How little I know

I thought there were only two types of WLS.  Lap band and bypass.  I have a lot to learn.  This website is a font of information and I have only scratched the surface.  I have a info seminar to attend next week before my first appointment with the specialist.

Bypass frightened the life out of me and lap band seemed like a no-brainer.  Now I am reading more, and seeing that while some people do well with lap band, a lot of others don't.

I'm also seeing that I have more than two options.  I'm trying to find out about the differenty options open to me (including behavior therapy)

I am reading my insurance policy and it looks to me like some of the other options may not be available.

I'm about to read up on the sleeve as some people swear by it over the lap band but don't want to get  too interested as it may not be covered.

Policy says it covers: bypass, stapling or gastroplasy  to include vertical banded gastroplasty.

Exclusions are: non surgical treatment, biliopancratic bypass (whatever that is) Gastric bubble or balloon (unproven- according to them), Gastric Wrapping (this sounds like the sleeve to me??)

So bypass and stapling including a vertical banded gastroplasty and an adjustable gastric banding are covered.

Can anyone help me with the medical speak and tell me what is and what isn't an option for me?

Thanks,

Sounds like your insurance covers the sleeve, based on the vertical banding verbiage. Good luck! There is also the DS. People who have that swear by it, but my insurance would not cover it. You're doing the right thing by looking into all options. Although I had the RNY, I would have had the sleeve if my insurance would have allowed it. At the time, my BMI had to be at least 50. One year later, and now they approve it for a BMI of 40. My bypass has been working very well, and I have no complaints. All options will require you to make changes to your diet for sustained success. Good luck.

This is the vertical banded gastroplasty, aka VBG, a WLS that has fallen out of favor with most surgeons due to its high failure rate.  Consider the Vertical sleeve gastrectomy if you are only interested in a restrictive surgery.

I would start with the assumption that if my insurance policy covers ANY form of WLS, they can be FORCED to cover any of the 'Big Four' that I choose. (The 'Big Four' are Band, Sleeve/VSG, RNY/gastric bypass, and DS/duodenal switch.)

Research them all. Unless you understand all your options, you simply can't make an informed choice. Once you've decided which form of WLS, if any, YOU can live happily with FOREVER, choose a surgeon based on his or her experience in doing THAT procedure. Not all surgeons do all procedures.

Things to think about: How much do you need/want to lose? What's your BMI? Do you have any current health problems? Are there any the run in your family? In the past, have you been successful at losing weight, but just can't keep it off? Or do you struggle mightly just to keep from gaining? Do you use NSAIDs regularly? Are you good at taking vitamins and keeping follow-up appointments? What foods are your downfall, when it comes to dieting?

This should get you started. (*grin*)

www.dsfacts.com

From what I have read the DS seems like a good choice but it is specifically excluded on the policy albeit under an alternate name.  (Tricare Prime insurance) It also seems like not many surgeons do it.

I am about 100lbs overweight - maybe a little less - but it is causing me all sorts of problems on this 4ft 10" frame.  I may come in as too light for surgery depending on how they measure my frame. BMI is over 40 but insurance doesn't look at that.  They look at how many pounds you weigh, plus one co-morbidity.

I have fatty liver, sleep apnea, joint pain, diabetes, high cholesterol, and high blood pressure. Sadly, I tick all those boxes.  I've actually had all of that since I was about 60-70lbs overweight. Frankly, it would make more sense for insurance companies to spend less time focussing on weight and more on co-morbidities.

I lost 30 and gained 40.  I'm actually scared to try to lose weight again unassisted now because losing isn't the issue, it's the regain and I noticed I felt worse the second time I hit 200lbs. 

Ms. Batt... I love you... ;)

and if it were not for ladies like you .. and quite possibly you... I would be having the wrong surgery this coming Monday..