Tom, I sympathize with you. I truly do. I was very fortunate when I had my surgery in 2003. There was not these strict requirements as many insurers require nowadays.

I did not have a psych eval. I filled out paperwork about my health conditions, both physical and mental. I had sleep apnea, diabetes, hypertension... a perfect candidate to benefit from WLS.

There was not a documented 6-mos weight-loss program. I did have to list all of the programs I had tried throughout my life to lose weight -- there were many of them.

The first time around the insurance approved my surgery. There wasn't any need to go back and forth debating the procedure.

I suspect that the steady rise in WLS caused insurers to take a closer look at the procedure because some of the surgeries were not successful in the long term. A long time ago, there was a common perception that WLS was a magic bullet. I wish!!! So, it seems that there was a gap in the aftercare and education that needed to be in place to ensure long term success, and the best outcomes for patients after WLS. My surgeon told me, I do the surgery, the rest is up to you. That's kind of hard to do, learn how to live healthy on your own accord after decades of not being able to do so.

Aftercare and education has improved in recent years but there is more that needs to be done. That is why I write, to try to help others achieve lifetime obesity disease management after WLS.

So, the insurers say that this more rigorous prescreen process better equips patients for success after WLS, and I supposse weed out some of the folks that they deem not likely to be successful. I am not sure if I whole-heartily agree with that logic... I myself was binging like crazy before my surgery because I knew it was my last time for doing so. And yet you have to follow a 6-mos weight loss program to be deemed "fit" for surgery.

Bewst of luck to you my friend. Stick with it. The surgery really is life changing. It was the best thing that I ever did for myself.

MBL