Denied by insurance for gastric sleeve today :(

I got the call today. I was denied by my insurance company the coverage for the gastric sleeve. The reason? I've lost too much weight during the 3-moth process in which I had to attend a class once a month that educates you on the lifestyle change you will be embarking on. This was required by my insurance company in order to attain their coverage.

Despite being told by the doctor, nutritionist, and insurance lady that weight-loss BEFORE surgery is preferred and even some-what mandatory, in some cases. And, despite being reassured not once, but three times that it wasn't going to be possible to lose too much weight before surgery, I seemed to have achieved this task.

I did everything I was supposed to. I did what I was told and I started taking charge of my life. Now they're telling me I took too much charge and I no longer have the privilege of their services.

It's bitter-sweet. I mean, who can't be a little proud of losing nearly fifty pounds? At the same time though, I was REALLY looking forward to having another weapon in my arsenal for when my Will Power gun was running low.

I can't say I'm ready to just give up or anything pathetic like that. The thought of launching myself into a downward spiral seems rather annoying and self-mutilating.

Has this happened to anyone else? Can someone share their story with me? I still feel strong....almost like this is a sign I should be doing this on my own....or a sign that surgery might lead to something far worse.

I would like to point out to some of the detracters that Bariatric Surgery is not the "easy way out". It requires LIFELONG dedication, determination, a strict eating plan, and lifelong supplementation. Many people lose weight only to regain it, but most people who lose weight with surgery keep it off if they follow the eating plan that is required.

That being said, the best way to lose weight is without surgery, but if you cannot because of multiple medical issues and severe obesity, it can be a way to get your life back. Yes, there are some that could have done it slower and without surgery, but really it is something that is available because of a need.

It is hurtful and discouraging for those of us who had bariatric surgery and were literally one foot in the grave to hear things like "the easy way out" and the like. It's not easy, it's hard work and the surgery only really is useful for weight loss for the first few years. After that, we lose weight just like everyone else with the unfortunate side effect of needing supplementation because of the malabsorbtion.

People do end up deathly ill after the surgery, but usually that is because of their own doing and poor behaviors. Those that supplement and eat right never have problems.

/endrant

Years from now, you will be able to look at the new, fit, thin you and say that YOU accomplished this. Not "a team of doctors". Not "medical science". YOU, and you alone, through willpower and perseverance.

Well, clearly you don't need surgery then.

You're 22 for christs sake. You can achieve anything you want if you put in the work. You don't need shortcuts like that. It's a good thing you were rejected in my opinion. You have the strength to do this without medical intervention.

You're too good for those quick fix solutions. You've proved you've got what it takes without needing surgery.

Um...you obviously don't know a thing about gastric bypass surgery. It is far from a "quick fix" solution. Indeed, it is a lifelong commitment to eating healthy food, and not very much of it, to avoid vomiting and other unpleasant side effects.

The prejudice against weight loss surgery on this thread is appalling, and so obviously born out of rank ignorance that I hardly know what to say. Study after study has shown it to be the only effective method of long-term weight loss, even if some of the weight is gained back, because very low calorie diets are usually the only method of weight loss that works for morbid obesity. It is not a way out for the lazy, and you are not a better person because you managed to lose it "on your own." It is a difficult, torturous path that means never being able to eat like a normal human being ever again. It is a brave and sensible thing to do in the majority of cases, and shame on all of you who implied otherwise without the slightest bit of research just because you heard Dr. Oz or Oprah say it was bad, or your friend's second cousin's gardener's sister had a hard time with it. Who's lazy now?

OP: Congratulations on your weight loss, and sorry to hear about your experience with the insurance company. I've known people to appeal these decisions and get somewhere, especially if their doctors are willing to write letters about how this early compliance makes one a particularly good candidate for the difficult regimen to follow. It might also make sense to see what other insurance options your employer offers. From what I understand, the PPOs are much more likely to approve these surgeries than HMOs, although it varies from company to company. You might check out the renewedreflections bulletin board for those who have had or are contemplating the surgery. There's an entire section on people's various experiences with insurance companies, so you might be able to find a company more amenable to helping you reach your goals.