awaiting the dreaded prior auth

on 12/15/15 11:42 am

Hey everyone, 

I introduced myself a while back (maybe 2 weeks) and was just starting out in the whole process. I have since had my visit with my primary care physician who agreed that the surgery would be extremely beneficial to my overall health. I also did some investigating on what is required by my insurance prior to surgery, and they require a 6 month documented diet with physician assistance. Problem with that is I keep putting it off saying I'll wait until after the holidays, but I really shouldn't wait. 

So, not much of an update but it's more than my original post :) 


anyone in here in the pre-weight loss surgery group? Although I love the success stories I'd love to connect with someone going thru the same process as I am. Anyone in AZ? Meeting someone near me would be cool too. 

Thanks everyone! Have a blessed day!!!  


on 12/15/15 12:24 pm

what diets worked for you when you were dieting prior to surgery? low carb? heart healthy? low cal? I think if I can pick one that works for me it will be much easier. Perhaps the low carb, because it looks like most people are following that diet post op. 


Darcy G.
on 12/15/15 2:20 pm
VSG on 04/07/16

Hi Jenny,

I'm pre-op, though I hope not for much longer. Thursday is my month 5 of 6 required nutritionist visits for the surgery.  As I understand it, all surgeons/centers have different requirements for the pre-op supervised diet. Mine wanted me to follow the plan that the nutritionist gave me, which isn't low carb for me. It's six mini-meals per day, following a 10/10/10 rule that translates to--every meal over 10g protein, less than 10g fat and 10g sugars. Sugar alcohols count for half their stated amount, so if they say 16g sugar alcohol on the packaging, they count as 8g. Also, fruits (not juices) are included in my plan. My plan isn't looking for weightloss prior to surgery(at least not for me), they just want me to establish a livable eating plan and change my habits to what I will need to follow after surgery.

That's just the food part, but there's also a whole list of stuff my bariatric surgery center requires before approval with this office, just from the nutritionist standpoint(counting out all the different pre-op tests they wanted for the benefit of the insurance hurdles).

I attended a group nutrition class one month, then the next month began the 6 months of 1 on 1 dietary consults with nutritionist

This is my list of behavioral changes to make over the 6 months/stuff to learn:

  • Develop new eating schedule(every 2-3 hours for 6 mini meals per day),
  • Reduce portion sizes per meal, consume adequate fruits and vegetables(2 fruits/3 vegs)
  • Reduce sugar and fat intake
  • Consume adequate protein and fiber per day(60-80g protein, 25+g fiber)
  • Eliminate caffeine
  • Eliminate carbonated beverages
  • Eliminate alcohol
  • Practice eating and drinking slowly
  • Drink adequate fluids(between meals only)
  • Take multivitamin & Vit-D supplement
  • Increase physical activity
  • Understand clear and full liquid diet guidelines
  • Complete daily food records and bring to all dietitian appointments

I had the consultation part of my pre-op psychologist visit last Thursday which was just under 2 hours but was pretty darned painless although I was in full-on arm-flailing mode the week before. My insurance requires the evaluation and the testing to happen on two different days for some reason... found out that day, so I have to go back and do the other part.

I won't get into the other loops require by my insurance, but there are a good number of them... Everyone's deal is different though. You might get to choose your diet, you might have one given to you. My nutritionist gave me guidelines that first month, then just sorta let me fly and work out stuff I wanted to eat that fit it for the first month, and then every month after we've gone over the journal and talked about what is on plan, what isn't, and she's made suggestions based on what I have been eating... what she thinks I might like. I actually look forward to the nutritionist visits, gives me someone to talk to about what struggles I've been having, and she's just very supportive. Since I began seeing her, I've lost about 25 pounds, only around 5 pounds per month but I had lost a good bit before that on my own so my first month of awesome numbers happened like... three or four months before I saw the nutritionist :)

You want to prepare and I get that, but outside of just learning a summary kind of deal on what the different diets are like in case your nutritionist wants to work it that way where you talk it out ahead of time, I wouldn't start making big sweeping changes yet. I have always done low-carb on my own so I really know it? Meshing that low-carb mindset with her plan was probably the hardest thing out of the gate. Learning to limit fats to the point that like... a lot of beef in normal-sized portions don't work with the plan, and to actually eat carbs? That was hard for me, unlearning what I'd had long-ago drilled in my head on two different fronts.

Good luck!

on 12/16/15 9:53 am

Hi Jenny, Gabe here. I know what you mean, I just had surgery a couple weeks ago after having to wait FOREVER for approval, hang in there and don't forget to keep asking if it's moving along and if they need any documents or such!

on 12/16/15 5:23 pm

Hi Gabe,

Congratulations on your surgery!  I'm curious - How long was the "FORVER" surgery wait?


on 12/16/15 5:27 pm

Hi Jenny,

I'm in the pre-WLS group!  I'm in NJ though.

I just completed my sleep study last week and my second nutrition visit today.  I know I want this, but a part of me keeps yelling, ARE YOU REALLY REALLLLLLY READY FOR THIS?!!  I'm anxious, but I'm so inspired by the stories from everyone.


(deactivated member)
on 12/28/15 12:05 pm

Hi Jenny! My name is also Jenny, and I live in AZ too :) I live in Chandler, you? I am working with Dr. Podkameni at Banner Gateway in Gilbert and he is great. I highly recommend him. I am having surgery on January 19th, and am nervous, but these boards seem to help. Don't wait though, do it now :)