Need to Be 10lbs Heavier by 04/28/14 - 1st Supervised Visit w/PCP

Maureen H.
on 4/2/14 8:01 am
VSG on 10/30/14

I have my first out of six supervised weight loss visits with my PCP on 04/28/2014. Before I started this journey I tried to lose weight on my own, but stalled at about 6lbs down. My insurance requires a BMI of 40 for approval (35 if you have a co-morbidity, which I do not have). I am currently 9.5lbs short of weighing in at a 40.0 BMI. I kind of regret losing those 6lbs, but I was trying to do it on my own. Now I'm in a bind. If I don't weigh-in at 40.0 on my first visit, then I wont qualify for my insurance. My insurance DOES allow me to be UNDER 40.0 at subsequent supervised visits, at the time insurance approval is requested, and at the time of surgery. Any ideas on how to make it work? I am frustrated by being too heavy that I am having a hard time losing weight, but now NOT QUITE heavy enough to get approved.

H.A.L.A B.
on 4/2/14 8:18 am

I just stopped dieting a month before my first visit.   Just had the last month food syndrome.   I had to work very hard not to gain before my WLS.  

But even now - I can gain 10 lbs in 2-3 days.... then lose it in 2-4 days.

  1. chinese and any high sodium foods.
  2. carbs loading (retains water)
  3. 'last but not least (not recommend) - I had to work hard to have BM.. a couple of days without my Miralax and I get 2 lbs heavier (and in pain - so really do not recommend that) 

Lets not forget heavy shoes, and heavy clothing.  shrinking a bit - will get your BMI higher... ("I am not too fat, I am just too short")  

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

Citizen Kim
on 4/2/14 8:29 am, edited 4/2/14 8:29 am - Castle Rock, CO

I was going to mention but not recommend a week of calcium citrate at 1500mg per day and no stool softeners or regulators LOL!   I could probably gain 20lbs in a week with just that 

 

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

H.A.L.A B.
on 4/2/14 8:34 am

 LOL.. yup.     

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

mmnishik
on 4/2/14 8:33 am

you could also put some change in your pocket....

Single mom to 2 girls! Love them <3

    

Sparklekitty, Science-Loving Derby Hag
on 4/2/14 8:36 am
RNY on 08/05/19

Or rocks! But put them in a plastic zipper bag first so you don't get dust all over your pants.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

jaifra78
on 4/2/14 9:08 am
RNY on 04/16/14

or ankle weights :)

    

        

pebtash
on 4/2/14 10:43 am
VSG on 11/25/14

sounds like me. I'm at BMI of 40 and actually trying to gain some. I'm going to my PCP tomorrow just to talk to her about WLS. I'm going on vacation the end of the month so I'm taking that time to gain a little more. I have Medicare and when I called them to find out what I have to do I got no where. I read on line about the 6 month medically supervised with my PCP but they knew nothing of it. When I asked if having a BMI of 40 without a commodity would qualify they said 35 or more with one commodity. I have isolated systolic high blood pressure and from what I read that is considered  HBP in older adults. I usually take water pills to control that so I went off them just for tomorrow's appointment then I will go back on until the end of the month. I think my best option is to go to the WL clinic and talk with them. Medicare knew NOTHING. All they kept saying is if your PCP says it is medically necessary then I qualify. However after reading what people were saying about your post and weight I got some good ideas. Before surgery they want us to lose 5 to 10% of our weight so loading up on other things helps.

Cheeky1500
on 4/2/14 11:00 am

I just had my RNY on 2/10/14.  I just barely had a bmi of 40 at my initial consult appointment with my surgeon 11/2012.  I had no co-morbidies.  I started my 6 month supervised weight loss at bmi of 40.  Lost the required amount of weight.  When it came time for insurance submittal, I was denied because my bmi had not been at 40 for a full 2 years ( was at 39.5).My surgeons office kept fighting for me, and after 3 denials, I was finally approved by an independent 3rd party.   They said my bmi should have been rounded up all along to 40.  Just make sure your surgeons office will go to bat for you.  Best of luck with everything!!

Maureen H.
on 4/2/14 11:41 am
VSG on 10/30/14

Cheeky, my insurance only requires you to be at 40 at the first weigh-in on the first supervised visit. I made sure I have the insurance requirements in writing from my case manager at the insurance company. Sorry to hear about your long process. Hopefully nothing strange happens to me. 

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