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Pissed Off and Rebelling



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5 minutes ago, blizair09 said:

There is a real reason a lot of insurance companies require the six month (or three month or whatever the duration might be) diet program. The problem is that most people do absolutely nothing with that time.

My personal feeling for insurance companies having a required 3, 6, 12, (and once upon a time) 24 month wait, is in hoping people will have second thoughts and not do it, therefore, saving them a crap load of money. As of 2014, my insurance company doesn't make patients wait anymore. I feel as prepared as I'm ever going to be. Will I still wonder how I'm going to get my Protein and liquids down three days out? Yes, I probably will even though I read that this is a common worry straight out of surgery.

Some things you just can't prepare for until you're in that situation. Truth is, many people who gained back their weight from bariatric surgery had their surgery years ago when all insurances required a wait. So, to me, those statistics are kind of dubious. For some people, you can make them wait two years, and still, three months after the surgery, they'll still post about how they were able to drink milkshakes instead of Protein Shakes. For some people, wait time does not equate to suddenly having common sense.

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Some have the wait and aren't successful. Some don't have the wait and still are successful. So, in my opinion, whether or not there is a wait; it's ultimately up to the individual to implement the changes for success post-op. But overall, I do believe combatting those issues that have gotten all of us to the point of WLS being confronted with and making changes beforehand, will lead to long success post-op.

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33 minutes ago, Finding_Stacy said:

My personal feeling for insurance companies having a required 3, 6, 12, (and once upon a time) 24 month wait, is in hoping people will have second thoughts and not do it, therefore, saving them a crap load of money. As of 2014, my insurance company doesn't make patients wait anymore. I feel as prepared as I'm ever going to be. Will I still wonder how I'm going to get my Protein and liquids down three days out? Yes, I probably will even though I read that this is a common worry straight out of surgery.

Some things you just can't prepare for until you're in that situation. Truth is, many people who gained back their weight from bariatric surgery had their surgery years ago when all insurances required a wait. So, to me, those statistics are kind of dubious. For some people, you can make them wait two years, and still, three months after the surgery, they'll still post about how they were able to drink milkshakes instead of Protein  shakes. For some people, wait time does not equate to suddenly having common sense.

I don't doubt that money is involved with many of the insurance companies' policies and requirements. And the problem is that it is viewed as a "wait" rather than a time to prepare. I disagree that you can't prepare "until you're in that situation." You can re-define your relationship with food during that "wait;" you can develop better eating habits during that "wait;" you can work with a therapist to get a handle on your emotional issues with food during that "wait."

Unfortunately, tons of people go from their doctor's appointments straight to McDonalds to have a 1500 calorie lunch. Nothing changes. And then they are a hot mess after surgery. I have seen it over and over again on here, and those are the people that will say that WLS "failed them."

But I do agree with you that common sense won't just appear in some people regardless of how much work people try to do with them.

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If you come up with some journals talking about how people who declare they're emotionally and physically prepared should expedite their surgery with decent success I'd be glad to buy into this argument. Otherwise, the failure/regression rate from the attitude displayed by impatient people speaks for itself. Anecdotal stories and arguments made from emotion has no relevance to what objectively works and does not.


Success of surgery is not dependent on the time you are forced to wait before surgery but in the success of implementing the habits before surgery and dealing with the underlying causes that had an individual eating excessively in the first place. Some patients go through the program for years and don't use the time to implement the needed changes, other implement them immediately and work on their issues. Your success is dependent on you and not on a preconceived time that an insurance company deems fit. I said before, my program actually doesn't require you to wait 6 months or take any nutrition classes. It just requires you to prove you are committed and are following the lifestyle with mandatory weight loss. Why is my program and the individuals part of it so successful if they didnt have to go through nutrition classes and required waiting periods? I have lost the weight and my dietician is beyond happy with the changes in my food and routine. My program is also short handed right now causing a delay in surgeries. I came on here originally saying that I actually wished that they had some classes to offer since I am now being forced to wait longer but no I am not happy that my surgery is being delayed. I responded to the post that becuase people like me are impatient means that we are "emotionally immature" which is a ridiculous claim.



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57 minutes ago, blizair09 said:

I disagree that you can't prepare "until you're in that situation." You can re-define your relationship with food during that "wait;" you can develop better eating habits during that "wait;" you can work with a therapist to get a handle on your emotional issues with food during that "wait."

Unfortunately, tons of people go from their doctor's appointments straight to McDonalds to have a 1500 calorie lunch. Nothing changes. And then they are a hot mess after surgery. I have seen it over and over again on here, and those are the people that will say that WLS "failed them."

But I do agree with you that common sense won't just appear in some people regardless of how much work people try to do with them.

I think you and I are talking about two different things. Yes, there are dozens, if not hundreds, of things we can prepare for before the big day. We can change our diet and start exercising. We can start taking Vitamins and research the crap out of Protein Shakes. There are numerous things, but I'm talking about the things we all read about, but can't truly grasp until we're in that situation. The reason being is because all our bodies are different. Why can some get down Water and Protein shakes two days out and some can't? That's not because they didn't prepare enough, there's a biological issue happening. It's those things that I'm talking about when I said I'm prepared as can be for my surgery.

Also, generalizations are the crux to all arguments. Since I didn't have a wait time, but still managed to lose 20 pounds in four weeks so far, with a month to go before my surgery, can I say "See? All people who have no wait are putting to use their knowledge beforehand." I can't, but neither can anyone who says no wait time equates to being ill prepared. Truth is, some are going to fail no matter what because it's an individual battle. If it were based on wait time, people would be gaining weight after the first month. Have you seen that? I haven't. What I keep seeing is that many plateau around the ninth-twelfth month and regain happens after the twenty-fourth month. It's hard to prove a lack of wait time was the reason to regain since years go by before that dreaded spike in weight happens.

And the McDonalds thing I want to see. If that's true, maybe that was an anomaly, I don't know. I've never read anyone stopping by McD on their way home from the hospital. The stomach is so swollen I can't imagine anyone woofing down a Big Mac within forty-eight hours of surgery and I definitely think that would have zero to do with no mandated wait before surgery. That's an idiot problem, wait or no wait.

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Just now, Finding_Stacy said:

And the McDonalds thing I want to see. If that's true, maybe that was an anomaly, I don't know. I've never read anyone stopping by McD on their way home from the hospital. The stomach is so swollen I can't imagine anyone woofing down a Big Mac within forty-eight hours of surgery and I definitely think that would have zero to do with no mandated wait before surgery. That's an idiot problem, wait or no wait.

I wasn't talking about stopping at McDonalds on the way home from the surgery. I was talking about stopping at McDonalds after going to the doctor/NP/nutritionist/psychologist/etc. during the six month (or however long it is) diet program. And yes, that happens all the time because people are "waiting" and not using the time as it should be used.

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15 hours ago, blizair09 said:

I wasn't talking about stopping at McDonalds on the way home from the surgery.

Yeah, because McDonald's would be so ridiculous and unbelievable to hear that it couldn't possibly happen.

Now, Taco Bell? Yeah, that happened. Seriously; on the way home from the hospital where the person had gastric surgery less than 24 hours earlier. Huge stink here on the forum when some of the more vocal vets had an apoplexy and posted accordingly. It got so bad I think the thread got locked or removed.

My reason for bringing this up is that you cannot project your situation, the the situation that you are familiar with, unto a person you know nothing about. Many members on this site are so positive and helpful and want to believe the best about everyone. But the truth is that not all people deserve that assumption. Me personally, I don't think there should be a mandated waiting period. I believe that a person should be responsible for their decisions. If they don't want to follow plan, let Darwinism sort it out.

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On 3/23/2017 at 10:16 AM, Greensleevie said:

Point is, impatience with the process is a red flag. The whole process takes patience and persistence. And even after you've lost the weight, the hard work REALLY starts. Forever.

Start implementing lifestyle changes now. Take this time to be positive and learn as much as you can about the process, not instantly go negative. A negative mind never produces positive results.

I disagree with the 'red flag' part though. 6 months can be rather annoying. It all depends on the individual. I feel it places too much emphasis on the surgery for some. My program just mandated weight loss. I feel mandating some kind of weight loss, and 2-3 nutritional visits over 2-3 months general requirement is better.

Edited by Middus

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4 minutes ago, Middus said:

I disagree with the 'red flag' part though. 6 months can be rather annoying. It all depends on the individual. I feel it places too much emphasis on the surgery for some. My program just mandated weight loss. I feel mandating some kind of weight loss, and 2-3 nutritional visits over 2-3 months general requirement is better.

I do agree that the surgery is the main point for so many people. I have read so many posts on here where people can't wait for the surgery "so that they can get on the loser's bench." And the "so" is the key word. They believe the journey doesn't start until the surgery happens. For me, the surgery has been a supporting player since the beginning of the second half of my journey. It is not the star of the show!

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I understand. All the points that have been said. Bariatric surgery (and research) keeps evolving. One thing we have to realize is that these insurance guidelines keep being reworked or tossed out, because research doesn't really back them up. Many researchers also warn that policy statements should not be issued based on their findings.
Even the pre weight loss requirement by some insurers isn't backed by research. Some programs just want evidence of some kind of commitment (and also to make surgery safer for those with super obesity, )

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This has been a very interesting discussion with lots of good information. I do want to comment on the original vent. To me, the comment comparing WLS to cancer or other surgery is an extremely important one. Even with tons of recent research that shows that obesity often has physiological origins that we aren't even close to understanding, insurance companies and even health care providers still treat obese patients as if they are too stupid and out-of-control to know what's best for them. You must be stupid if you allowed yourself to get this fat, so we'll educate you for your own good. Your "relationship with food" must be unhealthy.

And yes, there are always a few people out there who seem happy to conform with the stereotype just so that we all have someone to point to as proof that the lowest common denominator is alive and procreating.

I'd be happy if insurance companies would leave it to the surgeon to decide if the patient needs more education, or counseling, or time. At least I can have a real conversation with my surgeon, but every time I try to have a conversation with my insurer, I end up deeply depressed and sure that humanity has contributed to its own demise.

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On 23.3.2017 at 6:46 PM, Finding_Stacy said:

Some things you just can't prepare for until you're in that situation.

This.

Quote

Truth is, many people who gained back their weight from bariatric surgery had their surgery years ago when all insurances required a wait. So, to me, those statistics are kind of dubious. For some people, you can make them wait two years, and still, three months after the surgery, they'll still post about how they were able to drink milkshakes instead of Protein  shakes. For some people, wait time does not equate to suddenly having common sense.

This.

I have to search more than half-heartedly for a study that compares 5-year-or-more outcome between different groups ( e. g. the holy and mature 6-months-or-more waiting period with all the required hoops patients vs. the immature and evil patients without an extended waiting period and only quick education about post-op nutrition). I wonder if there will be significant and clinically relevant differences in regards to EWL after 5 years or more between the groups.

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BTW, when reading some of the posts in these thread I wonder why some people on here needed WLS in the first place. They were obviously so good at implementing all these changes and new habits before surgery happened... it should have made that sideshow thing WLS unnecessary. Maybe with a longer waiting period all that excess weight would have been gone without surgery after all. ;-)

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