Weight Loss

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Sunday, January 28, 2007

Where I've Been

After over a year of contemplation and weighing my options (no pun intended), I have decided to have weight loss surgery. I realize that some people would be shocked to learn this. I do not look like a candidate for WLS. I carry my excess weight well, and most of my friends and family would be surprised to learn that my BMI is over 40. I am able to lose some weight with dieting, but my results are so modest and hard won, and I am unable to sustain these losses for any length of time. In the end, I decided that this was the only way to give myself a reasonable chance of permanently keeping the weight off. I believe that the years of yo-yo dieting have left me worse off than ever, and I don't think that is a realistic way to expect to live the rest of my life. And with the genes in my family, I stand an excellent chance of living to be 100. I'd like my knees and heart to make it there with me.

Before I seriously contemplated this option for myself, I used to think of WLS (gastric bypass, Lap Band, or any of the other surgical options available) as the extreme, last-ditch effort, made only when you are sure that staying at your current weight is more risky than having this extremely dangerous surgery. But some research on the current statistics behind WLS shows this is a fallicy. In the past 5 years surgical techniques and postoperative care regimens have advanced to the point that it is considered very safe elective surgery for most patients. And I was surprised to learn that only 1 in 20 morbidly obese patients are able to lose weight and keep it off for any significant length of time. Currently, WLS is actually considered to be the only effective method of achieving and maintaining a healthy weight for the morbidly obese patient who has tried and failed more conservative methods of weight loss. And that, my friends, is me. Just because I don't look "THAT heavy" doesn't mean that I am not considered by medical professionals (including myself, a health care professional) to be morbidly obese.

In future posts, I will attempt to address many of the philosophical and emotional issues surrounding WLS, at least from my own perspective. Today I wish to simply take stock of where I am and where I've been, lay out the groundwork for my plan, and possibly draw some conclusions for myself about this next phase of my life. This blog will mostly serve as a place to journal my thoughts and post my photos and successes and failures for my own edification. It might also become a place to point friends and family who wish to join me on the journey, if I feel ready for that next step in the future.

Today I am 225.8 lbs wearing only underclothes. I am 5' 3.5" tall. This makes my BMI just over 40. I've been obsessed with these numbers lately, because my approval by my insurance company hinges on the numbers. If my BMI is 39.9, they will not cover my surgery, unless I had diabetes, which I don't. Luckily, my measurements on my "official" weigh in day were higher than that, so I met the BMI-40 threshold. Next I had to have a significant comorbidity to qualify. I am not hypertensive or diabetic. GERD doesn't count for Regence, although I do have mild GERD. It all hinges on the sleep study I had 2 weeks ago. My snoring has gotten worse over the last year, significantly so. My husband tells me that I do have apnea periods during my sleep. If my sleep study showed obstructive sleep apnea, that is a significant comorbidity that causes known complications later in life, and can be alleviated by weight loss. In fact, the sleep medicine doctor informed me that I do have mild sleep apnea that showed up on my sleep study, and I should start using CPAP, and lose weight. According to these conditions met, I should be approved for surgery, but that still might not happen. I won't find out until the surgeon's office submits my paperwork to my insurance for approval.

Obsessing over my exact weight in pounds (or kilos) is new for me, as I spent many years training myself not to worry about the numbers. For several years I didn't step on a scale, which didn't prevent me from gaining a lot of weight, just from feeling worse about it than I felt about not fitting into my clothes. I am hoping that I can stop obsessing about it for a little while until I have surgery, but it hasn't abated yet. If I am approved for surgery, I will have a laparoscopic Roux en Y, since that is what is covered by Regence BCBS. If I am not approved, I will have a Lap Band, which I will have to pay for myself. I would much rather have this covered by my insurance, of course, but if it can't happen, I still need to do something now, before my health starts to seriously decline and before I move on to graduate school and then hopefully parenthood.


Snippety Gibbet said...

Hi, Gwen...I'm starting to read your blog at the very beginning, so I'm looking at Februray 2007 right now. It seems as though weight wise I am at the same place you were. I could be bmi 40 or I might not be, so I'm wondering what I need to do to guarantee the numbers. Did they go by your weight from your doctors or did they go by a number at your surgeon's office? Did they weight your with clothes on or off? Sheesh, that sounds personal, but I'm really concerned about how close this thing will be. Thanks for any info you'll tell me. I'm so happy for you! Jan

Gwen said...

Let's see...my surgeon's office weighed me with clothes on each time. I tried to wear things that were heavy to ensure I would meet the threshold. They did have me take off my shoes, so heavy boots didn't help. :) But I have heard of people putting rocks in their pockets to add weight. I was really concerned about "making weight" too--there is so little difference between BMI of 39.9 and 40, but all the difference in insurance approval. But that said, I've never heard of someone not being approved because their BMI was 39.9. I'm sure it happens, but I think more often the surgeon's office fudges the numbers to make it work. I have no proof of that, just speculation. Good luck! Thanks for reading!