My insurance requires a 6-month physician supervised diet?!? :(

[piemonade 25]

Hello, everyone! I am so very new to all of this. I just found out that I have to do a 6 month physician supervised diet for insurance purposes. I'm so sad! I've already been attempting to diet through Weight Watchers, then a personal trainer at the YMCA, then a weight loss group at the Y... but none of it counts for this requirement.

No one just wakes up one say and notices, "Hey, I'm fat! I think I'll try surgery first." Lol. So frustrating.

Did you have to do this? How did it work for you?

Thank you!

[Miss Mac 6,261]

Almost all of us had to endure a three month or six month pre-op diet. The time will pass quickly enough and you will learn many valuable eating habits that will change the way you interact with groceries.

Plus you will likely get a head start on your weight loss. I lost 22 pounds on a three month pre-op regimine.

If you want the time to go fast, I suggest you schedule a root canal or colonoscopy for six months out. Time will fly by!

[muzical1 85]

I did a 3 month program as well. Even though the total time was 4 months it flew by so fast. During the time you'll be so busy learning how to live your new life.

Edited December 31, 2015 by muzical1

[DaisyAmy 561]

My insurance has the same requirement - and then I had to put off WLS to deal with a little cancer issue, so I ended up on the 11 month plan. But, in the end, I feel like I learned a lot, dropped about 60 pounds pre op and was really prepared for this lifestyle change. The time will fly by, and you'll be better for it!

[animallover1247 249]

The six months really does fly by. I used the time to discuss issues with my therapist and did TONS of research. I prepared a pretty lengthy list of questions for my surgeon as well.

I've read one reason the insurance requires a 6 month waiting period is because they believe many (or at least some) will drop out due to all the requirements.

I would suggest you read some books,in addition to doing the research online, there are some good books on WLS.

[swimbikerun 1,039]

Mine was one year of a supervised diet and I had to pay for it by month. Could be worse ... they do that to basically discourage people because all the items I've seen are 6 months.

[NTL44 43]

I had 9 months! It will go buy before you know it and actually help you a lot.

[atontor 1,068]

Hello, everyone! I am so very new to all of this. I just found out that I have to do a 6 month physician supervised diet for insurance purposes. I'm so sad! I've already been attempting to diet through Weight Watchers, then a personal trainer at the YMCA, then a weight loss group at the Y... but none of it counts for this requirement.

No one just wakes up one say and notices, "Hey, I'm fat! I think I'll try surgery first." Lol. So frustrating.

Did you have to do this? How did it work for you?

Thank you!

I had to do the process for 4 months but it gave me time to think about my changes and I enjoyed the best foods I loved knowing things would change. My SW 320 CW 200. I was sleeved on May 2015

[CzechPleez 6]

I guess I'm fortunate in that my insurance requires no mandatory pre-op controlled diet. (BCBS-Illinois, BTW.) That said, I tired to get the sleeve op approved by insurance 18 mos ago (same ins) and was denied because my "official" weigh-in put me at a BMI = 39. I needed a BMI => 40. With no qualifying co-morbidities I was denied. I decided to wait a year and try again. When I went in for official weigh-in I made sure to have a big lunch and held my bathroom break until AFTER that meeting. My BMI was over 40 and I was approved first try, no supervised diet.

Many insurance carriers who mandate pre-op diets do so in order to ultimately disqualify many candidates because the patient winds up losing just enough to be under the BMI guidelines, or drop just enough BP to drop meds. Most everyone on the forum knows all too well about struggling with weight our whole life. Dropping 20 lbs on a restricted *diet* doesn't help us in the yo-yo long run. But it's enough to save the ins companies some $. I won't encourage anyone to cheat or scam insurance, or be dishonest. Just make sure you know what the qualifiers are for your ins to approve the surgery and proceed with restricted diets "carefully."

Good luck everyone.

[LadyK44 263]

I did a 6 months pre-op diet with my primary care physician. The surgeon told me that only 40% of the people who he works with actually get the surgery. Had a psychological evaluation and appointment with the nutritionist. It went by fast but it was frustrating.

[MikeyS 455 12]

My ins required a 6 m0

[piemonade 25]

Thank you all so much for sharing your experiences. I'm scheduled for an Optum Health nurse call on January 11, and will find out more. (I have UHC Choice.)

I had my initial appointment with the surgeon on December 18th. I'm hoping that I can continue seeing him to meet my requirement for the diet, so I can expect to be approved for surgery in May/June.

Thanks again!

[The Candidate 3,215]

It is very common. I had to complete six months of classes, with weekly weigh ins and food journals. There were also several seminars I had to attend, and labs, not to mention having to lose 10% of my weight. The list goes on. It took me a year to satisfy my requirements.

I know exactly how you feel right now with the waiting, as it was very hard. But now that I'm five months out I can tell you that it was definitely worth it. And once it's over all that waiting will feel like nothing. I'd do it all over again in a second.

Good luck!

[Romo4miles 2]

They told my wife we had united health Care so we had to do the 6 month diet we called our insurance and they said we didn't have to so after a couple back a forth calls between insurance and the baratic doctor we didn't have to do it

[piemonade 25]

Thank you all for sharing your experiences and encouragement!

I finally had my OptumHealth nurse phone call today. It was just under 30 minutes. It was mostly just rehashing everything I already knew.

But two very good bits of information... my surgeon can and is willing to be my 6 month diet physician. So now, I'm closer to 5 months out instead of 6, as my first appointment was 12/18.

Secondly, I asked the nurse a very important question nagging at me... I've been losing and gaining the same 20 lbs for at least 5 years. I clarified that losing weight on the 6 month plan won't disqualify me from surgery. They approved me based on my first weigh in, so I feel better now. I can't lose enough on my own to get under the 35 BMI mark anyway!