drugs.

My BMI is well over 40 so that will not be an issue. I have not had any preventive screenings and I am in my late 30s. If the surgeon is going to be concerned, is there anything I can do or say to alleviate his concern? I get an annual physical at work and they always said I was fine, until last year when they said my blood pressure was high and recommended I go to a doctor, so I went to the doctor then. I have gone to the dentist regularly for years -- does that count for anything?

Well, that's the potential problem -- until a couple of months ago, I hadn't set foot in a doctor's office for 7-8 years. I guess I should cross my fingers that the insurance takes my PCP's word for it...

Thanks for the info! That is really good to know about the follow-up appointments. AZhiker, can you tell me where on the BCBS web site I can find the requirements document? I have looked and looked and haven’t been able to find anything about specific requirements. The only thing I can find is that the surgery is covered on my plan. My BMI is well over 40 so that won’t be an issue, and I’m prepared to do a 6-month supervised weight loss program, but what happens if I do not have a documented weight history to prove I have been morbidly obese for at least two years? Will I have to wait until I have a two-year weight history before they will approve my surgery?