Would you allow DD to have bariatric surgery?

[Stephens90]

Hi,

DD is 17 and has recently been referred, with the intent of having a gastric bypass. She has a BMI of almost 60.

This isn't a post to figure out why I let her get that size. She gained 10 stone in the last 6 years since she joined secondary. My other children are not overweight.

She has recently been diagnosed with PCOS.

I've tried to support her with weight loss for a very very long time. She did slimming world last year but couldn't keep the weight off. Followed the NHS weight loss plan, calorie counted, etc.

She has bad depression and it seems everything is such a vicious cycle, I'm worried I will lose her if I don't support her down the surgery route. She is breathless after getting up and walking to the bathroom and honestly it scares me I'll wake up without her.

On the other hand, she is so so young and I feel it's such a life changing decision at just 17, but I do trust the consultants who have said to me she simply won't have a life if it continues and they believe surgery is the best thing.

I'm just so unsure and want to ask from other parents perspective instead of from health professionals.

Thank you

Yes before even reading your OP I said yes in my head, because I was the fat daughter and I wish it had been offered to me at 17 instead of struggling with my weight for the last 20 years.

I agree that it sounds like you need to look at her mental health first.

Those wondering if she has a medical issue causing the gain have made me think. What I’d do is try and talk to her about that. Try and work out between you if what she has been eating is enough to cause the gain. I would mention that she doesn’t want a load of medical appointments for no reason, which is what would happen if she doesn’t include all the food she’s been eating. Maybe let her have a go on ‘my fitness pal’ herself and let you know if she’s eating 3-4000 calories a day or if it’s much less. Suggest this high amount as the expected amount so she isn’t as embarrassed. Or you can help her if she’s ok with that. She can just tell you what an average day looks like. Make sure you ask how many slices of bread ‘a sandwich’ includes etc.

If she’s ordering pizzas in the night, although she has her own money would she consent to you looking after it for her? I.e. the cash itself or her card? With the proviso that of course she can have it if she wants something which isn’t food?

Will she come out on walks? Might be easier with spring approaching.

Sorry those are just two small things. I’ve no experience about bariatric surgery but it sounds to me that her mental health needs to be tackled first and that route might not be completely exhausted.

Yes I would, it's not an easy road but it will save her health.

I hope she gets a good team with psychologist and bariatric nurses who will go through all the aftercare and rules with her. She should get 2 years psychologist support as well 6 months before and 2 years afterwards, something that sounds very needed to work through her habits

The younger she gets a decent grip on everything the better, the less damage done and the less loose skin she will get with weight loss (more collagen when younger) and the waiting lists are very long so please encourage her to attend every appointment and not lose her place.

There's an excellent community on instagram with various bariatric related hashtags to help you/her find them. It's where I went to learn and support my mum when she had it done.

This is so difficult, but on a balanced view I would have to say that without a clear explanation of why a young girl is effectively eating herself to death, I would be very reluctant to use this surgery as "the cure". She is still gaining weight - there is no clear evidence that the surgery will do anything for her because she is still eating unhealthily. It could put her more at risk. And it could force her into new but equally dangerous behaviours.

I'd have to be honest and say that from the description in front of me, I would even be dubious about "mainstream" mental health services being useful. This degree of weight gain and binging is another form of self-harm. I would suggest pushing for a specialist psychiatric referral. They aren't usually easy to get and you will probably have to fight for it since you say you can't afford private treatment. But this is a very extreme case in my view, and not one that will resolve with the surgery or some therapy. I think your daughter needs serious and sustained help.

I would support her but I think it needs to come with some support for her mental health. Weight loss surgery is no quick fix, she will still need to restrict her food intake and become more active.

Hi,
Just to mention, I didn't personally get on well with CBT when my mental health was suffering (on and off antidepressants for over 20 years, self harm, suicide attempts). I was lucky that in my area they were trialling acceptance and commitment therapy (ACT) and I found that far more helpful than anything else tried previously. Not sure how widely available it is but there are a lot of resources online for it.
Best wishes

I would go by what the medical professionals are recommending for her as they will have good reason for thinking it's the best thing for her based on their expertise.

Yes. Good luck OP.

There might well be a local counselling organisation or even eating disorder service that your daughter could self-refer to. The sessions might still have a cost attached but they're very unlikely to be the same prices that private counsellors charge. Local Minds often offer discounted counselling for people who would struggle to afford the service otherwise, for example. At services your daughter might see a trainee counsellor who's nearing the end of their training, but they are closely supervised by experienced colleagues.

I’d agree to it, yes.

OP, I really feel for you, it must be so hard.

I think anything is worth a go. Perhaps conder seeing a hypnotherapist to retrain her mind to want sensible foods at appropriate times.

@Moondust001

What you say is very true. This is what happened with my relative. They turned to other forms of self harm. I wrote earlier this morning on this thread that I was just waiting for the day something happened. Well I got a call 2 hours after I wrote that and had to call an ambulances for her as she had spent all night on the floor and couldn't get up.

I am not saying she didn't have issues before but she was living a relatively normal life - seeing friends, working etc. Since she had the surgery her life has gone sharply downhill and she is merely existing and always searching for something to fill that hole that food used to.

OP also just to say I had a friend who weighed about 27 stone I think

She lost weight without surgery

Her obstacle was a very strange family - don't ask - but she lost the weight and kept it off. This was in her 20s. She ate so much due to being miserable at home.

This is 20 years ago so she was never offered surgery.

You've got to find out why she is eating, if that's the cause. I'd still look for a medical one - unless you see that what she eats could lead to it.

My understanding is that you still have to limit your intake after getting a band, because it will snap if your stomach is overfilled? This is why I've not tried it - I'm on medication that makes me permanently hungry, and a band won't change that. It sounds like your daughter is also permanent hungry.

Will she be able to stick to the pre op liver reducing diet? Not sure if everyone has to do it, but a friend of mine had to do it.

Also, can I just say, this is NOT your fault. I put on several stone in my teens when the bullying started at school. I also attempted suicide. None of it was my mum's fault and she couldn't have stopped it.

My brother was, and still is, a little underweight. Our mum gave us the same food.

Read up on the long term regain statistics for this surgery. She's likely to regain some, most or all of her excess weight back if the underlying issues are not addressed.

This must be such a difficult time and decision for you.
I think her weight and eating needs to be seen as a symptom of a mental health problem which needs to be treated first and foremost. As others have said, surgery isn't a magic cure and she could still fall back into bad habits and make it all pointless. She needs it physically yes, but unless you treat the underlying cause I worry she will go through it all for nothing.
I would say she needs more intense help than Camhs. Could you get her to see a psychologist, an eating disorder specialist or have some intense counselling/therapy?
Would she engage in some kind of physical exercise, slowly of course, if you could hit on something she really enjoys?

Could something have happened to her around age 11 that might have triggered this? Abuse, bullying or trauma or something she might not know how to deal with? Just a thought as so many people on my 600lb life seem to have suffered abuse :-(
I would listen to the doctors and go with what they suggest x

I'm sorry that I haven't read all the other replies, but have you tried www.feast-ed.org/around-the-dinner-table-forum/ and/or
www.beateatingdisorders.org.uk ?

Her obstacle was a very strange family - don't ask - but she lost the weight and kept it off. This was in her 20s. She ate so much due to being miserable at home.

This was my experience too. I had a difficult childhood. When I was 17, I was suicidal and my BMI was in the 40s. I went to uni at 18 and by the time I graduated, I had a healthy BMI and even played casual sports.

Based on my experience, I would personally hold off on surgery for a couple of years. In the meantime, push the doctors for more intense support than CBT, and see if there are any other changes that could help her mental health (eg changing schools if school is an issue, but I'm sure you've thought about that before).

I'm another person wondering whether a referral to an endocrinologist would be a good idea before making a decision about surgery.

I'm surprised that Metformin hasn't been considered or prescribed due to the PCOS (Metformin can aid weight loss).

OP I’ve sent you a PM

If there are no other physiological reasons for the weight, then yes without a doubt. I have personal, extremely positive experience of this surgery and the long term health benefits are worth it.