Eating my way to the qualifying BMI

[blubberbegone 0]

Hello, I'm new here and just wondering if anyone else had to put weight on to qualify for lap band surgery? I'm nearly there according to my GP. How fussy are the surgeons? I am wide but also quite tall!

Doing lots of research,

....Lisa

[SuzanneG 1]

I'm 5'4.5" and weighed 209 when I went in for my consult. That put my BMI at 35.1. My insurance company said they would pay for min BMI of 40 or 35 with comorbidities.

I got denied the first time through and had to file an appeal. Meanwhile, I was eating everything I could think of that I love and basically just enjoying myself, no rules, no diets, no holds barred. I gained to 225 (with clothes on) in a matter of months and when my appeal letter went in my BMI had risen to 36.7. This apparently was just enough, along with my letter to approve me.

I was starting to panic once I got stuck in the delay, it seemed like once I got started with gaining, I couldn't stop it. I was terrified what would happen to me if they denied me again, but alas all's well that ends well.

Good luck to you.

[morganclan 0]

I think it depends on your insurance company and their requirements. Many ins. companies require 6 months of supervised diet from a doctor or nutritionist. I don't know how it would work if your weight kept going up each month. If you are self pay, it would just depend on the surgeon's willingness to perform the surgery on someone with lower BMI

[blubberbegone 0]

Thanks SuzanneG,

Likewise - same concerns.

I need to either get approved or get sensible!

Can't stop eating,

Lisa.

Just realised... You're such a newbie! Hope it's going well for you. I Wish you every success.

[blubberbegone 0]

Thanks Morgan, I will quiz my insurance company.

So many more questions to ask,

Lisa.

[Sunshine08 0]

Aww, don't do that to yourself - there are plenty of surgeons that will perform the surgery with lower BMI - (mine was) Co-Morbidities can be anything from sleep apnea to Plain old back pain, which I think all of us heavy people have. Also, if you can get your PCP to write a letter on your behalf saying that you would benefit from weight loss surgery and be less at risk for heart disease, diabetes, etc., that helps.

hope this helps, good luck

[chica 2]

Gosh, I just joined too and am doing the same thing -- eating to qualify! It sounds stupid, but can't afford to self-pay!!

[VegasGrace 1]

I did thinking that same thing...got so sick of fast foods. But you only have to worry about that if you are trying to get insurance to pay.

Silly me. I was self pay and ate all that for nothing. Was tastey!

[VegasGrace 1]

Oh, I even didn't stand so straight when getting my height checked.

Hey! An inch is an inch and skews the bmi.

[chica 2]

I'm with you on the height thing! The last time I saw my PCP, they measured me 1/2" taller than ever before. I'm going to insist that was a bad hair day and that they need to re-measure. Then I'll get my chance to slouch a little!!

[SuzanneG 1]

I made them measure me twice, then I told them that I weighed a pound heavier the previous day at my GPs office. They took my word for it on that one and took 1/2" off my height on the recalc.

Federal BCBS only considers 3 co-morbidities for BMI under 40 and they are

1. Heart Disease

2. Lung Disease

3. sleep Apnea

That's not the way my handbook read, but my rejection letter specifically called out those three. My appeal letter listed about 10, none of the above included. I got letters of support from each of my doctors and was finally approved, but not before gaining 19 pounds! Eeeek!

I just lost that back off so now I'm hoping for a loss this week. It's my first week on mushies and I eat three 4oz meals a day (started Friday) and haven't lost an ounce yet on mushies. :-(

[PTinUtah 0]

Suzanne, I should be a shoe in for surgery , as I have all three of those co-morbidities and have a bmi of 41.4. If I am correct you had Blue Cross Federal, if so how much did you have to pay out of pocket? Im glad you got yours done good luck with it

[ronwifey 0]

I think I'm doing that too, LOL. Today I weighed 242 but I am 5'6"- 5'7". I do have serious knee, hip and back pain. I think I have sleep apnea too because sometimes my husband wakes me because he says it sounds like I'm going to choke and I'm sleepy ALL DAY long everyday so I know I'm not getting a good night rest. I also have BC/BS federal Basic. Wish me luck.

[kcmomx3 0]

I am very new to this whole process-I live in KC, MO and so far had gone to Dr. Malley's orientation and had a consult with him. Now.....onto the insurance stage. I have BC/BS Federal insurance and wondering if I need a letter of all failed past attempts at weight loss and if so, can anyone giveme an example of that letter. Like any of us who have been trying to lose weight for the last 20 years-have it documented somewhere. I don'T. I did get a letter from my primary care stating medical necessity-but the surgical center seems to want more-HELP

[Jachut 487]

My surgeon saw my DH recently, as he's going to be banded too in June.

He knocked an inch off his height and added a kilo or two to his weight. Just to get him to a BMI of over 36. They will band you from a BMI of 30 in Australia but not routinely, generally you'd need some significant comorbidities for that.

I dont think he'd necessarily do that if he didnt feel the surgery was a good choice for the individual.

Myself, when I first began investigating I thought I'd have to have a BMI of 40, becuase I based everything on all the American literature I found on the internet. I had a BMI of 36, I had no hope of gaining to 40, and I would NEVER do that to my body. To gain 10lb is one thing, to try to gain 40 or so is quite another, very dangerous and bad for your health and all that weight you have to lose again. So I just went along hoping for the best. Weights in the pockets, heavy clothes, lol, slouching when being measured. In the end all that mattered was I had a weight problem, it wasnt huge, but it was getting bigger and I'd been battling to one degree or another since puberty.

good luck! I dont think its silly to gain a bit but dont gain dangerous amounts.