Insurance wants me on a DIET!!!! Here's my rant... - Page 2 - ThinnerTimes

lealphachienne · 04-27-2005, 05:57 PM

When they ask you to jump, you ask, "How high". Whatever the obstacles, it's worth it in the end.

Nikkigotrocks · 04-29-2005, 11:22 PM

You know most insurence companies have that requirement, it sucks I know. But three months isn't too bad. I had to do one for at least 6 months before I could even think about the surgery. Hang in there.

notsosmall619 · 07-15-2006, 10:58 PM

Try to use your optifast case.. thats what I did I just had the doctor who put me on the HMR write a letter and I had stopped well over 6months, but I did have diabetes and hypertension.. but the insurance people can be ignorent..they interviewed me and told me that I could die of this surgery and I said I had alot of faith in god and they told me I should try a spiritual diet if I had so much faith..they pissed me off but I got my surgery so screw them..they don't understand how hard it is to loss weight.

vbee · 07-16-2006, 05:35 AM

My insurance didn't require me to diet, but I chose to. I just hopped on the high protein/low carb bus for awhile, started in Feb and have lost 40 lbs. I started into all this at 368 lbs. My BMI is higher than most of the folks who have had the surgery where I'm scheduled to go, so they are bringing in another surgeon to assist. its been extremely tough, I have tried hard to stick to it, and you will too! We all know dieting has been difficult or we wouldn't be here today to talk about it. Fortunately we are and I'm glad for that. Best wishes to you. One day at a time and when you're feeling you need to rant...this is the place to come, among friends who know your frustration! Hang in there!

Gina in NY · 07-16-2006, 10:57 AM

and it took a lot longer than 3 months! So don't worry - you can do it and it gives you some time to get "stuff done". And really, I think the wait gets you even more ready and in better shape. My recovery has been amazing, in part I think, because I had so much time to get information and get myself psyched up and over my fears.

Hey - you have many decades of health ahead - 3 short months won't be too bad.

StephRye · 07-16-2006, 11:06 AM

what a reality check that this got bumped up! This was over a year ago that I was whining about 3 little teeny weeny months of dieting. I had totally forgotten the anxiety i was going through before surgery. I am now almost 11 months out and have lost 160 lbs. Life is amazing! I'm almost ashamed that I was complaining back then...silly silly me!

For all of those still in the beginning stages...it seems like an eternity (took me 8 mos start to finish for testing, labs, diet, etc.)...but you really are going through a process where you will experience a "rebirth" as a result. Totally worth the wait! My life is better than I could have ever expected. I am so active and busy now...the 8 month pre-op wait is a distant...distant memory! It's almost a prerequisite to being able to start the life you've always dreamed of...good things come to those who wait...be prepared to be blown away!

Congrats to all!

lealphachienne · 07-16-2006, 02:20 PM

Yep,. the waiting seems sooooo loong...now, 2 1/2 years have passed for me and I wonder where the heck all the time went?????

Routerqueen · 07-16-2006, 09:43 PM

Well I have been reading about the problems some of you have faced with required weight loss before surgery. My insurance company wanted me to lose 10% of my weight before I could have surgery. Well sort of. I have Kaiser and 4 years ago they were so backlogged they were sending people to San Diego for surgery. If you got chosen to go to S.D. you didn't have to lose weight. However, if you were chosen to have it here in N. Calif. then you had to.

So here is my story. I was chosen for San Diego. Scripps Medical Center. Surgery date was to be Sept. 27, 2004. On Aug. 1 my husband got laid off and we lost our insurance. He went to work for another company and he got insurance right away. Pacific Care. I went to a seminar for the surgery and then saw the surgeon. No weight loss requirement. The day after seeing the doc, they called to say my insurance no longer covered the surgery. Talk about depressed.

My husband then went back to his former place of employment and we were put back on Kaiser immediately. That was Jan, 2005. I had to start all over again to get the surgery. Kaiser was no longer sending patients to S.D. because they had added more hospitals to do the surgery. So the 10% weight loss requirement now applied to me. However, while on my other insurance I was at my highest weight ever, 332lbs, and was down to 315lbs. The doc said if I provided the medical report from that doc they would use it for my weight requirement. That was Aug. 2005. In Sept. 2005, I seriously injured myself exercising and ended up laid up for over 2 months. Then ended up with other health problems as a result of the injuries. I finally felt recovered in March of this year. I got the medical report to my doc and I'm 3lbs away from goal. They called me June 30 and said my surgery will be scheduled in the next 2 to 3 months.

My opinion is this. If we could lose weight we wouldn't need the surgery. We have continuously failed at weight loss and in my opinion all the weight loss requirement does is set you up for more failure which lowers your self esteem even more. I think it's all about money. They're banking on failure. I'm wanting to find out the failure rate for women who have to deal with such requirements. I'll bet it's high. I say congrats to those of you who had the requirement and acheived your goal. But I would like to crusade for the women out there who are being denied the surgery for that very reason. I don't think it's right and I don't think it's fair. And like I said, I KNOW it is about money.

Routerqueen

"Keep away from people who try to belittle your ambitions. Small people always do that, but the really great make you feel that you, too, can become great." - Mark Twain

Gina in NY · 07-17-2006, 02:12 PM

I had to lose 10%, like I said in my last post, but not for my insurance company, for my surgeon. The biggest risk of death after GBP are heart attack and stroke and if you lose 10% of your weight, you decrease your risk of heart attack and stroke by over 20%. There is also some evidence coming out that those who lose 10% before surgery adjust better to the post-surgery life style and don't reagain their weight because they've made the life changes necessary beforehand.

Now don't get me wrong, I cried and complained and stomped my feet for several weeks before I broke down and completely changed my life to lose the darn 10%. But in my case at least, it certainly wasn't about money for my insurance company or the doctors. The surgeon's could make more just slicing you up w/o requiring it. Like I said, my insurance company only wanted to know my BMI - no other requirements. It is my surgeon who required the 10 other things I had to do.

So - it sucked the whole time I was losing it - but my life now is very similar to my life while I was losing the 10%. It was a good preparation.

Routerqueen · 07-17-2006, 05:54 PM

Hi Gina,

Congratulations on being successful. Unfortunately, there are many out there who are not. There are also many out there who had no requirements and have done very well.

There is also some evidence coming out that those who lose 10% before surgery adjust better to the post-surgery life style and don't reagain their weight because they've made the life changes necessary beforehand.

I totally agree with you on that. It's what I have had to do. I have been to many seminars, done a lot of research and talked with many people about this surgery. I think the best preparation is being part of a GBS support group where you can learn first hand the ups, downs, ins and outs of this surgery.

You've only been out of surgery for a month. How do you feel right now and what is happening to your body that is different from pre-op? Feel free to email me.
Routerqueen