Where to start with everything?

[KellyRenae 5]

Hello everyone! I am new around here but you all seem helpful. I have been thinking about WLS for years and my weight has ranged quite a bit. My BMI (36) puts me in the "very obese" category. I always thought I wasn't heavy enough (yet) to have the surgery and have tried and tried on my own. Two years ago my cardiologist told me that he would refer me to a bariatric doctor if I couldn't get this weight off but I really wanted to try to to it without surgery. Well I have struggled with the same 20 pounds. (I have a family history of cardiac problems, diabetes,etc).

I am tired. I am depressed. I have no stamina. My joints hurt. I have foot issues and pain that make exercise painful. I am active though.

Where did you start with this? Your general doc? I know there is a long process.

How did you know which surgery was right for you?

Thank you for any help you can give me!

[WInston223322 160]

Start with a Bariatric surgeon in your area, And make a call to your insurance company to see if it is covered.

I just went with the sleeve but all the information you need is here and tons of videos on Utube describing the options

[JessLess 1,163]

I had thought about it for years, but when my PCP recommended it, I went to a highly recommended WLS program, met with my surgeon, and started seriously learning about it.

[catwoman7 10,876]

I started with my regular doctor since I'm in an Hm0 and I needed a referral to see a bariatric surgeon. But you can probably go directly to a bariatric clinic if your insurance allows it (or if you're going to be self-pay)

Edited April 28, 2020 by catwoman7

[BayougirlMrsS 3,933]

12 hours ago, KellyRenae said:

Hello everyone! I am new around here but you all seem helpful. I have been thinking about WLS for years and my weight has ranged quite a bit. My BMI (36) puts me in the "very obese" category. I always thought I wasn't heavy enough (yet) to have the surgery and have tried and tried on my own. Two years ago my cardiologist told me that he would refer me to a bariatric doctor if I couldn't get this weight off but I really wanted to try to to it without surgery. Well I have struggled with the same 20 pounds. (I have a family history of cardiac problems, diabetes,etc).

I am tired. I am depressed. I have no stamina. My joints hurt. I have foot issues and pain that make exercise painful. I am active though.

Where did you start with this? Your general doc? I know there is a long process.

How did you know which surgery was right for you?

Thank you for any help you can give me!

First start with your insurance.... makes no sense to do anything else if your insurance doesn't cover. So you know your BMI. Most and i say most insurance won't cover WLS.... and the ones that do you have to be in the following: 35+BMI with two comorbidities..... or 40+ with none. A "family history" won't do it. It has to be you.

after you find that out, then you can ask if there are dr.'s on the approved list. Some insurance will allow only certain dr.'s. Go on line and do some research about WLS in your area. Ask to attend there support group. Tell them you are considering WLS and want to get all the facts.

As far as referral's.... again it depends on your insurance.

Everything stims back to your insurance. If yours won't cover, and you still want to get it done... you may need to look into cash pay..... Cash pay most of the time is up to the WLSx.

[kc892020 90]

19 hours ago, KellyRenae said:

Hello everyone! I am new around here but you all seem helpful. I have been thinking about WLS for years and my weight has ranged quite a bit. My BMI (36) puts me in the "very obese" category. I always thought I wasn't heavy enough (yet) to have the surgery and have tried and tried on my own. Two years ago my cardiologist told me that he would refer me to a bariatric doctor if I couldn't get this weight off but I really wanted to try to to it without surgery. Well I have struggled with the same 20 pounds. (I have a family history of cardiac problems, diabetes,etc).

I am tired. I am depressed. I have no stamina. My joints hurt. I have foot issues and pain that make exercise painful. I am active though.

Where did you start with this? Your general doc? I know there is a long process.

How did you know which surgery was right for you?

Thank you for any help you can give me!

For me, it began with a trip to my general doctor. We had a long talk and he referred me to a bariatric surgeon in our area that took my insurance (make sure you check with your insurance that they cover it...every insurance is different with what they look for in order to be approved). The journey is long. Once you have that initial consult with the bariatric surgeon, you then have to decide what surgery you want to have, and then you have to meet with a nutritionist. The nutritionist will go over your pre-op diet plan (most people have to do this to a.) meet insurance requirements and b.) test your discipline to make sure you can follow a diet). Depending on your insurance requirements, you might also have to attend required WLS support group meetings (though I'm sure that's changed since the pandemic) and attend sessions with a counselor. Mine required me to see a counselor, attend support group meetings, and undergo a bunch of medical tests and blood work to make sure it was safe enough for me to get it done. All of this usually spans out through a six-month period. In addition to seeing a nutritionist, I also had to attend nutrition classes. My insurance required a lot from me in order to have it approved. Like I said, everyone's insurance is different. And every surgeon is different.

I wish you the very best of luck. Please keep in mind, this journey isn't for everyone. It requires A LOT of discipline and lifestyle changes. You also have to understand there could be complications. I had complications, and it was scary. But, I'm still blessed that I was able to get it done. If you do everything right, it will work out.

[ChubRub 1,696]

Where are you in NJ? If you are in South Jersey, def check out Dr. Balsama. He was my surgeon and was great, but his staff are just as great, which is really important! They know what needs to be done to get insurance approval, and will hustle to get everything approved.

If you aren't in South Jersey, then I would suggest googling to find out who your local bariatric surgeons are. I would look for one who offers multiple classes per month, ideally once or twice a week. To me, this means they do a high volume, but also the more classes they offer, the more flexible it will be for you, and hopefully the quicker you can get in. My guess is there are no in-person classes right now, but hopefully they are doing via Zoom, etc.

No need to go to PCP first, but if your insurance requires a referral, call your PCP office to get that before your first class. At the first class, the staff will tell you everything you need to do to get insurance approval (lab work, sleep study, EKG, etc).

Good luck!!!

[KellyRenae 5]

Thank you for these replies and the information! I am in South Jersey so I’ll check Dr. Balsama out.

My insurance does cover it. I’ve actually been on the websites and just from that it looks like I’m a candidate. I’m going to call them and start calling doctors. Luckily I live outside of Philadelphia and there are great options here. I do not need a referral from my p doc.

Thank you thank you thank you for your help!