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How much did you lose before surgery was approved through insurance?



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I am just wondering how much weight you lost before your surgery? I have to see a doctor for a year prior to the surgery being approved by insurance. I was told that they want me to lose some weight to "show" I can lose weight. I have gone down ten pounds and then up six and then stayed the same. I don't want to lose too little or too much ya know. Because if I lose too much I won't qualify. I am at 300 and can't lose too much for my BMI to fall below the required BMI. How much did you lose while waiting to get approved by insurance?

Help, Cheri:eek:

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call your insurance comapny and ask them for a copy of the requirements for Adjustable Gastric Banding coverage. Ask them specifically how much weight it is required you lose. My ins co has a complex case management department that I was transferred to and a nice woman worked it out with me on the phone and then snail mailed me a copy so that I have it in hard copy in hand. My insurance requires a 12 month MD supervised diet with MONTHLY visits (and don't miss one, not ONE or that clock starts again) and a 5% loss of excess weight. What they do is take your starting weight (the first month you start seeing the MD) and then look at your ideal body weight according to the MetLife tables. They then take the difference between those and multiply it by .05 to get 5%. Mine was 9 lbs. So I had to lose 9 lbs in a year, not bad, huh? Well I got sick in that year and ended up gaining weight (starting weight was 344, went to 371). Despite having two MD letters explaining that I gained weight from meds, etc. My insurance company said I still had to lose the original 9 lbs and denied me the first time around. I applied at 348 (so I was already losing, but that didn't matter) and I had to be 335. No budging on that.

Hope that helps, please call your ins co ASAP for what they require.

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I am just wondering how much weight you lost before your surgery? I have to see a doctor for a year prior to the surgery being approved by insurance. I was told that they want me to lose some weight to "show" I can lose weight. I have gone down ten pounds and then up six and then stayed the same. I don't want to lose too little or too much ya know. Because if I lose too much I won't qualify. I am at 300 and can't lose too much for my BMI to fall below the required BMI. How much did you lose while waiting to get approved by insurance?

Help, Cheri:eek:

What is your BMI?

http://www.barixclinics.com/surgery/bmi_calculator.jsp

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 0 replies
      1. This update has no replies.
    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
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    • KimBaxleyWilson

      Three months and four days ago... I was in Costa Rica having a life changing surgery! Yesterday we had a followup visit with Dr. Esmeral via video chat and this morning my middle number changed.  I'm down 47lbs and two pants sizes. I can wear a Large tshirt for the first time in like... 14 years! Woot!! Everything is going great. I have zero regrets. I went down to the riverwalk with a friend and walked 2 miles on Monday without even getting fatigued. And no more snoring or chugging pickle juice for crazy leg cramps! I need to go to the gym more... I'm making new shirts next week so that will motivate me. LOL But I'm also just not as TIRED all the time! I have a LONG way to go...but seeing the progress on the scales and in the mirror is a huge motivator!! Thank you all for cheering me on and supporting me!!
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    • bellaamey

      https://alluniqueguide.com/java-burn-coffee-reviews/
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