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I am currently in the 6 month process of physician led weight loss program, when I went to my weight loss seminar I was told by my doctor that if I lost more than 30 pounds that I could possibly be denied by my insurance. My ob/gyn is doing my weight loss management and she prescribed me phentermine and Glucophage. I know that I can lose weight taking these medications I have in the past but as always I pack the pounds back on and then some. I am scared that if I lose more than 30 pounds that insurance will deny me and I will be back at square one. I was wondering if anyone else with BCBS AL has had this issue and could share your own experience with this. I have PCOS so I am insulin resistant and I also have my medical record proving that I have struggled with my weight for the past five years.

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Hey..

I have BCBS of al and Im currently in my 6 month doctor supervised weight loss program. I'm fixing to start month 5 out of 6 in two days so I'm nearing the end! I'm not sure what your bmi is, but you have to be above a 40 with no co morbidity's and 35-39 with co morbidity's.. If you dip below the 40 and don't have a co morbidity then they will not approve you. Also, I have PCOS as well and my particular bcbs of al does NOT count that as a co morbidity. If you have any questions or need to talk feel free to message me or email me anytime. :)

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I'm so happy to see this post, I just posted something similar because my primary said to be careful not to actually lose weight when he started me on my plan. I have BCBS of al too and have called my surgeons office but haven't heard back. Now I'm scared to even lose a pound but what if they need to see weight loss! This is all so insane to me, where did you get the 30lbs. rule? From your doctor or BCBS? I'm just about at a 43 BMI.

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I'm so happy to see this post, I just posted something similar because my primary said to be careful not to actually lose weight when he started me on my plan. I have BCBS of al too and have called my surgeons office but haven't heard back. Now I'm scared to even lose a pound but what if they need to see weight loss! This is all so insane to me, where did you get the 30lbs. rule? From your doctor or BCBS? I'm just about at a 43 BMI.

My surgeon is the one who told me that if I lost 30 pounds in the pre op diet that I wouldn't qualify for the surgery more than likely. If I do I will be below 40 BMI, so my plan is to continue on with the weight program and try to only lose 20-25 pounds during the program. I feel as though surgery is my last option to finally lose the excess weight, I know it is not going to be effective unless I am fully committed to this new lifestyle.

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    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
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    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
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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.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • 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
      1. This update has no replies.
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