Hey everyone. I'm 5'2 and weigh 184. My BMI is 34. I'm on Medicare; you have to have a BMI of 35 for Medicare to pay. Any suggestions for me? Paying out of pocket is not an option. I loaded up on cookie dough last week...I've almost polished off one package but it is killing me and I have to gag it down. I stepped on the scales today hoping for 190 or close, and I've lost 4 lbs!!!!!! This is driving me nuts!

Anyone know of something heavy I can stick in my bra when I meet my surgeon????? j/k....MAYBE! ARGH!

Blessings, Michelle

I think its better for our TAX DOLLARS to pay for her surgery now, then having to pay the thousands of dollars that will come LATER from health problems of being overweight!!!!!

Well I think the best thing would be for her to pay for her own insurance. That would solve the whole tax dollars thing.

Usually if someone can afford fertility treatments (which isn't covered by Medicare) they surely could afford insurance of their own.

Your kidding me right!? Who are you to decide if this person is "big" enough to have surgery.

Apparently I am not the only one that is deciding this. Medicare agrees with me. Hmmph.

OK Four months ago I did the same thing.

I had a BMI of 35 but needed 40 for insurance to pay. I put on 15 pounds. I couldn't gain enough weight so when they asked me how tall I was I took off 2 inches. That helped. Kinda...

So my insurance denied me right away saying not a high enough BMI. I am lucky enough to change to Bc/Bs as of the first of the year I need a BMI of 35 with HTN.. I have it. Yahoo.

I just finished my Phych eval on Tuesday and will be getting the rest done after the first of the year. I am praying all goes through.

Am I extremely overweight no, but this is something I want and need. How much weight would you have to put on?? and you can always put some rolls of quarters in your bra.

Good Luck.

I am her same height and at 184 I looked and felt great. I would never ever had even thought about surgery at that size. She's actually losing weight and upset about it? What? Come on, this is ridiculous and you have to see that.

I'm 5ft 10 and at 184, I was fat. Not obese yet, but well and truly chunky and not looking my best. Rolls round the belly, big boobs and not able to shop in a lot of normal stores - we're not quite so supersized clothing wise yet in Australia, but its coming. A BMI of 34 is obese! If you think that looks good, then that's YOUR choice. I've lost down from a BMI of 36 (they band from a BMI of 30 in Australia). The improvement in my physical health is remarkable, I needed to lose that weight. You're only comparing it and finding it an improvement from being much much heavier. That's not reality. Its still heavy enough to bring the beginnings of comorbidities.

This is two issues and I dont really want to weigh into the illegal/cheating the taxpayer thing. Your medical system is just way too complicated. But I ask you this - How is gaining a few pounds to get the surgery any different from someone who gains right up to 300 lb and THEN gets the surgery? Costs the same either way only the 300 pounder has also probably racked up a bunch of costs for treatment of comorbidities of obesity as well. It actually SAVES the taxpayer money to treat obesity before it becomes serious. Everyone has a right to weigh in on how this affects them as taxpayers, of course they do, but saying you wouldnt have had surgery at 184 so therefore she shouldnt, well, that's pretty arrogant.

Think about it. If it were somehow magically easier to lose the weight becuase you're 184lb and not 284, why didnt YOU do that when you were 184lb instead of having surgery? Why have YOU taken up someone else's opportunity for surgery (because of course, there's not enough for everyone is there?) when you could have just so easily lost the weight before you got heavier? Why do YOU deserve the surgery more because you've allowed yourself to get more out of control? How often did YOU lose 4lb and regain it? And how different might your life have been if you HAD actually acknowledged 184 as obese at your height and had the surgery back then before you got bigger?

Its so hypocritical, it just drives me crazy.

Edited December 10, 200916 yr by Jachut

I sympathize w/the poster. I didn't have to gain weight to qualify. I happened to be just fat enough to have a BMI of 35 w/comorbidities. And, I mean by half a pound when I started this process. I did end up gaining weight during the process. The process took a whole year for me between the 6 month nutritional visits and two denials, and two appeals. I ended up gaining because I am ALWAYS gaining unless I am actively restricting calories and hungry... hence the need for the band. Anyway, the reason I was denied was not my current BMI, but because my BMI had dipped below the required threshold two years back.

OK, I am rambling, but you can't tell me that at 207, I was healthy, but when I reach 210 I am suddenly not healthy. I had high BP for 10 years, sleep apnea, ended up developing high cholesterol and prediabetes over the course of this past year.

I wouldn't recommend eating cookie dough to increase your BMI, though. I would just enjoy the holidays and let nature take its course. If I don't watch my weight over the holidays, I can easily gain 10-20 pounds. You could also start exercising (if you aren't already), but don't change your eating habits. You should end up gaining some muscle weight that way.

I dont really want to weigh into the illegal/cheating the taxpayer thing. Your medical system is just way too unfair.

Come now, are you really informed enough to form and opinion on a country that is half-way around the world's medical system?

Our healthcare system is just fine.

But I ask you this? How is gaining a few pounds to get the surgery any different from someone who gains right up to 300 lb and THEN gets the surgery? Costs the same either way only the 300 pounder has also probably racked up a bunch of costs for treatment of comorbidities of obesity as well. It actually SAVES the taxpayer money to treat obesity before it becomes serious.

This taxpayer is willing to take his chances and wait until later. Maybe by then they will have dispatched Medicare or at least closed the loopholes in the disability laws.

Well as an American I don't think OUR health system is messed up like you do, as a previous poster stated - half around the world.

What is messed up are those people who instead of paying for insurance they buy everything else themselves (beer, cigarettes, etc) and then expect the govt to foot the bill when they get sick. When if they'd just do without a little they could pay for insurance themselves.

There are cases where that IS NOT the case, of course. I have a disabled parent who absolutely would love to be able to work and pay their own way but it's impossible. That's the kind that deserve the help, not the moochers.

But I do see way too often people doing just exactly what I stated before. Cheating the system is what it's called.

When I was 184 I didn't feel obese at all. Overweight, yes. I didn't have trouble finding clothing. I know every body is different though and I am well proportioned and wore the weight well. No one would have guessed that I weighed that much ever. I always stumped the Six Flags weight guessers.

I don't know about the others but all my weight gain has been through pregnancies. I never gain when I am not pregnant. I can eat and eat and never gain when not pregnant. But once the weight is there, it just stays there after pregnancy. I don't understand it either. I can, and have, lost weight lowcarbing though. It works great, but then when I stopped lowcaring and tried to do maintenance the weight came back and stopped again right at my highest weight. It's like my body has a stopping point or something as far as weight goes. Wish that stopping point was MUCH lower though.

Even at my highest I stayed there eating whatever I wanted. Something goes nuts when I am pregnant though. I eat exactly as before and at the end even less because there simply isn't room left for a lot of food and gain like crazy. My dr. says it's the huge hormonal change.

I am sure I've been pretty blunt in my posts. I won't edit them because that seems cowardly but I do want to say that the pain I am in from my surgery yesterday has made me hell on wheels (my husband said this) to everyone. I still say it's crazy to complain about LOSING weight when you are cramming cookie dough down your throat.

The ignorance of replies on this is absolutely absurd.

The poster has legitimate reasons for being on disability and is asking a question. She didn't need to be "bashed" on this thread because some people feel it's not right for her to use Medicare/Medicaid for a surgery that she feels she needs.

Get over thinking it's your tax dollars and allow some common decency to rule your thoughts.

And yes I live in the US and work for the healthcare system.

Well that is your opinion. We all have one. :eek:

Well that is your opinion. We all have one. :thumbdown:

Absolutely. I just chose not to be rude about it. :eek:

No you are just choosing to be rude to me and not her. Your posts are rude. Come now.

No actually I was referring to some of the other posts. If you choose to feel it was directed to you then so be it.

Ohh ok, I stand corrected.

Well as an American I don't think OUR health system is messed up like you do, as a previous poster stated - half around the world.

What is messed up are those people who instead of paying for insurance they buy everything else themselves (beer, cigarettes, etc) and then expect the govt to foot the bill when they get sick. When if they'd just do without a little they could pay for insurance themselves.

There are cases where that IS NOT the case, of course. I have a disabled parent who absolutely would love to be able to work and pay their own way but it's impossible. That's the kind that deserve the help, not the moochers.

But I do see way too often people doing just exactly what I stated before. Cheating the system is what it's called.

When I was 184 I didn't feel obese at all. Overweight, yes. I didn't have trouble finding clothing. I know every body is different though and I am well proportioned and wore the weight well. No one would have guessed that I weighed that much ever. I always stumped the Six Flags weight guessers.

I don't know about the others but all my weight gain has been through pregnancies. I never gain when I am not pregnant. I can eat and eat and never gain when not pregnant. But once the weight is there, it just stays there after pregnancy. I don't understand it either. I can, and have, lost weight lowcarbing though. It works great, but then when I stopped lowcaring and tried to do maintenance the weight came back and stopped again right at my highest weight. It's like my body has a stopping point or something as far as weight goes. Wish that stopping point was MUCH lower though.

Even at my highest I stayed there eating whatever I wanted. Something goes nuts when I am pregnant though. I eat exactly as before and at the end even less because there simply isn't room left for a lot of food and gain like crazy. My dr. says it's the huge hormonal change.

I am sure I've been pretty blunt in my posts. I won't edit them because that seems cowardly but I do want to say that the pain I am in from my surgery yesterday has made me hell on wheels (my husband said this) to everyone. I still say it's crazy to complain about LOSING weight when you are cramming cookie dough down your throat.

So..... perhaps you shouldnt have gotten pregnant? if everyone else's problems are their own fault becuase of their own poor choices, perhaps yours are too. Perhaps you shouldnt have qualified for surgery and overburdened the insurance company becuase, you know, you could always have chosen NOT to get pregnant and then you wouldnt have gained any weight.

Because if people like you who made choices that led to them being fat werent having lapband surgery then the insurance companies could afford to approve the people that REALLY need it?

See how insane you sound? Your arguments have absolutely no logic and you sound like someone who doesnt take responsibility for their own actions - do I detect a hint of "it wasnt me, it was my hormones"?. We pay taxes for a reason, and one of those reasons is to ensure that in a civilised countrie, people in need dont go uncared for. I actually agree with you that need and what led to it is debatable. You dont have dibs on it simply becuase in your own mind you're on moral high ground.

And by the way - how do you know about ANY of the original posters financial circumstances. You're making a lot of assumptions there.

Lets just hope that nothing bad ever happens to you to make you reliant on financial assistance.

If I had to make assumptions about you - I'd guess you're fairly young and full of your own self righteous and as yet unfounded political opinions, that you grew up easy, had everything on a platter and had the opportunity to make of your life what you pleased. You hate people that have very large families because they're sponging off your tax dollars by having kids they cant afford. But you'll be happy to take the benefit of THEIR tax dollars when you're old and infirm and all those kids are out there working.

Of course, you DO have a point. Our baby bonus scheme here certainly results in a suspiciously large number of new plasma televisions. Sometimes it is more profitable to push out another kid than go back to work with our welfare system the way it is.

Now that could be wrong (and in fact I know it is because you said you've had kids, which does tend to bring maturity), and you'll be bristling with indignation that I dare to make such assumptions about you. Not nice is it? But if you're older, have had a bit of life experience, and still shoot off your mouth in this way without thinking about what you're really saying, shame on you.

Edited December 10, 200916 yr by Jachut

This taxpayer is willing to take his chances and wait until later. Maybe by then they will have dispatched Medicare or at least closed the loopholes in the disability laws.

That doesnt answer the question. Moral issues of whether medicare should cover this or not, lets pretend it will. So how is it ANY different to treat a patient now, at a BMI of 34, than later at a BMI of 45, when the patient ALSO has a raft of comorbidities chewing up even more tax dollars for ongoing treatment?

Would we be arguing about whether she ought to be treated for her diabetes or not, or would you be happy for your tax dollars to pay for that?

I find so many people in this community have this inbuilt attitude towards weight loss surgery, that its somehow OK as long as the patient is massively obese but if there's even a HINT of cosmetic benefit, look out! For someone to suggest that SHE looked ok at 184 and 5ft 2 so therefore there's no need for surgery is just plain stupid. Its a BMI of 34. Its obese.

So tell me, how does waiting for another 120 lb to creep on benefit anyone?