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I don't think it is based on "safeguarding" the public's health. It's based on risk/benefit analysis, which is why it seems so way off for banding. The years of RNY and other bariatric surgeries are the body of experience they use to calculate such things. It will be several MORE years and MANY more banding patients will have to be studied before any changes are made. IMO, there should be a huge divide between RNY qualifications and those for banding. The current guidelines don't take into account the exponential difference in risk level. Someday, we can hope, they will.

WOw!!! Thank you EVERYONE!! I honestly didn't expect to get responses so quickly. Im sooo fresh to this I haven't even gotten my insurance card in the mail yet. (My husband and I just garried Friday and we sent in our insurance paperwork) However, the enrollment packet did say in plain black and white that it does cover bariatric surgery. Now I understand that's pretty broad so should I still call and see if the sleeve itself is covered? Also, I have SO many other questions...I haven't had a PCP in about 10 years besides my latest which was only for prenatal care. (I had my son in Oct) Also, having just had a child, will that disqualify me? Ive had obesity issues for basically my entire life. Also, My mother has a Lap band and told me Im better off going straight to the Dr. because getting through insurance and getting questions answered is usually pretty hard to do. Will I need previous proof of health issues? I have family history or diabetes and heart problems. Im honestly just trying to feel out the play field first before I even get my hopes up! Im afraid Ill be turned down. And again thank you all so much for your speedy responses.

Hi Asmith :smile2: You're definetly in the right place. You're 100% right that what you're experiencing now is far worse than the band. With the band as a tool you can regain your life and confidence Just poke around on here and read all that you can. There is a Plethora of knowledge on here for you to absorb. I would start with going to a seminar usually with your local bariatric surgeon to get a hands on feel for how it all works :biggrin: I am sorry but isn't that just an advertisement for your establishment Dr?

Hello! I posted about a month ago, asking questions about banding. From there I prayed, and researched (more) and decided the band is exactly to tool I need to succeed with my weight loss goals. I've so confused about all the insurance stuff. I called member services and they said the surgery is coverage and gave me a link to the clinical policy bulletin which reads... Aetna considers open or laparoscopic Roux-en-Y gastric bypass (RYGB), open or laparoscopic biliopancreatic diversion (BPD) with or without duodenal switch (DS), or laparoscopic adjustable silicone gastric banding (LASGB) medically necessary when the selection criteria listed below are met. Selection criteria: A. Presence of severe obesity that has persisted for at least the last 2 years, defined as any of the following: Body mass index (BMI)* exceeding 40 My BMI is 53 (good lord), and I have high BP. It also says naturally that you have to over 18 and done growing, attempted weight loss in the past without success in long term reduction, and meet either criterion 1 (physician-supervised nutritional and exercise program) or criterion 2 ( multidisciplinary surgical preparatory regimen). I am working with a weight management and bariatric surgery center near me. I have to complete consults, and tests with all sorts of different people on the team including attending support groups, and lose 5% of my body weight before surgery - it's a 3m process. So I'm assuming this meets criterion 2. Aetna words it like this: Criterion 2. Multidisciplinary surgical preparatory regimen: Proximate to the time of surgery, member must participate in organized multidisciplinary surgical preparatory regimen of at least three months duration meeting all of the following criteria, in order to improve surgical outcomes, reduce the potential for surgical complications, and establish the member's ability to comply with post-operative medical care and dietary restrictions: Consultation with a dietician or nutritionist; and Reduced-calorie diet program supervised by dietician or nutritionist; and Exercise regimen (unless contraindicated) to improve pulmonary reserve prior to surgery, supervised by exercise therapist or other qualified professional; and Behavior modification program supervised by qualified professional; and Documentation in the medical record of the member's participation in the multidisciplinary surgical preparatory regimen at each visit. (A physician's summary letter, without evidence of contemporaneous oversight, is not sufficient documentation. Documentation should include medical records of the physician's initial assessment of the member, and the physician's assessment of the member's progress at the completion of the multidisciplinary surgical preparatory regimen.) Sounds like my program right? I called my Aetna AGAIN to be sure they cover this surgery and she again assured me that it is covered so long as I meet the criteria and to bring the criteria to my NP consult. I know I have to wait to be approved after all my testing etc, but I'll (like anyone else) be so gutted if I'm denied. Anyhow, I'm waiting for June 30th for my NP consult and I'm so excited!! I've been reading everyone's stories and looking at before and after photos and I'm so impressed with the lot of you!! So inspirational. :confused:

My doctor is Mark Shina, an excellent man and a wonderful bariatric surgeon. He could have finished the surgery he said but my blood pressure kept bottoming out, and he was scared he was going to loose me because the scar tissue in my abdomen had to be removed to get to my stomach which would take an extra hour. Apparentally certain types of blood pressure medications interfere with the anesthetic used to put you under. I am going off 1 of my blood pressure meds for two weeks and we are going to do it again the 16th.

Hi Brittany1225, Regardless of the outcome stay positive. Besides being a Bariatric patient, I was lucky enough to have worked in their office for a while and was able to learn and understand a lot. Stay positive, let me know the outcome and I will help you through it as best as possible. Tranquila!! 👍

I got better advice from my Surgeon and Bariatric NUT than I did in the 5 months I went to see my dietician. She knew absolutely nothing! She was young and had a few years experience but didn't help me lose ANY WEIGHT AT ALL! It was a waste of time but my insurance insisted on it.

I looked at the Hopkins Bariatric Surgery Center a couple of nights ago, and viewed an information session. I've decided to fill out the required information package that they want, but one thing worries me greatly in that one of their requirements is that I have a "support network", i.e., family and friends. I do not have any family left that can help me, and very few social contacts due to my depression/mental illness. I feel very discouraged now about even applying, because once they find out that I don't really have anyone but myself... they may deny me on this basis (I'm not really sure of why that is - I may not have any visible source of support, but it also means that I don't have anyone to tell me it's the wrong thing to do, either, and that has to count for something). I did take and pass a required quiz about the procedure and the correct reasons why I should be doing it, so maybe there's some possibility that this might work for me. Time will tell. In any case, I've taken the first step. <gulp>

So I have been really quiet on here because I was just trying to get rid of the last of the health issues I had going on. Polyps are gone and uterine fibroids are gone. I had an appt with my bariatric surgeon today and we discussed getting the revision now that I have a clean bill of health. Looks like it'll be mid July sometime. BUT...my revision is a little more complicated. Here's what I was told: Normally they leave the bottom part of the stomach when they do the bypass because there might be a need for a feeding tube at some point, or something like that. HOWEVER, with my situation, the part they would normally leave is where all the polyps were. So the surgeon is going to completely remove the bottom part of the stomach (making my stomach about 2oz instead of the 4-5oz it is now) during the bypass surgery. He said that's not ideal, but given my situation, it's the best course of treatment for the GERD, esophagitis, gastritis, and getting me back to being able to work out and live a normal life again (which is really all I want). He said it does present a problem later on if I need a feeding tube or whatever, but that's a big "if", and considering all of my issues right now, it's worth the risk, if I agree. I agreed with him and I'm waiting for the coordinator to call me to schedule the surgery officially. I'm so close to this being over. I can see the finish line FINALLY!!!!!

"This is more of an academic question, I'm not concerned about my own adjustment and am not looking for encouragement or advice - just curious." None of us are medical professionals on this site. All we can give is our own experiences...Take what's useful and ignore the rest. QUESTION: Is bariatric surgery designed to stop patients from over indulging in taste and capacity? None of us can say how you will experience satisfied, cravings, taste, (tasted enough) feeling content, capacity. It is specific to each person. I can't predict how this will feel for you years out from surgery. All I can say is four years out eating healthy is normal. It's not an endless head game for me. I feel satisfied by taste and quality over quantity.

It's my understanding that NSAID issues are caused in the stomach by oral ingestion. And honestly, the very short amount of time you would take them probably wouldn't cause issues (but I wouldn't want to test it). But yeah, let them know for sure! I have my surgeon chosen because he specializes in post-bariatric plastics. Maybe see if you have one like that in your area?

Someone shared this article from bariatriceating.com that I wanted to share here: Don’t eat bread! That latte has 35g sugar! No macaroni salad. NO tortillas. No rice. It won’t last without change There is no delicate way to say this. We have always set ourselves apart from other bariatric groups in that we don’t look the other way while post ops continue to eat the bad carbs. We try and bring them back to the bariatric reality. We coax you to knock off the Pasta, rice, tortillas or bread and often people get mad or try and justify it. For years we’ve watched people blow through this surgery and they all have the same story. Everyone thinks they are ‘Different’, that they can handle the bad carbs and the sugar (they don’t get sick!) and ‘because they have lost 100 pounds in 7 months they must be doing something right’. The first hundred pounds is the surgery Hate to keep making the same point, but your surgery did it, not you. Remember that you are not driving the car for the first year. Eating the same foods that grew you to 300 pounds, but in smaller amounts is not a good long term plan as eventually you will be able to eat larger portions. Ask yourself why eating the same bad carbs would be a good plan. No doctor has advised you to eat the same way post op as you did pre op. Post ops pick this up somewhere, latch on to it and defend it, often to the bitter end of a total regain. No one fights for broccoli carbs! It’s not that the bagel will kill you, it’s that these carbs make you hungry. They rapidly turn to glucose and burn… poof, gone, #Lookingformore. They don’t give you any nutrients. They don’t create a feeling of satiety or lasting fullness. The empty carbs work against what you are trying to achieve. If you were arguing for eating salad or green bean carbs, more power to you… but people are trying to hang on to foods without value. If this big argument was for VEGETABLES… well it wouldn’t be a debate as vegetables didn’t make us fat, it was those ‘other’ carbs. Did you ever meet an obese vegetarian and wonder ‘HUH?’… how’d they get obese if they are vegetarian? Same deal… its not the vegetables, its the other stuff… the carbs… the potatoes, bread, macaroni, rice, tortillas and sugar! Square peg… round hole Stop looking for slightly better substitutes for bad choices and find new healthier foods to love instead. We keep trying to force that square peg into that round hole. Stop EATING crackers and chips… don’t find ones that you can justify because they have fewer carbs. Enough with the terrible fishy shirataki tofu noodles. Learn to live without bread and pasta so it will not call your name. We aren’t changing the behavior or trend if we continue eating them, just slightly shifting it. Before long you’ve got your hand back in the Doritos bag & fork in the Mac and cheese. Look It’s Protein Cheesecake! Don’t add protein to muffins and convince yourself they’re good for you. Stop with the Starbucks Creme Brûlée Lattes because ‘they’re your one indulgence'; they have 500 calories and thin people don’t even drink them. Stay the heck out of Wendy’s. I read an article the other day touting all the ‘good choices’ in fast food restaurants. How about stay out of them. That’s the best choice of all! Why go to the place where you know there is danger. Before you know it, oops… there are fries in your bag! You know people gain back weight, right? In our first month of new Facebook Support group I have cried for new members who have gained back all their weight. I am not immune either after fourteen years, three bariatric books and knowing better. When life hit the fan, I comforted my bruises in the way I knew best and it has taken me ten months to lose fifty pounds of it. People are having revisions, a lovely sounding word for a second serious body damaging operation. What will change? Unless there is major change along with that new surgery, won’t it have the same result? Step away from the bagel! Own that there was and maybe still is something wrong with your food picker! Use surgery as an opportunity to change, not cheat. I used be bothered by the ‘word on the street’ that we were the carb or food police, but am now proud of it. If you want to promote the virtues of Everything in Moderation while eating half a Subway, there are plenty of groups that will help you do it. If you want to eat right and learn new behaviors to make the feeling of slipping on those skinny jeans last… we have a support group that’s a healthier fit. Bariatric Surgery IS the easy way out It’s a personal food cop that is always with us, that helps us push away from the table. We make it hard when we don’t live by the bariatric rules we’ve been given. There is nothing harder then gaining weight back after surgery. There is nothing better than losing it a second time. Control is empowering. If you need to pick up and start losing again… If you need to work off a regain… it’s not too late and your pouch works just fine if you choose the right foods. Clean those lethal carbs from your life and go back to Bariatric Eating – protein first and lots of fresh salad and vegetables. We’ve got the support for you to make that change!

...something comes up to likely stop it altogther. Finally, after waiting 3 weeks for the initial wls seminars in my area for the 2 drs I'm considering (& getting my DH on board for me to get lap band (self pay) ) we just found out that DH may be out of his job! More than me getting wls, I'm so sad for him. The worst part is that he's not getting laid off. His industry isn't bad. Its literally like they just are letting him go for no reason. Well, they haven't officially yet but its looking that way. He spent yesterday refreshing his resume & contacting other firms. We'll see what happens. I haven't worked in almost 4 years. Its a little embarassing to make a student loan payment on a degree you don't use but I hope to work one day again. I always used to feel like I was overlooked, underused, and unappreciated because I was fat & frumpy. (Technically, I still am! ) Anyhow, I don't currently bring in an income to help. Fortunately, dh is an excellent saver & we can live for almost a year if he was out of work. Unfortunately for me, it was to be some of that savings for lapband. Now what do I do? Dh and I are supposed to go to wls seminar #1 tonight (for the Davis Clinic here in Houston.) I already know my insurance doesn't cover any bariatric surgery (but even if it did- my husband's insurance is now precarious as it is.) I was so excited at the prospect of lap band before the holidays. Now I feel guilty. Dh said we could still go to seminars and if his employment situation changes, it may still happen that I get 'banded' (someday.) I hope tonight brings some good alternatives & ideas for payment. On the one hand I really feel this surgery will save my life. On the other- how do I reconcile taking food off our table if given the option? I'll update post seminar.

go online and gregister at website,look to see if they cover wls or if they have Bariatric resource services, if they do call the number to BRS. If you're not sure call UHC to verify you have coverage for surgery.Find out the requirements. Find a surgeon and get the ball rolling. Good Luck!!

@@phatfatgirl Have you tried premier Protein ready made shakes? I too could not tolerate any of the powders in the beginning. My Bariatric team had me pick up Premier Protein. Each 11 oz. shake has 30 grams of protein with only 1 gram of sugar and 160 calories. They don't have that grit or nasty nasty after taste. The chocolate is the best as it is not overly sweet. The vanilla and strawberry seem sweeter to me and although I can drink them I pretty much stick to the chocolate. If you have not tried them, they really are better for you than simply drinking a protein shot. They have other Vitamins and minerals as well.

Well, my program with our military insurance gives me full access to a nutritionist, and labs pulled at 3,6,9, 12 months out, then yearly labs are pulled. That is the standard procedure for all bariatric patients through our military hospital here in Florida. My surgeon likes to do a endoscopy between 9-12 months out, earlier if there are any issues. So, there is another anesthesia procedure plus the scope cost. My PCP (is a civilian), and while he is not well-versed on VSG, I can easily go to him, have him pull my previous labs, or take him one of my copies, and have him pull my labs again if he thinks they need to be. I just dealt with this situation bc I've been having low blood pressure issues. Not really related to a complication of the VSG, it's essentially just my body trying to adjust to my drastic weight loss. Also, there are several patients that dealt with severe nausea post-op. It hits some of us, and others aren't bothered by this. Everyone is different. I honestly think if you can be that close to home, have that follow up care, and love your surgeon, there is NO pricetag that you can give you that reassurance. I'm super picky. You couldn't pay me to have this surgery, or any other major surgery, where they are removing 75% of a major organ in a "surgical clinic" without an ICU, and emergency facilities and capabilities on the premises. A lot of PCPs are willing to do follow up labs for patients that travel to Mexico, but those labs can run patients without insurance a few hundred bucks. The labs we need pulled are more extensive than just a normal Chem 12 and CBC. So, the out of pocket cost can be astronomical.

Protein shots usually are not made with "good" Proteins. General rule of mine: if it looks like a test tube or a vibrator, it's probably not good protein. "Shots" tend to be based on collagen, which is not a protein we want to take. Search for "incomplete protein" or "collagen protein" and you should be able to find quite a bit of information. Even the ones labeled "Whey" or "Pure Whey" are not. Here's a snippet from the "Pure Whey" shots, for example. My additions in blue: Collagen has it's place, but it is not a good replacement for the type of proteins we need to replace (the ones we aren't getting through foods like meats and whey proteins). It does not have adequate amino acids to really even be a healthy replacement (and let's face it, we really are replacing more than supplementing for the first long time after surgery). The Isopure drinks - I've not tried them myself, but as soon as I can find time to get to a GNC I plan to pick one up. I would get 1 bottle of the 2 or 3 flavors that sounded the best. Even if you like it now, you may not like it post-op. Something about these bariatric procedures tends to scramble our tastebuds a bit. Lots & lots of people find their tastes are completely different. GNC should sample things for you, the one by us does anyway. Have them make up some samples and see what you like. I don' think GNC sells unjury, but I really don't know. Let me know if they do. The Isopure powder tastes like infected ass. Don't waste your money. I haven't met anyone who likes it, ever, in like 7 years. HTH

Thanks! I will check it out. : ) I'm in Melbourne, Victoria. I'm looking at The Centre for Bariatric Surgery. In Melbourne!!

I am using Bariatric Advantage. The vanilla flavor has 27 grams Protein, 7 grams carbs, 1.5 grams fat and 150 calories per 8 oz serving. I actually do not find the taste offensive as I do other high protein Meal Replacements. I buy on Amazon for $63 for 35 servings. I have the chocolate flavor as well and that is also good. I was told that after surgery I could add powdered milk to up the protein. Not sure how that would taste!

The following bariatric surgical procedures are considered medically necessary for Members who meet the associated criteria: Gastric bypass (Roux-en-Y; gastrojejunal anastomosis) Vertical banded gastroplasty (gastric banding; gastric stapling) Biliopancreatic bypass (Scopinaro procedure) Biliopancreatic diversion with duodenal switch Gastric sleeve procedure (also known as laparoscopic vertical gastrectomy or laparoscopic sleeve gastrectomy) when done alone and not a part of the full operation to complete a biliopancreatic diversion with duodenal switch (BPDDS or DS) Medical Necessity Criteria The Member must meet the criteria of either A or B: Class II obesity (BMI 35-39.9 kg/m2) in a person who has attained an adult level of physical development and maturation, in the presence of one or more of the following comorbidities: Type 2 diabetes Cardiovascular disease (e.g., stroke, myocardial infarction, stable or unstable angina pectoris or coronary artery bypass) Life-threatening cardiopulmonary problems (e.g., severe sleep apnea, Pickwickian syndrome, obesity-related cardiomyopathy) [*]Class III obesity (BMI equal to or greater than 40 kg/m2) in a person who has attained an adult level of physical development and maturation. New CPT CODE: 43775 - Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)

Hi All, I have been reading a lot of interesting information on here and I am really excited about getting started! This is great! I am really a rookie here though. I am just going for my first visit at the bariatric center on Monday, Feb. 26th. So, I'm on here trying to absorb as much info as possible. I'm married with a 13 year old daughter who is very active! I want to be active with her, so I need to get down to business here. I have gerd, a hiatal hernia, high blood pressure (controlled w/meds) and I have just been diagnosed with severe sleep apnea. Yee haa! Just one thing after another. I have a birthday coming up in March and every year it seems like another ailment goes along with it! Enough! I need to get my weight under control. I have been on sooo many diets it isn't funny. Now I am hopefully going to be able to have the lap band surgery. To be continued......:clap2:

That's really going to be a question for your bariatric team. The pre-op diets vary greatly! Some surgeons don't even have you do one. Some have you on liquids only for up to two weeks prior to surgery. My practice didn't require liquids only but for the two weeks leading up to surgery wanted us getting at least 80grams of Protein while staying at or below 800 calories a day - so lots of lean protein and very low carb to achieve that. This two week prior to surgery phase is often referred to as the liver shrink diet. If your bariatric center or your insurance requires you to lose weight or at least not gain weight between 1st appointment and surgery, your center may have you making other dietary changes now to achieve that. So add the pre-op diet to your list of questions to ask at your appointment next tuesday! Good luck on your journey!

Maybe call the bariatric practice and ask what all tests you should ask for, and then go and request them through your primary doctor so they are covered. I am sure the bariatric center would be happy to try and work with you if you call and explain the situation. I'm sorry this is happening!

Hi First of all, you're not too old! I'm 51 and am 4 weeks post op. Folks in their 50's and 60's are on this board and are successful I don't know if you've had prior surgeries, but I have had more than my share. This is pretty easy. You'll have a few days in the beginning that are the most uncomfortable. But after that every day really gets better quickly. Nothing to be afraid of. The initial pain from right after surgery really seems to vary by person. But you're in the hospital and don't be afraid to ask for a painkiller if you need it. As far as work goes, you don't need to tell anyone, even your boss, what the reason is. It's just "medical" leave. It's a personal choice as to whether you tell people at work. The only time anything is noted about the surgery is on the FMLA form. That goes to HR and they would be violating HIPAA if they told anyone. My HR person doesn't even look, just puts it in the file. What helped me the most in this journey was the preparation before hand. Not every surgeon has the same program, so if you haven't chosen one, I would suggest finding one with the support you'll need. Not one that wants to do the surgery in two weeks and that's it. I had 4 months of learning to eat properly prior to my surgery, involving support groups, Nut appts, and so on. This made the post op transition much easier. In addition to nutrition, it enforced eating slowly and drinking/sipping Water all day. As far as complications go, there is a forum for that. It's good to read what some unfortuante folks have been through. But also keep in mind that the odds are very low of having a problem. But you have to understand what can happen and make an educated choice to proceed. Spend some time checking out the different areas of the site. Do lots of reading. Ask questions (great support here). Find a very good surgeon/Bariatric center if you move forward. Undertand that they operate on your stomach, not your head. So be prepared to deal with your relationship with food - it IS going to have to change to be successful. In the end, do what's right for YOU.

Iam going through the Detroit Bariatrics. On location at Barix Clinics/Forest Health Center in Ypsilanti. Dr. Nunn will be my surgeon.