35 BMI????

Hello everyone! Im new here and could use a little guidance. About 7 years ago I was diagnosed with PCOS after a pretty significant weight gain in a short amount of time. Since then I have battled with my weight, I see a nutritionist on a regular basis as well as working out twice a week. All I can seem to manage is to maintain the weight I am at now. I have tried every diet, pill and program on the market but with little success. I know that PCOS plays a huge part in that so I finally spoke to my Dr about VSG. She has always been a huge support of mine and had no problem writing the referral; she knows how hard I have worked. I spoke with a bariatric program and found out the requirements. I am at a 35 BMI right now; my insurance states that I can have it but need 1 co-morbidity to go along with it, which I do (sleep apnea). Here is my question/fear....I have my first appointment with the program nutritionist in a couple weeks and have been told that the weight at that appointment determines surgery approval. What if I fall below 35 BMI after that appointment?? will they still perform surgery if I say, fall to a 33 BMI???

This depends on both your insurance and your surgeon and may be different for everybody. The only way to know about your particular situation is to call their offices and ask.

I was literally a fraction off of a 40 BMI at my first consult. I had had to gain some weight and try again later. Yes, they are strict.

I will do more research and find out for sure. I have read that the nutritionist will put me on a modified diet/calorie regimen at the first appointment then again as I get closer to the surgery. I don't want to do all this work only to be denied a week before the surgery date.

Yeah, that bit is definitely an insurance thing. My insurer only cared about where I was at initial consult. In fact, they stipulates that during the 6 month pre op period that I could not gain any weight (okay for me to lose)

Insurance is very strict about the rules. With that said some will use the initial consultation weight and some will use weight at the time of approval/surgery. You should call and find out. Mine was at the time of consultation which might be partially because they required a 6 month supervised weight loss period prior to requesting approval for surgery (and I was assigned a case manager by the insurance company).

I have Aetna and also have the 6 month waiting period so I'm pretty sure it will be my weight at consult. I've tried calling my insurance company like 6 times WHAT A PAIN!!!! I try to ask customer service questions and all they want to tell me is what percentage my insurance covers.?. I've asked about talking to a case manager and they keep telling me that I will have one from my surgeons office. My "orientation" is tomorrow so I am hoping to have more info. I've watched a lot of vlogs but there aren't a lot of people with a starting BMI of under 40.

My surgeons coordinator did all that work for me (although I?d found it prior on my insurers site). That woman made it so much easier! She kind of figured everything out vis a vis my insurance and then just told me the steps I needed to take. I truly don?t know if that?s typical or if I?m lucky. I?m gonna PM you.

I was under 40 at consultation and actually under 35 at the time of surgery. Insurance can be a pain. Mine was changed a couple of months after I started exploring WLS and they kept telling me I couldn't get answers from the new one until they went in force until I really pushed it. They were telling me I had to go to a center of excellence, but wouldn't tell me which locations qualified! When I got a manager and told him why I was asking I finally got some information. I had United Healthcare and they may be unique in having a special program they require you use with case managers following your progress.

Thank you for the information! your the first one that I think I have heard of that was under 35 BMI at time of surgery. Congratulations on your progress!