6 month pcp dietary evaluation and weight gain...

Nicole S.
on 7/28/16 4:34 pm - WALNUT COVE, NC

Hi everyone, I'm o my 4th month  of a 6 month evaluation for surgery, and I've gained weight, I lost 6lbs during the first month, but since then I've been gaining. I was wondering if any of you guys experienced this, and was it a problem for your insurance or surgeon?  Any info is appreciated. 

Stats:

 310 lbs

5"8 lost and inch somehow..?

Humana /Medicare ins

Diabetes

PCOS

Hypothyroidism

High blood pressure

Chronic Kidney Disease

Nicole. S



Sparklekitty, Science-Loving Derby Hag
on 7/28/16 4:38 pm
RNY on 08/05/19

As far as insurance goes, this will be different for everyone. Some policies require that you lose a certain percent, or that you don't gain any, or that you don't lose any. Some just want proof that you tried.

Call the customer service number on the back of your card and find out what they specifically require from the pre-op diet/eval. Get it in writing if you can.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

Nicole S.
on 7/28/16 4:42 pm - WALNUT COVE, NC

Thank you , I called them, but I think they were just telling me anything to get me off the phone, I'm going to call back and see if I can get in in writing!  Tks

Nicole. S



chassibi
on 7/28/16 5:42 pm

My surgeon told me point blank that he would not operate if I gained weight in the three months leading up to surgery. I don't know what my insurance would've said. 

Consult Weight:276/Surgery Day Weight: 241.6 /Goal Weight: 150

Deanna798
on 7/28/16 6:04 pm
RNY on 08/04/15

my surgeon wanted me to lose 10% of my excess weight before surgery.  I needed to lose about 150lbs to get to a normal BMI, so he asked me to lose 15lbs.  I was still a few pounds short when I scheduled my surgery in June, but surpassed it by a few pounds by my surgery date.  

I'm not sure about insurance, but I would definitely check with your surgeon.  He/she may be unwilling to operate if you don't show at least some weight loss.

Age: 44 | Height: 5' 3" | Starting January 2015: 291 | RNY 8/4/15 with Dr. Arthur Carlin| Goal: 150

Listen to advice and accept discipline, and at the end you will be counted among the wise. ~Proverbs 19:20

steph_foodcoachme
on 7/28/16 6:29 pm

In my experience the insurance companies that do have a policy on weight gain have an issue with a "net gain" meaning they want you to weigh at least what you started at, if not less. So my best recommendation is to focus on losing 6 pounds in your last two months!! 

Laura in Texas
on 7/28/16 7:26 pm

My insurance did not require any loss during my six-month doctor supervised diet, but looking at the fine print from my surgeon at my last appointment pre-op, apparently he had a policy that he would not operate on anyone who gained more than 10 pounds. Thankfully my weight remained the same. Phew!!

I would ask your surgeon.

Laura in Texas

53 years old; 5'7" tall; HW: 339 (BMI=53); GW: 140 CW: 170 (BMI=27)

RNY: 09-17-08 Dr. Garth Davis

brachioplasty: 12-18-09 Dr. Wainwright; lbl/bl: 06-28-11 Dr. LoMonaco

"May your choices reflect your hopes and not your fears."

Nicole S.
on 7/29/16 6:45 pm - WALNUT COVE, NC

I called my insurance today, and they didn't have any requirements regarding me losing weight during the 6 month evaluation. I'll call m y doc next to see what they say, I do remember him saying lose what you can..... but not percentage or anything.

 

Nicole. S



H.A.L.A B.
on 7/29/16 5:08 am

I was self pay..so no insurance issues, but my surgeon required we loose weight during the 4 week prep semi liquid diet. Everyone got a "number" of lbs to lose - based on their initial weight.

Some insurance companies don't care of you lose or gain as long as you "try to follow the 6 months plan" . hope it the that case for you. 

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

swim_bike_smile
on 7/29/16 5:14 am
RNY on 06/13/16

I was told that I was not allowed to gain weight over my starting weight.  A friend of mine went through the process the same time I did, and she lost 6lbs, but gained 1 or 2lbs.  Since she didn't go over her starting weight and still had a net loss of 4ish lbs she was cleared.  

 

However, I would really dig deep and try to address the root cause of why you are gaining, because once you have the surgery you lose the crutch that food has become for a lot of us.  Better to address it now, than have the rug pulled completely out from under you after surgery.

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