Hey everyone,

thanks for everyone who helped me when I was looking for a surgeon from Central America. I found a surgeon in the United States who I am talking to, and I am going to go visit in January. I also have a back up option, if insurance doesn't come through, in Mexico.

I was hoping someone might have had experience with an odd issue. I am very fearful that I am losing too much weight, and I will soon disqualify myself. I am 5'7.9 inches tall (I say 5'7 so my BMI looks larger) and my starting weight was 336.2 (BMI 52.7).

This is not the first time I have lost a lot of weight before. I have had multiple drops over 50 lbs and two drops over 100 lbs. Each time I gain back more weight. All of the medical research seems to say I am not alone in this. I have been obese since infancy, I can lose weight better than any person I know. I can also gain weight like a champ. It my hope that getting a sleeve done will be a powerful tool to help me maintain these losses long term, or at least be a buffer to help me make the diet changes I want to make permanent.

When I started to get serious about surgery I put myself on a whole foods, calorie restricted diet.
I am eating about 1,500 calories, around 60 grams of protein, moderate fat intake, with moderate physical activity 3x week. I am eating lots and lots of veggies, some vegan protein supplements (pea protein, seitan, soy). Lots of beans, nuts, veggies, and about 2-3 servings of fruit per day.

This is in line with what the U.S. surgeon says, but it is completely contrary to what the local nutritionist wants (see notes below - I just want to vent about how frustrating he is).

I started doing this 80 days ago. I started seeing the local nutritionist on October 23rd (52 days ago). This morning I was under 289 (47 lbs down). That makes my BMI 45.3. (but if i use the more accurate 5'8 - only 43.9).

My insurance mandates a 6-month, medically-supervised, weight loss program. They also require a BMI over 40, or over 35 w/ a co-morbidity. As far as I know, I don't have a co-morbidity. Perhaps I can claim that my weight has made one of my knees really painful, and that impacts my physical activity, or that it caused PCOS. However, that seems like a stretch.

If I keep losing weight at the current rate (and if my previous weight loss is predictor of future performance i will for at least another 50 lbs) I will soon be below that 40 BMI mark. Does anyone have any experience with trying to qualify with a low BMI? Has anyone been disqualified for that? Any experience or insight would be helpful.



Ok and now for a rant about the local nutritionist:

The local doctors do not understand veganism/vegetarianism, and rely heavily on highly processed, artificially low-fat, low calorie food. I understand the need for some protein supplementation, especially after surgery, but they want me on 130 grams of protein on a below 1,500 calorie a day diet. I tried it for two weeks and I had so many digestive issues I almost gave up. I don't eat a lot of protein normally, I don't eat meat, I don't use dairy, I don't eat eggs. I am a tofu fanatic, but it is hard to get here. So I get that isn't good. But 130 grams seems like a recipe for kidney and colon issues.

I don't really trust the local dietitian. They drew out a diet plan that was filled with fake sugars, light/low fat foods, multiple tiny meals with less than 50 calories. I used MFP to calculate the calories, the days went between 1,800 and 700 calories per day.

He wanted my diet to be primarily glucerna shakes, even though those are not vegan, and insisted I drink diet soda, and eat sugar-free jello. I never drink regular soda, I am a water and coffee type of a girl, so that makes no sense to me.

He insists my problem is sugar and that I am eating way to much fruit. Mind you, I was eating 2-4 pieces of fruit per day before this whole thing, and I am pretty sure my tendency to pick fruit over pastry isn't what made me 336 lbs. Yet, he drew out a diet plan that had apple juice in it.

He he told me I was lying because I obviously had a problem with consuming too much sugar. I think he meant because my stomach looks round. It is a hernia, I am not apple shaped. I also have perfect blood sugar levels. he then got on a "if you are not serious about losing weight I cannot help you, you need to be truthful about the amount of sugar you consume and be willing to make changes" I had already lose 20 lbs, so this felt incredibly condescending

He pulled out a 1990's version of the U.S. food pyramid to show me why drinking milk is so very, very important.

The absolute worst was when I showed up for my 3rd appointment, which i had schedule 3 weeks earlier. He hadn't been in for a week, he didn't refer any of his patients, and then his secretary said she didn't expect him to come back until next year.

I am frustrated to say the least.

Ok rant on the local nutritionist done.


Any insight on the insurance issues would be appreciated.