Question:
do i qualify

hello i am 5 foot 3 and weigh 175 lbs. i am not 100 lbs over weight however, i have sleep apena refulx high blood pressure poly cystic ovary disease metabolic syndrom and suffer off and on from depression. does any body know if i would qualify for bypass surgery base upon these conditions? i have heard you have to be 100 lbs over weight is that true even if i have all of these syndroms thanks in advance for your time donna    — donna957 (posted on July 27, 2006)

July 27, 2006
I am 5 3 and weigh 198..and no we do not fit the bill...sorry but try to gain weigh is what one dr told me
   — shortskirt_ky

July 27, 2006
You really need to take a serious look at what you are asking. Research is very important and you will see that you must have a BMI over 40, and at least 100 lbs. A good approved diet would most likely work for you.
   — Steve Cohen

July 27, 2006
Donna..go to one of the weight loss websites and figure your BMI....I done it for you on the weight loss website..and your BMI is 31.5...it said that you were 48 lbs overweight but you do have other problems..if u paid for surgery in cash..yes you could have the surgery right away but if you have insurance they have guidelines that they go by..some people pay for it..$14,000 to $21,000..different prices and different types of surgery Gastric, LAP Gastric or lap band...check on other sites and u can see what they require for the surgery...some have the sleep apnea to qualify them...just check with your regular doctor and see what he tells you...good luck
   — shortskirt_ky

July 27, 2006
It's possible. I heard of a case of a women who had serious back problems and she was only 60 pounds overweight. However, most doctor's will only take BMI's over 35 and most Insurance companies won't pay unless its 40. I had a BMI of 40. I don't think it's worth it to have the surgery just to lose 50 pounds. There can be serious complications and there are usually some side effects.
   — smparker2

July 27, 2006
It depends on your insurance. Some will do surgery on less that 40 BMI if you have so many comorbidities, at least 2, I believe. The more comorbidities you have, the greater possibility. It would have to be medically necessary. On the OH site, I have seen lapband advertised for $10,000. It was from Texas.
   — geneswife

July 27, 2006
The National Health Criteria for WLS are BMI of 35 or greater, with co-morbid factors-sleep apnea, diabetes, osteoarthritis of weight bearing joints, asthma, coronary artery disease OR a BMI of 40 or greater without co-morbid factors. Doctors should follow these guidelines, unethical if they do not.
   — anyce

July 28, 2006
Donna, I don't believe that you qualify for this surgery, you might qualify to have the lap band. This may work for you since you are not over the 100 pound qualification. Do not in any circumstance gain weight just to have this surgery. That could cause death. It sounds like a Good Dr. supervised diet with exercise would help you out more than this surgery would. Put some discipline into your life & see if that helps with the weight loss before anything else. Good Luck with whatever you decide. Marilyn, the Bearlady
   — Marilyn C.

July 28, 2006
Donna, What you have are called co-morbidities. The standard for WLS is 100+lbs overweight or a BMI of 40+. However, you may still qualify for a WLS if you have a BMI of 35+ coupled with co-morbidities. I have asthma, GIRDs (Gastro Intestinal Reflux Disease), borderline diabetic, and arthritis in my lower back. My BMI was 37 at the time I had my Lap-Band surgery on May 15th of this year. I was close to 90 lbs overweight. My doctor took the pro-active / preventive approach to my obesity, especially because of the high risks in my family of diabetes and stroke. He did give me the option of which WLS I wanted to pursue because I did fit the co-morbidic category. However, he recommended the Lap-Band only because he thought I would be an excellent candidate for it. I don't regret it at all. I know you are wanting a bypass, but you need to look at all aspects. If you have under 100 lbs to loose, having a bypass could be extremely dangerous because you might find yourself struggling to keep weight on when it is all said and done. That may sound nice now--- but that is how people fail with that surgery and have less fortunate outcomes. Explore your options with the Lap-Band. Try attending a WLS seminar in your area.
   — ahluchtman

July 28, 2006
If your BMI is under 35, then you do not qualify. 175 lbs just isn't obese enough to qualify ... Ask your doctor for a referral to a nutritionist and begin a healthy eating plan.
   — peacefuldaizy

July 28, 2006
I don't think 175 is going to qualify you. Now if you shrunk an inch, it might get you closer, but it's hard to say with the co-morbidities. It is one of those things I think the insurance might likely deny though. If you were to pay out of pocket, I would think you might be one of the candidates who would do really well with the band. Since you don't have a lot to lose, it would be relatively easy for you to get all your weight off without anything too invasive. You can also go to Mexico where it is cheaper if you can't pay the steeper prices in the US here. More and more people are going to Mexico now, so you might check it out.
   — Dinka Doo

July 28, 2006
You dont qualify for gastric bypass but you probably qualify for lap band surgery. You should talk to your Dr. about it.
   — shannonwaycott

July 31, 2006
Get a copy of your insurance company's clinical guidelines for surgery. that will tell you if you qualify. Sometimes you do if you hvae comorbidities, but you do not sound heavy enough. Check your BMI using Obesity Help's calculator.
   — Novashannon

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