Went in today for my first consult and found out that I need documented dieting for 6 months. 

Here is my problem...I am right at the cut off point for surgery. My BMI is 40, I'm blessed to not  have any other health issues. Because of my high BMI it is a covered benefit, if I fall below 40% it is not due to my lack of illness. So if I do a wonderful job and drop 30 pounds in six months I am still stuck at 245.....that's still considered morbidly obese. 

SO..if i diet..i can't get this done...but at the same time I want to change.


I don't want to sound ungrateful, I know I am lucky to have no health complications or to start at a higher weight. Just frustrated with being told all this today.

I was in the same spot a year and a half ago. Lost weight then my insurance denied me. So this time around I played their game went to dr and did not do anything to lose any weight I was not getting turned down again to regain it all again.

 You can also call your insurance company and ask specifically if you will be denied if you lose weight as part of your presurgical diet.  You can also ask your surgeon what weights are sent to your insurance company -- I thought in an info session I attended, that question was asked, and the doc said he only submitted the beginning weight.

I'm calling tomorrow because I am right at 40 as well, and I want to make sure of the same thing!

Some plans require that you show some progress (ie, the ability to follow a diet to show that you can follow post op). 

Best of luck!

It depends on your plan. I had no comorbidities but was a BMI of 41.

My insurance said I would not be denied for losing weight during the doctor supervised weight loss period in the 3-months prior. Their goal *should* be for you to get healthy.

I was also told by my insurance company that I needed to go through the doctor's supervision for six months. Though my BMI is much higher than yours, I was concerned about losing too much weight in six months. My PCP expects around fifty.

When I shared this with the nurse and NUT at my center, they told me I should not be concerned about the scale but about changing my behaviors....such as eating only at mealtimes, lower fat foods, chewing etc. They did not even mention exercise...though I am doing that daily.

I misconstrued the message (or purpose) of the six month period, which is behavior modification, not weightloss.

Did they specifically tell you the six months was for weightloss?

 Yes. It was made very clear that if my BMI falls below 40 and remains that low at the end of 6 months I will no longer qualify for surgery. 

I thought it was a behavior modification trial as well. I was heartbroken at first to learn it was going to decide if i qualify or not. 

On one hand I want to change my lifestyle ..I know I need to...but on the other, history has shown me I can loose but I ALWAYS ALWAYS gain back...it may be well beyond six months or  not to the weight I am now  but I will regain to some degree. 

On my first doctor's visit my BMI was a little over 40, 3 months into my 6 month supervised diet I'm at 39. They said they take the first weight and BMI and if by chance the insurance does deny the Dr writes a letter and it goes through. They have never been denied after a letter from the Dr. I have Cigna. My doctor is pleased with my progress and expects to see weight loss at this point because it shows dedication and motivation.

that is very encourging

 I am a month into my 6 month diet.  I hadn't lost a pound!  I did switch to Splenda and am starting to drink water (I hate the stuff) because I know the life style change is going to be so different/hard. I know I am expected to lose some weight but I don't know how much.  I am going to ask at my next appointment.  I am not going to drive myself batty about it because my BMI is waaay over 40.  Unfortunately,  my PCP is a jerk and I will probably get a lecture every month anyway because he doesn't believe in WLS. 

Cut out sugar and drink lots of water.  You may lose a bit but not enough to put you under 40 BMI.  Good luck!

I have BC/BS of IL and they don't penalize you for losing weight on the 6 month mandated diet. They approve or disapprove based on your 'starting' BMI. Mine was 38.9 but I had several comorbidities. I losts 36lbs on my diet and was below the 35 minimum BMI but they still approved the surgery because of what I started at. Call your insurance company and have them send you the requirements for the bariatric surgery. It took me 2 days to get mine and saved me a lot of grief. Also, make sure that you see a doctor EVERY MONTH and have your weight documented. If you don't they won't accept the diet time frame and you'll have to get 6 months 'documented' weight checks to get approved.

When I first went to my consultation, I was told the same thing and I felt just like you that my world ended. I didn't want to wait 6 months and be on this so called diet with a doctor. Lucky for me my insurance (BCBS of IL ) changed their policy in February and took that off.

But...when I was first told about this, my insurance coordinator actually told me that many will just wirte down a bunch of stuff. I asked her flat out - How many lie on these things? She told me that more than likely, most do. She did see one that did actually write out their exact diet (which was NOT diet food) and they were denied. So, if you have to, eat normally, not execessive to gain any weight, but also document as if you are dieting. You will be fine.

I ended up taking 4 of the 6 months to get everything done and the other 1.5 to fight with my insurance on documents.

Good Luck.

Hey! I only had to do a 3 month diet. However, during those 3 months, I did all the other requirements for both my dr and insurance company. Besides, the financial coordinator should be there to help you. The financial coordinator at my surgeon's office reminded me this is what she does, so if thier's an issue, they'll help you.

 You have to do what you have to do.  Definitely get a clear answer from your insurer...in writing if you can manage that.  My insurance did not require a 6 month diet, but BMI had to be over 40.  Comorbidities were not considered.  I just missed it.

What worked for me?  I had told the doctor that I am 5'7 because that is what I was in high school and that was the last time I recall being told my height.  I got my mom to measure me and hey, guess what?  5'6!  Age + excess weight can make you shorter.  If nothing else the weight can depress the arch of the foot.  Now I'm about 5'6 and a half.