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Hello. My first doctor visit and education class is next week. I expect my gastric bypass surgery to be six months from now. I did a good amount of research before making my decision, and I am eager to start my journey. I know I will have questions answered next week, but am eager for answers now. My biggest fear is my BMI is close to being too low, however, I have many weight related health issue (D2, HBP, and High cholesterol). I am hoping to be able to diet a bit before surgery. Anyone in a similar situation?

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Many insurance plans are similar. This is the language in my plan.

•Surgical treatment of obesity (bariatric surgery) is covered only if:

- eligible enrollee is 18 of age or over

- clinical records support a body mass index of 40 or greater (or 35-40 when there is at least one co-morbidity related to obesity). Applicable co-morbid conditions include the following:

•Type II diabetes mellitus (by American Diabetes Association diagnostic criteria).

•Refractory hypertension (defined as blood pressure of 140 mmHg systolic and or 90 mmHg diastolic) despite medical treatment with maximal dose of three antihypertensive medications.

•Refractory hyperlipidemia (acceptable levels of lipids unachievable with diet and maximum doses of lipid lowering medications).

•Obesity–induced cardiomyopathy.

•Clinically significant obstructive sleep apnea.

•Severe arthopathy of the spine and or weight bearing joints (when obesity prohibits appropriate surgical management of joint dysfunction treatable but for obesity.

- Documentation of failure to lower the body mass index within the last 12 months through a medically supervised program of diet and exercise of at least 6 months duration.

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That looks very much like what mine says, thank you. I will, of course, discuss with my Dr. next week. I would love to shed a few pounds because I am so uncomfortable.

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Hi KCB

I have very similar requirements from my insurance; I do have to go through the medically supervised weight-loss as well. I heard that you will do better with the surgery if you lose a good amount of weight prior to the surgery. I actually looked up to see what my weight would be for the BMI to be acceptable for surgery. I could lose like 40 more pounds before I get to the BMI that would require co-morbidities. I do have some comorbidities so I don't think I will have an issue. The way I look at it is I am going to have the mindset to lose as much as I can before the surgery. If I happen to lose more weight than I expect....well I will deal with that when it happens. Good luck....I will keep in touch as I am also just under 6 months out from the DS surgery.

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Great! Looking forward to supporting each other!

Sent from my iPhone using the BariatricPal App

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    • Aunty Mamo

      Iʻm roughly 6 weeks post-op this morning and have begun to feel like a normal human, with a normal human body again. I started introducing solid foods and pill forms of medications/supplements a couple of weeks ago and it's really amazing to eat meals with my family again, despite the fact that my portions are so much smaller than theirs. 
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    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
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      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
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    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
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