Why won't the doctors i see recommend me for the lap band? i'm 5'5 and weigh 200 pounds, i know my bmi is not at the morbidly obesed rate, but i am overweight and have depression. i've had depression for 6 years now that started when my little sister pass

There : There are many rules an insurance company requires before they chose to cover a lap band procedure. If you are paying out of pocket and you are 200 lbs 5'5" and if you are a good surgical candidate (meaning you do not have high risks to undergo surgery) then I am sure you can find a surgeon to do a lap band for you.

I : I am sorry to hear about your sister. There is a high correlation between obesity and depression but is dificult to determined what came first. There are many patients with depression without obesity as well as the other way around. Is like the old question " what came first the chicken or the egg". I always warn my patients that loosing weight may not solve their depression though most of the times it helps. You mention that you don't eat red meats.The vast majority of the time proteins are not the source of obesity, carbohydrates are. I would watch-out for starches like potato, rice, pasta, breat; and simple sugars like candy, sodas, juices. Bariatric procedures like sleeve gastrectomy or adjustable gastric bands ( lap band, realize band) will restrict the amount of food that you eat but not the quality of the food you eat. You should start by dramatically decreasing the amount of carbs you eat and increase the proteins. Your bmi is 33.3 the fda aproved the lap band procedure for patients with bmi between 30 and 35 with medical problems related to obesity and for patients with bmi greater than 35 without the need of other medical problems. This procedures are very effective and if you are interested you should contact a bariatric surgeon at a center of excellence. He/she should be able to explain the procedure and see if you are a candidate. Obesity is a real health problem and should be treated early and efficiently. Good luck.

With : With a bmi of 33 you are outside the current standard for being a candidate for lap-band unless you have a significant co-morbidity or medical problem related to obesity such as diabetes or high blood pressure. Insurance companies will not likely cover the cost of a bariatric procedure in your case although the fda has approved lap-band for your bmi with comorbidity you do not have one. If you were about 15 pounds heavier with a bmi of 35 insurance would still not cover a lap-band but it would be within the new fda approval guidelines and many surgeons would be willing to offer you a band though you would have to pay the cost.

I : I am so sorry that you are having such a difficult time. Unfortunately, there is no easy answer. A lap band will not cure the problems you are having with depression--you might need to address this separately by seeing a therapist. Your insurance probably will not cover any bariatric surgery because you don't meet the criteria for weight or associated health problems. The only way to lose weight is to eat fewer calories than you are using up. It can be discouraging, but this is truly the only way. Focus on foods that are good sources of lean protein: low-fat cottage cheese, white meat turkey or chicken, steamed vegetables. You have to stay away from sugar, foods made with white flour, potatoes, and fried foods. If you are going to eat bread, make sure it is whole grain bread. Switch to skim milk. Read ingredients--even so-called healthy foods like yogurt can have a lot of added sugar in the fruit. You're better off to buy plain, low-fat yogurt and sweeten it yourself with splenda. Even a healthy diet can allow you to gain weight if you eat too much of it. Portion control is the key. No portion should be larger than the palm of your hand. Generally, a good rule is to eat half of what you currently eat, and you should start to see steady loss of 1-2 pounds a week. This sounds slow, but it will lead to a 50 pound or more weight loss in a year! good luck!

Has been: See a bariatric surgeon as your weight and height may put you into a class for the band. It is up to the surgeon to recommend you. There are new guidelines and surgeons who specialize in this can help you.

Band: Your bmi qualifies you for lap band according to the fda. However, you're unlikely to be able to get it covered by insurance. They use the nih guidelines and refuse any patient with bmi <35. If your only health problem is depression, it is unlikely you meet the fda requirements.

medical weight loss: Though lap band will be successful , you do not currently meet surgical criteria , trying weigh loss may be able to help with your self esteem and your weight. Remenber after lap band you can still regain the weight.

Weight loss surgery: The reason is that at your current height and weight, you have a bmi of 33.3 and would not qualify for surgical intervention by insurance criteria. That only means that no insurance company will pay for it to be performed. It doesn't mean that you wouldn't benefit from surgery. In fact, there are many studies that demonstrate a benefit in patients with a bmi 30-35 from lap band placement.