Considering Gastric Bypass with a BMI of 39

Hello everyone,

I am new here and have been considering Gastric Bypass for a year now... I have struggled with my weight since my late teen years and am now 30. I have been considering gastric bypass surgery for a year now and wanted to wait a while to see if I could lose the weight myself... after a year of trying, I'm heavier than I was when I started :( My current BMI is 39 and I don't have diabetes, sleep apnea, or high blood pressure. I do however have depression, anxiety, fibromyalgia, chronic fatigue, an auto immune disorder etc. So I have a lot of health issues, but I am unsure if this will qualify me for surgery. The first surgeon that I had a consult with a year ago told me that we could "try" to get me approved through my insurance. I am looking at going for a second opinion to a surgeon at Mass General Hospital in Boston soon.... I'm nervous because of all my health problems that the surgery may complicate things... but then again, it could help a lot of my health problems as well. I'm very nervous about the unknown part of it, but I do know that I am sick of feeling terrible all of the time and weighing 100 lbs more than I am supposed to!! Any feedback or suggestions would be greatly appreciated.

Thanks Rebecca

Insurance usually won't cover WLS unless you have health problems that are clearly weight related and expected to improve with weight loss, like diabetes, high blood pressure or sleep apnea, unless your BMI is at least 40.  Have you checked your policy to see what they cover and what their requirements are?

You can probably find a surgeon to operate on you if you are willing to self pay, though.

Thanks for your response. I still need to call my insurance, but 40 seems to be the magic number... Seems crazy that I need to gain weight in order to be approved to do what it takes to lose it! But I'm actually only 7 lbs away from 40bmi which my husband consistently jokes, could take him a day to gain.... I can't even stand the thought of gaining another pound... 

Make sure you check with your insurance company before trying to gain weight to get approved.  Many, but not all, require you to have had a BMI of 40 for a period of time, often two years or sometimes even five years.

Find out if they will consider fibromyalgia a comorbidity.  I'm thinking they probably won't but it's certainly worth asking.  Also, are you sure you don't have sleep apnea?  Have you had a sleep study?  Many people don't realize they have it until they are tested.

Oh my gosh! Good point!! I'm going to call my insurance today. I did have a sleep study last fall after I had my first appointment with the bariatric surgeon... All clear, no apnea. Which is honestly surprising because I have all of the symptoms. 

I was at a BMI of 38 6 years ago with no co-morbidities and was told the same thing "we will try to see if we can get you approved" I had to go through 6mo of appts, supervised weight loss, TONS of tests etc and finally I was approved for the lap-band procedure…. through a series of events and a family crisis, I cancelled my surgery and was so bummed out. 

Fast forward 6 years and I decided I was at a place in my life to try again. I still have no co-morbidities but my BMI was 46 … I had the testing redone and went to my appts but my new insurance is AWESOME and I didn't have to do a 6mo supervised weight loss… I had RNY Gastric Bypass on Feb 25th of this year (I am 27yr old) and I am down 78lbs since my highest weight and it was the best decision that I have ever made. 

Everything played out the way that it was supposed to for me and it will work out for you. I was 150lbs overweight and am now at a BMI of 35 and well on my way to hitting my goal weight. 

As far as worrying about your current health problems, it is important to listen to your doctors and keep an open line of communication with them. Like anything, surgery of this magnitude takes a HUGE toll on you mentally and physically. Part of my journey pre-op was to see a psychologist and that really helped me to pinpoint if this was the right time for me. I knew that I was ready to lose the weight but I needed to make sure that this was the time to do it.

I hope that some of this helps you. You can do it!

One thing I've noticed is folks who don't think they have sleep apnea, end up getting tested for sleep apnea, and are amazed they have it.  Not saying you do, but don't dismiss being tested for it.

I was under 40 BMI but had a co-morbidity and not enough of the signs for sleep apnea to warrant the test.

Also, if you're looking for a place to go in the Boston area I can certainly recommend Lahey.  They are a Center of Excellence, and have a very extensive program.  Nothing against MGH, but I would have gone nuts trying to get in there for so many appointments :-)

Best of luck to you!

Has your Dr said that by losing weight it would help with Fibromyalgia and any other autoimmune disorder? If the Dr you see for Fibromyalgia said that losing weight would help the disorder, then he could write a letter explaining the need for the surgery. In my case I have a rare brain disorder with no cure, but one of the things my Neurosurgeon wanted was the bypass to help lose weight fast in hopes that it would send the disease into remission, and I also have PCOS. Those two things, and even by themselves would cause the insurance to approve with a BMI under 40. Because I had it documented in my medical files that the Dr's recommended this for medical reasons it was relatively easy to get approved. Also a call to the insurance yourself to ask questions will clarify all of their requirements and give an indication as to wether they would approve it or not.

Rebecca,

My insurance would not cover my RNY.  I was just fat.  If you looked at my blood work and did not look at my weight, you would have thought that I was in perfect health.  The weight was affecting my ability to move.  When you are carrying around an extra 100 pounds you are not very apt to be out and enjoying life.  I felt the weight was turning me into a recluse.  So, I borrowed the money and had the surgery.  I might not have as much money in my retirement, but I will be able to enjoy my retirement.  Plus, once you get past that first month of all of the extras you need for surgery, you will be spending a lot less on food.  I literally spend about $30 a week at the grocery store.  It is probably less than that.  You just cannot eat what you use to eat.  What a concept.

What was your BMI?