Do I qualify for the lap band?

Question
Hi.  In 2008 I weighed 308 pounds.  I went on a diet on my own (nothing crazy, just cut calories and exercised) and I dropped down to 187 in about one year.  Last year we moved out of state, bought a new house, changed jobs and life suddenly got chaotic.  I started to fall back into old habits and regained some of the weight back.  Today, I am 210 pounds.  For the past 2 weeks I have resumed my good eating habits and have dropped a few pounds already.  Instead of going back to the gym, I power-walk about 30 minutes a day around my neighborhood five days a week.

My problem is that I have been obese nearly all my life.  I have three children and I was over 300 pounds each time I delivered one of them.  I can't even tell you how many times I have tried to take the weight off--but it's been at least 20 times through the years.  It's been a very frustrating problem!  I think my own diet has been the most success I've ever had.  Even though I regained some of the weight, I didn't not gain it all back plus more (which is what usually happens#.  I am very active.  I have three young kids #ages 5,4,and 2# and they keep me hopping.  I love to be busy.  I am really self motivated, determined, and stubborn; I think this is both my saving grace and my downfall, if you know what I mean.  So here are my questions:

1.  Would I qualify for the lap band even though my BMI is only 33?

2.  With a low BMI and no co-morbidities would I have a hard time getting approved for the surgery #both with a doctor and insurance)?

I do not look at the lap band as a cure.  I look at it as a tool to help me keep my weight in check.  I think when you have a propensity to over eat and not have that full feeling, you run the risk of being morbidly obese all your life.  I have so much to live for.  I really love life...but I need help.  I have a problem, and I know it.  I'm just not sure where to turn to get it.  Thanks for your help.  I really appreciate it.

-Tanya

Answer
Hi Tanya:

Congratulations on losing so much weight and developing some great exercise habits!  As far as getting insurance approval for the Lap-Band, I think it would be tough.  You could work with your surgeon and your primary care physician to document your weight history and reasoning.  Most likely you would still be denied, but it wouldn't hurt to try.  Sadly, even though in other countries, bariatric surgery is being done on people with BMIs simply over 30--here we're still kind of stuck in the 40/35 with comorbidities mindset.  

Here are a few studies you/your surgeon could try and include in your letter to your insurance company.  There was a study done a few years ago on the Lap-Band on people with BMIs less than 35.   http://www.ncbi.nlm.nih.gov/pubmed/17015204  It showed excellent results.  There was also a study that looked at the Sleeve Gastrectomy on a similar population. This showed even greater weight loss.   http://www.ncbi.nlm.nih.gov/pubmed/18996758  

Even with that, I do think you could find a few surgeons willing to give you a Lap-Band or Vertical Sleeve Gastrectomy as a cash pay.  Some even offer their own financing, etc.  My guess is for either, you'd probably have to budget at least $10,000.00.  If that seems out of reach, you can at least try the insurance route--and appeal if necessary.  Also, be sure to ask about the cost of fills (adjustments to your Band)--what is covered, for how long, etc.  

I sure hope you're able to have the surgery.

Kind Regards,
Karla

1. Prev:Please Help!!!!!
2. Next:how do you choose a doctor?