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Hi! Yes, I got the approval on the 23rd and they submitted everything on the 15th. They were off for Good Friday so it took 6 business days to get the approval. They did however, ask for more info on the 17th and my insurance coordinator faxed it over that same day. They seemed to be most picky about seeing my weights for the year. Here’s the requirements taken right out of my plan for the Bariatric surgery. I have the basic plan. Just make sure you get as many letters of medical necessity from all your drs. Especially your primary. That seems to help things. Good luck and keep me posted!!! Procedures to treat morbid obesity – a condition in which an individual has a Body Mass Index (BMI) of 40 or more, or an individual with a BMI of 35 or more with one or more co-morbidities; eligible members must be age 18 or over. Benefits are available only for the following procedures: o Roux-en-Y o Gastric bypass o Laparoscopic adjustable gastric banding o Sleeve gastrectomy o Biliopancreatic bypass with duodenal switch Note: Benefits for the surgical treatment of morbid obesity are subject to the requirements listed on pages 66-67. Note: For certain surgical procedures, your out-of-pocket costs for facility services are reduced if you use a facility designated as a Blue Distinction Center. See page 91 for information. Note: Prior approval is required for outpatient surgery for morbid obesity. For more information about prior approval, please refer to page 23. • Benefits for the surgical treatment of morbid obesity, performed on an inpatient or outpatient basis, are subject to the pre-surgical requirements listed below. The member must meet all requirements. o Diagnosis of morbid obesity (as defined above) for a period of 1 year prior to surgery o Participation in a medically supervised weight loss program, including nutritional counseling, for at least 3 months prior to the date of surgery. (Note: Benefits are not available for commercial weight loss programs; see page 41 for our coverage of nutritional counseling services.) o Pre-operative nutritional assessment and nutritional counseling about pre- and post-operative nutrition, eating, and exercise o Evidence that attempts at weight loss in the 1-year period prior to surgery have been ineffective o Psychological clearance of the member’s ability to understand and adhere to the pre- and post-operative program, based on a psychological assessment performed by a licensed professional mental health practitioner (see page 104 for our payment levels for mental health services) o Member has not smoked in the 6 months prior to surgery o Member has not been treated for substance use disorder for 1 year prior to surgery and there is no evidence of substance use disorder during the 1-year period prior to surgery

You are overthinking this. Pick a b s bariatric practice with an excellent track record and do what they say - follow the program you signed up for. Sent from my KFJWI using the BariatricPal App

I'm guessing my bariatric surgeon, Dr. Michael Baptista, is getting more and more successful. He's moved from his partnership with another doctor and into his own spiffy new office MUCH more conveniently located for me, in Arlington right off 9A and Monument in the Brooks Rehab Building. Now, I'm not saying his former partner was a bad doctor-- not with that many awards-- but I didn't like the other doctor and that's the honest truth. I'm allowed my opinions, and my two experiences with the former partner were unpleasant. Now I feel much freer to help Dr. Baptista with his newer patients! I'm pleased to say Dr. Baptista asked me to start attending the monthly support group so I can provide cheerfulness and inspiration to a group that has recently begun to focus on negativity in his opinion. One subject he mentioned specifically I could help with was the low carb diet. Many have difficulty in going beyond what's on the face of low-carb living and consider it bland and without joy. Do you think I can change that? Yeah, I can. Especially since it's official-- I lost another 7 lbs, and I'm now within 10 lbs of One-der-land! I can do it! Now the question to ponder is-- what issue with low carb life do people have the most trouble with? I found it easy, so I have no clue where to begin. I need opinions, here!

Are you struggling with the question "Is Lap Band Surgery for Me?" I was. I spent endless hours confused while I was researching weight loss surgery. Now I'm in my fifth year and maintaining a normal, healthy weight, something I never thought possible. With a combined weight loss of 340 pounds and ten years of experience using the lap band as a tool to achieve our goals, my lap band mentor and I wrote this book to help others answer this question. It's a step-by-step guide, written from the perspective of real patients, to help you with your decision process and it's now available on amazon. Learn what a leading bariatric surgeon has to say about why you should read this book if you are considering lap band surgery here. You can read the introduction here. I'm happy to help answer your questions. I really struggled with my decision and am hoping to help pay it forward. Good luck on your journey.

I almost reached that weight and I realize how fortunate I was to have a second chance. BMi is based on height and weight and at 5'6 488lbs my BMI was 78.8 the day I walked in and met my Surgeon. He told me if I could lose 5% of my weight and put the work in and if insurance approves it he would give me a tool to use to help turn my life around. It is unfortunate help is not easily as accessible for others as it was for me. I think all insurance companies should cover bariatrics but I agree with educational side of it. Blindly approving people for it without proper education would be a huge mistake. Fear of death is a huge motivator it is just unfortunate it came to that but it also taught me a life long lesson that there is no "fix" for obesity and it will forever be work in progress until the final day of my life. Edit: Not a complaint but rather an observation....I have lost 325+ pounds and I am still in the overweight category. I am sure if I had all the loose skin removed I would be in the norm but let's face it those BMI charts are a joke. My Surgeon even told me they're BS.

So far, the only problem I'm having is with Bariatric Pal

OK Kylee have you called your doctor? We all understand the costs when it comes to finance but no amount of money is worth your life or that of your child. Most people from what I understand have their bands totally unfilled when they are pregnant so that their baby can get all the nutrition it needs. Yes the baby will take from you what it needs, but you will suffer and the more you are depleted the harder your baby has to work to get what it needs and could soon become depleted as well in which case you could be at risk for all sorts of gestational abnormalities and complications you don't want. If you have not called your bariatric doctor please do so today, you don't necessarily have to be scoped but he should know that you are pregnant and having these eating issues. Hormones are going to cause you to have different eating patterns where you might be more hungry from day to day, some of us have issues during TOM where we are tighter and can't eat as much and then looser again. Being pregnant your hormones are all going to be up and down and all around this could affect your band depending on the level of fill you have which is why I think doctors like to un-fill the band during pregnancy. As Pretty Thick said earlier weight loss can wait, now is time for you to take care of your health and that of your baby. Call your Dr. today!! (if you haven't already) Congrats and Best wishes to you and your little one!!

You should check with your PCP to make sure the absorption rate will not be affected by the size of your stomach. At the beginning I took mine two at a time with sips of water. After about a month I was able to take them all at once again. I was also told no pill bigger that the bed of your pinkie nail but fortunately the only one that was, was my multi which I switched to a bariatric brand and they are much smaller. I felt full but it lasted a short time. You should be fine, especially doing it right before bed.

They have them here at Bariatric Pal, protein gummies. They are just relatively high cal vs. protein content

You can google bariatric friendly recipes. I still get in foods ruts at four years out. This is a long term sustainable way of eating and still is flavorful. I think the fear and questioning if you are doing this right is normal. It gets easier as food becomes habit. Beef, chicken, seafood, dairy and eggs. Hundreds of options to cook them. I do fajitas no tortilla, Smoked salmon salad, bariatric pizza (my goto) eggplant as lasagna layer instead of noodles. Experiment to find what you like. Below is my dieticians recipe page for food ideas. Make sure they fit your plan. http://insidekarenskitchen.com/bariatric-friendly-recipes/ Are you logging your food in a food app? I use myfitness pal. My food diary is open https://play.google.com/store/apps/details?id=com.myfitnesspal.android&hl=en_US My username is fit_chickx https://www.myfitnesspal.com/profile/fit_chickx

Surgery should always be looked at as risk -vs- benefit. If you don't believe that the benefits justify the risk....you shouldn't do it. If you do believe the benefits justify the risk...you should. It's really that simple. To me....this looks like you're not yet ready to accept the risks. About fatty liver disease. Most people getting surgery (greater than 75% of obese people) already have fatty liver disease. I'm guessing the biopsy would be to stage it, if you have a particularly unhealthy looking liver at the time of surgery. Weight loss surgery generally helps to treat it. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061986/ If you have questions about any of this....talk to your doctor. It's what he/she is there for. This surgery is safer now than gallbladder surgery. Particularly, with the preventative labs and imaging you'll be doing, (chest x-ray, ekg, imaging of your stomach, lab work)...there shouldn't be too many surprises. At a major hospital like Mass General, you'll be in good hands. When weighing your benefits vs risks... make sure you include the risks of obesity: increased risk of heart attack and stroke, increased risk of several cancers, increased risk of loss of mobility, increased risk of cellulitis, diabetes, sleep apnea, etc...etc... You really do need to be 100% sure that you're comfortable with the decision you're making. My first bariatric surgery consultation was almost 20 years ago...and I had my surgery almost 4 months ago:) Part of me wishes I'd done this years ago...because I'm feeling fantastic and believe I made the right decision. The other part of me is glad I waited because time and research opened up more options, and I found a group I absolutely love and feel comfortable with. What ever you decide....best wishes:)

Hopefull,do you need an older perspective? I am 72, [emoji70]going to have RnY surgery within a few months and anticipating it being great. Yes I too read the" coulda" list, like the others said,there is more danger walking downstairs and you might fall, you could choke on your Breakfast, get run over by a bus or car, none of that has happened yet? Good, and the likely-ness of any of the others happening, even less likely. Life is a gamble but with all the advances in science and medicine you are holding a winning hand. I too will have my surgery in a teaching hospital, that doesn't worry me because those are the best cutting edge facilities. Shoot when I'm sprawled out, if I can help with their instruction, okay. I'm sure my doctor will have me surrounded with the best of the best, if there are junior doctors they will also be trained well or they won't be allowed to be present. Those bad things you've heard about are more likely to happen to someone my age. Am I concerned? Heck no, my life with surgery will be vastly superior to the life I currently live. I have had arthritis since 25, every bone is or has ached, I have had 2 knee replacements, I have a plate and 12 screws in my upper right arm that fixed a fracture. I have had a bunch of minor breaks that ache, they ache more because I am and have been obese for years. You do get sick and tired of being sick and tired. You have an opportunity to have your body repaired, realigned and made better. Do not wait as long as I have---please. Your skin will go back into shape and smooth out as you lose weight. Mine will probably look like a Shar pei, but guess what, its better to be a loose skinned puppy than lie dead in a casket. I may not have too many more years on this earth but I want to live them healthier fitter and smaller. The trade off for me: surgery and a renewed life vs. obesity and the chance of death? I chose life, [emoji13]my journey started in August 2015, many bumps and twists in the road there,but I'm sticking through to the finish. I feel I can do naught else. If you feel scared,if you feel nervous, talk to me. I have had a lot of life experiences, some scarred me but most have made me stronger. I am a tough old female [emoji70]who's going to win this battle. The world will not vanquish [emoji626]Major General frust8, I will fire every gun and cannon at my disposal until.[emoji606] my war is won[emoji121]. Can you do any less? Come join me if you can.[emoji14][emoji14][emoji14] Sent from my VS880PP using BariatricPal mobile app

Welcome welcome. We hope you'll hang around and get to know us better. There are people at all levels of the weight loss journey, newbies like yourself, pre surg like me who have or are in the process of finishing up requirements, ones whose surgery dates are shortly coming up, people who have just had their surgeries and are in the process of recovering and many seasoned veterans who are still active. We[emoji173] them especially as they mentor the rest of us. We treasure their advice for they have walked the walk ahead of us. Ask any questions you like,if I don't have an answer somebody else on Bariatric Pal will. We all may be having different approaches and viewpoints but we are unified in wishing you well and hope we can ease things for you. Welcome again, we think you'll find yourself at home here. [emoji14] Sent from my VS880PP using BariatricPal mobile app

Hello! After 7 years of telling myself I would get myself back to a healthy range, I finally admitted I just can't do it on my own. I've started the process with Mount Auburn Weight Management Center in Waltham/Cambridge MA, and am suddenly terrified that everything will go wrong. I contacted my insurance company (Harvard Pilgrim) and confirmed that They do cover Bariatric Procedures There is no condition requiring a certain amount of time on a program There is no waiting period from entry to surgery date However I just have this feeling that I am going to go through the whole process, only to be told that my insurance denied it and requires me to wait or something. Did any of you run into insurance issues? What are some best practices that I may be able to do to ensure things run smoothly? When I spoke to my insurance, they claimed that *I* didn't have to do anything, that it was all on the docs... but it just can't be that simple! Help and advice would be most appreciated! Anyone else on here have Harvard Pilgrim? Kind regards, Kay

Hi Laney. I don't know if I have much to offer you, as my surgery was 11/29 but my bariatric RN said to wait till Monday to introduce the chewable vitamins. She said one a day for a couple of days then increase as tolerated. She did say break it up in your protein shakes. Maybe that will help? Hope you feel good today. I've been told every day is a little better than the last!🎉

2 days post op and i started Bariatric Advantage mixed berry vitamin and I thought it was a little better this morning but same reaction a min later. Mouth watering and trying hard not to throw up. Did anyone else have this issue with Bariatric Advantage and does it go away? What brands do you like? Need an alternative stat.

I agree with Laurend. That sounds like an amazingly bad idea. It would sound as though the patient is trying to go to message boards to trash his rep and honestly, if I was the doc I'd be fighting back against the patient. I damn sure wouldn't be wanting to change my policy for someone doing something like that. But I might warn the other bariatric surgeons in the area about this patient. Nobody will want to see her. The OP has already been given more appropriate methods to deal with the problem. The ball is in her court now.

I don't like pain. Surgery is painful, and gastric bypasses are major surgery. If I were in your shoes, I would try to find another surgeon in my area who would be willing to take on another surgeon's patient. If I couldn't find one, I'd go back to my original doctor. You might get a disapproving look. You might not. Explain that you were discouraged and afraid, but now you're ready to do what you can to make the band work for you (but this part applies only if you are really ready). I'm newly banded, but I've done a lot of reading and have learned that fills are fickle things. The first one doesn't usually give restriction to people. I was told to expect four to six fills (or more!) before mine would be where I need it to be. Maybe one fill wasn't enough for you. Don't forget that nutrition is important, too! If your surgeon didn't give you instructions on how to eat after you were banded, do research or call your surgeon's office! There's a wealth of information available in this and other forums. Find a nutritionist who specializes in bariatric surgery. Exercise!! If I did all of this and the band still wasn't helping me, I would consider other surgeries, but not before. Mainly because of the anesthesia, cutting, and recovery time :confused: Really, this is how *I* would approach it. You have to weigh your options and consider what is best for you. Lap-bands don't work for everyone; neither do bypasses. Sometimes it's because, for whatever reason, the particular method was incompatible with the patient's body. Sometimes it's because the patient cheated the system, which is possible with ANY weight loss procedure. You HAVE to follow the rules or you're not going to be successful. You HAVE to go to follow up appointments to make sure you're doing well and things are working as they should. *hugs* I understand feeling out of control and spiraling into a bad place. That's how I got to be 300 pounds. There came a time when I realized that what I was doing wasn't helping me at all. I had to pull myself up by my bootstraps (that was hard), admit to my mistakes (even harder), and decide what to do about the situation. It sucked! But I did it. And you can too. (Sorry for babbling and/or incoherency. I'm tired!)

Hi All, I know most surgeons and literature around bariatrics discuss losing 'X%' of your 'excess weight' however what do they class as excess? I'm assuming they are using the BMI, but what do the class as your 'ideal weight' to then calculate your excess? Is it the highest BMI point you would be classed as in the health range or is it the mid point of the healthy range for your height/gender, the lowest point or something else? It's just i'm trying to set up my weigh loss journal and app and set goals etc but i'm at a loss as to what this mystical calculation is based on Thanks in advance - and yes I would be amused if this like everything else varies between surgeons!

Whether you’re reading this as the patient who needs bariatric surgery, someone who loves that patient, or the provider committed to caring for the patient, there are at least three important lessons coming out of this experience that should be taken away for future benefit. Three takeaways coming from beating CIGNA and winning another bariatric surgery appeal

Well I have a leaky port that's going to be fixed in a few weeks! I found out that Phoenixville Hospital has a new bariatric center and a doctor who will fill me even though I'm not a patient. A 15 minute drive compared to the 2+ hours to Gaspar! Thank god. Pages - Bariatric Surgery Dr. Kaczmarski 610-983-1975 I have lost some of the weight I gained, but have decided that post-op I really need to get a local support group together. So I hereby would like to announce I'm forming a Chester/Delaware county support group!! I'd like to meet my fellow bandsters in person every now and again, have meetups, etc. I think a huge problem for me is I am a solitary eater. When I'm with other people I talk a lot and am not interested in food. When I'm alone, I'll peck at something for 2 hours unconsciously, so, having people around will really help me stay on track. I've been isolated for a long time, and now that I work from home, it's becoming imperative that I meet with other people! We can share recipes, stories, shoulders to cry on, go out and do things when the weather is nicer if we like. Anyone interested??

You are not alone, there are soooo many of us out here, looking for advice, support or just someone to listen, that understands what we have gone/are going thru. My bariatric team seems to ‘be done’ with me since the surgery. I’ll ask a question, and they will return the message with ‘you may need to see your PCP’. I feel abandoned by them. My insurance company even placed a call to them to return my call, and they still have not. I’m 10 days out, still bloated, minor pain, but I’m probably ok. 😊

Mark, A huge congratulations on getting the surgery behind you! The toughest part is over. On exercise: Like you, I started walking pretty much immediately after surgery and gradually ramped up from there. Now I do a regular mix of cardio and weight training. It's so much easier and more enjoyable to exercise without all the extra weight and you can really see the results. On telling others: I choose to basically tell no one. My experience is that the general public views bariatric surgery as some sort of extreme, unnatural decision. I'm not embarrassed but I just didn't want to explain VSG to everybody. When people ask how I lost the weight, I tell them that I eat and drink a lot less and exercise more (all true). When they hear that, they lose interest and change the topic! Anyhow, I'm really excited for you. Send me a message anytime you want.

holy hell! I'm frustrated. I'm above my bounce weight of 130's for maintenance . It's not a good feeling. I'm getting things reigned in before they get out of hand. Some days I need to shut my inner voice off. I'm telling myself It's my new medication, My sports injury, I might as well eat this because I'm already at a higher weight. The scale is not moving. I'm pressing on! I'm tracking food and I have increased my workout for the last 5 days. Keeping up all the things I have been taught by my bariatric brothers, sisters and professionals. Waiting for the scale to move again.

If the Protein you are using doesn't agree with you, I would try another kind. I am drinking the premier Protein shakes (2 a day) and that is about all the protein I can get in. I do make my meals (2 oz) with added protein if I can and that adds a little bit. Protein is important. You may want to try some of the engineered foods that are designed for bariatric patients as they have added protein. I have seen Soups, puddings, oatmeal etc. I have not purchased any of these yet myself, but it might help to use those for meals so that you are making sure to get more protein. Also, you can use the unflavored protein to mix into a beverage that you like to give you more variety. Mix it in crystal light or another zero calorie beverage. If you body does not get enough protein it will take what it needs from your muscles. This is not a good thing. Your heart is a muscle also. Hope some other members can suggest other types of Protein drinks that might help but I would definetely try some different brands. Its tough because everything is done so slowly (eating and drinking). Seems like every waking hour is consumed with remembering to constantly sip. Good luck to you!