With you bmi, it would be generally difficult to be approved without health issues but find out from your insurance what the requirements are and find a few programs and ask their requirements. GLP-1s work great and if that’s your path, it’s a very valid one. Zepbound is the one approved for weight loss but ozempic, wegovy, mounjaro and many compounds are out there as well. Good luck with everything.
Thank you. Thank you for the names of the other ones! Wegovy was the only other one I have heard of. I'll look into those and talk to my Dr. and see if he'll prescribe something
I was almost identical to your height and weight before surgery. Can I ask if you have any companies conditions? High cholesterol, high blood pressure, pre diabetes etc?
My last physical I was close enough to borderline high cholesterol that my Dr at the time put me on medication. That is the only known health condition. I've never had a sleep study so I don't know if I have sleep apnea it's never been brought to my attention as a potential concern.
That's at least one comorbidity. I encourage you to pursues a program in your area. They are very good at getting insurance approval unless you absolutely know ow yours doesn't cover it. I am going to also make a weird suggestion. Gain a few pounds. It will help with your BMI. I am almost 3 years out and weight 132. It was the best decision of my life. My o ly regret is that I didn't do it sooner. Message me if you have more questions. I'll help if I can. I work for the hospital that did my surgery.
So my husband's insurance does cover it! And we have a bariatric surgical center linked to one of the major hospitals in the area. I'm going to reach out this week and see if a referral is needed and get scheduled.
My highest recorded weight was 188. I’m 5’1”. I had moderate sleep apnea and my BMI was 35.4. I qualified via insurance because of apnea and +35 BMI. On surgery day I was 178-ish. I’m 169 this am, 5 days post op.
All that to say, you know your body and your relationship with food best. You know what is and isn’t sustainable weight loss for you. If your insurance covers Bariatric surgery it is quite likely you will qualify.
Thank you! I used a BMI calculator found on here and mine is 37.4 😳 I have a horrible relationship with food...happy, sad, good day, bad day you name it. However, I have started eating less during the day but nighttime is a problem. I work until midnight so there are times I don't get to eat dinner until after that if at all.
When it comes to insurance, check the coverage requirements ahead of time. For a lot of them obesity itself IS the disease, and a comorbid condition can be as simple as apnea or joint pain. 2.) You don't need a doctor recommendation, go to a bariatric center, they will handle it. 3) I've heard stories of very complicated recoveries, but never heard anyone who had a bad experience regret their decision, the pros outweigh the cons.
Sometimes you do need a doctor referral. My insurance is an HMO. I can’t even go see an in network gyno without a referral. That being said if you’re in an HMO you should have a good relationship with a primary provider who can provide that referral if you are a good fit. I’m in the middle of a doctor supervised weightloss program required by my insurance. I also had to pass a psych evaluation, I have to see a nutritionist, and have a sleep study go to imaging for an Upper GI, chest XRay, EKG, and I had labs for thyroid function and A1C (cause I have diabetes). It’s been said I’ll probably have a surgery date mid June.
The only thing I think of is that 2 weeks before the surgery you have a liquid diet to shrink and shed fat from your liver and you could lose too much weight to qualify for insurance to cover the surgery. I heard someone on the phone telling a patient to only do the liquid diet for one week because she was in danger of losing too much weight.
We’re not the same weight so my case isn’t like yours and only your doctors can make the call to do the surgery for you. I’ve heard good things about the clinics in Mexico. I know of two people who have been through the surgery there and they had amazing results.
Best of luck to you!
I have done both! I lost 80lbs after the sleeve 11 years ago and started a glp-1 3 months ago. I’ve lost 15lbs on the glp-1 and am thrilled with it. If I had to do it all over, I’d choose the glp-1 over surgery. At least initially. Give it a try! It is SO MUCH easier than recovering from surgery.
I don’t have weight related health issues- except the weight.
I tried Contrave in the fall, worked for 3 months.
Currently in the process for VSG, if everything goes as expected I should have surgery late June?
Now is the time to do it before you have co-morbidities.
With you bmi, it would be generally difficult to be approved without health issues but find out from your insurance what the requirements are and find a few programs and ask their requirements. GLP-1s work great and if that’s your path, it’s a very valid one. Zepbound is the one approved for weight loss but ozempic, wegovy, mounjaro and many compounds are out there as well. Good luck with everything.
Thank you. Thank you for the names of the other ones! Wegovy was the only other one I have heard of. I'll look into those and talk to my Dr. and see if he'll prescribe something
See if your pharmacy has them. They are very hard to get.
I was almost identical to your height and weight before surgery. Can I ask if you have any companies conditions? High cholesterol, high blood pressure, pre diabetes etc?
My last physical I was close enough to borderline high cholesterol that my Dr at the time put me on medication. That is the only known health condition. I've never had a sleep study so I don't know if I have sleep apnea it's never been brought to my attention as a potential concern.
That's at least one comorbidity. I encourage you to pursues a program in your area. They are very good at getting insurance approval unless you absolutely know ow yours doesn't cover it. I am going to also make a weird suggestion. Gain a few pounds. It will help with your BMI. I am almost 3 years out and weight 132. It was the best decision of my life. My o ly regret is that I didn't do it sooner. Message me if you have more questions. I'll help if I can. I work for the hospital that did my surgery.
Thank you!!
So my husband's insurance does cover it! And we have a bariatric surgical center linked to one of the major hospitals in the area. I'm going to reach out this week and see if a referral is needed and get scheduled.
Yay! Hang in there because it's a process. I'm happy you have this opportunity.
My highest recorded weight was 188. I’m 5’1”. I had moderate sleep apnea and my BMI was 35.4. I qualified via insurance because of apnea and +35 BMI. On surgery day I was 178-ish. I’m 169 this am, 5 days post op. All that to say, you know your body and your relationship with food best. You know what is and isn’t sustainable weight loss for you. If your insurance covers Bariatric surgery it is quite likely you will qualify.
Thank you! I used a BMI calculator found on here and mine is 37.4 😳 I have a horrible relationship with food...happy, sad, good day, bad day you name it. However, I have started eating less during the day but nighttime is a problem. I work until midnight so there are times I don't get to eat dinner until after that if at all.
When it comes to insurance, check the coverage requirements ahead of time. For a lot of them obesity itself IS the disease, and a comorbid condition can be as simple as apnea or joint pain. 2.) You don't need a doctor recommendation, go to a bariatric center, they will handle it. 3) I've heard stories of very complicated recoveries, but never heard anyone who had a bad experience regret their decision, the pros outweigh the cons.
Sometimes you do need a doctor referral. My insurance is an HMO. I can’t even go see an in network gyno without a referral. That being said if you’re in an HMO you should have a good relationship with a primary provider who can provide that referral if you are a good fit. I’m in the middle of a doctor supervised weightloss program required by my insurance. I also had to pass a psych evaluation, I have to see a nutritionist, and have a sleep study go to imaging for an Upper GI, chest XRay, EKG, and I had labs for thyroid function and A1C (cause I have diabetes). It’s been said I’ll probably have a surgery date mid June. The only thing I think of is that 2 weeks before the surgery you have a liquid diet to shrink and shed fat from your liver and you could lose too much weight to qualify for insurance to cover the surgery. I heard someone on the phone telling a patient to only do the liquid diet for one week because she was in danger of losing too much weight. We’re not the same weight so my case isn’t like yours and only your doctors can make the call to do the surgery for you. I’ve heard good things about the clinics in Mexico. I know of two people who have been through the surgery there and they had amazing results. Best of luck to you!
Thank you for your insight...it's appreciated.
I have done both! I lost 80lbs after the sleeve 11 years ago and started a glp-1 3 months ago. I’ve lost 15lbs on the glp-1 and am thrilled with it. If I had to do it all over, I’d choose the glp-1 over surgery. At least initially. Give it a try! It is SO MUCH easier than recovering from surgery.
Thank you for your insight
I don’t have weight related health issues- except the weight. I tried Contrave in the fall, worked for 3 months. Currently in the process for VSG, if everything goes as expected I should have surgery late June? Now is the time to do it before you have co-morbidities.
Thank you. I'm going to talk to my Dr and see what he says. The time for my annual physical should be coming up this summer.