Last week I had completed my pre surgery requirements for my insurance company and was told by my surgeon's office that they would be submitting for approval. However this morning I received a call from them that they have decided not to submit and will not until end of November. My surgeon feels that I have not lost enough weight and wants me to attend another NUT group appointment and lose 8 pounds.

I had been working out 5-6 times a week and eating 1200-1400 calories and losing weight fast however 2 weeks ago by foot starting hurting horribly so I went to the doctor and found out that I have a stress fracture and will be in boot for 4-5 weeks. Since then I have been doing upper body weights but I am not losing any weight. My surgeon said that I need to lose 8 pounds by November 13th so that we can get everything set up for beginning of December but if not it will be pushed out until January because he takes the last 2 weeks of December off. I am an commercial insurance agent and can not afford to take time off in January.

I am not giving up but just feeling a little defeated today. Any suggestions on what exercises I can do to help? Do I need to change my calories?

Thanks for listening!

You could try the pre-op liquid diet; I wound up losing 9 pounds with that and moderate cardio.

Agree with built2livenotexist, I would start your pre op diet. I did several practice runs before surgery. See if you can get your surgeon to agree that if you lose the 8lbs by say Mid November that they'll submit you before the end of November. If you have access to a pool you could swim. Maybe Pilates moves that dont involve standing?

Since you can't exercise strenuously, you'll have to severely modify your diet to create a deficit between what you eat and what you burn. Maybe do shakes during the day and something good and healthy for dinner. I actually like to keep dinner fairly light so I ate during the day and had a shake for dinner. You can pump the shakes up with fruit and veggies and a good Protein powder and maybe something filling like flax.

Also make sure you get in lots of Fiber so that you errrm evacuate on a regular schedule! Good luck to you! I really hate the dangling of the carrot that your doc is doing. Reasons why I self paid and went to Mexico.

Edited October 23, 201411 yr by TheCurvyJones

Last week I had completed my pre surgery requirements for my insurance company and was told by my surgeon's office that they would be submitting for approval. However this morning I received a call from them that they have decided not to submit and will not until end of November. My surgeon feels that I have not lost enough weight and wants me to attend another NUT group appointment and lose 8 pounds.

I had been working out 5-6 times a week and eating 1200-1400 calories and losing weight fast however 2 weeks ago by foot starting hurting horribly so I went to the doctor and found out that I have a stress fracture and will be in boot for 4-5 weeks. Since then I have been doing upper body weights but I am not losing any weight. My surgeon said that I need to lose 8 pounds by November 13th so that we can get everything set up for beginning of December but if not it will be pushed out until January because he takes the last 2 weeks of December off. I am an commercial insurance agent and can not afford to take time off in January.

I am not giving up but just feeling a little defeated today. Any suggestions on what exercises I can do to help? Do I need to change my calories?

Thanks for listening!

I agree with @@built2livenotexist on doing the pre-op diet with moderate exercise, like swimming. For my pre-op, I was allowed 1/2c. oatmeal in the morning. The rest was Protein shakes (to = 60 grams) and up to 1100 calories per day. I found them so satisfying, I actually had 615 - 750 calories per day instead. I had to do the pre-op diet for 9 days. I lost 4lbs.

Having said that, I also agree with @@TheCurvyJones to get agreement from your doctor ahead of time to put your paperwork in. I also don't like what your doctor is doing. I would like to see you put your foot down, that you are NOT waiting until January.

Use a stationary bike or if you have a gym you go to - a Nustep if they have one.

My pre op diet consist of 2 shakes and a protein and non starchy vegetable.

It's worked for me, surgery is Monday.

I'm so sorry to hear this. Why are people required to lose weight before surgery? Isn't the point of surgery to assist those of us having problems losing weight?

i am sorry you are going through this. Did your surgeon explain the logic or medical necessity behind his weight loss requirement? Perhaps he feels surgery would not be advisable at your current weight? If that is not the case, then I would ask him to reconsider his decision. Unless you are especially at risk, it doesn't make any sense!

Before my surgery (actually before I even decided to have surgery), I dieted by having two Protein shakes in place of two meals and a third meal that was low carb, high protein and moderate in calories. I did this for 5 months and lost over 40 lbs. Perhaps a plan like that would work for you.

How crazy-making is that? Can you get your doc to prescribe an appetite suppressant?

I have been eating 1200 calories a day with the help of phentermine, prescribed by the surgeon who is going to do my sleeve. I am still waiting for insurance approval, and was cautioned by my doctor that if I lose too much, I risk dropping below the threshold (40 BMI unless comorbitidy, then 35 BMI).

Damned if you do, damned if you don't! I am tempted to show up at my next appointment with rocks in my pockets.

My surgeon requires each patient to lose 10% of their weight prior to surgery. In fact, if someone shows up for surgery and hasn't done so, he has been known to send them home.

In most cases (depending on your insurance) this pre-op weight loss will not keep you from getting approved - in fact, it shows them than you can stick with a weight loss plan.

Weight loss before surgery is very important, primarily to shrink your liver. This makes the surgery quicker and less risky.

Exercise isn't an efficient way to lose weight. Decreasing calories is the only way to lose weight quickly. I think a trial of the pre-op diet is a great idea. I still have about 10 pounds to lose before my surgery - and I'm completely stuck. I'm going to try the pre-op diet for a week or so myself.

Good luck!

Edited October 24, 201411 yr by docbree

My pre op diet consist of 2 shakes and a protein and non starchy vegetable.

It's worked for me, surgery is Monday.

Congratulations - and good luck Monday!

Thanks everyone for your advice. I have been doing 2 premier protein shakes a day and one low carb high protein meal since Thursday and I weighed myself this morning and I was up 3 pounds. Who knows what my body is doing.

Hi, @LisaLou30. I know you can do this! Sometimes it can be discouraging when unexpected circumstances seem to put off or threaten to put off your surgery along your journey. If your physical activity has decreased because of your injury, you should definitely consider decreasing caloric intake. I used the premier shakes for my preop diet, one for breakfast and lunch and a normal meal for dinner. The meal consisted of 3oz of lean protein and 3 oz of non starchy veggies. It worked for me and provided results. How is your fluid intake? For me, my body seemed to like water more that any other zero calorie liquid.

Thanks everyone for your advice. I have been doing 2 premier Protein shakes a day and one low carb high protein meal since Thursday and I weighed myself this morning and I was up 3 pounds. Who knows what my body is doing.

Push thru. You know it's not fat, you haven't eaten 3lbs of calories worth. Suck down some Water and push thru!

I am sorry for the difficulties you have had. Your story is raising some red flags for me and a lot of questions. 1) Were the expectations laid out in advance? 2) What made the doctor choose 8 lbs? Frankly that seems almost bizarre to demand someone with limited mobility lose 8 lbs in less than 3 weeks.

Suggestions: While I have no clear answer maybe some of the following will help;

1) As someone else suggested, talk to your surgeon right away to find out his rationale.

2) Ask your surgeon to submit for insurance approval anyway and give him your reason

3) Keep a diary of all your weight loss efforts and bring to him.

4) If there is a partner in the practice maybe ask to consult with him-- (this would obviously have to be very diplomatic)

5) Drink a ton of Water and drink Protein as has been suggested-- don't be discouraged at first sometimes it takes a few days for the body to catch up. if you have Fluid retention, kidney problems, or other health issues make sure you find out if this is safe for you to do.

Good Luck. I hope it all works out.

Linda

You can still walk with that boot on your foot........not on a treadmill mind you but at the track or on the sidewalk. I broke my foot 3 yrs while doing cardiac rehab and my trainer/physical therapist took me off the treadmill and put me on the indoor walking track at the facility. Just remember any exercise is better than NO exercise. Be strong and don't get discouraged!!! I know that you can do this!!!! GOOD LUCK!!!!!