Hey fellas,

My wife is three months post surgery and she's doing phenomenal. I've just scheduled my initial consult with the surgeon, so I'm very early in the process here. I did have some questions/concerns that I'd love some input on.

I'm 5'10" 260ish. While I'm on the smaller side of people who want the procedure, I have sleep apnea, hypertension, and hyperlipidemia. Has anyone been really close to the BMI cutoff and what happens if you dip below it during the preop diet?

I currently enjoy obstacle races such as Spartan and Tough Mudder. Post surgery, will I be able to fuel and hydrate myself to handle a 16-mile race on a mountain?

Thanks!

Ray

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Most insurance companies use the initial weight at time of first consult to determine qualification for bariatric surgery. Many insurance plans require a 6 month doctor monitored weight loss and exercise program in order to qualify. Since you wife recently went through this process, she will have many of the answers.

My insurance plan reads: 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:
• T ype 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 arthropathy 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

So if your plan is written in a similar manner than since you have at least one comorbidity it would mean that you could qualify for surgery if your BMI is 35 or greater.

As far as extreme exercise, I think you will still be able to do these, but not at the beginning and you will need to work over many months towards that goal. There was a Chef Woody in Indiana who cycled. He was a restaurant chef in real life and after surgery specialized in developing dishes fit for bariatric patients. Anyways cycling was his passion. He regularly competed. In one race he rode from one side of Indiana to the other. After he passed the finish line, he fainted. He needed a little more food intake along the way. Unfortunately, he moved to Florida a few months after I had my surgery. But I did meet him once at a Bariatric Surgery Support Group meeting.