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09-06-2008, 04:37 PM
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#1 (permalink)
| | Big Loser
Join Date: Aug 2008 Location: Oregon
Posts: 128
Weight Statistics December 14, 2008 Start Date:
February 4th, 2009 Surgery Date:
5' 2"
Height:
241 lb Start Weight:
173 lb Current Weight:
135 lb Goal Weight:
68 lb Weight Loss:
38 lb Lb Left to Lose:
28.2157676349 % % Lost:
Body Mass Index44.0746618106 BMI Start:
31.6386576483 BMI Current:
24.6891259105 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
|  What if I loose weight & don't fit the BMI requirement any longer??
I am currently a 41-42 BMI & I know some insurance companys require that you loose weight before surgery. What if I loose the amount of weight they want, & then no longer fit the BMI requirement for surgery? I mean, if I loose 5 lbs or so, I will no longer be the required 40 BMI (without co-morbidities), that is needed for approval from my insurance company. Maybe my surgeon will not require me to loose weight before surgery.
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09-06-2008, 04:55 PM
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#2 (permalink)
| | Guru In Training
Join Date: Aug 2007 Location: North Royalton, Ohio
Posts: 207
Weight Statistics June 4, 2008 Surgery Date:
5' 1"
Height:
214 lb Start Weight:
198 lb Current Weight:
125 lb Goal Weight:
16 lb Weight Loss:
73 lb Lb Left to Lose:
7.47663551402 % % Lost:
Body Mass Index40.4305294276 BMI Start:
37.4076861059 BMI Current:
23.6159634507 BMI Goal:
Weight Loss MethodPhysician Prescribed Diet/Exercise
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While I'm part of a clinical trial and did not have gastric bypass, my surgeon sent for insurance approval prior to the liquid diet where you lost weight. When I was your BMI, my surgeon only wanted me to lose about 10 pounds prior to surgery. In addition to BMI, however, you also need to have co-morbidities to go along with it. One doctor once said to me I was the "healthiest fat person" she'd ever seen. I just don't have a lot of co-morbidities and that's VERY important for insurance approval.
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09-06-2008, 08:24 PM
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#3 (permalink)
| | Big Loser
Join Date: Aug 2008 Location: Oregon
Posts: 128
Weight Statistics December 14, 2008 Start Date:
February 4th, 2009 Surgery Date:
5' 2"
Height:
241 lb Start Weight:
173 lb Current Weight:
135 lb Goal Weight:
68 lb Weight Loss:
38 lb Lb Left to Lose:
28.2157676349 % % Lost:
Body Mass Index44.0746618106 BMI Start:
31.6386576483 BMI Current:
24.6891259105 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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I have a feeling my surgeon will submit all my information & data before she has me loose any weight. (if weight loss is needed prior to surgery). Geeezzz what do I have to do, gain 25lbs so that I still fit the 40bmi..ugh, this isn't fun anymore 
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09-06-2008, 10:21 PM
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#4 (permalink)
| | Guru In Training
Join Date: Apr 2008 Location: Oregon
Posts: 300
Weight Statistics 2001 Start Date:
June 24, 2008 Surgery Date:
5' 5"
Height:
379 lb Start Weight:
251 lb Current Weight:
179 lb Goal Weight:
128 lb Weight Loss:
72 lb Lb Left to Lose:
33.7730870712 % % Lost:
2010 Goal Date:
Body Mass Index63.0620118343 BMI Start:
41.7640236686 BMI Current:
29.7839053254 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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My insurance company did not penalize people for weight loss. As long as you statrted over the bmi limit.
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09-06-2008, 10:52 PM
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#5 (permalink)
| | Big Loser
Join Date: Aug 2008 Location: Oregon
Posts: 128
Weight Statistics December 14, 2008 Start Date:
February 4th, 2009 Surgery Date:
5' 2"
Height:
241 lb Start Weight:
173 lb Current Weight:
135 lb Goal Weight:
68 lb Weight Loss:
38 lb Lb Left to Lose:
28.2157676349 % % Lost:
Body Mass Index44.0746618106 BMI Start:
31.6386576483 BMI Current:
24.6891259105 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Reastland, what insurance company did you have ? Im sure they all would be the same in this respect; either accepting you based on your BMI before any weight loss, up front. Or, accepting you based on your BMI after the weight loss your surgeon wants you to achieve, prior to surgery.
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09-07-2008, 12:36 AM
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#6 (permalink)
| | Super Moderator
Join Date: Nov 2005 Location: Tokyo, Japan
Posts: 24,703
5' 5"
Height:
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Basically, the weight you are at the start of the process is what is accepted. The requirements of weight loss by the surgeons do not have any effect, as this is to decrease the risks involved in surgery, not to influence or have any effect on approval. I don't think there's been anyone on this board being denied surgery because they lost pre op the weight required by the surgeon.
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09-07-2008, 04:03 PM
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#7 (permalink)
| | Newbie
Join Date: Sep 2008 Location: PA
Posts: 9
Weight Statistics 6/9/08 Start Date:
still in question Surgery Date:
5' 9"
Height:
320 lb Start Weight:
170 lb Current Weight:
175 lb Goal Weight:
150 lb Weight Loss:
-5 lb Lb Left to Lose:
46.875 % % Lost:
1/25/09 Goal Date:
Body Mass Index47.2505776097 BMI Start:
25.1018693552 BMI Current:
25.8401596303 BMI Goal:
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i am in a similar position , at my initial consultation they said they normally require there patients to lose 15 percent of their weight but they told me to only lose 5. They openly admitted that they did not want me to lose more in order to make my case stronger for the insurance company.
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09-07-2008, 05:17 PM
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#8 (permalink)
| | Big Loser
Join Date: Aug 2008 Location: Oregon
Posts: 128
Weight Statistics December 14, 2008 Start Date:
February 4th, 2009 Surgery Date:
5' 2"
Height:
241 lb Start Weight:
173 lb Current Weight:
135 lb Goal Weight:
68 lb Weight Loss:
38 lb Lb Left to Lose:
28.2157676349 % % Lost:
Body Mass Index44.0746618106 BMI Start:
31.6386576483 BMI Current:
24.6891259105 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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PEWWW!! Thanks Doc Sanae & Bucwild! What a relief..I was worried that my insurance wouldn't accept me if I lost some weight up front, for my surgeon. It does make sense to accept or deny you before you loose any weight, but with these insurance companys, you just never know what their thinking. Doc Sanae, I don't know what this forum would do without you! Your knowledge is appreciated.
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09-08-2008, 04:17 PM
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#9 (permalink)
| | WLS Master Guru
Join Date: Jul 2007 Location: SouthWest
Posts: 707
Weight Statistics Jan 2007 Start Date:
non op Surgery Date:
5' 6"
Height:
267 lb Start Weight:
157 lb Current Weight:
180 lb Goal Weight:
110 lb Weight Loss:
-23 lb Lb Left to Lose:
41.1985018727 % % Lost:
Body Mass Index43.0902203857 BMI Start:
25.3376951331 BMI Current:
29.0495867769 BMI Goal:
Weight Loss MethodWeight Watchers
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Quote:
Originally Posted by Andrea45  I am currently a 41-42 BMI & I know some insurance companys require that you loose weight before surgery. What if I loose the amount of weight they want, & then no longer fit the BMI requirement for surgery? I mean, if I loose 5 lbs or so, I will no longer be the required 40 BMI (without co-morbidities), that is needed for approval from my insurance company. Maybe my surgeon will not require me to loose weight before surgery. | They always submit to the insurance company, your start weight but many surgeons DO require people to lose weight before surgery (some more, some less) - surgeons say if you lose some weight, it makes the surgery less risky (reduces fatty liver etc). I know surgeons who ask patients to lose 30-40 lbs on a liquid diet before surgery just to make their liver more healthy but the start weight is always the one submitted for insurance approval. 
__________________ Sue ---There are no shortcuts to a place worth going. (Beverly Sills) ---
http://obesitysurgery-info.com
Nothing tastes as good as thin feels!
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09-10-2008, 12:13 PM
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#10 (permalink)
| | Whipper Snapper
Join Date: Aug 2008 Location: North Platte, Nebraska
Posts: 35
Weight Statistics 08/31/08 Start Date:
May 19, 2009 Surgery Date:
5' 3"
Height:
247 lb Start Weight:
143 lb Current Weight:
149 lb Goal Weight:
104 lb Weight Loss:
-6 lb Lb Left to Lose:
42.1052631579 % % Lost:
Nov 19, 09 (6 month mark) Goal Date:
Body Mass Index43.7493071303 BMI Start:
25.3285462333 BMI Current:
26.3912824389 BMI Goal:
Weight Loss MethodRoux en Y Gastric Bypass
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Wow, this is EXACTLY what I have been worried about! I just started this 'journey' last month. I was referred to the surgeon and meet with him Oct 13th. I too, am currently at 41 for my BMI and I'm afraid that in the 6 months that my insurance requires me to be under the watchful eye of my dr, that I will lose weight and no longer qualify. Andrea, may I ask who your insurance company is? Just curious.
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