Hi everyone!

I am approaching my PCP tomorrow about getting a referral to a bariatric surgeon. I have spoken with my insurance provider and have confirmed they will pay as long as my BMI is over a certain amount (mine is 56.5) and they said my particular insurance program doesn't require the proof of a medically supervised nutrition program, or the other hoops some insurance companies require you to jump through first. When I go to my consultation with the surgeon, can I specifically request the gastric sleeve? Based on research I have done over the past months, it seems to be the best option since I have Inflammatory Bowel Disease.

I have been preparing myself mentally for the last year, and building the courage to ask for more help. Over the last 9 years, I have tried Weight Watchers, L.A. Weight Loss, counted calories, taken Phetermine, Belviq and Contrave. I lost anywhere from 30-50 lbs with each program/medication only to gain it back. I have spoken with my supervisor at work and she is behind me 100% and has already approved any time off I need. I am hoping to go through with the surgery before July since I have already met my deductible and out of pocket for this year (my insurance runs July 1 - June 30).

Thanks in advance for any information you can give me!

I guess it depends on the surgeon, but yes you can. I went in asking for the sleeve and he said that it was what he would have chosen for me anyway. He was pleased that I had already done my research and didn't have much explaining to do.

Hi ShrinkingKimber,

I requested Gastric Sleeve and had no issue with my surgeon. I have a high BMI and for me I also believed this was my best option.

Best of luck on your journey!

OnTurf

Edited January 11, 201610 yr by onturf

Yes, you can ask for a specific procedure. If your surgeon recommends a different procedure for you it wouldn't hurt to find out why he or she recommends it, though.

As far as I am concerned, the sleeve was right for me and my surgeon agreed.

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

I would definitely hear your surgeon out about all of your options, but it will ultimately be your choice.

You should be able to! My surgeon asked me on my first visit which procedure I was wanting and I said sleeve and that's what I got.

@shrinkingkimber of course you can! It's your body, your decision, your surgery ...

I chose sleeve because I knew that lapband wasn't something that I was even interested in ... and bypass just looked too invasive for me ... just unnatural ...

I love my sleeve and I wouldn't have done a single thing different ...

Best of Luck !!

I went in thinking that I wanted the lapband. But the surgeon explained each of the procedures and why he thought I should go with the sleeve. I'm so glad that he did. I didn't know much about the lapband then. I definitely would have regretted it.

Of course you can! BUT... If the surgeon has a strong recommendation for a different WLS option based on your medical condition, be open to what they have to say. Get another opinion if you like, but don't let your online research and\or friends experiences with sleeve vs bypass outweigh the expert's opinions on which procedure is safest for you. Best of luck!

You can do whichever procedure you think would be best for you. However, I went in thinking that the lap band was what I wanted and was set on it. After talking to the surgeon, he said that he really doesn't do the band anymore and recommended the sleeve. After him explaining that a lot of lap bands end up having a revision, I ended up going with the sleeve and Im glad I did. So basically really take what your surgeon says into consideration, but ultimately its up to you.

I originally went in asking for the LapBand and my doctor said he didn't recommend it and gave me a ton of reasons why. I left there in tears cause for me, it was the only option I was considering. After having time to process what he said, doing research, reading posts on here, I am so glad he suggested the sleeve cause now I wouldn't even consider LapBand. I'm still in my 6 month waiting period so haven't had it done but thought I would share cause as others said, you can do whatever you want but I would definitely listen to your surgeons suggestions.

In my program the medical team will assess you with a million tests and then determine which procedures you're a candidate for. They're not going to do a procedure on someone that has a medical condition that precludes them from that procedure. When that's done, a person may be a candidate for all of the procedures (choice is yours) or only a candidate for one (you have bad GERD therefore gastric sleeve and lap band are not an option).

So, for me and those in my program, the choice is ours assuming we are healthy enough for any of them.

Honestly it comes down to what your surgeon thinks is best for you if your bmi is over 50 and you have gerd go with bypass because it can get way worse with sleeve

You can certainly request the sleeve. But I concur with the others that say be open to listening to your surgeon if he recommends a DS or bypass. Make sure he provides sound medical reasons for that recommendation and if you still aren't comfortable get a second opinion.

I think everyone should have evaluations by multiple programs if they have a few good programs that are a reasonable distance. I went to one just over an hour away since I was more comfortable with that surgeon and practice. You need to find the program that will best support you in the way that you need to be supported not the way I need to be supported.

Even if you insurance does not require a pre-approval diet or a psych visit I recommend that you have the psych visit. I also recommend going to a nutritionist that you can build a relationship with that can prepare you for the eating changes specific for a bariatric patient. That NUT may be part of the bariatric practice or it may be a different individual.

I think that starting to make the changes in eating prior to the actual surgery makes having the surgery and resulting changes less of a shock and less traumatic.

I weaned off of caffeine and soda 1 month before my surgery. This way I wasn't going through caffeine withdrawal during my 10 day pre-surgery liquid diet phase. I even started easing into that diet about a week early and going replaced a few of my meals with the Protein shake. This way when I did go to the all liquid diet for the 10 days it wasn't as hard.

I personally feel there is a correlation on this board between the people that don't know what to eat after surgery, are surprised about the 3 week stall, are surprised about what to expect after surgery for their restrictions for the rest of their lives are those that went to the evaluation and suddenly 1 month later have surgery.

I think that when you get the approval so quickly you don't have time to go to pre-op support groups, you don't have time to research realistic real-life expectations post op.

My insurance made me do the 6 month medically supervised diet. It was not the worst thing. It gave me time to really do my research. It gave me time to internalize the life-long changes I need to make to my diet and exercise to succeed.

You can certainly request the sleeve. But I concur with the others that say be open to listening to your surgeon if he recommends a DS or bypass. Make sure he provides sound medical reasons for that recommendation and if you still aren't comfortable get a second opinion.

I think everyone should have evaluations by multiple programs if they have a few good programs that are a reasonable distance. I went to one just over an hour away since I was more comfortable with that surgeon and practice. You need to find the program that will best support you in the way that you need to be supported not the way I need to be supported.

Even if you insurance does not require a pre-approval diet or a psych visit I recommend that you have the psych visit. I also recommend going to a nutritionist that you can build a relationship with that can prepare you for the eating changes specific for a bariatric patient. That NUT may be part of the bariatric practice or it may be a different individual.

I think that starting to make the changes in eating prior to the actual surgery makes having the surgery and resulting changes less of a shock and less traumatic.

I weaned off of caffeine and soda 1 month before my surgery. This way I wasn't going through caffeine withdrawal during my 10 day pre-surgery liquid diet phase. I even started easing into that diet about a week early and going replaced a few of my meals with the Protein shake. This way when I did go to the all liquid diet for the 10 days it wasn't as hard.

I personally feel there is a correlation on this board between the people that don't know what to eat after surgery, are surprised about the 3 week stall, are surprised about what to expect after surgery for their restrictions for the rest of their lives are those that went to the evaluation and suddenly 1 month later have surgery.

I think that when you get the approval so quickly you don't have time to go to pre-op support groups, you don't have time to research realistic real-life expectations post op.

My insurance made me do the 6 month medically supervised diet. It was not the worst thing. It gave me time to really do my research. It gave me time to internalize the life-long changes I need to make to my diet and exercise to succeed.

Thank you so much for all the information. The surgeon that I am seeing requires a psych consult and visit with the in-office NUT before surgery. He also requires attendance to a support group, then a class that goes over everything from pre-op diet, the actual procedure, to post-op diet. I have lurked here for months before actually signing up to ask questions. I have been researching WLS since Dec 2014 when I was saving money and planning to be a self pay patient, then I happened to get promoted in July of 2015 to full time (which includes awesome benefits), so the fact that I have insurance now that will cover and everything else in life just seems to be right, that is why I have chosen to move forward now.

Thanks again for the insight from everyone, I will keep an open mind and make sure to consider everything my surgeon suggests, but I will let him know that I am most interested in the VSG.