Fear of weight loss making me ineligible for surgery

[pindoctor 49]

I am new to this group and I have been considering sleeve surgery for some time. My problem is that I am very close to the cutoff where I am no longer eligible for surgery (BMI <40 ineligible) my current BMI 41.8. I have visited with the surgeon, nutritionist, the exercise physiologist, the wellness coach and have completed much of the workup (today had EGD). I have 2 months left in 3 month mandatory supervised diet and have maintained (not gained). My insurance does not require any preop weight loss. I am very familiar with losing weight but have cycled between BMI 35-42 in the past 2 years. I want to launch myself into this 100% but I'm terrified that I will drop below the BMI that makes me eligible for surgery. HELP!! Any suggestions for how I should proceed during the next 2 months?

[BLERDgirl 6,417]

Maybe you could speak with the nutritionist about putting you on a maintenance diet.

[Pac-woman 325]

I remember my first two visits to the nutritionist, and I was doing good, I lost 7 lbs. And when I told her on the third visit, she kind of mentioned " oh that is great news, but you don't want to loose too much right now" and she changed the subject. I took that as a massive hint. So I pretty much maintained my weight the same (not hard for me to do cause I retain a lot of water). I was careful with what I was eating but not in a "diet sense". I was learning and applying it daily, but I was eating my carb in a normal portion.

I maintained the weight.

[Elode 8,093]

@@pindoctor Maintain the 40! That's what I did I was 40.3 at first weigh in and I had to keep it at 40 for the 3 Months. In fact I lost some and had to eat junk to make up for it. That's what I did. Your insurance my be different. I was cautioned not to lose a whole lot.

Edited January 3, 2015 by Elode

[athena3127 199]

Sounds like the same thing my Mom had to do. Maintain and not loose. She lost a bit and her nut advised to to be careful because she could work herself out of the surgery.! so she watched her weight and was careful not to loose .

[Miss Mac 6,261]

My surgeon submitted the weight that I was the day I walked through their door for the first time, even though I had lost 22 pounds during the 3 month pre-op process. My MBI went from 40.1 down to 36.6. I had several co-morbidities which would have still qualified me unless my BMI dropped below 35, but they submitted the original weight anyway.

[pindoctor 49]

Thanks for the suggestions. I am someone who launches myself into things wholeheartedly so maintaining rather than trying to lose is a bit challenging. I did ask someone in the first day of visits about my concern about losing weight and being ineligible. I seen to remember someone "hinting" that perhaps only losing a few pounds would be best.

[greatestnameever 49]

I got screwed by insurance because I lost like 5 pounds when I shouldn't have. It's bonkers, right? You do what you're "supposed" to and you get punished for it and you have to start over. Gotta maintain that 40 or else. :-/

[Elode 8,093]

@@greatestnameever That stinks!

[alwaysvegas 702]

I was worried about the same thing because I was on the weight loss path before surgery. My surgeon's office said that my insurance (Aetna) goes by the weight/BMI that I first took at the surgeon's office. I lost 50 lbs before surgery and that was fully supported by my surgeon and nutritionist. No problems with my insurance. My insurance also required two years of weight history also, so that factors into the insurance approval, in addition to the co-morbidities.

It's actually worse if you gain any weight before surgery as some insurance companies will deny you (even a 1lb gain), so trying to 'maintain' may or may not work. If in doubt, call your insurance.

Best of luck to you!