<p>I initially lost 25 lbs within like 1.5 months then all of a sudden I didnt lose anything for 2 months...very discouraging....i am nearing the end of my 6 month program and I have gained some back....its hard....i have stopped going to the weight loss clinic as often bc now i have decided to go with the lap band..i just go the required amount by BCBS .but this is how it always works...i do good and lose a lot of weight really fast and then i cant lose anymore...everyone thinks its bc i start cheating but its not....i dont start cheating and giving up until after i start regaining the weight...then its like forget it.....</p>
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Friendship is like peeing on yourself: everyone can see it, but only you get that warm feeling that it brings Banded 1/31/08
Last edited by kaninag; 11-25-2007 at 02:47 PM.
Reason: typo
The reason I ask this is because I am afraid to go below 40BMI. I was 41.5 when I started, and have lost 7 pounds the first month. If I lose more than 1 more pound, I will be below 40. Will that hurt my chances for approval, or does insurance co. go by your BMI when you started?
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Dr. John Marsden-DFW
Surgery 3-14-08
1st fill - 4-14-08
2nd fill - 5-23-08
It depends upon who your insurance company is. Also, do you have any co-morbidities? For some BCBS insurances, you can be below the 40BMI but if you have at least two co-morbidities (diabetes, high cholesterol, hypertension, pre-hypertension, sleep apnea, and some others...) you can still be approved.
You should call your physician, get the procedure codes for the Lap Band and the fills, call your insurance company and talk to them about it. I did that and they told me what the requirements were. I have BCBS Federal and their guidance was what I stated above.
Let us know what happens...
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Banded 11/09/07 Dr. Singh, St. Agnes Hosp. Baltimore, MD, Highest Weight 308 (November 2006)
Start Weight 287.1, Current Post-Op Weight 251.0
Goal Weight 175
MollyBrown - Thanks for the reply. I have Aetna. Yes, I have diabetes, high cholesterol and pre-hypertension. I called the insurance company when I first started thinking about this and they faxed me the info. on obesity surgery. It is BMI exceeding 40 OR greater than 35 with one co-morbidy. I guess I just answered my own question! Plus, I just read a section they have in the info. about the rationale for the requirements, and they clearly say that a patient's compliance with a diet before surgery provides an indication of the likelihood of compliance with the restrictions imposed post surgery. And then it says "the appropriateness of obesity surgery in noncompliant patients should be questioned." So I think I will continue dieting and exercising. Thank you for helping me sort it out. Sometimes we just need someone to focus us in the direction where the answers are right there.
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Dr. John Marsden-DFW
Surgery 3-14-08
1st fill - 4-14-08
2nd fill - 5-23-08
Banded March 14th!
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