Question:
My BMI has finally hit 40, how long do I need to make sure i stay here?

My BMI has been 37-39 for 5 years now. No matter what diet I try, I cannot lower it below there. Before that it hovered around 35 for a few years. Last year I started to talk about WLS with my PCP. He did not think I could qualify for surgery because he thought that my difficulties such as chronic pain when walking and breathlessness upon exertion did not qualify as co-mords. My bp is slightly elevated and I have GERD but he doesn't find them to be significant enough to qualify as comords. He gave me a hard time about not "trying hard enough" to lose weight (I did try, honestly). He cautioned me not to try to gain weight because my insurance is almost an auto approve when you are over 40 BMI. I don't know what their policy is for at 40 because it says over 40. I can't believe I am saying this but I didn't listen and worked hard (it really did feel like hard work) to get my BMI over 40 and it's just 40 now. I have an appt with a brand new PCP who is supposedly supportive of WLS pts (though I don't know if he will be for someone who is on the line) and with a surgeon next week. I am afraid that because it is just 40, my insurance won't approve. Anyway, I am fearful of dipping below 40 in the next few weeks. What should I say to my new PCP? Should I tell him about the co-mords? I think my last PCP thought I was making it up. After I see the surgeon, will I be weighed again? Is there a possibility of being denied at 40 and is there a possibility of being denied after approval? I feel like I am in hell, can't get below 37 and can't get above 40. Marlene    — marlene O. (posted on November 27, 2002)

November 26, 2002
Hi Marlene: When you go to the new PCP and surgeon, lower your height by an inch. I was extremely close to the borderline, and was worried just as you are. My height was in debate between 5'3" and 5'4', and I used the 5'3". My height was never measured. My surgery was 6 weeks after the consultation. Of course in that time, being afraid to lose weight and dip under 40 BMI, I gained enough to make my BMI 40. I don't feel this will do any harm, as if I would have kept going the way I was, my BMI would have surpassed 40 and probably have been 45 if I had waited any longer. Good luck. I don't think you should have any trouble. By the way, my surgeon considered GERD a comorbidity. Love Grace
   — Grace H.

November 26, 2002
Hi Marlene, What a shock I got when I went to see my PCP and found that I had shrunk an inch from the weight I was carrying around. That inch put my BMI at 46. So maybe you wont have to gain more weight to put you at the BMI you need to be at, but your height could help.
   — Lisa R.

November 26, 2002
Marlene, why wouldn't you tell the new PCP about the co-mords!?!? GERD and elevated b/p certainly qualify! My surgeon listed the fact that I am short of breath on excertain also. It sounds as if your other doctor was just against WLS. When I went for my consultation, the surgeon's staff weighed me and measured my height. However they measured me at 1 inch less than I believed I was, so the previous posters may be on to something about the weight dragging you down and inch or so!!! Good Luck on your journey! God Bless!
   — garnet156

November 26, 2002
Marlene: I am also pre-op and in the same boat as you. My height is 5'8" and I weigh 255, which puts my BMI at 38.8. I'm planning to "gain" a few pounds by wearing heavy clothes to get weighed, and possibly putting a few rolls of quarters in my pockets. Also, I've found that if you wear some wide-leg pants, it is fairly easy to conceal that you are slouching a bit when you are measured. I have actually practiced this a couple of times to make sure. I can "lose" an inch in height and hopefully "gain" about 5 pounds, which should put my BMI at just over 40. I have very few co-morbids (heel spurs, back pain, possibly sleep apnea, but probably just bad snoring, and depression which comes and goes). I have decided that WLS is the answer for me. I have spent my entire adult life on one diet or another, gaining and losing hundreds and hundreds of pounds, only to be back where I started every time. I've had it with this lifestyle, and want and need something which will give me some control and help for this problem. I'm 45 and want to live the rest of my life as a normal weight person. Even being under 200 would feel wonderful. I haven't been there since my early 20's. I am not going to let the BMI rule stop me at this point. I don't like being deceitful, but if fudging the numbers a bit will help me get this surgery, I'm prepared to do it. Good luck to you, and keep researching this site and others - it has been a fantastic education in WLS!
   — Carlita

November 27, 2002
Marlene, Your BMI only has to be 40 when you meet with your surgeon. That's the info. that's submitted and looked upon by the ins. co. My BMI was 40 at the time of my surgery. Most ins. co's state a BMI of 38 with a minimum of 2 co-morbids. Usually, when you hit a BMI of 40 you don't need co-morbids(altho, most of us have them). Once you see your surgeon than most encourage you to try to lose weight if possible. This helps with less fat in the liver etc..So, as long as that BMI is 40 for the surgeon you're in good standing. Also, sounds as if your first PCP dsn't have a clue. Gerd, out of breath and all those things are co-morbids. Who's to say how much of a co-morbid is right for one person. It can and will affect you differently than me. Make sure you list them all. Good luck on this journey!
   — Linda M.

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