HELP! I AM NEW HERE..

I HAVE A BMI OF 45 AND JUST STARTED THE PROCESS OF LOOKING INTO WLS. I HAVE CALLED MY INSURANCE (HBCBS OF NJ) AND IT IS A COVERED PROCEDURE AS LONG AS YOU MEET ALL THE REQUIREMENTS. I HAVE TO DO A 6 MONTH MEDICALLY SUPERVISED DIET AND I TALKED TO MY PCP ABOUT THIS AND THE PROBLEM IS SINCE SHE HAS NOT DONE ONE BEFORE SHE IS HESITANT ABOUT DOING IT AND I CAN TELL SHE IS NOT A FAN OF HAVING WLS. I NEED TO FIND A NEW PCP IN THE SAN JOSE CA AREA... ANY REFERRALS?

It's important to have a good PCP who is pro-WLS and who will be willing to do your WLS follow-up. I'd call around to PCPs in the yellow pages and just ASK if they were pro-WLS.

The 6-month diet usually isn't a big deal, but check with your insurance company and find out specifically what they want. Most people just see their PCP once every month, get weighed, maybe discuss their diet with their PCP. You may or may not be required to lose a certain amount of weight before surgery.

DO you meet their requirements? Usually with a BMI above 40, you aren't required to have any co-morbs. Do you have any? Things like diabetes, high cholesterol, GERD, arthritis, asthma high blood pressure? These can effect which form of WLS is best for you.

I advise you to start researching the main forms of WLS now. There's the LapBand, which has the lowest success rate and the highest re-operation rate.

There's the VSG/Sleeve, which removes a big part of your stomach but leaves it fully functional. It just keeps you from eating much at once.

There's the RNY/gastric bypass, which divides your stomach into a tiny little pouch and a huge remnant stomach, and bypasses a little bit if you small intestine. This causes you to malabsorb calories for about 2 years, but you'll malabsorb vitamins forever.

And finally there's the DS/duodenal switch, which is a Sleeved stomach plus a BIG intestinal bypass. The DS also causes you to malabsorb vitamins forever, but you also malabsorb a significant per centage of the calories you eat forever, too. The DS has the very best long-term, maintained weight-loss stats and the best stats for resolving or preventing things like diabetes and high cholesterol.

If you can check with your insurance for a list of pcp in your area, the information might be listed online at the ins site, you can then cross reference with those familiar with wls, sometimes the surgeons who perform wls can refer you to a pcp who is familiar with documenting weight loss, or the surgeon himself can document it, that's what I did, the only thing I needed from my pcp was the letter for medical clearance & a recommendation letter for wls. Some ins companies lists a center of excellence when it comes to wls, going to them will also give you a starting point for pcp, nutritionists, therapists etc. Good luck!

I went through a bariatric center affiliated with a local hospital...they handled all of my preop preparations and insurance authorization stuff, scheduled all of my testing for me and provided the medically supervised weight loss services. I actually didn't have to go through my PCP for anything. The center also hosts support groups and has a nutritionist that I can consult with forever ...no extra charge. There might be something similar in your area...takes all the guesswork out of getting authorized for surgery.

I would go with a doc at the weight loss center you are using... my pcp was completely against the surgery. I was not required to have the supervised diet though. I had the surgery anyway, and now she has changed her tune :)

Thank you all so much for your replies. I am definitely going to start looking for another PCP.

I had to do the 6 month supervised diet and I found the surgeon I wanted and his office employed a nutritionist specializing in weight loss surgery that I saw every month.  Easy peasy.  I did have to find a PCP for lab work and and EKG closer to surgery but that was just one appointment.  Have you decided who your surgeon will be?  The office should be able to help you out.