Why does my insurance require 6 months of continuous doctor supervised weight loss prior to...

obioxiupa
on 10/6/15 1:20 pm

My insurance requires 6 months of continuous physician supervised weight loss prior to surgery approval. I did a physician supervised program for six months, but it has taken so long to get everything going, I guess I need to do it again. Is 6 months normal? It seems like a long time.

(deactivated member)
on 10/6/15 2:21 pm
RNY on 05/04/15

A few insurers don't require this, and some only require 3 months, but 6 months seems to be the standard for most. WLS requires a lot of commitment to developing healthy habits and keeping follow-up appointments...the 6 months is used both to equip you with all the tools you'll need after surgery and to demonstrate your compliance and ability to keep appointments.

Eggface
on 10/6/15 3:22 pm - Sunny Southern, CA

While the wait can be used in exactly the way the above poster shared... it's really weight bias at the core of why. Obesity deserves to be treated in the same fashion as diabetes, heart disease, cancer, any other chronic disease. Policies like waiting periods/supervised diets to prove readiness to change are an example of weight bias... however they want to spin it... those affected by obesity should have access to the same medically necessary treatments afforded to any other chronic disease.

I'm sorry you can't get chemo or that tumor removed for 6 months while you prove you can change your lifestyle. I'm sorry you can't have a triple bypass or a stint put in until you document for 6 months you are ready to make a change... These scenarios would never thankfully happen.

But... *person affected by obesity* despite your pain, deteriorating health status, conditions like high blood pressure, diabetes, GERD, etc. your many diet attempts, and despite a Dr saying this is the right treatment for you to improve your health you need to show us readiness to change?!

OK ;) just saying... off my soap box (for now)

Weight Loss Surgery Friendly Recipes & Rambling
www.theworldaccordingtoeggface.com

SkinnyScientist
on 10/7/15 6:18 am

I agree with this too a point. However, how many people have we seen post on here that did NOT GET that WLS is a tool, not a miracle, you WILL have to change your behavior, you will have to change your portion sizes, and you will have to change the things you eat, despite the 6 months of supervised weightloss.

Far too many.

I think the 6 months is a good thing to get people to prepare their houses, pantries, minds, and develop support systems.

RNY Surgery: 12/31/2013; 

Current weight (2/27/2015) 139lbs, ~14% body fat

Three pounds below Goal!!! Yay !  

hl1524
on 10/7/15 6:29 am - Austin, TX

While I agree there should be some level of people getting prepared for the surgery and all of the changes that will be heading there way -- there are FAR too many hoops one has to jump through to get help. I can see why statistically so many drop out of the programs. Most people can't afford to miss work for the numerous amount of days needed for the various appointments. It's almost as if it was designed this way.

  RNY 8/27/2014

Eggface
on 10/7/15 4:47 pm, edited 10/7/15 9:47 am - Sunny Southern, CA

Absolutely... you and I both know being on the other side for awhile that permanent changes must be made because that scale can go both ways still. So yep yep... high five to not a miracle cure... but... I believe for many (too many) the waiting period does more damage than good. 6 to however many months of their obesity related conditions worsening... and probably raising post op complication rates... sicker going into major surgery trumps all I think.

and... at least in what I have read... no change on the weight loss % for those that had 6 month supervised weight loss programs versus those that didn't.

I'd personally rather see the effort be put into post op counseling, nutrition and otherwise... seriously that's when people need the help.

Weight Loss Surgery Friendly Recipes & Rambling
www.theworldaccordingtoeggface.com

Sharon SW-267
GW-165 CW-167 S.

on 10/13/15 11:38 am - PA
RNY on 12/22/14

Good points. The post-op period is uber important. I had a supervised diet (that failed) shortly before I investigated surgery, so I did not have a lengthy waiting period - I had about 8 weeks of pre-surgery dieting. I think it helped me because I was not diet-fatigued when I went into surgery.

Sharon

obioxiupa
on 10/7/15 10:06 am

I agree it is bias. Thanks for haring your thoughts, it's nice to know there are others with the same feeling.

hl1524
on 10/6/15 3:42 pm - Austin, TX

Check with your insurance to see if your previous physician monitored diet will apply. I had to have mine within the past two years with the ability to prove it through documented visits.

  RNY 8/27/2014

Minkey
on 10/6/15 9:24 pm

Mine required 9 months of supervised visits, but by the time all of the other doctors were seen (cardiologist, psychologist, pulmonologist) it was 13 months before I had surgery. I think they want to make sure you will stick with the program once the surgery is done so they're not wasting their money (actually your money). Take this time to really think about the changes that will occur and what you'll have to give up or change so you'll be better prepared once surgery is done. Good luck!

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