Hi Folks,

I am new to the forum, but have gotten a lot of good information over the years from you folks, so thank you! A bit about me, I am a corporate attorney in the D.C. market (I live in northern VA), an author, an avid outdoorsman, a husband in about as perfect a marriage as I could dream existed (I got together with my wife when we were teenagers), and the dad of an adorable toddler. I have finally settled on a gastric sleeve as the right surgery for me, but I have been quite disappointed to learn that insurance will not likely pay for the procedure, and at least at the first level of contact at different institutions that perform such surgeries tell me that they will not likely even consider me, even if I pay out of pocket, which I am quite prepared to do.

My BMI is right now at 30, and although I know this is not as high as is generally the case for bariatric surgery, I have made Herculean efforts to lose and maintain a good weight for the past 14 years (since I was 16), and no matter how hard I tried, nothing worked. I was a high school athlete (football, lacrosse, daily weightlifting), and am used to pursuing physical goals in a very disciplined way. Some examples of ways I have tried to lose weight have been running 28 miles per week, extreme dieting, even bulimia, and basically my body just seems to want to be between 210 and 230lbs, regardless of what I do. I still lift freeweights every day, hike, fish, and do lots of physical activities. My mind boggles that I have such high physical endurance and strength - I am, if anything, more athletically able now than I was as a high school tight end/linebacker - and still cannot get down to what is considered a health weight. I know that my BMI is partly artificially elevated by the fact that I have been lifting weights since I was 12 and have a very large amount of muscle mass, but I still have a noticeable gut and I know that I will have a healthier future if I can drop about 70lbs.

My goal for weight loss is not to look great like I did at 15 again - my awesome wife is very supportive of me and met and fell in love with me when I was 19, so she has never seen me at my trim, 6'1 165 figure from high school football - but to decrease my risk of obesity-related illnesses. For that reason, I want to get moving on this as quickly as possible. I have researched and tried weight loss procedures, including reading all the scholarly articles I could find on bariatric surgery since I was 24, and I think that now, while my blood pressure, cholesterol, and heart rate are all excellent, is the best time to slim down, as it is harder to correct these health problems once they start than it is to head them off.

I am particularly hoping to hear from folks on where they went and how they went about getting a gastric sleeve done when they were below the 35-required BMI. I do have sleep apnea (I've had it since I had a BMI of 22, so it is not obesity-related), so I would be able to get insurance coverage if I got to 35, but I do not feel like gaining 40 pounds in order to qualify for a surgery I can easily afford out of pocket. I know that Mexico and Brazil are options a lot of people use due to their low cost, but my wife really wants me to spend the extra money and get it done in-country.

For those of you that have gone the foreign route, what were your experiences with it, and is there anyone in particular you would recommend? For those who have had it done in this country, are their doctors or clinics around that are willing to hear you out and accept that you have made the decision that you need it? I understand that doctors have to be gatekeepers for people who want this kind of thing for a vanity goal on a whim, but I have been dieting, exercising, meeting doctors and nutritionists, and researching all possible weight loss methods for 14 years, and now that I have decided on a gastric sleeve, I do not want someone to patronize me or condescend to me. I hope to find a doctor who will listen to me, then take my money, and cut off part of my stomach!

Thanks again, and I look forward to hearing your thoughts.

Hi Salazar. I'm in Loudoun, and I've found that we have no shortage of bariatric surgery practices here. There must at least a dozen of them between Winchester, Fredericksburg, and Baltimore. PrupleSleeve mentioned Virginia Bariatric, which is where I have my initial consultation scheduled. I am fairly certain that I heard Dr. Fitzer mention, either in his webinar or on one of his youtube videos, than the current criteria for surgery were established when surgery-related morbidity/mortality risk was much greater than it is today. If you haven't already reached out to his office, I think it's worth a few minutes to call and ask if he would consider someone like you as a candidate.

One other thing to consider (if you haven't already done so) is to have your thyroid checked. I was super active in high school but could not seem to lose the 15 - 20 extra pounds I carried around unless I went on a severely calorie restrictive diet. I was diagnosed with hypothyroidism at 17, and once on medication, I lost that extra weight in college.

[Now, I ended up gaining about 50 pounds in grad school thanks to some mild depression resulting in inactivity, over eating and poor food choices. This and weight gained since is what I'm struggling with 25 years later resulting in my considering the surgery now.]

Alabama Weight loss center in Birmingham, Alabama. Heard great things about this place. They will do 30 BMI with self pay . The do ins too for all others