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

    • LeighaTR

      I am new here today... and only two weeks out from my sleeve surgery on the 23rd. I am amazed I have kept my calories down to 467 today so far... that leaves me almost 750 left for dinner and maybe a snack. This is going to be tough for two weeks... but I have to believe I can do it!
      · 0 replies
      1. This update has no replies.
    • Doughgurl

      Hey everyone. I'm new here so I thought I should introduce myself. I am 53y/o and am scheduled for Gastric Bypass on June 25th, 2025. I'm located in San Antonio, Texas. I will be having my surgery in Tiajuana Mexico. I've wanted this for years, but I always had insurance where bariatric procedures were excluded. Finally I am able to afford to pay out of pocket.  I can't wait to get started, and I hope I'm prepared for the initial period of "hell". I know what I have signed up for, but I'm sure the good to come will out way the temporary period of discomfort and feelings of regret. I'd love to find people to talk to who have been through the same procedure or experience before. So I look forward to meeting you all. Hope you have a great week!
      · 1 reply
      1. Selina333

        I'm so happy for you! You are about to change your life. I was so glad to get the sleeve done in Dec. I didn't have feelings of regret overall. And I'm down almost 60 lbs. I do feel a little sad at restaurants. I can barely eat half a kid's meal. I get adults meals often because kid ones don't have the same offerings at times. Then I feel obligated to eat on that until it's gone and that can be days. So the restaurant thing isn't great for me. All the rest is fine by me! I love feeling full with very little. I do wish I could drink when eating. And will sip at the end. Just a strong habit to stop. But I'm working on it! You will do fine! Just keep focused on your desire to be different. Not better or worse. But different. I am happy both ways but my low back doesn't like me that heavy. So I listened (also my feet!). LOL! Update us on your journey! I'm not far from you. I'm in Houston. Good luck and I hope it all goes smoothly! Would love to see pics of the town you go to for this. I've never been there. Neat you will be traveling for this! Enjoy the journey. Take it one day at a time. Sometimes a few hours at a time. Follow all recommendations as best you can. 💗

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
      · 0 replies
      1. This update has no replies.
  • 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

    ×