Hi there! Not sure if this is the right place to introduce myself but here I am.

I have made an appointment with my doctor to talk about WLS. I have my doubts that he will refer me though because we have never talked about my weight before. With that said, I have struggled with weight for over 15 years.

With some recent health issues, I have realized I need to do something because my current course of action is not working.

I'm in Ontario Canada. 33 years old. BMI over 40.

So, there it is.

Not 100% sure how things work with the National Health Care system, but I'm pretty sure it starts with your doctor. Just be prepared to have to try a few things in order to have it documented by your physician.

In the United States a lot of people see the surgeon at the bariatric program first, then begin progressing through the motions of pre-op, and somewhere in that whole circus go to their primary care doctors and get the required referral. Insurance requires the PCP letter (not an issue in Canada obviously) and the surgeon also generally requires it for his own purpose. I highly doubt your PCP will refuse to issue a letter of referral once you are any more than knee deep with the bariatric program. I attended a weight loss information session and within two weeks of that I was able to see a surgeon in the same hospital as the one that gave the session. That is another way in.

It may not happen very often but I have read others on this site had the same problem as me...that is my PCP refusing supervise me before and after surgery. He had not ever supervised any bariatric patients (which is funny because we are the fattest state in the entire nation) and honestly did not know what the he was doing. So I found another PCP to supervise me and she did not give me any problems. There are many PCP's who do not understand WLS or they don't agree with it. I hope yours will be supportive!

Not 100% sure how things work with the National Health Care system, but I'm pretty sure it starts with your doctor. Just be prepare to have to try a few things in order to have it documented by your physician.

I am thinking they will ask me to try a few things. None of my past weight loss efforts were ever documented as I didn't have a PCP between my pediatrician until this one a few years ago. And with that said, I've never actually met the physician since I've mainly been seen by the nurse practioner and the mental health nurse.

It may not happen very often but I have read others on this site had the same problem as me...that is my PCP refusing supervise me before and after surgery. He had not ever supervised any bariatric patients (which is funny because we are the fattest state in the entire nation) and honestly did not know what the he was doing. So I found another PCP to supervise me and she did not give me any problems. There are many PCP's who do not understand WLS or they don't agree with it. I hope yours will be supportive!

This may happen. I live in a rural area and there are two physicians at the practice, both part time. There are nurse practitioner's as well but ultimately I have no idea at this point what any of their thoughts are.

I have my appointment next week.

Not 100% sure how things work with the National Health Care system, but I'm pretty sure it starts with your doctor. Just be prepare to have to try a few things in order to have it documented by your physician.

I am thinking they will ask me to try a few things. None of my past weight loss efforts were ever documented as I didn't have a PCP between my pediatrician until this one a few years ago. And with that said, I've never actually met the physician since I've mainly been seen by the nurse practioner and the mental health nurse.

>It may not happen very often but I have read others on this site had the same problem as me...that is my PCP refusing supervise me before and after surgery. He had not ever supervised any bariatric patients (which is funny because we are the fattest state in the entire nation) and honestly did not know what the he was doing. So I found another PCP to supervise me and she did not give me any problems. There are many PCP's who do not understand WLS or they don't agree with it. I hope yours will be supportive!

This may happen. I live in a rural area and there are two physicians at the practice, both part time. There are nurse practitioner's as well but ultimately I have no idea at this point what any of their thoughts are.

I have my appointment next week.

Keep us updated on your appointment goes! I actually see a NP. She does the visits and has the physician in the practice to sign off on all the documentation. The physician has actually had WLS himself.

@@Anilyn -- I can speak only as a wannabe Canadian, but it may be that the criteria for surgery there are the same or similar enough to those in the U.S. You've looked over the list of 'co-morbidities,' yes?

If, like many U.S. medical plans, National Health requires a three- or six-month, supervised diet as a requirement for approval, it may stand in for a documented history of weight-loss efforts. If you've ever done Weight Watchers or similar and happen to have weight progress charts or even receipts for payments, the surgery practice should know if they're useful.

Be sure to mention the recent health issues to the primary, as one or another may go undetected if not part and parcel of the routine exams.

@@Anilyn -- I can speak only as a wannabe Canadian, but it may be that the criteria for surgery there are the same or similar enough to those in the U.S. You've looked over the list of 'co-morbidities,' yes?

If, like many U.S. medical plans, National Health requires a three- or six-month, supervised diet as a requirement for approval, it may stand in for a documented history of weight-loss efforts. If you've ever done Weight Watchers or similar and happen to have weight progress charts or even receipts for payments, the surgery practice should know if they're useful.

Be sure to mention the recent health issues to the primary, as one or another may go undetected if not part and parcel of the routine exams.

Here anyway, you need to have a BMI over 40 with no co-morbidities, or 35 with. I don't know that I have comorbidities. There is heart disease and diabetes in the family. I've never been tested for diabetes and it's long over due. My BMI is around 43.

Good idea about the progress charts. I have tried WW and myfitnesspal. (and others but nothing with documentation)

My process was to consult with the surgeon, do a psych evaluation to rule out eating disorders, then had a sleep study because that would have to be addressed before doing surgery ( I didn't have one). I had to meet with a nutritionist 4 times to satisfy the insurance requirements.

My insurance denied me in December 2014 ( I was already scheduled for VSG and they canceled). My surgeon went to bat for me based on my uncontrolled high blood pressure, and she was successful at getting approved! Finally had VSG in May of 2015. Hope your approval happens faster than mine, but it's worth the wait????

Thanks.

Welcome and best of luck with your journey. I can't share any insight into the Canadian process other than there are many Canadians on this site who may be able to provide more insight.i just recommend you learn as much as you can and be prepared to be patient, proactive, and persistent.

Best of luck and keep us posted on how you are doing.

.I'm sitting in the Drs office now. The staff here have been great. Waiting on the Dr. Got my flu shot since I'm waiting anyway.