I am a newbie to the process. I attended my weight loss seminar August 27th. My program ( Comprehensive Adult Weight Management at Baystate Health Systems in Springfield, Massachusetts) has a minimum 6 month program commitment and I have BMC Health Net for insurance. I have went to my Nurse physical, 1 of my nutritional counseling, blood work, and went to another physician that states their recommendations that I have the sleeve surgery. Today I had a sleep study seminar scheduled because the nurse I saw suspects that I could have sleep apnea as I am always tired. Well I woke up and I was 2lbs OVER the weight I need to stay at. Being as I have no medical issues that have been discovered my weight needs to stay exactly at 240 or my bmi will drop below 40 and I won't qualify for surgery from my insurance. I do have the sleep study and I will have an ultrasound of my liver and gall bladder to see if I have any other medical issues but until it is confirmed or denied I NEED to stay at exactly 240lbs. Waking up to 242lbs this morning meant I had to reschedule my appointment or risk having to weigh in over and having to wait a year to start the program all over again. This is a set back and I feel discouraged that I have to prolong this process even by a month. The next seminar is not until November. It is so hard to stay at the same exact weight. I feel like it's harder than loosing weight! I feel like it's just a matter of time before I either weight over or dip too low. Ugh. I'm so frustrated. And Mexico just isn't an option for me. Any comments appreciated.

Wow that does seem physically impossible to stay the same weight. I understand not being able to go under a certain weight for insurance purposes. I was in the same situation. But if my program wouldn't let me gain 1 single pound or start over, honestly, I would probably be looking for another program.

Uh ... calibration.

You weigh on the same scales at the doc's office every time you go there.

Once you know what the doc's scales weighed you at, you go home and immediately weigh yourself in the same outfit / kit to see what the difference is.

Then the next time you go, you wear the same clothes and adjust the half-pound weights in your pockets (and whatever else you are "packing") to weigh that same "home scale" weight you weighed the first time.

Worked every time.

I didn't have to play the weight game like you did, but I knew that my surgeon's office's scale weighed me four lbs higher than my scale. Always.

Wow that does seem physically impossible to stay the same weight. I understand not being able to go under a certain weight for insurance purposes. I was in the same situation. But if my program wouldn't let me gain 1 single pound or start over, honestly, I would probably be looking for another program.

I have looked into other programs. I chose mine because of the surgeon and the great reputation that they have. There are only 2 other programs in my area and they also have the stable or loss requirement. In any program here if you gain any weight you are disqualified.

My daughter has the same strict weight requirements. She was denied first time by insurance because her BMI was too low. When we submitted to the ins company she was at 40BMI but her past 2 yr history indicated below 40 BMI 2 years ago. Really!???? I hate these games the insurance companies play with you. Why can this not be between the dr and the patient? So now we are waiting on the next round of games. She is required to show weight loss while working with her NUT, yet because she is at 242 pounds she cannot lose weight and stay over 40 BMI. If denied again we are throwing in the towel and heading to Mexico. Dr. A. Ortiz is our surgeon of choice. I have contacted them today to get date scheduled. We have wasted a yr with the crap the ins company has put out there. Time to take control of the situation and go to option 2. I am confident the surgery in Mexico will be as safe as if done here. She desperately wants to have the surgery and I know from my own experience it is a life changer.... All for the better. I want this for her as much as she wants it for herself. So very frustrating!

I am going thru the same thing. I gained 10 lbs to meet the 40 BMI but was denied AGAIN because it wasn't over 40 for the entire 2 yrs. it was 38.86 when I started, & I didn't have one of the 3 major co-morbidities. I'm having Lindstrom work my case. i started in March. this is SSOOO frustrating!

Edited October 6, 201411 yr by peteyrulz

I know what you are going through! Luckily, my insurance only requires a 3 month diet, or I would be a nutcase by now. It has been very difficult to stay at the exact same weight. They told me that even on the day of surgery, if you weigh one pound over original weight or one pound below the 40 BMI that they will cancel the surgery. Talk about stress!!! They use a completely different scale at the hospital and I have no idea how it weighs!

I have my psych eval on the 14th and paperwork gets submitted to insurance the next day. I can't wait until this is behind me and I am on my way to worrying about REAL stuff instead of these ridiculous hoops that we have to jump through!!! If only they had to walk a mile in our shoes. I wish you luck! I truly understand what you are going through! Try to stay sane during this crazy period, sweetie.

Well, I wouldn't wish this stuff on anyone, but once in a while I bring out my National Insitute of Health's co-morbitidies list of conditions that insurance companies consider. Maybe you have some of these other conditions that the insurance company "forgot" to mention may qualify you for weight loss surgery.Obesity Comorbidities

To follow is a list of comorbidities (additional conditions or diseases) related to obesity which may help you in qualifying for weight loss surgery.

• Family history of heart disease
• Family history of stroke
• Family history of diabetes
• Family history of heart attacks
• Hyperinsulinemia
• Diabetes
• High blood pressure
• Coronary-artery disease
• Hypertension
• Migraines or headaches directly related to obesity or cranial hypertension
• Congestive heart failure
• Neoplasia
• Dyslipidemia
• Anemia
• Gallbladder disease
• Osteoarthritis
• Degenerative arthritis
• Degenerative disc
• Degenerative joint disease
• Recommended joint replacement from specialist
• Accelerated degenerative joint disease
• Asthma
• Repeated pneumonia
• Repeated pleurisy
• Repeated bronchitis
• Lung restriction
• Gastroesophageal reflex (GERD)
• Excess facial & body hair (Hirsutism)
• Rashes
• Chronic skin infections
• Excess sweating
• Frequent yeast infections
• Urinary stress incontinence
• Menstrual irregularity
• Hormonal abnormalities
• Polycystic ovaries
• Infertility
• Carcinoma (breast, colon, uterine cancer)
• sleep apnea
• Pseudotumor cerebri
• Depression
• Psychological/sexual dysfunction
• Social discrimination
• Premature death in the immediate family
  

Through Kaiser you cannot gain any weight, not even an oz or lb once you meet your goal/surgery weight or you will not be eligible for surgery. My comfort zone is to keep losing more so that i dont have that fear in me that my time of the month might put me over. And honestly once i did reschedule my appointment because it looked like I was going to be over. My dr counts oz also so i went in one day thought i was at goal weight which was 281 and she called me later and said that by next week i had to be at 281 to get my surgery date. i said im confused because I weighed in this morning at 281 and she said no you were 281.4 which means 4 oz over.(yes Im serious) So next week i was super careful and when i went to weight in i even ran to the bathroom first and took off my bra and undies which gave me another oz to spare.

All the other programs I heard of including mine, you get a starting weight, logged in, then that is what your BMI is based on and is what the surgeon uses to determine how much weight they want you to lose prior to surgery. You are supposed to lose weight and attend classes to gain the knowledge needed for success and most EVERYONE starts out surgery day down at least 2% from the weight they were originally started at.

I would clarify that with your program. Make sure its really that.

If it does really mean you cant gain or LOSE a lb then I would most def lose the weight needed and ad weight on. I know what shoes, pants etc. weight what because i weight in same outfit everyweek. I go to kaiser and weight in the health education dept. then i go get the lady and she records it but i always go weight myself first and i make sure my scale at home matches exactly!

@@VSGAnn2014, you are a riot! i love your 7 lbs of 1/2 pound weights!

i am feeling very fortunate right now, because my primary care doc wrote in his letter that i have had over a 5 year history of obesity. he hasn't even been my doctor for 2 yrs!

good luck in this crazy balancing game!

These things worry me also....Before I met with a surgeon or PCP I called my insurance to see if they covered it. They asked my my weight and BMI...and told me about the 6 month program. Well...I went to the doc 2 days ago and he weighed me in full clothing...the weight was 4 lbs heavier than what I told the insurance I was. As soon as I got home..I re-weighed myself and realized the doc scale was wrong. So now Im worrried that they will deny me cuz of such a small weight difference cuz of scale calibrations. My plan is to join Jenny Craig to show them that I am really trying hard. But like most I only have a 41 BMI and cannot lose much....smh...I hate this game.

Part of me feels like saying F THIS, IM GOING TO MEXICO! But I really prefer to be close to home for my operation in case something goes wrong.