Question:
6-month diet for insurance approval

I have just completed my 6 month diet. I only lost 6 pounds through the 6 months on the last month I had gained all 6 pounds back. Will my insurance still approve me or will they deny due to not keeping the six pounds off?    — pugsley101 (posted on October 5, 2008)


October 5, 2008
I know that loosing weight is hard or we would never be here. I know one reason they put you on 6 months is to see if you are serious to loose the weight, I yo yo;d for 6 months loosing gaining I know this is frustrating, depressing I finally had to ask myself how bad did I want the surgery and I knew what I had to do. They know how hard it is for you also.I do not know if they will deny or not .I know when I started my 3 week pre diet I was down 15 pounds and lost 10 more before surgery and this takes fat off your liver to help with the operation. I hope and pray the best for you. Tammi
   — Tammi Sandoval

October 5, 2008
The first thing you need to ask yourself is why did you lose six pounds and not more.....I am guessing but think you probably didn't follow the diet completely that your Dr put you on....most insurance companies require this to see how committed you are before they put out 25 to 30 thousand pounds........IF they are generous enough to go ahead with approval....I would look at the choice you are making here and re evaluate your committment.......If you do not FOLLOW THE RULES....you are going to be dissappointed and not do well....this is a lifestyle change and you have to do what's expected of you........every WLS surgery can be eaten around and you have to know that you are willing to make those changes not for a few months but for a lifetime....studies atre now being done that say 40 % of all RNY Patients are gaing weight back after 3 years by adding more and more food to thier meals stretching out thier pouches.....so please take a good look and make a decision that will benefit the rest of your life and feel really lucky that you have a insurance company that will pay for WLS ...I had to pay cash and I'm not about to throw away my investment......Good luck .
   — pphillips4720aol.com

October 5, 2008
I too had to do the 6 month supervised diet, at the end, I gained all back what i struggled so hard to lose the first 5 months and still was approved, tg, the lady that was sending in the paper work was worried, but I just put it in God's hands and I was approved within 1 week after she submitted my paper work. I had surgery (sleeve) July 22nd and have lost 52 pounds since July 6 (full liquid diet). Good Luck and I am sure things will turn out just fine.
   — [Deactivated Member]

October 5, 2008
Approvals/hoops to jump through vary for different insurances. Some would look at not losing weight over 6 months as a non-committment and refuse to approve the surgery. You are blessed to have an insurance company that would even consider covering WLS as mine did not. I paid all out of pocket and would do it all over again....a drop in the bucket to save my life. Saving for all of the plastics I'm going to need in the future now. A popular thought is, "well, if I could lose the weight on my own, I wouldn't have to have surgery". Is this what is going on with you? I understand completely. We have an addiction with a very strong hold over us, a disease with serious consequences both mentally and physically. Dig deep and do some emotional work this week and evaluate the pros and cons of having WLS... if the pros outweight the cons... decide what you want, where you want to go and decide what you are willing to do to get it done NOW... not next Monday or tomorrow morning.... NOW!!! Don't look at how much you have to lose, it can be overwhelming... take it one hour, one meal, one day at a time by following the rules and exercising just a few minutes per day, drinking water, avoiding carbonated drinks, not drinking at mealtimes and eating what your doctor has ordered. Get the junk food out of the house, enlist support from all of those around you and get them to help you. If you expect your insurance to pay, unfortunately, you have to do what they want. WLS is not the answer for obesity, it helps, but the real work is with learning about yourself and really getting to the heart of the matter. Why you overeat, when you overeat... this addiction is as serious as any other out there. WLS is just the beginning... we need to learn life-long habits to be successful in the long run. If you get WLS and one of your triggers rears it's head, you won't be able to turn to food to medicate/fix the problem like before so you need to exchange habits and deal with the actual issue, not feed it. Part of it is getting to goal, the other part is staying there for life and we are always going to have to work at this. Not being able to follow a diet for 6 months makes me very concerned for you and I wonder if you can really do it forever. This is the hardest thing I have ever done, certainly not "the easy way out" as idiots say. If you want this and I mean REALLY want this, you will do WHATEVER it takes... period. That is the mentality it takes. I really try to look at the work I have to do to lose weight as a positive thing instead of a negative. Instead of saying to myself... wow, I have so far to go, I look at it in 5 or 10# increments and reward myself with non-food things such as a pair of earrings or something I saw in the store that I wanted. I will purchase a few things like that and put them in a reward drawer for myself... inexpensive things really, just things I like... earrings, polish, etc. for the 5 and 10# rewards. When I reach 25# or 50#- bigger numbers equal bigger rewards for myself like a trip to the salon or an evening out celebrating with my husband or the girls. Once you get some success under your belt, it makes you want more and more and it can happen if you will commit to the process. Have you gone to any support group meetings? As the numbers on the scale keep going down, you will focus on getting down to such and such a number, reach it, reward yourself and set your sights on an even lower number... it's really exciting. Decide what you want and do what you have to do. If this is for you and you are ready, you'll do it. Sorry so wordy, I just get where you are coming from. The very best of luck to you, Dawn Vickers, RN, BLC, CLC
   — DawnVic

October 5, 2008
I think it will depend on your insurance company. I lost and gained and I was approved in 3 days. It wasn't because I didn't want the surgery or that I wasn't serious about the diet either. Every persons make up is different. I have seriously tried many things and nothing ever worked. I am on my pre-surgery fast and it is a breeze. I thought I was going to be on it for 3 weeks but it ended up only being 2 since the insurance came back so fast. So yes an insurance can approve you if you don't lose weight.
   — tonitoot

October 5, 2008
As others have said, different insurances have different rules. I went through my six month program and didn't lose a pound. My six month program was more to prepare me on what to expect after surgery. The last month before my surgery, I gained 9 pounds. I was grieving the loss of my best friend - FOOD. I ate everything in sight, and all my favorite meals thinking I could never have them again. My surgery was approved with no questions asked.
   — Ursie77

October 6, 2008
I am going thru the same thing that you are. I am in my 4th month and so far my weight loss total is.........."0". Well, actually it might be a few pounds. I do exercise, watch what I eat and nothing seems to help. My nutritionist said I may just need this surgery because I am doing everything I should and not loosing. I cheated on days but who doesn't...... but still and all I go in there and I think I lost but didn't. The only thing I can say is, I am hoping that my insurance company sees that I am trying and nothing seems to work. I will cross my fingers that yours will think the same. Oh plus each month I go for appt, it is soon that time of the month and I have water retention. That is not even fair!!! LOL Good Luck to you!!!!! Doreen
   — doreen513

October 6, 2008
I gained weight on mine no matter how hard I tried and I was approved no problem. Good luck
   — shackett0426




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