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Help with 5 year history...

I am a month into the six month physician supervised weight loss program. However, I am afraid that when I'm done the surgery won't be approved because I have no weight history. I guess I am disgustingly healthy for a fat person, or just don't go to the Dr when I should. Anyway, I had to have a tetanus booster last year and that's it. My youngest boy is almost six so my pre-pregnancy weight from that would have been almost seven years ago, and I was obese then. Will this be good enough? Anyone have any experience with this? That's what I get for not costing the insurance company enough money up until now, I guess.

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I got my weight history from my gyn and that was sufficient. They kept track of it when I went for my yearly appointment so I had at least a yearly record.

My insurance approved so .... it worked.

  • Author

Glad that worked for you. I haven't been going to the gym so that's not an option for me. I talked to my PCP and he says he will write a letter. I haven't been a patient, but he's seen me with my six kids and hubby many times over the last five years. Hopefully that will be good enough. Thanks for the response.

I used to do appeals for an Insurance company. I had one member send in dated pictures of herself which showed she had BMI over 40 for the missing years. Sometimes you have to get creative, think about anywhere that might of recorded your weight. Weightwatcher cards etc.

I'm just starting this process. Do u have to actually go on a diet with your primary doctor, i mean if you lose weight will they not approve you?

  • Author

kalew: Great idea about the pics, thanks. Not that I have many of those, lol, since I hate having my pic taken so heavy, but I should be able to find something.

Kimmysil: The six month physician supervised diet is something my insurance requires, not my surgeon or Primary care Dr. I really don't know what they would do if I don't lose weight. I know the purpose is to show that you are ready to change your lifestyle and add diet and excercise. Without that the sleeve will eventually stretch and you'll gain anyway, so, other than the time it takes, which I am bummed about, it will be a good way to get ready for life after the sleeve.

I just dont understand why you would have to go on a diet prior if you are asking for surgery. It doesnt make any sense unless they are seeing i people could actually lose weight. I dont get it.

Kim

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Kim

I agree actually, unfortunately, if I want the insurance to cover my surgery I have to comply with what they require. My insurance, as with most, requires a BMI of over 40 and I have heard that if you go under that while on the six month pre-op diet they will then deny the surgery. My BMI is 48 so I would have to lose over 50 lbs pre-op before that would be an issue for me.

I think they actually believe that big BMI people will have a better outcome with surgery and fewer complications if they exercise and loose weight prior. Some people are so out of shape they can not walk around the block and are poor surgical risks. Believe me your insurance company does not want any complications!

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