Denied or accepted? 6 month diet program? Weight gain!

Oliviawashere
on 7/22/14 3:54 am

Acceptance/Denial or anything inbetween. United Health Care & their bariatric excellence program (employee program) says I have to have a 6 month doctor weightloss program. My 3rd month is coming up in 2 days. My first appt I weight around 270, 2nd month 275, and now I am up around 280. Has anyone got denied for gaining weight on their 6 month doctor program? I can't say I have been really trying my hardest to lose the weight, with my birthday & everything. They never metioned I could be denied or any of that mumbo jumbo, but just wanted a feel for this. Thanks!

jenorama
on 7/22/14 4:02 am - CA
RNY on 10/07/13

I also have UHC and went through their 6 month supervised program.  I also did not lose weight and gained a little.  I did not get denied, I think in part because my BMI was so high (52? 56?) but I knew my surgeon wasn't super happy with me.  My surgeon required only two days of liquid diet and I managed to drop 20 lbs on it, even though I had a "farewell to Mexican and frozen yogurt" dinner with friends the night before starting the liquids.  

UHC hooked me up with a consultant person, not sure if she was a nurse or what, but she would call me periodically to check in and see if I was still planning on doing the surgery and to make sure I was informed on all of the details. All in all, my experience with UHC was pretty good.  I think I had just a $200 surgical copay.  

I think if you do your best and you're honest with your diet supervisor about your efforts, you should be okay.  If your surgeon actually requires you to lose weight, you'd best buckle down and do it because even if your insurance approves it, if your surgeon doesn't feel you've met his or her requirement, you can still be turned down or postponed.  I was seriously sweating it the morning of my surgery and I was quite pleased to see the number was down.

Good luck on your journey!

Jen

Lmo2291
on 7/23/14 6:59 am

Hi Jen,

I noticed you have UHC. I just opened my case with them and was assigned a nurse. I was just wondering what they required from you in terms of documentation? I have notes from my surgeon, pcp, personal trainer, and weigh****chers from various attempts. Also the dietician and psych evaluations. I'm concerned where the 6 month diet is concerned. My pcp filled out a 6 month diet form from my surgeon but I was just wondering if you had to show 6 months worth of notes and visits. If you could tell me a little about your experience with UHC I would really appreciate it.

thanks!

Lauren

T Hagalicious Rebel
Brown

on 7/22/14 9:56 am - Brooklyn
VSG on 04/25/14 with

I was told to just not gain weight during my 4 month supervised program. I think the insurance, as well as them wanted to be sure I was serious about losing weight & the changes I was willing to make. When I did gain some weight (2lbs) I had to make something up, either I had food that had a lot of salt in it, or I was on my period. You don't want to go thru all this just to be denied later, might as well get in gear & start now. Good Luck!

No one surgery is better than the other, what works for one may not work for another. T-Rebel

https://fivedaymeattest.com/

Cece2014
on 7/22/14 12:08 pm

I'm actually very pleased that UHC requires a 6-month program in order to prepare for WLS.  My hospital/surgeon have an integrated program for both medical weight loss and surgery, and I am taking FULL advantage - classes, support groups, regular weigh-ins, Nutritionist and nurses.  I have had only one call with a UHC case worker but know they are receiving updates. In the end, I think they can deny the procedure (you need to check on this with your policy).

I feel that taking these 6 months to really get my head straight, learn new habits, get friendly with low-carb meals/cooking and enlisting friends is exactly what I need to undertake this journey. In fact, I'm beginning to look forward to the classes; granted they are not always scintillating or high energy - but hearing from other people going thru the same struggles helps put this all in perspective.

PLEASE reconsider the entire process, find support and a personal reason for this journey.  A medical procedure alone is not the answer, and many people feel that if you resort to surgery you're taking the easy way out.  We know this is SO not true!  Us food lovers have different reasons for our habits and loving to eat is only one of them.  

God Speed,

 

 

Christine

Low Carb Lifestyle is working!   HW: 370   CW: 295  GW: 200

    

Amy K.
on 7/24/14 2:54 am - Tucson, AZ

I have United Health Care Military and Veterans and gained weight my 3rd month of the 6months required nutritional counseling and was told that if I gained again then I would be denied the surgery by UHC.  I also had to prove to the doc that I was making a lifestyle change by eating the right foods and incorporating exercise into my life otherwise he wouldn't do the surgery.   Gaining weight was the best thing that could have happened to me; it gave me a much needed kick in the butt to get back on track. That month I lost the 7 I'd gained plus another 5 for a total of 12lbs lost in one month. After that it was game on and I was ready to tackle anything.

High Weight: 264, BMI 46.8, Surgery Date: July 1, 2014, weight 227, BMI 40.2

  

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