Hi,

So I finished my 3 month pre op. The dr office called me today and said that most likely my insurance will not cover the surgery since I had gained 17pds.. I am devastated!! I explained to them that I had been taking Phentermine for over 3 years and as soon as I stopped taking it I have gained like crazy!!! I feel like I have changed my eating habits.. At times I feel like I was starving yet I still gained??? I am frustrated at this point. I was suppose to have surgery next Friday September 26. But the lady at the doctors office said she is most positive that my insurance will deny it. Has anyone had this problem where they gained weight while at pre-op and what did your insurance say?

Unfortunately my insurance company would do the same thing. The nutritionist told me at the first meeting, don't care how much you lose, just don't gain. Maybe this is only a bump in the road and things can be fixed in the next few months. I can't imagine how frustrated you are at this point...hang in there and don't give up the fight!

Not only can the insurance company say no, but so can your surgeon. I was self pay in Mexico and my surgeon will send you packing if you don't lose the preop weight you were supposed to. Makes surgery too risky.

I wish your doctor's office would have told you this from the start. My nutritionist told me at our first appointment that Aetna would not approve it if I gained one pound during the six months.

Insurances put a lot of requirements on weight loss surgery because it is a lot of money to dish out to cover it. So gaining will reflect negatively for the insurance company because your asking basically for them to cover a weight loss surgery, and gaining is telling them in their own opinion that you are not ready. Your surgeon will possibly deny you because gaining makes the surgery way risky because of your liver. Your liver must shrink to make sure that when they move it, it will not bleed. If it bleeds it complicates the surgery by a ton. They would have to actually open you up to do the surgery. I would write a letter or get in touch with your insurance agency and tell they your predicament you are in with being off such medicine and talk with your primary care physician about a most effective way to loose weight and being off the med you were on. Hopefully you can get this all fixed up so you can get the surgery. Insurances are a real pain sometimes. Best of luck! I am cheering you on, you can do this!

I gained weight during my Dr assisted diet, (if I'd lost I'd have been just under the BMI to qualify still with 100 pounds to lose!) but had not been submitted to insurance yet. My surgeon requires ALL the pre-requisites be met before meeting for the first consultation after which they submit to insurance. For my insurance, they required the 6 months of documentation, but the results didn't matter.

My insurance company BCBS said absolutely no net weight gain during the pre op supervised visits with my PCP.

I have 6 months pre-op, my dietician said...I don't care if you loose..but please don't gain. She never said the insurance company wouldn't approve otherwise though. I think I gained 1 or 2 lbs at the beginning..I was still learning and will continue to learn how to eat right...but the last 2 months I have lost a 1/2 lb. each month...although I am curious to know next week what it will be..I have tried..but I also quit smoking which is another pre-requisite to the surgery. I don't think I have gained..and pray that I haven't ...but in all honesty..I have been eating good.

my insurance company says no gain, but doesn't care how much i lose.

My insurance requires me to not gain anything not even a pound are they will deny but I can lose all I want...there real strict when it comes to that.