what is supervised diet works too well?

from what i understand, most insurance plans (i have aetna) want you to go on a medically supervised weight loss plan. my surgeon uses opti-fast. right now i am 5'4" 225, with a bmi of 38.1....my co-morbidites are arthritis (i've had one knee replaced already) and sleep apnea. What if after the weight loss plan, aetna says that i don't weigh enough to have the surgery? anyone had this experience? thanks; kim

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