I had weight loss surgery on the NHS. 5 months ago. AMA

[smallereveryday]

I had a Sleeve gastrectomy in October after 8 yrs of obesity and god knows how many attempts at Conventional diet and exercise including ww /sw/ Atkins/low carb/ 5:2 /Cambridge /blood diets. I have gone from a size 24 to 14 in just under 4 months and feel amazing and healthy at last.

Wow, a size 24 to a 14 in 4 months

How much weight have you lost?

48lbs . So far. The smaller size of me is lovely but the very best part is the ongoing health benefits. I can now walk more than 100m without stonking lower back ache. In fact I walk 10 miles every weekend and about 8 during the week.
(I carried all the weight on my abdomen so was like being 15 months pregnant)
I'm off blood pressure pills
My knees no longer hurt
My type 2 diabetes went into remission before I left hospital.
It's life changing.

What did rhe procedure involve?

Do you have any loose skin?

How did you get them to agree? I’ve been told I’m not over weight enough

How to you match your head to your new stomach size?

I would still have the same appetite mentally I think, especially for chocolate

Wow, that's a big weight loss.

Sorry if this is a stupid question, but what will stop you continuing to lose weight when you reach your ideal weight?

Whoa. That’s a big loss. How have you coped mentally with the changes to your approach to food?

how are your hunger levels? I'm seeing a dietician, doing as instructed and am on the list just to get the ball rolling but still undecided

Do you have any regrets?

@smallereveryday ??

Sorry guys have been sent on a Work course to the only place in uk with no bloody signal !!!

The prodedure involved a Referal from my GP to the nearest NHS Bariatric Service. 6 weeks later I had to complete a 6 page questionnaire about my eating habits. And complete a psychological evaluation online.
6 weeks later I had my first appointment on what they call Tier 3. The nurse weighed and measured me, went through my questionnaire and then a group discussion about expectations.
2 months later another appointment. A group session about food labels and nutrition.
2 months after that another group session about the different procedures . Bypass, Sleeve, Band and balloon.
3 months after that a meeting with the surgeon who will discuss your personal preference and give their advice. You are then put on the waiting list for surgery.

What did it involve?
Ten days pre op on 4 pints of milk a day and nothing else but a salted drink like bovril. Yuk !
Then in to hospital at 7 am . Surgery takes about an hour and a half. Recover for 2 days then discharge.
2 weeks is liquid /then purée food. 2 weeks of soft food like scrambled eggs. Then pretty much anything you can manage. Little and often but nothing more than 4 g of sugar so must read the labels on everything.
Protein heavy diet but full after 3 tablespoons...

They agreed because my BMI was over 35 and I had sleep apnoea. Most obese people have sleep apnoea because their airways are compromised with neck fat.

Head hunger vs real hunger is still hard but just have to get on with it. Have no desire for bad stuff because you can't. If you eat sugar you get dumping syndrome. Explosive diohrea and shivers shakes and temp.

Do you worry that you're making it sound like an easy option? I have experience in this area, although not for bariatric reasons and know of others who have died and experienced major complications.

I don’t see how a 48lb loss can reduce you from a 24 to a 14 , what actual weight were you before you started and why did normal diets or just eating healthily not work for you was it just lack of will power ?

Has your sleep apnoea got any better?

No I am not worried I am making it sound an easy option. It's no more or less of an easy option than having any other surgery to correct a life threatening condition.

I had my gallbladder removed because of stones and excruciating pain. Gallbladder surgery has a greater morbidity risk than Sleeve gastrectomy (my procedure). I had my appendix removed because of appendicitis. Again greater risk than my Bariatric OP. I also had my spleen removed due to a life threatening blood disorder. Much much more dangerous than Bariatric surgery. I did this for my health. I am off blood pressure, and diabetes medication.

There are 1182 people on my fb group for the nhs Bariatric Centre that performed my surgery. There has been one death. Very sad, from a person with severe heart condition . She died of the heart condition three Weeks after surgery. Some people have had some complications. It is to be expected with surgery., especially from a cohort of morbidly obese people with life threatening illness. Most of these complications are transient.

No I do not regret it for a moment. It has changed my life for the better. I can walk I can exercise I can enjoy life and I am substantially more healthy and use the NHS a lot less.

Why didn't I just diet and exercise ? Because like most people who are obese, it is just too hard to sustain a diet for that long. You need to create a calorie deficit. Most people who are obese have an over stimulated ghrelin producing hormone. They feel hungry and cannot keep up a calorie deficit required for the years that are required to achieve a healthy weight.

University College hospital centre for obesity studies did a very large scale research into diets in 2014.
1:240 women will successfully diet back to a BMI of 35 (obese type1) to healthy. BMI 25. Of those '1s' 78 % will put it ALL on and more within 5 yrs.

For those women who have a BMI of 40 the chances are 1:630. With the same 78% regain within 5 yrs.

I was one of those '1s'. It's basic statistics and science. Bariatric surgery is still the ONLY long term successful, sustainable weight loss method for the morbidly obese. That's why the NHS do it. They don't spend money on stuff that isn't evaluated as effective.

I've been trying to lose weight for 30 years and getting more and more tired and more and more fat.

I have an appointment at the NHS obesity clinic with a psychologist soon.

Did you go through that, OP? Was it helpful?

I was 241lbs am now 193. 17stone 3 to 13 st 11.
Carried it all abdominally.

No loose skin yet but it will come and I don't care. It was about feeling better and healthier.
If I have skin that chafes and hurts I will go abroad and have it removed. It's unlikely. The bad 'aprons' are from people much bigger than I ever was and are shown on TV for dramatic effect, they are rare.

Back quickly to regrets. This question was asked on our fb group yesterday. Of over a thousand members not a single negative reply. (Over a hundred and fifty replies).

I had to do an initial evaluation. That is basically a screen to pick up people who may have psychological issues. I wasn't picked up as needing help. Which was the right call. I didn't have that need. However some of my Bariatric cohort have had referrals to the psychologist. They will not put you forward until they are sure it will help more than hinder however many people DO have severe disordered eating and it is still recommended .

Ultimately once you have had surgery there is NO WAY to over eat. You will be sick. And you cannot put in more than your stomach can take. You can't eat sugar it makes you very very very unwell.

I don't know if my sleep apnea is gone as I haven't had a sleep study. However I now sleep all night and no longer snore like a train. So I suspect it has.

I don't want to sound rude, and I am asking this because I am interested, not because I am having a go. If you are able to pull the discipline out of the hat for a week before the operation and then again afterwards, why can't you use the discipline to lose weight without the surgery?

Again I really don't mean to have a go, but it's AMA and this one always makes me wonder. I couldn't have surgery because I know I don't have the discipline, which is my whole problem in the first place.

My greatest bit of advice is educate yourself about weight loss surgery. Even most GPs don't understand it, it's expected outcome and its effect on overall physical and mental health.
There is far too many 'daily mail' reader attitudes about it being the 'easy way out'

If you had a life threatening condition that was curable by surgery would you look down your nose on those who opted for this method rather than trying to cure themselves - knowing that the statistical chance of doing this is minute ? Of course you wouldn't. Obesity IS a life threatening condition.

Educate yourself about the different types of surgery.
The NHS 'gold standard' is the Gastric Bypass.
Followed by a Sleeve gastrectomy.

Very very few surgeons do the Gastric band these days. They DO have a much much lower success rate and those with very disordered eating will simply liquidise 'bad' foods which will slip through the neck of the band. People don't become obese by accident. They eat too much. The first to types of surgery prevent this.

The balloon is a temporary method usually employed to assist super morbidly obese people (30stone plus) to lose weight sufficiently to make surgery safer. Although some people who can't have an anaesthetic are offered this.

Because like all thinks people can manage them short term , especially if their is a VERY large inventive. In the case of the milk diet, people stick to it because they cannot have surgery unless they do it. The milk diet is also called the liver shrinking diet. It is a requirement because the surgeon cannot operate with an enlarged fatty liver in the way.

Stick to a diet for ten days and get the surgery you have been waiting an average of 18 months for. (The average length of the Tier 3 and 4 process from GP referral to surgery) That's a pretty powerful incentive.
Lose 2 lbs a week through weigh watchers or slimming world type process... you have to keep that diet up for months sometimes years. (See the statistical chances of successfully achieving that in previous post).

Sorry didn't see the bit about 'discipline afterwards'...
No discipline required afterwards. Just common sense. If you have just has
D surgery because you hate being obese, then MOST people are already highly motivated.
The awful constant hunger is gone.
5 teaspoons is all you can manage for weeks. You simply can't and do t want to eat too much.

Even tonight. Many months since I can eat 'normally' I have been out to dinner. I had a child's carvery and ate a quarter. I was stuffed. Everyone had deserts except me. I don't feel even slightly deprived. I am full , satiated and happy. Sugar would make me feel ill, so it doesn't interest me.

This is so interesting, thank you.