6 month program first???

[dmhavlat 0]

I posted this in the pre op area too, but i guess it is more fitting here....I am fortunate enough that my insurance company pays for 100% of the surgery if I jump threw a few hoops. The main one being "documentation of a successful completion of at least 6 consecutive months of supervised conservative weight loss program ( e.g. weight watchers, jenny Craig, etc)." Have any of you had to do this? Suggestions? Also, I have done many of these programs in the past with temporary success. My fear is if I lose 40+ lbs, I won’t have a eligible BMI, then what? Thanks!!

[honk 780]

I did not have a six month required program but if my surgery goes forward in August it will have been 7.5 months. Not easy for a zero patience person such as myself. One thing to keep in mind is that most surgeons' require you to loose 5-10% of you weight before they will perform the surgery. One of the reasons is that this leads to your liver shrinking which who knew gets fat too (And the liver is your second largest organ.). It took me 3 months to loose the required 30 pounds that my doctor ordered. I had to postpone due to another health issue that I am hoping is resolved so I can go forward with the surgery. So six months might not be that bad. I think the doctors office sends in your initial weight and they just make sure you are loosing/not gaining weight in that 6 month period. Talk to your doctor's office for details. In my case I am down 54 pounds from the consult and have 14 days till the surgery.

[stleochic 5]

My insurance also covers 100% after 6 months of a medically supervised diet. Basically, all you have to do is go see your primary care physician once a month. He/she has to document what kind of diet you're doing (ie. 1200 calories), and what your new weight/progress is. In other words they write something like this:

2/20/08: Weight Management Appointment: Susie Jones came into the office to discuss her obesity. We discussed various weight loss methods and we have decided to try a 1,200 calorie per day diet. She will keep a journal of what she eats and attempt to increase her exercise level. Her weight today was 275 pounds. She will return in one month for follow-up.

3/21/08: Weight Management Appointment: Ms. Jones returned today for a follow-up appointment. We discussed her progress and she stated she was having difficulty staying on the 1,200 calorie diet. She stated she is unable to exercise due to the pain in her legs and lower back. Her weight today was 276 pounds. She agreed to try harder to adhere to

the diet during the next four weeks. She will return in one month for follow-up. If she is still having difficulty we will explore other options.

You might want to give that to your primary care physician, because apparently insurance companies are very particular about how the record is worded.

Good luck!