Should people barely over 200 lbs or below 200 get Lapband or any WLS...?

Nanook -

I mean that if you have a BMI over what is healthy for your height, with or without co-morbidities you should qualify for surgery, and that the current guidelines of having to wait until you have a BMI of 40 or more or 35 with co-morbidities to qualify is having to wait too long.

Jachut -

I agree with your statement that the Medical Professionals should be able to spot the people who may have eating disorders and would disqualify them, but my concern is that there always seem to be people in this world who will do anything for a dollar and people with eating disorders and money may be able to find doctors that are willing to perform surgeries on them just because they have the funds to pay.

I think we probably look at it a little differently because of the difference in our health systems.

In Australia, that's already the case. If a surgeon will do it, most health funds will pay. But I get the idea that there, the health insurance companies themselves have rules, so that even if the surgeon will do it, the health fund wont pay?

Ghrelin?

That's what the sleeve does. Actually, all WLS interferes with ghrelin production to some extent. It's just that the sleeve takes out the portion of the stomach that produces it. There is still some being produced in your intestines though.

They are working on a pill to supress ghrelin production, but right now it doesn't work too well.

I think that's true. But I also think you can't make policy based on trying to keep the fringe lunatics from harming themselves. If the policy is sensible (and I don't think ours is), then that has to be good enough.

Don't we all pretty much have an eating disorder....we all over eat that's what got us here, lots of us binge...that got us here. lol

No, I don't think we all do have an eating disorder. An eating disorder is not just eating more than you need. It's about body image and disordered eating. If someone gets hungry 6x a day and 6x a day they have a healthy meal or snack, they may be overweight but they don't even have disorderd eating, let alone an eating disorder

An eating disorder is a very serious thing. People who have them often die because they can't stop themselves from their destructive behaviors. Disordered eating isn't quite as severe and probably everyone engages in it at least sometimes in their lives in a very mild way, but most people don't exhibit those signs very regularly so it's not really a problem.

So some overweight people have disordered eating and some of those have an eating disorder but not everyone who is overweight.

Yeah, I ate a lot, I ate when I wasnt hungry, and I really overdid certain foods. That was disordered eating.

I've never binged. I always ate till I was full and stopped, but full was too many calories for my body. I've never eaten things I've pulled out of the rubbish bin, or eaten an entire cake or eaten till I've been sick.

Likewise I've never starved myself or exercised excessively and obsessively.

I'd say definitely I dont have/didnt have an eating disorder. I had an appetite too large for my energy needs and a distinct lack of self control and accountability.

That's right, typically US health insurance companies have a specific list of what needs to have been done in order to qualify for surgery. Anything from a psychiatric evaluation, to 6 months of a medically supervised diet and others can be necessary depending on the insurance company. I actually had to write a paper about how my excess weight effected me both physically and emotionally. I had to include the fact that I had diabetes and heart disease in my family and how I feel that the surgery would help me to avoid future health issues. My doctor also had to turn in a similar letter. Oh, and the nutritionist had to turn in a letter stating that I understood what foods were healthy and how to prepare healthy meals. Basically, you run around like crazy until you have everything the insurance company needs.

All of that running was probably a good thing for me as it made me really confident that I could accomplish this and really put in perspective the changes I was going to have to make in order to be successful.

Quote:

Originally Posted by Desy1701 I can't agree that just because someone has the money they should be able to get banded. There have to be limits and criteria (although I think a BMI of 40 and co-morbidities is too late).

I do see where your coming from....but, Who would then set the limits? The Insurance companies? The AMA? The Government? The mere fact this discussion/debate is taking place on a WLS forum – it’s no wonder the Insurance companies, that put many of us through the ringer – laugh all the way to the bank. We’re supposed to be their customers, and if one has to use their cash stash to pay for the advancement of health, because the Ins company that collects “our fees” can arbitrarily decide who can / cannot have Lap Band .. who does that hurt? This OP has 200lbs to loose – why on earth should she be on a 6 month diet. That’s just plain cruel in my opinion.

I would assume that ethical standards come into play with WLS/PS surgeons, and as consumers’ we have the choice in elective surgery to find one that suits our individual needs = meets our criteria. So long as I have cash – and my Insurance wants to play judge & jury w/my body and my aesthetics, I will spend away, can’t take it with me….but in the mean time I will kick obesity to the curb and keep mother nature at bay.

I was just over 200 lbs when i got banded. I am short and there are several co-morbites in my family. I turn 40 this year, and I was only getting larger. I want to prevent the health problems that my grandparents and now my mother have gone/are going through.

I think a bmi of 35, you should be able to get banded. I agree with those who say that by the time you are at 40, it's no longer preventive, but trying to reverse the clock.

The other thing which I think is not totally irrelevant is that if you get banded at a lower BMI and prevent the morbid obesity in the first place, it is possible to lose weight and not need cosmetic surgery.

I know the medical profession would argue that nobody "needs" cosmetic surgery anyway but they're not walking around wearing enough skin for two people. When so many bandsters lose their weight and then have to go and spend thousands (and have more surgeries) to remove all the loose skin, that's something to consider. It really is a part of the cost and risk of weight loss surgery.

And there's loads more that can go wrong with cosmetic procedures such as a tummy tuck which can seriously affect your health and your life. So if a really "need" for it can be avoided by preventing obesity in the first place, then isnt that another reason to band people at lower weights?

I think some people are blessed to have their skin be more elastic than others. Maybe it's hereditary I don't know. All I know is after my second child I received the "apron" or whatever the scientific term is.

My daughter has just lost about 75 pounds in the last few months and I know at her age she'll probably want to get a TT. I think it can be a bit unsettling for people to go through WLS and lose so much weight only to be extremely unhappy with their sagging parts afterwards. I think if you go through all the trouble for WLS to be healthy and to look good why not have PS too! If I were younger or single or both I probably would too. But at my stage in life it's not that important to me. If my husband wants to see perky boobies he can look at his own Nanook.

See that bold bit - *sighs* me too :(

I hope my skin doesn't get too saggy but I know it will

I'll take the saggy skin any day over the fat... I feel to frickin good to worry about it too much - I feel so much healthier and 10 yrs younger and heck that's why God invented Plastic Surgeons...