If You Had To Gain Weight to Get Lap-Band Covered By Insurance...?

[Apples2 19]

Need to clarify that my BMI was at 39 and had been for more than five years. My surgeon wanted me to be at the 40 mark

[Apples2 19]

Good advice, Periwinkle. You can be so close yet so far away when you want to be accepted to the program. Good luck with your surgery (and the days anticipating it). If I get approval this week, I should be able to have the surgery on Feb 19

[ssdown 0]

For my first appointment, I was ten pounds shy of the 100 pound/40 BMI requirement and I didn't have any co-morbidities. I was told that I did not qualify for the lap band. So, my choice was, hmmm, loose 90 pounds on my own and gain it all back which is what I've been doing for years and years and years, or gain 10 pounds and then qualify for the lap band and have this valuable tool to help me loose the weight and keep me stable. It was a no-brainer.

[ssdown 0]

To clarify, I am self-pay and didn't have to mess with insurance.

[rottimom 0]

Boy I thought I was the only one in this boat. I am also just at 40 BMI. I still have 6 months of dietitian’s consultation to go through before my Dr will even submit my paperwork to my insurance so I had a chocolate bar today without guilt for the first time in 20 years. I figured if I put on a few pounds it can only help my case to get insurance to pay. But I do not want to put on to much more. I still have a small fear that even with the LapBand taking of the weight is going to be hard. Boy how screwed up is it that we have to gain or find tricks to make our weight higher just to have this problem fixed.

[losingjusme 12]

i think the most i would intentionally gain would be about 5 pounds. if i needed more, i'd put a few rolls of quarters or something in my pockets.

[Frustrated 1]

I gained wait to get approval. It was a simpler way than having to jump through more and more co-morbidity hoops. The medial physician who initially denied my claim actually TOLD me that I would be approved if I got my weight up to a 40 BMI. I was, at the initial consultation, sitting on 35.9. I needed it to be at 36 in order to qualify with the co-morbidities that I had. But on consulting with the insurance physician, he told me that I was only taking 1 medication for my insulin resistance and I needed 2. I only had slight sleep apnea. My joint problems were not severe enough. My PCOS wasn't really considered a co-moridity. I wasn't overweight enough. So I asked him if I got my doctor to prescribe another medication for my insulin resistance if that would be enough to be accepted. He said (and this is no lie) that if I got my BMI up to 40 I'd be accepted no problem at all. That's right. I had to gain weight in order to be approved to lose weight. :cheers2:

To make a long story short, that's exactly what I did and haven't regretted a single extra ounce I had to gain in the process. Sure it meant I had more weight to lose in the long run, but the long run was what I was after anyway. This is a lifetime journey for me.

[ssdown 0]

I couldn't believe that I had gain ten pounds, but I finally got my date for March 4! Yea! The stupid thing is now I have to loose the ten pounds to get ready for surgery!

[desperategal 0]

i have a consulation on friday for the lap band procedure, two days away. I need to be twenty pounds heavier than what i am for my insurance, united health care, to consider approving this surgery for me. Does anybody have any advice to give, do they make you take off your shoes or clothes to weigh in? i was actually thinking about putting weights in my shoes. Is it cut and dry as far as the doctor approving you for the surgery if you are borderline, or do they want to work with you and your insurance to get approved. With weighing in at an extra 20 pounds, it will put me at a bmi of 38. Please if you have any advice or tips let me know. Thank you

[ronwifey 0]

I had to take my shoes off. I had to have a BMI of 40. As far as weights.......those ones maybe that go around your ankles, like walking weights, and wear pants.

There are some posts on here somewhere with ideas that helped others out.

[Frustrated 1]

Please if you have any advice or tips let me know. Thank you

My advice would be to wait a little while and pack on some more weight. When they measure your height, slouch as much as you can. One inch can make a huge difference as far as BMI is concerned.

Lap band surgeons want you as a customer, so they're going to give you all kinds of advice to get you to where you need to be. It would be in your best interest to have the BMI you need to qualify for surgery, else you risk being declined the first time. That kind of set-back is really stressful and depressing.

So wait until you're more sure you fit the criteria for being approved before your documents are submitted to the insurance company.

[ssdown 0]

My MD and the lap-band clinic insisted that I be at a 40 BMI weight. I am self-pay, so I didn't have to play the insurance game. I protested the height that I was given and my MD placed it at 1/2 inch less. That helped, but I still gained the weight, which was much harder to loose than gain, but it put me over at the 40+ BMI requirement. I basically had no co-morbidities. If you have some co-morbidities (high blood pressure, diabetes, etc.) perhaps your insurance will allow less weight. I think waiting and gaining is a good idea, but I also like the idea of the ankle weights. Maybe do both, only gain 10 pounds, and wear 10 pounds on your ankles! Like I said, play the game and go for it! Good luck and keep us posted.

[Rascal76 0]

I can't believe this exists... I'm so happy I'm not alone... I am about 10 pounds from 40 and I know I don't have a co-morbity... I bought this and don't laugh... a pair of mens steel toe workboots last night! I had to... they are black so they are less noticeable... I though about weights but I don't want to get caught so please tell me what you did! When I asked what the meeting would be like they said it's like a physical... Gulp!

Thanks,

Shannon

[Frustrated 1]

I can't believe this exists... I'm so happy I'm not alone... I am about 10 pounds from 40 and I know I don't have a co-morbity... I bought this and don't laugh... a pair of mens steel toe workboots last night! I had to... they are black so they are less noticeable... I though about weights but I don't want to get caught so please tell me what you did! When I asked what the meeting would be like they said it's like a physical... Gulp!

Thanks,

Shannon

They're not going to strip search you. But they may ask you to remove your shoes for the weigh-in. Be ready for that. Someone has already mentioned ankle weights. Wear those under long pants. Or you could stuff bags of rice or sand in your bra. It sounds ridiculous, but the insurance companies can be ridiculous too. Play the game. Needing to gain 10lbs in order to be approved for a procedure that can help you lose 10 times that much is worth it in the long run. It'll take some time to lose that extra weight, but if you're anything like I was, it's only a matter of time before you hit that high anyway. :eek:

Another tip for when they're measuring your height, slouch down so that you're half an inch to an inch shorter. That makes a big difference to your BMI.

[Rascal76 0]

Thanks for the tips! I measured myself and I'm actually just under 5'5 so I'm not going to be able to say 5'3, but I'm definitely going to be prepared... It is so weird to actually have to gain weight to qualify... I mean seriously how much more do my thighs have to be rubbing? How many necks do I need? LOL I have even said I might as well try to gain 5lbs to help for next week and for the first time ever I'm actually having a hard time mentally doing it... When I restrict myself I want everything in site, now that I'm telling myself eat whatever you want until next week I have been feeling not hungry and full and almost like it's a chore to eat a cookie! That so never happens until now! Weird... Any way I have some parties and stuff going on this weekend so I should def be able to put on 5 pounds and find a way to gain 5 more (ankle weights). I have not been this excited about something in such a long time! It's like there is some light at the end of the tunel. Thanks for listening to me bable! :-)

I am definitely going in after weighing in at home and making sure I'm spot on 40... Has anyone been denied being at 40 with no co-morbities?