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20 pounds to lose BEFORE surgery???

NurseBonBon
on 10/11/12 8:58 am - El Paso, TX
 Did any one else have to lose weight before the surgery?

I thought it was a bit much and what if t puts me out of the surgery zone? i have gained and lost and regained weight in the past. I'm so frustrated. 

            
Mom4Jazz
on 10/11/12 10:06 am
How tall are you?

20 lbs may or may not put you out of the BMI range for surgery, and many folks ask this question, but they typically go with your starting weight not your weight after your pre-op diet.

I don't know why some folks have to do this. Do you know if the requirement is from your doctor or your insurance company? 

Highest weight: 335 lbs, BMI 50.9
Pre-op weight: 319 lbs, BMI 48.5
Current range: 140-144, BMI 21.3 - 22

175+ lbs lost, maintaining since February 2012

NurseBonBon
on 10/11/12 10:18 am - El Paso, TX
 I'm about 5'7, 5'8 on a good day? I think it's an insurance requirement.
I hope they do go with the starting weight. I learned that they hook the patients up with nutritionists and a gym membership for 3 months to help the surgical candidate to lose the 20 pounds. Either way I'm motivated to lose the weight but I just hope to do it in a healthy manner.

            
Mom4Jazz
on 10/11/12 10:47 am
That does put your BMI pretty borderline, but as I said, they typically use your starting weight for insurance approval.

I'd check on something...what height does the surgeon's office have you at, and what BMI does your insurance require for surgery? I ran your 245 ticker weight at 5'7" and got a BMI of 38.4. Most insurance companies require a BMI of 40 unless you have several co-morbidities.

Highest weight: 335 lbs, BMI 50.9
Pre-op weight: 319 lbs, BMI 48.5
Current range: 140-144, BMI 21.3 - 22

175+ lbs lost, maintaining since February 2012

poet_kelly
on 10/11/12 10:30 am - OH
I know some surgeons require patients to lose a certain percentage of weight before surgery.  I don't know if some insurance companies require it as well.  Unless your current weight makes surgery too risky for you, I don't see the point, personally.  I'm glad my surgeon did not ask me to lose any weight before surgery, but if I had to in order to have surgery, I would have done it.

Usually they go with your starting weight, but if losing 20 lbs will make your BMI too low to qualify for surgery, I would check with your insurance company to make sure that will not disqualify you from having surgery.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

NurseBonBon
on 10/11/12 10:32 am - El Paso, TX
 that's a good idea. I'll call the insurance and see if it is an actual requirement.
But if I have to lose the 20 pounds then I better get to walking! :) 
lizpete
on 10/11/12 10:34 am - Marlboro, MA
My dr explained it by saying they wanted me to be "committed" and not to splurge on my "final meals".  Nothing about insurance  just wanted to be sure I was committed.

    

  

NurseBonBon
on 10/11/12 10:46 am - El Paso, TX
 Commited? Wow I guess that is a nice way to transition into it. 

For the ones that have already had WLS would you recommend it or would you do again knowing what you know now?
Mom4Jazz
on 10/11/12 10:50 am
For me, absolutely. I'm 5'8" and weighed almost 75 lbs more than you. I had a Vertical Sleeve Gastrectomy (sleeve or VSG). Here's the before and after:

Highest weight: 335 lbs, BMI 50.9
Pre-op weight: 319 lbs, BMI 48.5
Current range: 140-144, BMI 21.3 - 22

175+ lbs lost, maintaining since February 2012

NurseBonBon
on 10/11/12 11:06 am - El Paso, TX
 Holy Smoke Mom4Jazz! You look awesome! 
Great results!
Game_Change
on 10/14/12 1:29 pm
 You look amazing!!! Congrats!! I'm just starting out had my sleeve almost two weeks ago. You are an inspiration. 
stlfocus
on 10/11/12 10:51 am - IA
I had RNY a year ago or so, and yes I would do it again knowing what I know now. Absolutely without hesitation.

As far as the weight loss goes, my surgeon said the insurance company uses the starting weight to determine whether you are approved, and any weight you lose before surgery only helps surgery and recovery to be somewhat easier.

I only lost 10 lbs during my 6 months pre-diet, but I lost an additional 10 lbs during the last 2 weeks before surgery on a high protein low carb diet.

                                
NurseBonBon
on 10/11/12 11:08 am - El Paso, TX
 Yeah that's good to know. I'll go in next week and get my "official" weight and then lose the 20 pounds from there (hopefully).
I really want this and will do what they ask as I'm sure they have my best intrest in mind. :)
lizpete
on 10/11/12 12:29 pm - Marlboro, MA
I would do it again in a heart beat.  Best thing I have ever done for myself.  6 Mo post op 80 lbs lost. Went from a size 22 to a 12 and best of all I now am living life and not just sitting around wathing it pass me by.  

    

  

Ashleyxx
on 10/11/12 3:17 pm - Detroit, MI
VSG on 11/16/11 with
On October 11, 2012 at 10:34 AM Pacific Time, lizpete wrote:
My dr explained it by saying they wanted me to be "committed" and not to splurge on my "final meals".  Nothing about insurance  just wanted to be sure I was committed.
I had to lose 20 pounds too, my doctor said he wanted to make sure I was "serious" about having WLS.

Posted Image    

skinny cat
on 10/11/12 11:30 am
VSG on 01/08/13
Most surgeons want you to lose at least 10% of your body weight to shrink your liver. It makes it easier for the surgeon and less risky for the patient. You have less of a chance of your liver "cracking and bleeding" by being moved if you lose weight.
As far as insurance, I was told they take the initial weight. I was EXACTLY at a BMI of 35 when I weighed in so I was worried about losing weight too, until they told me this.
        
NurseBonBon
on 10/11/12 11:43 am, edited 10/11/12 11:46 am - El Paso, TX
 Hey Skinny Cat, thanks for that info. I calculated my BMI and it will also be close to 35 after the 20 pounds. I'm currently over 38 so I guess I shouldn't worry! 
Good to know it's the pre-diet weight. 
lady_myst
on 10/11/12 11:46 am
I was told it was for my liver as well.  I had to do a two week liquid diet before surgery to help "shink" the liver.  I actually lost about 60 pounds on my pre-diet surgery.  This did not surprise anyone as I lose awesome on diets at first.  Then I hit a wall.  And I cant get my body to co-operate.  It starts grabbing everything I put in and i stay at that weight or gain.  Then i would get frustrated because i would be accused of cheating....or I would THINK people thought i was cheating...and i would give up.  lol.  the things my mind does to me.  Any way.  I was around 450 at the highest.  My primary docs scale didnt go past 400 so the last time i was in the hospital the scale said 450 and that's what i went with.  Heck i may have been higher.  anyway.  i was 450 at last actual known weigh in.  I was 390 the morning of surgery.  My insurance company didnt back out.  (tho i had room to shrink) and i was totally glad i did what i was told as i had less risk with surgery.  I think some want you to lose to prove committment but I also know my doc said it had to do with the liver too.  Do as your surgeon says for health reasons.  That's the best advice I can give.  Knowing what I know now would I do my surgery over again?  In a heartbeat.  Without hesitation.  My health is greatly improved.  I am grateful for every movement i make today that doesnt have me gasping for air or cringing in pain.  I am grateful that all i take are supplements and not medications to fix diabetes or high blood pressure or relieve pain.  Do i still have to take medications in the form of supplements every day?  YEP.  Is it worth it?  ask my children when we get home from playing outside in the yard tonight.  ;)
                
NurseBonBon
on 10/11/12 11:51 am - El Paso, TX
 Lady Myst, thank you for your reply! What an inspiration. I do plan on listening to the surgeon and all the professionals who are in the bariatric team. The liver shrinks that quickly?!? It's amazing to know that! Enjoy your kiddos and congratulations on reaching your goal! 
Mom4Jazz
on 10/11/12 12:29 pm
Oh, my goodness. Your ticker just doesn't tell the whole story. You have done AMAZING things.

  Congratulations!

Highest weight: 335 lbs, BMI 50.9
Pre-op weight: 319 lbs, BMI 48.5
Current range: 140-144, BMI 21.3 - 22

175+ lbs lost, maintaining since February 2012