RNY....is it the safest choice for...

Maybe her doc is one of those that "specializes" in Medicare ...

I am strongly leaning towards this same thought.....I am honestly just baffled as to how she got approved.  I am just really concerned for her, taking on a malabsorption surgery with such a reasonable amount to lose.  I fear she will be trading one set of health issues for another...I hope I am wrong, but typically my "gut" feelings are right on.

Missy-h

Maybe she is lying about how much she really weighs and only want to lose 40-50 lbs. A few years ago I had a friend that said she only needed to lose that amount of weight to be 185 and almost had a nervous break down because I knew that I needed to lose that amount to be 185 and she was clearly twice my size!

At any rate with only that amount of weight to lose I wouldn't ever chance my life like that for that amount of weight. But then again maybe the surgeon is suggesting that amount of weight loss for her to make it look realistic and is hoping she progress past that. I remember reading a post somewhere before a lot of WLS people place their goals in their comfort zone rather than where they should actually try to reach. For example I can lose 100 lbs and still be consider obese but my instead I listed a for out goal which will be my BMI at normal...not obese, not over weight, but normal and healthy and this is my ultimate goal!

And yes many of us have to fight to the death for an approval and we need to lose 3-4 times that amount of weight!

Like you I'm shocked she got approved with only 40-50lbs to lose.  Perhaps the others are correct that she's actually got more to lose and doesn't want to say it out loud. 

That said though - before I'd go for a lap band - I'd go with the VSG as well.  It's restrictive only but less likely I think to have complications than the lapband.

As for why the surgeon didn't tell her all of her options - well because he likely doesn't do all of them - he probably only does the Rny and he'd lose a customer if he told her she'd be better off with something else.  It's all about money for many surgeons unfortunately - which is why so many people go into surgery without really knowing all of their options and ending up regretting what they had.  It's very sad and it annoys the crap out of me.  There should be a law stating that the doctor MUST tell you of all of your options.  Although, I do think people should take some responsibility on themselves too and make sure they actually do some research before blindly going into a procedure too.  Ok tangent here...sorry!

HTH

 Something seems a bit fishy to me. Unless she is really short-statured, I can't imagine that 40-50 lbs would put her into the proper BMI range to qualify for any type of WLS.  

Unless she is lying about her weight, or has many more co-morbidities than she is letting on, something seems very, very wrong indeed.

I have wondered about the co-morbidities as well, and I asked if she was diabetic, no, but both her mother and father was insulin dependant diabetics, and there is alot of hypertension and heart disease in her family.

She is 5'6" and 183.

Missy-h

Yikes, Missy. I'd think that any doctor willing to perform WLS on someone of that weight with such minor co-morbids must be a quack, money-grubbing, or both.

Well it does. You need a BMI of 35 -- which is around 50 lb. to lose to get to a normal BMI (which may not be a good weight for her -- if she has a small frame, she could still have a lot of body fat at that weight) -- and at least one co-morbidity. Both sleep apnea and uncontrolled high BP count so she has TWO.

 MacMadame, I agree with your general point, but according to the stats she has provided, this friend has a BMI of 29.5.  Something seems amiss...

After she lost some weight on the pre-op diet. The insurance approval generally goes by the weight at the time of the surgical consult. (There are exceptions, but most insurances and medicaid do it that way.

The only thing I see "amiss" is a lot of prejudice against lightweights. Here is someone with TWO co-morbidities, both serious, and meets all the NIH guidelines and was approved by her insurance, yet people are *determined* to find something wrong.