For those with BMI 35-40?

[snowbird 2]

If you don't have one already, find a primary care physician who will sit down with you and go over your health in tiny detail. He/she may find things that you do not consider to be co-morbidities, but they really are. My doctor wrote up borderline hypertension, borderline high blood sugar, a history of knee problems, skin rashes, reflux, everything he could think of that I had, as co morbidities, and my insurance paid for my surgery.

I went to Tijuana too, and had a wonderful experience. My BMI was 35-37 before my preop diet. I am now in the "normal" BMI range, a size 6 pants, and thinner than I have been in the past 30 years. This surgery was a wonderful thing for me.

[monalisah 0]

thanks for the info I have people to gain more to get to 40bmi

Trying to lose it. I will check it out

[coboom 0]

Sooverit, WoW I am so happy for you finding that study. I live in Northern Va. My endrochronologist suggested I go to Richmond. for banding and he reccommened VCU medical center. When they told me I was 10lbs shy of the BMI 40 I actually tried to gain more weight, and wouldn't you know it I lost 3 lbs ugh

I really don't want to wait and play the insurance game, because from what I read here it takes forever to get approval or with my luck denied. I tell myself that it is like buying a new car, but times are tough.

[Sooverit! 1]

Coboom: I agree...I'm glad I didn't take out a loan. You get crazy and just want it to be over and be banded. BuT from my experience ...be patient...if things aren't falling into place it is because I believe the universe isn't ready yet. It took me 2 years to find this extremely reputable facility that does the low BMI study AND my daughter is now old enough to process me having surgery like this....AND the money literally came from heaven. My mother died years ago and left me money that I had in a CD that kept rolling over and the bank didn't have my right address....they called theother day with the amount of money maturing which was exactly the amount i needed! true story Have faith....

[Cocoabean 430]

I am thinking seriuosly about getting the lap band. My BMI is 35.2, but I also have high cholesteral, Gerd and foot problems like plantar fasiitis and swollen tendons. All of it is from being over weight. My insurance Anthem BCBS covers bariatric surgery with a BMI of 40 or above...or 35 with at least one co-moribity. Anyone out there have any idea of my chances of approval? Oh...I was on weight watchers earlier this year and the latter part of last year too. I am hoping I have the criteria needed mostly covered.

Hi Phenry, I have BCBS California Care. I had a BMI of 38 when I started researching Lapband. I was denied a consult but appealed it and won. One of the things they stated in my denial letter was a lack of a 6 month supervised diet. I gave them my Weight Watchers records and other diet diaries I have and won the appeal. I was then approved for surgery without further denials.

My co-morbidities were metabolic syndrome and joint pain in my legs.

Metabolic syndrome includes:

1. Abdominal obesity: a waist circumference over 102 cm (40 in) in men and over 88 cm (35 inches) in women.
   
2. Serum triglycerides 150 mg/dl or above.
   
3. HDL cholesterol 40mg/dl or lower in men and 50mg/dl or lower in women.
   
4. Blood pressure of 130/85 or more.
   
5. Fasting blood glucose of 110 mg/dl or above. (Some groups say 100mg/dl)
   

The World Health Organization (WHO) has slightly different criteria for the metabolic syndrome:

1. High insulin levels, an elevated fasting blood glucose or an elevated post meal glucose alone with at least 2 of the following criteria:
   
2. Abdominal obesity as defined by a waist to hip ratio of greater than 0.9, a body mass index of at least 30 kg/m2 or a waist measurement over 37 inches.
   
3. Cholesterol panel showing a triglyceride level of at least 150 mg/dl or an HDL cholesterol lower than 35 mg/dl.
   
4. Blood pressure of 140/90 or above (or on treatment for high blood pressure).
   

Best wishes!!

Denise

[phenry 0]

Thanks Cocoa..I am reading my list of criteria that needs to be met. This came from Anthem BCBS. It states whether patient has failed conservative therapy and to outline conservative therapy. I have my weight watchers records...but I haven't attended WW since about Feb. or March 2008...hopefully too much time has not passed since I tried WW. I will see what they say if I get to talk to anyone at the seminar on the 10th.

[Cocoabean 430]

Hi phenry,

I referred to the book Weight Loss Surgery for Dummies quite a bit when researching my decision for surgery. The author provided a sample of an appeals letter, that is what I used to base my letter on.

I also included in my appeal information included in the National Institutes of Health Consensus of 1991, it contains a lot of information. It also does not include a recommendation of a 6 month supervised program, so your WW stuff should suffice, IMHO:

The National Institutes of Health (NIH) Consensus Development Program: Gastrointestinal Surgery for Severe Obesity

Here is what is says for BMI 35-40:

In certain instances less severely obese patients (with BMI's between 35 and 40) also may be considered for surgery. Included in this category are patients with high-risk comorbid conditions such as life-threatening cardiopulmonary problems (e.g., severe sleep apnea, Pickwickian syndrome, and obesity-related cardiomyopathy) or severe diabetes mellitus. Other possible indications for patients with BMI's between 35 and 40 include obesity-induced physical problems interfering with lifestyle (e.g., joint disease treatable but for the obesity, or body size problems precluding or severely interfering with employment, family function, and ambulation).

Best wishes to you!

Denise

[pheobe 69 0]

Hi Jenifer,

Im getting the same responses, and it makes me very angry, you know, i wonder if we told them that we were getting a boob job done, would the comments be the same ?

no they would probably say "You go girl" and support us all the way.

Im thinking that im going to find i supportive person and run with them, If someone hasnt had to struggle with there weight, they have no idea the pain we go through. if they did these so called friends would be more supportive!

Im in OZ and this site has a lot of support for us, we can all do it together.

Im going to remember that this is a positive health step for me, not an easy one but one with an helping hand.

Be strong as we are all entitled to our own opinions and our choices,

These people may not agree with what we are doing but if they are true friends or family they will be there to support us

my op is booked in for Feb 09, bring it on !!

[harliquinn 1]

i told my friends and family and only 1 friend wasnt supportive. she fed me some BS along the lines of, "i wont support you in this because surgery is serious and you could DIE! you just need to diet one more time and really stick with it and work at it again!"

i told her, "you know what? i could die in the shower. i could die while driving to the store. i could die under general anesthesia while im having my wisdom tooth out. does that mean i shouldnt do those things? ive TRIED again and again. it doesnt work. im doing my best and im losing hope. i hope that this can help me be successful."

she still doesnt support me but i have plenty of friends and family who arent being close-minded so ill be alright.

stick with the people who stand by you in your decision and dont let anyone bring you down! *big hugs!*

[ShiraSimcha 0]

I did tell one friend and she came back with "You don't need that! Let's do this together!" meaning losing weight on WW again. We've been doing it for the past 25 years and I am bigger than ever. My friend is 5'2" and nearly 300 lbs. She won't accept it. The problem for her is she has a friend who got banded at AGH in Pittsburgh and the surgery was a failure...no counseling, no nutritional support and she lost NOTHING. Her PCP wouldn't even treat her when the band slipped off. So my friend thinks its the most horrible thing. I broached it with another friend...what do you think about WLS? And she went off about how you have to move more and eat less. No duh but you know what? For me even an hour every day at the gym on the treadmill AND doing WW religiously....I gain. Obviously I need extreme measures right?

I have had my gallbladder out but not many folks know so thats a GREAT excuse. I didn't even think of that! :smile2:

[rrod0991 0]

My BMI was 46.6 and the nurse said I was a petite one. It felt good. Luckily my family is behind me and I have talked my mother into doing it as well. I almost have my sister talked into it as she needs it as well. we are all more than 100 lbs over weight. Anyone outside of my family says I am not heavy enough and should just diet. I tell them the lap band is not an easy way out but a tool to help me loose. They say if I can do it with the tool I can do it on my own. I say be careful who you tell as you may end up defending your decision.

[BillOh 15]

Your post said bmi 35-40, I'm not included in that but....

my bmi was lower than that when I was banded. And yes, I so know what you mean. I wasn't like morbidly obese but this fat all over me....couldn't get rid of it.

I suggest just not mentioning it to anyone...tell your mom, your favorite sister, and then your best friend aka spouse.

I was 35 when I applied and was accepted, I'm 1 week into 4 week pre surgery nuitrition classes. I may be lower than 35 when surgery day comes (late this year?) Last night I went with my wife to a local support group and even among the patients there, they seem to look down on me. One guy even said, "Why don't you look like we did?" I didn't know this guy and didn't feel like explaining my self to him. My wife was with me and I felt like I had to be polite, or risk not being allowed back. I carry all my extra weight up front making my BP go up and making it hard to breath and perform simple excercise. My sleep apnea is beyond severe and I am not tolerating cpap. My brother in law just died in his sleep last week at 57, probably from apnea. I know at work the word will spread about why I am out, I told my boss and one coworker. If they ask what kind of surgery I had, even knowing what it was, I just plan on answering, "A lobotomy":cursing:

[Sooverit! 1]

So what do you tell people when you lose the weight? I imagine saying I had a thyroid condition that has been taken care of but....lying is almost always the wrong choice. I live in a fairly small town and don't want everyone knowing and If I say it was just diet and exercise that that's lie too. What have you said and how have you said it?

[Shamrockgirl60 1]

Hey I had the same problem, went to first meeting and I was one of the "thinnest" there at 229. I was looked apon with dirty looks by the people who were much heavier. Hey I felt like saying, I don't want to end up in a wheelchair and on oxygen and have more life threatening morbities. So I am doing it NOW....before my BMI is 50 or above.

I just go along now and usually when I tell someone and hey I don't mind doing it. People are fascinated and most are very happy and say how great I am looking. The people who are overweight want to ask all sorts of questions and I am happy to answer them. They get such a look of hope on their faces I tell them to please look into it. I hope I have helped a few decide to check out WLS.

[Sooverit! 1]

Many surgeons in my area of NY are accepting patients with BMIs below 40 without co mobidities. Some are even studying Lap Band surgery for those with BMIs as low as 30. Surgery is much easier on a patient with a relatively lower BMI and why wait. Most people who reach obesity levels stay that way and or become severely obese.