Jump to content
×
Are you looking for the BariatricPal Store? Go now!

BMI of 38, hoping I don't get denied...



Recommended Posts

Hi everyone.

I have an appointment for a consult with a surgeon in 3 weeks. I've decided after this past year of diligently working out (5 or 6 days a week), and sorta-kinda eating okay, to only lose a grand total of almost nothing, I am about to give up.

I'm afraid I'm not overweight enough for my insurance to approve it. I told a friend this the other day. She had gastric bypass surgery years ago. I told her, "I almost want to stop working out and just start eating so that I can be a BMI of 40 by the time I see him (where it would be approved).

She said, "oh, that is so common. People do that all the time."

Do they?

I am so sick and tired of trying so hard to get nowhere.

Share this post


Link to post
Share on other sites

My insurance company approved payment for the sleeve with a BMI of 37 and one comorbid condition of dyslipidemia (a.k.a. elevated cholesterol).

Do you have any comorbidities such as high cholesterol, diabetes, heart disease, osteoarthritis, sleep apnea, or high blood pressure?

If you're a "healthy" person with a BMI of 38, my politically incorrect suggestion is to gain the 25 to 30 pounds to ensure your BMI is 40 by the time of your consultation.

Share this post


Link to post
Share on other sites

My ankles are always sore, and my right knee crackles loudly. Neither of those things have a diagnosis to go along with them.

My husband says I used to have sleep apnea, but the working out has made it go away. I never did have that officially diagnosed, either.

I do get acid reflux, and that is on my chart.

I have a gyne appointment tomorrow to check on a thing that might qualify (vaginal childbirth messes you up! Lol).

I didn't think about having heavy things *on* me...

Edited by WonderWhat

Share this post


Link to post
Share on other sites

I went into the program with a BMI of 40 but was required to lose 15 pounds, I lost 30, so my BMI going into insurance approval for surgery was 37 and I have no co-morbidities. I was approved with no issues but that may have been since I went into the program at a 40 BMI.

Share this post


Link to post
Share on other sites

I would talk to your insurance company first before doing anything drastic. I gained a few lbs (harder than it sounds) to meet their criteria. Then, I found out I had to have a 3 year history of bmi over 35 with comorbidities or 40 without. Plus, I couldn't drop below 35 during the 4 month supervised diet or they'd deny me.

So, I basically wasted time gaining, then had to go self pay and lose what I had just gained.

Sent from my XT1254 using BariatricPal mobile app

Share this post


Link to post
Share on other sites

This is the issue i am having. i loose 5 pounds i get below BMI of 40. My stomach is all messed up from going back to eating what ever. I have no problem eating healthy i actually prefer it except around my menstrual lol. but im always stuck at in the 240's if im in the 250's im in the bmi of 40 it is so easy for me to get the the 240's but i get absolutely no where once i am there it is so frustrating that is why i decided to get the sleeve. So i did the seminar and i have my consultation appointment scheduled i cant wait until that appointment.

Share this post


Link to post
Share on other sites

My appointment is tomorrow. I'm going in fully loaded (with a full tummy and lots of Water. And pockets of change, lol).

I have no idea how much I weigh. I don't have a home scale, so I guess I'll find out tomorrow!

Just a little nerve-wracking.

Share this post


Link to post
Share on other sites

This seems to be an area (like the pre-op diet) where there are different approaches from practice to practice. Mine made it clear to me that if my BMI went below 35 before they filed that insurance wouldnt approve me.

Share this post


Link to post
Share on other sites

Full belly, lots of Water, layers of clothes, heavy shoes. Oh! And see if you can make yourself a bit shorter on the bari doctor’s chart.

My BMI with comorbidity was a bit over 35. When I made myself 2 inches shorter, my BMI jumped to almost 39.

To be on the safe side, I intentionally didn’t lose any weight (drank water, wore heavy shoes) during my 6 mo diet period.

Insurance didn’t challenge my shorter height, but if they had, I would have probably measured about 1.5” shorter than my file stated.




Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • ChunkCat

      I have no clue where to upload this, so I'll put it here. This is pre-op vs the morning of my 6 month appointment! In office I weight 232, that's 88 lbs down since my highest weight, 75 lbs since my surgery weight! I can't believe this jacket fit... I am smaller now than the last time I was this size which the surgeon found really amusing. He's happy with where I am in my weight loss and estimates I'll be around 200 lbs by my 1 year anniversary! My lowest weight as an adult is 195, so that's pretty damn exciting to think I'll be near that at a year. Everything from there will be unknown territory!!

      · 3 replies
      1. AmberFL

        You look amazing!!! 😻 you have been killing it!

      2. NickelChip

        Congratulations! You're making excellent progress and looking amazing!

      3. BabySpoons

        So proud of you Cat. Getting into those smaller size clothes is half the fun isn't it?. Keep up the good work!!!!

    • BeanitoDiego

      I changed my profile image to a molecule of protein. Why? Because I am certain that it saved my life.
      · 1 reply
      1. BabySpoons

        That's brilliant! You've done amazing!! I should probably think about changing my profile picture at some point. Mine is the doll from Squid Games. Ironically the whole premise of the show is about dodging death. We've both done that...

    • eclarke

      Two years out. Lost 120 , regained 5 lbs. Recently has a bout of Norovirus, lost 7 pounds in two days. Now my stomach feels like it did right after my surgery. Sore, sensitive to even water.  Anyone out there have a similar experience?
      · 0 replies
      1. This update has no replies.
    • Eve411

      April Surgery
      Am I the only struggling to get weight down. I started with weight of 297 and now im 280 but seem to not lose more weight. My nutrtionist told me not to worry about the pounds because I might still be losing inches. However, I do not really see much of a difference is this happen to any of you, if so any tips?
      Thanks
      · 0 replies
      1. This update has no replies.
    • Clueless_girl

      Well recovering from gallbladder removal was a lot like recovering from the modified duodenal switch surgery, twice in 4 months yay 🥳😭. I'm having to battle cravings for everything i shouldn't have, on top of trying to figure out what happens after i eat something. Sigh, let me fast forward a couple of months when everyday isn't a constant battle and i can function like a normal person again! 😞
      · 1 reply
      1. kezbeth

        I may have to have gall bladder surgery during my weight loss surgery. Not thrilled about it either but do not want 2 recovery times. Just want it over with.

        Thanks for your post. I may need to rethink my decision... :(

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×