Cousin has Medicaid and was approved immediately

[summerset 5,261]

@@Aggiemae just because you don't wait months to have surgery doesn't mean you aren't prepared.

Agreed. A lots of patients (the majority?) educate themselves about WLS before even making the first contact with a surgeon.

The waiting period for surgery is useless and harmful and it still doesn't stop people from making bad food choices, not understanding math or physics.

I wonder if there is actual evidence (real evidence, not just personal opinion or some kind of gut feeling) that patients who've had waiting periods and pre-op programs and whatnot in general really do better after WLS.

[Aggiemae 739]

@@Aggiemae just because you don't wait months to have surgery doesn't mean you aren't prepared. I went from first visit to surgery in 8 weeks and I am very successful.The waiting period for surgery is useless and harmful and it still doesn't stop people from making bad food choices, not understanding math or physics.

I was put out by having to wait...actually my inability to wait for what I want is one of the biggest reasons I am fat.... The tools and knowledge I gained in the six pre op months where life changing.

I am sure that's true in some cases but based on some of the questions and comments posted on this site (for example: three days post op can I eat sausage?) there are many people who don't give this nearly enough thought before they have major abdominal surgery that will require a life time of commitment.

[Djmohr 6,965]

All I will add is that I totally 100% believe that because I went through the long drawn out process it allowed me to change bad behaviors more slowly. Not everyone leverages that time to do the best they can but I am not certain I would be as successful as I have if it were not for the 9 months I spent with my nut, surgeon and bariatric nurse.

I learned a ton about this disease and how to treat it properly. If i were to have gotten through the process so quickly I am convinced I would not have lost 100% of my excess weight nor would I have kept it off this long.

Just my two cents.....it would be interesting to get a real accounting of success rates with a waiting period vs none. There is a reason why many surgeons and insurance companies require it. I have to believe there is real data somewhere about why.

[OutsideMatchInside 10,166]

@@Aggiemae just because you don't wait months to have surgery doesn't mean you aren't prepared. I went from first visit to surgery in 8 weeks and I am very successful.The waiting period for surgery is useless and harmful and it still doesn't stop people from making bad food choices, not understanding math or physics.

I was put out by having to wait...actually my inability to wait for what I want is one of the biggest reasons I am fat.... The tools and knowledge I gained in the six pre op months where life changing.

I am sure that's true in some cases but based on some of the questions and comments posted on this site (for example: three days post op can I eat sausage?) there are many people who don't give this nearly enough thought before they have major abdominal surgery that will require a life time of commitment.

And a lot of those people wait months for surgery. It doesn't matter how long the program or wait is if people are determined to eat around their sleeve.

I was highly motivated so I made it work for me

[Aggiemae 739]

According to my Dr the follow up on the surgery performed before establishing the full service (PT, NUT, PSCH) bariatric clinic found that 80% of the patient regained most or all of their weight at the five year follow up. The four year out data for patients getting comprehensive pre op care show that about 50% still real n some weight 25% still regain at least 50% of their weight but 40% are still at or BELOW goal The goal is BMI of 27 or less, so still overweight.

[summerset 5,261]

I am sure that's true in some cases but based on some of the questions and comments posted on this site (for example: three days post op can I eat sausage?) there are many people who don't give this nearly enough thought before they have major abdominal surgery that will require a life time of commitment.

And I am sure a lot of them had to wait months for surgery and had to go through pre-op programs to get approved. Or is there any evidence they all had no or only short waiting periods?

[summerset 5,261]

Just my two cents.....it would be interesting to get a real accounting of success rates with a waiting period vs none. There is a reason why many surgeons and insurance companies require it. I have to believe there is real data somewhere about why.

I'd like to believe that as well. However, just because "everyone does it" doesn't mean it makes sense or that it is evidence based. By far it doesn't mean that it's evidence based. It just means that everyone does it for whatever reason. (Don't get me wrong, it also doesn't mean that it doesn't make sense until proven otherwise.)

I don't believe in waiting periods until someone can really prove that it's a real benefit. I understand that people have to cope with the fact that they have to go through waiting periods or that they had to go through the waiting period of several months while their neighbor got approved within a few weeks. I had to cope with waiting periods myself in the past and had to jump through several hoops.

IMO waiting periods are just good for insurance companies. In Germany people even get denied after jumping through all the hoops and the insurance companies count on the fact that only a few people go to court.

[summerset 5,261]

According to my Dr the follow up on the surgery performed before establishing the full service (PT, NUT, PSCH) bariatric clinic found that 80% of the patient regained most or all of their weight at the five year follow up. The four year out data for patients getting comprehensive pre op care show that about 50% still real n some weight 25% still regain at least 50% of their weight but 40% are still at or BELOW goal The goal is BMI of 27 or less, so still overweight.

Link to full paper?

[higher 966]

My theory is that people give up on surgery due to the waiting periods and some of them actually die.

[laceemouse 631]

According to my Dr the follow up on the surgery performed before establishing the full service (PT, NUT, PSCH) bariatric clinic found that 80% of the patient regained most or all of their weight at the five year follow up. The four year out data for patients getting comprehensive pre op care show that about 50% still real n some weight 25% still regain at least 50% of their weight but 40% are still at or BELOW goal The goal is BMI of 27 or less, so still overweight.

Link to full paper?

I would like to see them as well, my surgeon quotes stats all the time and I have never heard anything this bad. In fact, 80% of people gaining all of their weight back in 5 years is what they say about people who do NOT have surgery but try to do it on their own. Why would insurance pay at all if the stats are no better for people who have surgery? That sounds like a huge waste of money.

Edited November 9, 2016 by laceemouse

[laceemouse 631]

According to my Dr the follow up on the surgery performed before establishing the full service (PT, NUT, PSCH) bariatric clinic found that 80% of the patient regained most or all of their weight at the five year follow up. The four year out data for patients getting comprehensive pre op care show that about 50% still real n some weight 25% still regain at least 50% of their weight but 40% are still at or BELOW goal The goal is BMI of 27 or less, so still overweight.

Link to full paper?

I would like to see them as well, my surgeon quotes stats all the time and I have never heard anything this bad. In fact, 80% of people gaining all of their weight back in 5 years is what they say about people who do NOT have surgery but try to do it on their own. Why would insurance pay at all of the stats are no better for people who have surgery? That sounds like a huge waste of money.

Also, most doctors think BMI is crap so "only" getting down to a BMI of 27 is probably fine for most people, they may not be model thin but much healthier than they were at BMI 40+.

[shedo82773 1,236]

I'm going to take this to another thought. Kind of the same but not. Around 30 some odd years ago, my cousin had the old what they referred to as the Stomach Stapling She had a hell of a time, lost her spleen because they did NOT do the preop fasting and she went out for her LAST SUPPER ate Chinese food and after her surgery a bell pepper got stuck in her stomach. When I went to see her in the hospital she looked like hell. She had a tube down her nose and they were putting meat tenderizer to digest the bell pepper. They had to take her back to surgery and her Spleen had adhered to her stomach and when they pulled it down they ruptured her Spleen, Had to remove it. She gained everything back she had lost plus. My friend a little later than my cousin had Gastric Bypass. She lost her weight but gain quite a bit back NOT following her Dr.s orders and she hs to have Iron Infusuins all of the time. NO education for them at all. No Support at all. Well, now comes me!! I looked into it at the same time as my freind, I had no insureance coverage so NOPE. Years later I had my RNY. I have been sucessful. I am so very HAPPY I did NOT have my surgery back then. Because you see I really don't think I was ready for all of the changes we have to go thru. I have support now. Look what we have, Facebook, physical support groups, and real Dr.'s to anwser our ?'s. My family and freind was turned out with no support from the DR. In fact when my freind had gained 20#'s back her suregon told her she was a disgrace to his program!! My cousin's suregon quit doing WLS. So I guess what I am saying it will sometimes pay to wait for things. I feel very fortunate that I didn't get WLS years ago!! All of the steps we go thru just helps us be more prepared for what is coming next. I don't want to piss anyone off but GOOD THINGS COME TO THOSE WHO WAIT!!!

[Butterflywarrior 241]

I'm glad I had a six month wait bc it gave me time to truly think about this decision. When I got approval for RNY, I realized I wasn't ready or willing. I came back another five months latter and my surgeon, getting to know my extensive health history and problems better realized RNY was actually not the right surgery for me and sleeve was safer.

See, when I first saw him, I was new to this healthcare system and although i informed him about all if my health issues, he just saw super morbid obesity but six months to a year latter, he could see in living color on the computer all of my hospitalizations, specialist visits, medications,etc and seeing that jolted him into reality that rny was dangerous for me in reality...

If it weren't for waiting periods and thinking, I could be worse off or dead from RNY in the short or long term so the waiting saved me from a bad decision

And this program as well as surgeon is accredited by the barriatric associations, etc so it's not like he was sloppy but even he took things for granted and tge waiting period helped us both...

Of course, this doesn't prove that waiting periods help or harm... I think having a good comprehensive program with education and support is key. One can wait..it's whats happening during this t waiting that is important I believe....

[summerset 5,261]

I have support now. Look what we have, Facebook, physical support groups, and real Dr.'s to anwser our ?'s.

Indeed, there is more support now.

However, there is also way more post-op support than there ever used to be. In the earlier times of WLS the so called experts thought that it would be enough to perform the surgery and that's that.

What changed in Germany over the years was that there is now organized post-op care. Regarding the pre-op requirements. From what I read on the boards it didn't change much. Even 16 years ago you had to prove that you took part in medically supervised programs, therapy and whatnot and that you "did everything else and failed". They now have a fancy name for it "multimodal concept" which includes nutritional counseling and exercise. However, even years and years ago you had to prove that you did these things.

What makes a lot of people here focus so much on pre-op support (maybe I'm wrong, please correct me if that is the case) but totally seem to neglect the post-op support?

I personally think the post-op support is way more important and I'm not only talking about the first year post-op. I'm talking about several years post-op.

[Aggiemae 739]

According to my Dr the follow up on the surgery performed before establishing the full service (PT, NUT, PSCH) bariatric clinic found that 80% of the patient regained most or all of their weight at the five year follow up. The four year out data for patients getting comprehensive pre op care show that about 50% still real n some weight 25% still regain at least 50% of their weight but 40% are still at or BELOW goal The goal is BMI of 27 or less, so still overweight.

Link to full paper?

Been a smarmy bitching long?