Should people barely over 200 lbs or below 200 get Lapband or any WLS...?

[Carrie_C 9]

My goal is 150, but I can't wait to get to 200 too. I am 5'7, and when I weighed 200 (a million years ago) I thought I looked pretty good.

[Texasgirl1966 0]

I am 5'1" and weigh 212 lbs. My BMI is 40+. I have high blood pressure, joint pain, and have had surgery on my feet. My BMI makes me a candidate for lap band and I am not wanting to put more stress on my body and organs. The Dr wants me to weigh between 112 to 124 lbs that is 88+ lbs that I am over weight. I would be happy at 140 or less. Regardless if your weight your BMI is the usual determining factor in having WLS.

My surgery is scheduled for November 18th and I am so ready to get banded and begin to lose this extra weight.

[grateful1 0]

This thread is PRECISELY why I am part of the BAND3035 study! I am 5'5" with a BMI of 34.5. I have no co-morbidities or health problems. I have been overweight all of my life and have lost hundreds of pounds on many diets. Now I'm 40 years old with 2 small boys and the extra 70 lbs. is weighing heavy on my frame and making it difficult to keep up. I know that I could go on another healthy eating and exercising routine and lose some weight, but my past predicts that I will not be able to keep it off and I'm TIRED of the restriction. I can either wait until I put on 45 more lbs. and start having co-mordibidty problems, or I can deal with it BEFORE that happens! I'm part of a study that is trying to get FDA and insurance approval for gastric band surgery for those with lower BMI's and the propensity to be morbidly obese, whether they have co-morbidities now or not. I really wish insurance would approve my case BEFORE I end up needing their coverage for co-morbidity issues. I am going to show that even low BMIers can be successful with the band and that offering the band to the low BMIers may lower the morbidly obese death stats.

[fatme 0]

I totally agree with gratful1 you have been through it all and it will only get worse. I hope everything goes smoothly for you. I'm 48 and although I had a high BMI I hadn't yet had health issues and I'm so grateful that I had the surgery. I am a slow loser but I am losing and my health is improving with every pound that comes off. The weight gets so much more difficult as we get older and it's harder to take it off. Everyones situation is different but the bottom line is we all need to keep or regain our health. Good luck I hope we hear from you in the future so that we can Celebrate your success.

[Nibblet 0]

I know it might seem somewhat superficial if it would appear my road to recovery is a bit shorter than others, but 5'04" 200 is really getting out of control. Although I'm healthy & active, my family has a serious history of heart disease. I have lost weight in the past by other means, but slowly put it back plus more each time. My closet looks like an advertisement for Verizon & things that were once easy now cause me to breath heavy. I wish I possessed the discipline to do it another way, but the reality seems to dictate otherwise.

[Sooverit! 1]

There's an important element you are leaving out and that is age. Someone who is your age and is healthy and a 30 bmi well then it's her and her doctor's choice.

=Someone at age 50 will find it extremely difficult or impossible to lose more than 50 lbs.

I'm 49 just had the surgery yesterday actually and I did it because the weight was piling on every year and wouldn't respond to exercise. Just developed Hypertension also.

to each is own I say

[smsmithart 4]

I'm glad I did...my higest was 195...I'm almost to goal now.

[imacha 0]

I think this a good question because i think about it often with regards to insurance approval. I was told at one of my band meetings that insurance companys don't take into account at the individual weight history amongst their clients.

All that matters is the results of the 6 month diet/excersize pre-op hoop jumping they make you go through. That got me to ring the "that's not fair" button! Simply because I've been obese all my life since I was 2yrs old! Diets, excersize, pills, Atkins, yadda yada yo-yo! I've been 200lbs+ since 12yrs old and haven't been under that since!

Now, I'm kinda competeing for approval from insurance with people who, let's say, for the most part of their lives have been thin/healthy weights but now has had kids and have no time to workout or eat right etc... and let thmselves go.

I believe their "hoop jumping" for approval from insurance would be easier since "now"

they're putting their bodies to work and it will "on the record" prove to insurance that they're serious about getting surgery. Meanwhile, someone like me is and HAS been putting in the effort and no real change happens, as per usual, thus showing mr.insurance that i'm NOT serious enough to make the changes needed for the surgery!

I mean, is that how it works on their part?!?!

If so, that not right.

SO, height/weight/bmi aside, I think there should be some sort of consideration between persons of genetic obesity and lifestyle obesity when insurance approval is involved.

My apologies, I think I may have gone off topic.

Oh my darn rants!

peace

[Jachut 487]

With all due respect, there goes someone again with the "I deserve it more than you coz I'm fatter" argument.

I dont think you can judge those things. Who's to say who suffers more mental anguish, who's to say that I wasnt thin during my teens simply because I worked harder than you did? If that's an offensive thing to say, then so is saying that someome like me ought not to have the surgery becuase we dont deserve it as much as you. Why should I be disadvantaged because I chose to run and play softball and netball and stay fit and active until I had my first baby?

You cant distinguish between lifestyle and genetic obesity, there's no such thing. All obesity has genetic and lifestyle components. How would you propose we break it up, do we have to quanitfy it and say everyone who has over 50% lifestyle component ought to pull their socks up and their fingers out and work harder? Come to think of it, how would you know that someone who has a weight of 200lb and has not been fat all their lives is not just very very strong willed and has fought it successfully for so long but can hold out no longer?

you make it sound like all those who are less obese have just let themselves go while you have struggled valiantly all your life, being perfect but being obese through no fault of your own!

People who think that fat people are discriminated against so unfairly should drop in to lapbandtalk for a brief spell and hear some of the prejudiced, biased views against those who arent so fat. It definitely goes both ways!

I had a BMI of 36, I hadnt been fat ALL my life, it definitely escalated after babies and with middle age approaching. I got banded, I worked it, I lost 120% of my excess weight and I've now run a half marathon. I think I can say I was "serious" about the surgery, every bit as much as you are.

PS: I want you to know I am attacking your ideas and interpretation, not YOU. I can hear the frustration in your thread and I really feel for you. In Australia, we dont have to fight for what is our right - decent health care. I'm sorry that its not so easy for you.

Edited December 7, 2008 by Jachut

[MacMadame 81]

I mean, is that how it works on their part?!?!

No, it doesn't work remotely like that. All insurance companies care about is that you dot the "i"s and cross the "t"s even when their "i"s and "t"s make no sense and are just arbitrary rules they put in place to make it harder to get approval. If you jump through the hoops correctly and meet the criteria, you get approved. If someone who weighs 200 lb. jumps through the hoops correctly and meets the criteria, they get approved. It's a bureaucracy.

If anything, works it the opposite of how you imagine it because of how the rules are set up.

Take me. I've struggled with my weight since I was 8 or 9. I went on my first diet at age 13. Because I fought the weight gain, it took me until 25 to be obese. Because I am short and 200 lb. is a LOT of weight on me, I spent much of my adulthood hovering between obese and morbidly obese. But in the US the NIH and insurance companies have picked the arbitrary BMI of 40 as their cut off. That's okay, though, as my BMI was 41 when I decided to get surgery.

But insurance companies have added all these other wrinkles and they favor the long-term MO and the SMO. For example:

1) Some ask for a 5 year history of MO. This is NOT the NIH criteria. The NIH says only a "history of obesity". So someone like me may not have been MO for 5 years in a row because I was constantly dieting and dropping below a BMI of 40 and then gaining the weight back and going over 40. Someone who is SMO has no problem providing a 5 year weight history.

2) Many ask for a 3 or 6 month doctor supervised diet. Again, this is not in the NIH criteria. They just say a history of failed diet attempts. Which I have. But if I had gone on a 3 month or 6 month diet and had really tried hard and done well, I would have dropped my BMI below 40 again. Some insurances would then use that against me to deny me.

3) Many surgeons then ask the patient to lose 10% of their body weight even though clinic evidence to support this practice is weak. Again, if I comply with this requirement, my BMI drops below 40 and I risk insurance not approving my surgery.

Neither 2 nor 3 are a big issue for the SMO. It's impossible to lose enough in even 6 months to get a BMI of 50 to drop below 40 and 10% of 300 or 400 or more isn't enough to do it either.

4) Co-morbidities. I had some. But many insurance companies puts extra restrictions on them and mine refused to count any of the ones I had. They weren't "bad enough". This is not an issue for heavier people as they qualify just on weight alone. Plus, even if their insurance company requires co-morbidities, they are more likely to have them.

The bottom line for me is that WLS works when you have 50 or more pounds to lose and dieting & exercise without surgery does not. Obesity is a disease that costs society. We have a treatment that works to combat this disease, yet we put restrictions on it and force people to get heavier and sicker than they need to before we give them the treatment.

That is not how medicine is supposed to work.

The funny thing is that there are other diseases that are much more of a lifestyle choice than obesity. My MIL died of lung cancer which she got from smoking. Smoking was totally her own choice. Yet when she was diagnosed, the medical profession treated her like any other sick person and not like someone who had chosen to have a disease and therefore had to constantly prove her worthiness before she got treatment.

[Sooverit! 1]

Hi peace....i rather liked your rant this morning. I think the rage inducing insurance companies in my experience are an equal opportunity pain in the Asjkljkf, but what I've seen so are is they usually know they have to cover a patient who's BMI is over 40 period. It's a shame because I only had a 37 BMI but 98 lbs. over weight and developed recently (during my ins co. coverge rejection period) Hypertension and pre diabletes.and dangerously high Trigliserides ..if I didn't find this low BMI study and do something to change fast...I think I would have had a heart attack like my sister and dad did and eehhh gad my daughter's only 11!! I can clearly see now as you will, that my hunger que was just way out of wack. I was plagued by hunger most of the time and couldn't feel full ever. I feel normal now with the band. I eat like normal folks...not like a woman with an over developed survival mechanism living in modern times! :-) best to you!

[Sooverit! 1]

Oh and MacMadame is complete correct and very astute in her understanding of these folks! I forgot to mention that my insurance company Cigna - worst - changes their stipulations constantly. THe 40 BMI rule changes often ...now it is having a 40 BMI for more than 2 years with substantial proof and uncer that comobities that don't respond to meds!

[MacMadame 81]

Yes, the co-morbidities that don't respond to meds is what got me. I have HP but it does respond to meds. (Well, I had it. Since surgery I haven't.)

I have Aetna. They, at least, make their criteria VERY CLEAR. It's right on their web site. Lots of insurance companies make you guess and you can't get a straight answer when you call.

Plus Aetna only requires 2 years of BMI over 40, so if I couldn't provide that, I wouldn't have *that* long to wait. But my company had an exclusion ... another subject that causes me to rant and rave ... so it was all moot.

In a way, that exclusion was the best thing that could have happened to me. Once I was off the insurance merry-go-round, I could do what made sense for me. I could pick the surgery I wanted (Aetna says the sleeve is experimental), I could pick the doc I wanted (my surgeon wasn't in-network), I could lose as much weight as I wanted waiting for surgery (I lost 30 lb.), and I didn't have to do a supervised 3 or 6 month diet (after spending 5 months doing an unsupervised one), all without fear of not getting my life-saving surgery.

The downside is that I had to pay for it even though I and my company pay them premiums every month. :biggrin:

I was 191 on the day of surgery, btw, with a BMI of 36. And if someone doesn't like it, they can go suck it. :biggrin: I did what made sense for me.

[marieg 3]

I weigh 200 pds and am 5"4 I am 37 and have struggled with my weight since I am 12.I was seriously considering lapband as I figured "what is the point of losing weight again only to regain it.I went to a seminar and booked my physical and nutriotnal appt.However after checking out the message boards and realizing tha NO ONE knows the long term affects ,in additon to scores of people have unpleasant complications.I decided to give dieting one last shot and hopefully I will be able to maintain it within 25 pds.I believe that ONLY after you are 100% sure that NO other way will do it for you,lapband is an option.LAPBAND should not be thought of as a cosemtic procedure or just another diet.LAPBAND is SERIOUS business.

[Jachut 487]

Oh, I dont know. That's just your opinion, not fact.

I man, how is lapband so very much more SERIOUS than having breast implants? Both operations cut you open, insert devices into your body and carry the risk of complications, dont they? I dont know about anyone else but having a lapband hasnt meant that I have to sacrifice my health to be thinner, I eat very well, much better than I did before. Its a much easier surgery to recover from than a lower body lift - and with less risk of uncomfortable and inconvenient complications. It drives me nuts that people accept all these surgeries without judgement - heck, injecting toxins into your face or plastic substances, that's all OK, but god forbid anyone have a lapband because they dont like how they look fat!

The cosmetic benefits were a huge part of it for me and I refuse to apologise for that, nor do I believe my *right* to the surgery was any less than yours becuase I didnt have comorbidities!