Hi Everyone,

I've been trying to do some research on Gastric Sleeve and was lucky enough to come across this website. I'm sure there are many other boards that answer this question but I wanted to share my concerns in hopes that I will get a response. I'm set to have my very first consultation with my surgeon this upcoming Thursday and I'm super excited but also very anxious. I have Aetna and I see that there are certain requirements needed in order to be approved. My BMI is currently 38.2. I started my weight loss journey 1,000 times back in November and have only lost 9 Pounds. I have seen that anyone above a BMI of 40 pretty much qualifies for the surgery but anyone between 35-40 needs to meet certain requirements such as High blood pressure or sleep apnea. However, I guess my question is whether they will take my 38.2 BMI along with other side effects due to my weight? Since I've had my son, I've had severe knee pain along with swollen feet. If I stand up in the kitchen simply cooking for too long then my feet will swell up and ache for the remainder of the night along with Severe GERD and IBS. Does the insurance take this into consideration? If your someone like me that has such a high BMI but not at exactly 40, will the doctor try to help, or do they automatically turn you away? I have high anxiety and knowing other's experiences would help me out a lot. I have been trying to lose weight the natural way for years and I'm over it at this point.

Your answers are very helpful.

3 minutes ago, lizonaplane said:

I wish I could have done my nutrition classes once a week instead of once a month - I would have paid more for that! Mine are group classes and they are so unhelpful. They don't focus on Bariatric Eating at all, just like "did you know french fries are unhealthy?" On the other hand, I've been able to lost 31 lbs since I started working towards the surgery in January, and I'm really starting to get used to the eating habits I'll need long term, so I am telling myself it's worth it. Anyway, surgeries were stopped until April at the center I'm using due to COVID.

Haha! Yeah, I've read that the classes are very pointless in relation to the foods that you should be eating before/after surgery and to lose or even maintain weight. Luckily, I believe all of these classes will be virtual so I won't have to physically go in. They also mentioned a virtual exercise class I will have to do. My goal is to try to knock everything out as fast as I can.

4 minutes ago, lizonaplane said:

I don't know, honestly. I don't drink at all (never liked the taste of alcohol), but I think it's a very reasonable question given that you won't be able to drink much after surgery. Can you ask the nutritionist rather than the surgeon? Also, you can try to find out how long before the test for alcohol you have to stop drinking.

Well, I'm more curious because let's say i get approved tomorrow and it marks day 1 of this new lifestyle change then my birthday is next month. I'm sure I will want to have a glass of wine (or more lol). I hope that doesn't get me disqualified. Nonetheless, If that will ruin my chances of this surgery then I won't take the chance. I think I'll ask tomorrow maybe just as I get closer to my birthday. I'm jumping the gun a little seeing as though I don't even know if I'll get approved.

I haven't heard of being tested for alcohol. I have been having a glass of wine here and there while I wait for my surgery to get closer. I only have to do a 2-week pre-op diet, so I won't be indulging at all during that time. I would assume as long as you don't have alcohol in your bloodstream for the pre-surgical tests, you'd be fine?

3 hours ago, Monique1123 said:

I've heard many gain the weight back eventually with Bypass but I'm not sure how true that is. I can't wait to find out more information during my appointment tomorrow!!

you can eat around ANY surgery, even the DS (the most powerful weight loss surgery out there) and regain all your weight. However, stats on that are a little better for bypass than for sleeve (in other words, you're less likely to regain all your weight with the bypass). However, stats are stats - it really comes down to the individual. Regardless of surgery, you'll always find people who never gain any of it back, and others who put on a few lbs (10-20 lbs after hitting bottom is very common - but with some people it's more like 40 or 50 lbs), and still others who gain it all back.

I wouldn't say that MANY people regain all their weight with bypass (or with sleeve). Some do, but they're in the minority. There are a lot who gain a good 40 or 50 lbs though (or even more) if they start slacking off too much.

2 hours ago, Monique1123 said:

Also, Another question.....This is a no-judgment zone... during the months of following this strict diet, I know with Aetna you're not allowed to gain at all so drinking isn't in your best interest. However, I heard you get tested for nicotine and alcohol because they are both a requirement (substance-free). Nicotine is no issue but am I allowed to have an occasional drink over the next couple of months? I'm a little nervous to ask my doctor this during the visit because I don't want him to think that my priorities are not in order.

I've never heard of getting tested for alcohol - but many surgeons do test for nicotine. I wasn't told not to drink alcohol during the pre-op period, but we were told to abstain for a year AFTER surgery.

basically, the bypass is a more powerful surgery than the sleeve. As mentioned in other comments, statistically you will lose more weight with it, and you're also more likely to maintain it. The DS (duodenal switch) is even more powerful than the bypass (RNY). But again - those are stats. Your success is going to be much more dependent on your level of commitment than which surgery you get.

32 minutes ago, catwoman7 said:

basically, the bypass is a more powerful surgery than the sleeve. As mentioned in other comments, statistically you will lose more weight with it, and you're also more likely to maintain it. The DS (duodenal switch) is even more powerful than the bypass (RNY). But again - those are stats. Your success is going to be much more dependent on your level of commitment than which surgery you get.

Yeah, to be honest, I'm not sure which one would be best for me. Was there a reason you selected the Bypass or was that recommended by your doctor? They both seem very similar to me as far as limiting how much food you can tolerate and from the seminar, I had to watch before my consultation tomorrow I know that with the Bypass you only get some of the Minerals/nutrients needed which I'm assuming can lead to dehydration, etc. so that makes me a little nervous.

15 minutes ago, Monique1123 said:

Yeah, to be honest, I'm not sure which one would be best for me. Was there a reason you selected the Bypass or was that recommended by your doctor? They both seem very similar to me as far as limiting how much food you can tolerate and from the seminar, I had to watch before my consultation tomorrow I know that with the Bypass you only get some of the Minerals/nutrients needed which I'm assuming can lead to dehydration, etc. so that makes me a little nervous.

there's some malabsorption involved with bypass (not so with sleeve), so you have to take vitamins for life to avoid deficiencies (you will also have to take vitamins for life with sleeve, but the consequences aren't as severe if you're not diligent with them). But the malabsorption is also part of the reason people tend to lose more weight with bypass, because you malabsorb calories along with nutrients. However, malabsorption of calories with bypass only lasts about two years. Malabsorption of nutrients is permanent, so you really have to be diligent about keeping on top of your supplements.

Dehydration isn't an issue with bypass. You have to drink at least 64 oz of fluids a day with either surgery, but I've never read about any dehydration issues with bypass (I've been on this and other bariatric forms for about six or seven years - that issue has never come up that I'm aware of)

as far as why I chose bypass:

1) my surgeon recommended it because I had GERD pre-surgery (sleeve can make GERD worse in about 30% of people. Bypass tends to improve if not outright cure it)

2) I went along with his recommendation because I didn't want to risk my GERD getting worse

3). I weighed over 300 lbs, so I wanted the most powerful surgery I could get (if my insurance covered the DS (duodenal switch), I might have gone for that instead. But it only covered sleeve and bypass)

4) At the time I had my RNY, the sleeve was still relatively new. It was in the process of replacing the lap band as the major non-RNY weight loss surgery option. The lap band turned out to be a not-so-great surgery (to the point where most surgeons refuse to do it now), and I didn't want to risk the sleeve becoming "Lap Band 2". However, that was a few years ago. The sleeve has been around long enough at this point that it's proven itself, so I would no longer have this particular concern if I had to make the decision today.

HOWEVER, due to my GERD issues, I would still choose the bypass if I was facing that decision now. If not for that, I'm not sure which one I would go with. They're both good surgeries, and you'll find a lot of success stories with both.

Edited May 12, 20215 yr by catwoman7

Update: I got approved for the surgery this morning!!! I'm so excited. They gave me the checklist and said that with my insurance I can complete the process as fast as I would like. When I asked what's a realistic time frame that someone could get this done as fast as possible they said it can all be completed in a month! I'm so excited!!

Congrats!! I had my first consultation on March 30. Had to have the psyche eval before they submitted it to insurance. Got that done and approval came through May 6th, so mine was a little over a month. Maybe you'll be having yours in June like me!!

Did you end up going with sleeve or bypass?

28 minutes ago, Monique1123 said:

Update: I got approved for the surgery this morning!!! I'm so excited. They gave me the checklist and said that with my insurance I can complete the process as fast as I would like. When I asked what's a realistic time frame that someone could get this done as fast as possible they said it can all be completed in a month! I'm so excited!!

excellent!!

On 5/13/2021 at 2:28 PM, justShell said:

Congrats!! I had my first consultation on March 30. Had to have the psyche eval before they submitted it to insurance. Got that done and approval came through May 6th, so mine was a little over a month. Maybe you'll be having yours in June like me!!

Did you end up going with sleeve or bypass?

So, it's interesting because The doctor never asked about GERD even though I had already told the triage nurse about it and because I was so excited about the approval and the load of information that I actually forgot to bring it up as well. So, as of now, we're going for a sleeve.

I have my EGD already scheduled for this Tuesday and I wasn't sure if I should mention it then or if that's something he can see? I would be ecstatic if I have mine in June! That would be such an amazing birthday gift to myself LOL.

I don't think my doctor asked about GERD either. Maybe because I don't take meds for it regularly? I'm sold on the sleeve for my personal situation regardless.

Yeah, I'll bring it up and see what he suggests. I'm not medication on it either and I don't have symptoms regularly...Maybe once every couple of months I get really bad chest/stomach pain. I'm okay with either option but I think I prefer the sleeve. I'm going in to get my primary care medical clearance and I'm hoping that there's no reason for her to not want to give it to me.