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Suggestions for staying focused while metting insurance requirements



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Hey everyone :)

I had my first appointment with my surgeon in May. I'm using my insurance so I was given a long list of requirements that I have to complete before I can submit a request for insurance to pay. Things like sleep study, medical records, attend a group session, 7 month weight loss program, etc.

The hard one of the list is the 7 month supervised weight loss program. I am lucky that I have a great doctor that is supervising my program. With me just being at the beginning the time frame of when my surgery will be seems like such a LONG time away. I am having difficulty getting motivated during this process.

Do any of you have any suggestions for surviving the insurance requirement process? I really want this to be a positive time for me and to use it as a time to get healthier before surgery and not just wishing it away.

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One thing I do while I'm on my "good behavior" with dieting is I plan a cheat day of sorts... Usually falls over the weekend, I limit the cheat foods to just one thing... Instead of feeling like I can never have what it is, in my mind I say just wait so many days and than you can have it... You could start with short walks... This is no easy journey, baby steps one at a time are probably best

"We can't solve problems by using the same kind of thinking we used when we created them"

Einstein

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Time really flies by with the supervised diet! I am almost thru month 5 of 6 and i cannot believe how fast it has gone. I will hopefully have surgery late August or early Sept.

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This is what I have been reading through this forum looking for. This is going to be the worst part for me I think… If you lose too much weight they won't even pay for it, right? Your BMI has to be over 40 for my insurance, and mine is 42.

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Do you journal?

Pre-op is a great time to use a journal to process your feelings and emotions, write a bucket list, envision what you want your future to look like, etc.

Also, if you struggle with eating issues, emotional eating, compulsive eating, etc. you may want to find a good therapist and/or attend bariatric support groups or recovery group meetings (like Overeaters Anonymous OA.org).

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Jolly- I was same boat as you. Specifically ask your insurance what happens if you are a bit below the 40 after the 6 months. Mine needed to be 6 months of a failed program so could not lose. Other insurance requires loss so it is very specific. Make sure you know yours. It does go fast, I promise :)

Sent from my iPhone using the BariatricPal App

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This is what I have been reading through this forum looking for. This is going to be the worst part for me I think… If you lose too much weight they won't even pay for it, right? Your BMI has to be over 40 for my insurance, and mine is 42.

Same here...my doctor told it'll be great if I lose a couple of pounds but if I lose more than that, no surgery. If I gain weight, no surgery. My goal is to lose 5 pounds and maintain it!

Sent from my SM-G920V using the BariatricPal App

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Hang in there, it may seem like a long time but it will go by quickly. My process from beginning to end probably took about 6-9 months...9 months would be when I initially told my Primary care phys that I wanted to look into wls. 6 months is when I attended the bariatric surgery seminar.

Once you finish that last Nut visit you will be SO proud of yourself and you will only want to keep going.

And if you look at it this way, from this point you should have your surgery by Christmas! you will step into the new year 2017, starting a new journey to a happier, healthier you!

Edited by reachbree

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Do you journal?

Pre-op is a great time to use a journal to process your feelings and emotions, write a bucket list, envision what you want your future to look like, etc.

Also, if you struggle with eating issues, emotional eating, compulsive eating, etc. you may want to find a good therapist and/or attend bariatric support groups or recovery group meetings (like Overeaters Anonymous OA.org).

I recently created myself a binder "journal" and printed off calendars of the months until my hopeful surgery month. I'm tracking appointments and weight loss goals. It seems to be helping me focus on the present and not just wishing away the next 7 months. I like the idea of going a little deeper with it and journaling my thoughts through the process.

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Hang in there, it may seem like a long time but it will go by quickly. My process from beginning to end probably took about 6-9 months...9 months would be when I initially told my Primary care phys that I wanted to look into wls. 6 months is when I attended the bariatric surgery seminar.

Once you finish that last Nut visit you will be SO proud of yourself and you will only want to keep going.

And if you look at it this way, from this point you should have your surgery by Christmas! you will step into the new year 2017, starting a new journey to a happier, healthier you!

Thank you!!!! I have to keep reminding myself that I am closer than I was before I took the first step. At least now I do have a timeline. I am hoping for a January surgery.

One of the things I am struggling with is that my patient advocate with my surgeon told me my insurance company doesn't really care if you loose (just not to loose big #'s), don't loose, or even gain. They just want a 7 month program completed. Which I guess is good because it doesn't put any pressure on me, but it also makes the process seem really pointless since there aren't any specific standards. I've set a personal goal of 20-25 lbs and to focus on establishing clean eating habits.

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I was also required a supervised 6 months weight loss program.

My doctor required a 7 month one. All of his patients have to do 7 months of nutrition classes. This helped me stay on track. I knew once a month I had to step on that scale. I learned so much in the process. It was definitely what I needed to keep my butt focused. Plus if we missed a class we had to start over and that meant more out of pocket expense or he would kick us out of the program. Either one of those was not acceptable.

Check with your hospital and your Dr to see if some type of program is available. It really helped me

Sent from my iPhone using the BariatricPal App

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Hang in there, it may seem like a long time but it will go by quickly. My process from beginning to end probably took about 6-9 months...9 months would be when I initially told my Primary care phys that I wanted to look into wls. 6 months is when I attended the bariatric surgery seminar.

Once you finish that last Nut visit you will be SO proud of yourself and you will only want to keep going.

And if you look at it this way, from this point you should have your surgery by Christmas! you will step into the new year 2017, starting a new journey to a happier, healthier you!

Thank you!!!! I have to keep reminding myself that I am closer than I was before I took the first step. At least now I do have a timeline. I am hoping for a January surgery.

One of the things I am struggling with is that my patient advocate with my surgeon told me my insurance company doesn't really care if you loose (just not to loose big #'s), don't loose, or even gain. They just want a 7 month program completed. Which I guess is good because it doesn't put any pressure on me, but it also makes the process seem really pointless since there aren't any specific standards. I've set a personal goal of 20-25 lbs and to focus on establishing clean eating habits.

Nothing you do between now and surgery is pointless even if the reason isn't readily apparent.

I have learned so much about myself, my health, the disease of obesity, nutrition, etc. while going through the WLS process. It isn't very often we really get to do such a comprehensive review of our health.

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I am in the same boat with you, lovestohike. Am feeling a bit lost and overwhelmed with all the time I have before surgery (it looks to be October/November/December, at this point - I can't get in to see the psych until late September, otherwise I'd meet my insurance requirements in August). I tell myself I'm good, that it's not that long a time, etc. I am doing pretty well with eating/measuring/etc. and have replaced 1 meal with a Protein shake already.

But it feels like I am just going through the motions. I don't have a lot of hope at the moment that I will get this weight off for good. I've done this so,so many times - my first structured weight loss attempt was when I was 14 years old. I will be 50 in October. I've more or less been this weight since I had my second child twenty years ago.

I don't really know where I was going with this thought, just that I am feeling bleh and not very hopeful right now.

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I am in the same boat with you, lovestohike. Am feeling a bit lost and overwhelmed with all the time I have before surgery (it looks to be October/November/December, at this point - I can't get in to see the psych until late September, otherwise I'd meet my insurance requirements in August). I tell myself I'm good, that it's not that long a time, etc. I am doing pretty well with eating/measuring/etc. and have replaced 1 meal with a Protein shake already.

But it feels like I am just going through the motions. I don't have a lot of hope at the moment that I will get this weight off for good. I've done this so,so many times - my first structured weight loss attempt was when I was 14 years old. I will be 50 in October. I've more or less been this weight since I had my second child twenty years ago.

I don't really know where I was going with this thought, just that I am feeling bleh and not very hopeful right now.

I can definitely relate to feeling like I am just going through the motions. I had my first months weigh in today. 1 lb down, 6 more months to go to complete my 7 month program. I have my sleep study next month. Then I'll just have to attend 1 support group meeting before the end of my 7 months and my packet will be complete for the insurance company. I am hoping to be ready to submit my packet in December.

I have small children so I don't want to wish the next few months away, but with my current weight and the summer heat I'm finding myself miserable and guilty of wanting time to speed up. I am hoping I will have a better outlook in the fall when I'm further into the process. Currently focusing on the tasks I have on my list are helping somewhat.

Good luck. Hopefully your time will pass quickly.

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