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.

Great thread OP.

Two people I’m very close to have had bariatric surgery. One worked really brilliantly and ten years on is still life changing. The other failed because of underlying complications in the patient unrelated to the obesity. It’s a shame because she still fights every day and if she’d been able to tolerate the band it would have had a huge impact.

Not the easy way out in either case.

Im surprised you were offered weight loss surgery on the NHS OP - I thought it was only offered to those woth a significantly higher bmi?

I am your height, weighed a stone more than your start weight 6 months ago. I have lost 67lb (so far) through healthy eating and exercise. My GP never discussed or offered me any nhs help with my weight.

I really really cannot advise the band. So many people on our cohort at the Bariatric centre had them a few years ago because they didn't like the idea of the more extensive surgery and wanted something 'easy to remove' if needed.
When I was in hospital for my Op there were four others . The first had a Bypass (and has lost more than me but started at 25 st. The second had a sleeve like me - whilst two others had what is called 'revision' surgery where the band has slipped causing intestinal problems and were now being converted to a Bypass.
It's bands that have caused a lot of the bad press. It is a very very rare NHS surgeon who would suggest a band these days and only in very specific circumstances where for whatever reason a sleeve or bypass couldn't be done. (Can't think what those circumstances would be though)

Yes I think that's what happened also. Patient one had a bypass. Patient two had the band - because of the underlying medical condition. It failed.

Hennypennyjenny My GP didn't hesitate to refer me when I asked. He knew I had done the research and at BMI 37 with high blood pressure (uncontrolled) and sleep apnoea - I fulfilled the NHS criteria of BMI over 35 with a co morbidity . Last year I also developed type 2 diabetes and my knees were so crippled with arthritis I was living on cortisone injections. So I qualified 4x over. !
(If your BMI is over 40 you don't need any 'qualifying' illness).

Well done on your weight loss You are one of the lucky 1:240 (see pp about the statistics for regain from University College Obesity research centre) . I really hope you manage to be in the 22% of people who DO manage to get back to a healthy weight and don't regain all and more after 5 yrs. No one WANTS to have surgery if they can manage without.
I did this twice. First time lost 55 lbs and regained 67. Second time I lost 71 and put on 83.
It is just too low odds for me to try it a third time and for my health I needed to make a permanent change.
No one HAS to have surgery .
I just want people to be aware that it's out there and WILL help you change your life as well as hopefully dispel some of the frankly appalling scare mongering about WLS
I want people to feel empowered to tell their GPS that they want to be referred to Tier 3 and explore if this option is for them without people accusing them of laziness because they want a healthier life .

Would you refuse any other operation if a surgeon told you it could cure a disease that WILL kill you prematurely?
People just need options, and facts rather than wasting money on yet another faddy diet.

The diet industry is worth billions on the back of all this yo-yo dieting that STATISTICALLY rarely works long term.

Well done for recognising the health risks and taking bold action. I recognise the yo-yo dieter syndrome - sadly though, obesity begins in the womb for most sufferers and a life-time if dieting cannot fix what is broken.

My mother and my mother' mother overate while pregnant - the science relating to the hormones is out there - and the first book I remember my mother having was the Beverly Hills Diet.
Hypnosis in the form of RTT helped me previously, but ultimately I am overweight again - not enough to qualify for a sleeve - but enough to cause massive distress. I have spent my entire life stressing over food and I am just at the end of my tether!

That is so sad to hear Notwiththeseknees. What is your BMI ? Have you worked it out ?

It's As though what I have to say now only has worth because I look better ! It reinforced to me just how prejudiced society is towards fat people.
I was fat. I wasn't stupid. Now I'm thinner it appears to have increased my IQ ! (In the way people interact with me ..)

^

Honestly, this with bells on. Now I'm thinner whatever I say is gospel. Before it was just irrelevant bullshit.... But I'm the same person?!

I'd also advise against the band. While I'm still deciding whether to have surgery or not, I'm part of a facebook group for bariatric surgery patients, those waiting and those who have had it done. I see so many reports of the band slipping, failing, causing problems and needing to be revised to a sleeve or bypass. If you look at diagrams of it and how it sits on the stomach it seems absolutely obvious it's going to slip, I am amazed they were ever approved.

as OP said, the procedures carry less risk than a gallbladder operation. If you're going to have surgery, make it a reliable and trusted one, not the band.

I think it's one of the reasons people don't even bother asking about WLS .Many Obese people spend their lives being ignored and sidelined and become used to having their views disregarded.
It creates huge self esteem problems and that is only compounded when they visit a doctor and ask for help with Weight loss. They will be told "diet and exercise " and no matter how many times they say I e tried that for years and here I am still obese and now with increased health problems- that is simply ignored. No practical advice beyond that is given DESPITE NICE guidelines that it should be offered to those with a BMI of 40 and above or 35 with health issues. Instead- the attitude is that you are stupid and simply don't understand that you have to eat less.
I want every obese person to feel how I do now. Or at least have that opportunity.

What made you choose the sleeve?
I've been looking at the endoscopic sleeve gastroplasty as it's less invasive but it's not been around long so that makes me nervous.

I did a lot of research. There so many quacks and so much scaremongering our there.
Look on specialist forums like WLS and YouTube blogs run by people who have actually had surgery.
If like me you want to know the science and statistics around things like diet and exercise vs surgery. Then I really recommend reading some of the academic and research papers from places such as
www.ucl.ac.uk/obesity/research
For me . Although the Bypass has the edge on the sleeve by a few percentage points - for the amount of sustained weight loss - I had extensive abdominal adhesions from prior surgery and sleeve was considered a safer procedure. I was also not in the top category of obesity - my Bmi was 37, so not super huge. Bypass mixes 'malabsorption' with portion restriction. Whereas the sleeve is the latter only. At 17 + stone the sleeve was enough. I am also not a sweet eater. The bypass has a really deterrent effect on sweet eaters as the dumping syndrome with this procedure is severe. Preventing any sneaky 'just this one malteaser' type behaviour . .. I am not tempted by chocolate, so Sleeve was suitable for me.

My issue was portion control. Not what I ate but how much I ate.
The bypass 're-plumbs' the intestine and creates a small pouch for a stomach - bypassing the rest of the stomach. However nothing is removed.
The sleeve is much simpler - a line of staples creates a small stomach of 100ml. The remaining stomach is pulled out one of the keyhole incisions and thrown away.

if I go for it, it will be the sleeve. This is because I don't suffer from reflux, I am happy to lose less weight than someone having a bypass and the ghrelin (hunger hormone) producing portion of the stomach is largely removed with a sleeve rather than left in the body continuing to leach ghrelin.

I really feel I need the ghrelin gone so it will be sleeve for me .

How long did you wait between first being referred and having the surgery?

not sure about the OP but GP referred me in June last year. Finally got dietitian appointment in November, assessed and weighed and asked to lose 5% of my body weight within 6 months of dietitian appointments

I lost that within 3 months (for me that was 16lbs) and now have just one appointment left before going into the 'pre-surgery' group

in the pre-surgery group, there will be two appointments, one to decide which operation is best and one meeting the surgeon.

as long as all is still well and no weight regained, then an appointment is made for the operation

my area aim to have your surgery within a year of your first dietician appointment though it may be sooner if like me you can demonstrate clearly that you can follow the rules and advice

I am expecting my surgery will be Sept/Oct so just over a year from first asking the doctor for help and about 10/11 months after first seeing the dietitian

I expected there would be more psychological assessment - that you'd have to look at the reasons why diet and exercise have failed. Sort of being held accountable?

The follow up appointments - are they life long?

Also, well done on managing to fulfil the criteria, Lubey

@vivariumvivariumsvivaria that has been covered very well by the dietician, though she didn't have a tough job on her hands with me because I'm very well informed, have already dealt with all the usual issues and she didn't have to convince me that calories exist and must be counted accurately, as with some people

Usual issues being- binge eating and comfort eating. I stopped that years ago, that's what got all the weight on me. Losing it is a different matter.

I ideally would like to lose ten stone. I am twelve stone over my supposed ideal weight. I can manage fine to lose three stone or so but with my insane hunger levels, it takes all my mental strength and focus. Each time I have got that far, something else started sapping that strength and I gradually regained the weight - and since dealing with larger issues it would very slow regain as I would only be eating very slightly over my TDEE. This adds up to 20 years of diets and getting the grand total of nowhere significant.

In my earlier attempts I would just be discouraged and give up when weight loss slowed down and I believed all the 'fat logic' bollocks like, 'I'm just meant to be curvy' or 'oh it's starvation mode' or 'oh my metabolism is fucked' but as time went on and I learned more, it would be bigger, more horrible issues stopping me. Things like bereavement, moving house twice in quick succession, Divorce and then four months of pleurisy.

Each failure is a massive humiliation and takes such a toll on self-esteem. The self-hatred for failing again is devastating. I resisted the idea of surgery for a long time, as an intelligent person I felt sure I must be able to do it. The last three attempts I was convinced that was it this time, my lifestyle had changed and there would be no regaining anything. The last three failures have been so devastating that I finally had to say enough - I cannot go through another humiliation and I cannot live as I want to with all the weight either so enough is enough.

This time I know there is light at the end of the tunnel in the form of GP support and my ghrelin being largely removed, thus (hopefully) it not taking every SHRED of my mental energy to stay in a large enough calorie deficit for decent results.

Plenty of people in that bariatric surgery group have been waiting for 2 or 3 years because they are still getting their heads around it all and are not ready. Psychologists are seen when needed, but it's not needed for me.

I was 17stone last July and size 20. Through diet and exercise I’m now 13 stone and a size 14. I still have more to go but I’m hoping other people at my start weight don’t turn to surgery.

For me it was August 2017 for first appointment. This followed the initial GP referal in June. My op was October 2018.

No didn't talk about why diet and exercise failed. Diet and exercise fail for the huge majority of people once their BMI reaches 35. (See previous post with stats from University college obesity research ). It is more common than not by a factor of 1:240 so they don't waste their time asking.
To create a calorie deficit that keeps an obese person motivated means eating max 800 calories a day. That is simply not sustainable without super human will power.

PrisonBreak now you see that's where we differ. I want people to be healthy. Being obese will kill you. That I think is something we can all agree on. Why would you worry how people achieve it especially when our NHS says "weight loss surgery remains the only long term sustainable answer to life threatening obesity '
... and given the statistical reality that you only have a 22% chance of not putting all the weight you e lost back on . (Which I hope you don't by the way) !

Because surgery is more likely to kill you than hauling your ass to the gym. I do want people healthy but the nhs is crippled right now and people could change their lives by eating right and exercising

Because surgery is more likely to kill you than hauling your ass to the gym. I do want people healthy but the nhs is crippled right now and people could change their lives by eating right and exercising

Blah blah, same old ignorant nonsense as people usually spout.

Not 1 thing mentioned wasn’t fact? Unsure how that makes someone ignorant. Perhaps it’s ignorance to ignore fact than face it

Fact- diet and exercise alone do not work in the long term for the majority of patients who are obese/morbidly obese.

-Barriatric surgery saves the NHS money in the long term.

-bariatric surgery is a proven effective long term treatment for obesity.

-barriatric surgery improves life quality dramatically and quickly. This improves mental health-improves the overall health and well being of the whole family, employment prospects rise.

-Barriatric surgery saves lives.