What are they looking for in the 6th month supervised diet?

I've heard conflicting reports/opinions and was hoping to get some clarification here...my question is...exaclty what are insurance companies looking for in the 6th month supervised diets? I have Medical Mutual of Ohio.  My surgeon's office has said "Med Mutual is great to work with...but they're sticklers for documentation with the supervised diet". They even sent me a special form for my PCP to fill out during my visits so that they were well documented. I've finished my 6th month and should be submitted for approval this week. I teeter-tottered through it...gaining and losing for 6th months.  When all was said and done, it evened out and I ended up about 2lbs more than when I started. With that being said...I'm not sure what the purpose of the diet is. My PCP said that "they want to see that you're not successful, even though I'm supervising it...so it really doesn't matter if you gain weight or lose weight...however, try to lose."   I've had people on OH say "it's just a hoop they make you jump through...many people won't do it so it weeds out those who aren't motivated enough for surgery. The results don't really matter." I've had people on OH say "you HAVE to loose weight on the supervised diet...insurance companies want to see that you're motivated enough to lose some weight and that you'll stick to a doctor's plan after surgery. If you don't lose some weight, you'll probably be denied." So, I'm just wondering, what the truth really is? Yes, I'm living in fear of denial from my insurance but I'd really like to know what to expect.  If I'm denied right away because of this, I'd already like to be working on an appeal. Thanks in advance to all who answer!

Hi Buckeye,  I currently have one more month on the supervised diet and cannot wait for it to be over.  I went on my insurance companies website and got the guidelines of what they wanted my doctor to note in each visit,  I also had them send it to me in writing as well.  I dont have to lose a specified amount, I think that varies by insurance companies. Some do want to see a 10% loss, others want an attempt at trying to lose weight and others want to see you have been unsuccessful at it.  So my doctor documents everything each visit and with one more to go I am down so far 11 pounds.  I hope this helps some.

Rahsheeda

Hello Sylvia,

I have recently completed my 6 month diet. I've lost 33 pounds. I am glad that I did. It doesn't really matter to me if I was supposed to lose weight or not. I do know that my blood was in a total mess before losing weight, and with that said I probably would have had to wait anyway to get my labs up to par. I had almost everything that an obese person can have elevated, in the upper limits, except cholesterol. I had iron deficiency anemia but also began to have elevated liver enzymes, not to mention nodules on my thyroid. I think the best thing I could do for my body was to try as hard as I could to lose some of this weight. My insurance company does not have a certain amount to lose but it was a nice thing to set a goal, which I did not meet. The goal was to lose 10% of my beginning body weight. I came close but did not meet it. To me that's an awesome double standard. I lost weight but did not reach my goal. I lost enough to get my labs within normal range, and that's the best thing. I no longer suffer from iron deficiency anemia and my liver enzymes are within normal limits. All of us are different, some lose, some gain, and some of us bounce around the scales like we've done all of our lives. You just take care of you, that's the best you can do! Well, hope I've inspired you to think outside of the box as to this mystery of why a 6 month diet is required. It has actually helped me more than anything. I think the hardest thing for me was having to give up chocolate and other junks foods that I knew were sabotaging me. I still eat them sometimes but in moderation. Take care and continue to advance in your journey.