Sleeve to DS/RNY revision

[FabNFit@40 52]

I have not been here in quite some time so Iittle update -background. I was sleeved 12/27/17. Starting weight was 256, I managed to lose 61 pounds and got to a low of 195, ( this was May of 2019)then I started to regain. I refocused, got back on the right eating plan/exercise but continued to gain weight. Went to see the nutritionist last fall for help. We went over my food logs and by the numbers I was a little low in calories for the amount of exercise I was doing so we adjusted my plan but still no weight loss. I was 242 in Jan/Feb. I was prescribed the generic form of Contrave in March for a 3 month trial, managed to lose all of 5 pounds down to 237. Labs have been decent- except now I developed high cholesterol and my primary prescribed Atorvastin(Lipitor) and I have been on that since May. I consistently tell the dietician that I feel no restriction and can eat way more than I think I should. However in all this time, not once have I had a scope to check to see if my pouch has been stretched out. My primary thinks I am eating to much, the nutritionist thinks I'm not eating enough so I'm just trying to eat enough Protein and stay low on the carbs. I have gone as low as 900 calories and as high as 1500. carbs as low as 20 and high as 75. All of that to say I found out my original surgeon does not believe in performing revisions so I have a consultation in 2 weeks with a surgeon that does perform revisions just so I can get answers. I still have sleep apnea, that has improved some but not enough for me to come off my CPAP. Recently I have had mild cases of heartburn late at night so I have altered my diet again, cutting out dairy, coffee, spicy foods to see what could be triggering it. I did intermittent fasting in July of just watermelon and Water and managed to get down to 224. I know this was not healthy but hey I was willing to try anything. So all of that to say, with my weight as it is now, my BMI is 36. I meet insurance requirements for BMI with my sleep apnea as comorbidity but the surgeon must find it medically necessary for revision- but if surgeon requires weight loss and lose weight that puts my BMI under requirements, would insurance deny the revision?

[JessLess 1,163]

Most surgeons won't require you to lose weight, or won't report out your loss, if it puts your BMI too low for insurance. Mine was 40 going in with no comorbidities and that's what was reported. Good luck, it sounds like you are trying a lot of stuff and something is just not working.

[catwoman7 10,922]

it depends on the insurance company. Most use whatever you weighed when you started up with the program with the new surgeon, but some use a weight closer to the surgery. I guess the best thing to do is just call them and ask. Or the surgeon's office might know if they've dealt with that company before.