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

I'm going to have barriatric surgery. Probably this year I've been waiting for 2. I'm 35 and my bmi is about 38. I have some health conditions and take some meds which cause weight gain. I don't feel particularly unhealthy but I am worried about the future for my health.

I've tried all sorts to lose weight and keep it off. I know loads of people think it's a lack of willpower but I know for me it's not.

As part of the pathway to surgery we have to do classes on eating. They are massively patronising but one thing they discuss is how diets don't work. I honestly think when you're at the extreme obese level of excess weight the chances of losing it and keeping it off are low without surgery.

Also its not actually a huge thing forever. In 5 years time she will probably be eating small to regular portions. I'd go for it.

I had a bmi of over 60 last year (I’m early twenties) and I had a gastric bypass on the nhs after waiting for 2 years. In 8 months since surgery my bmi is now under 40 and still going down. I would recommend it, it has changed my life!
However it’s not magic, it still takes some hard work and will power to make it work - especially after the first few months when you can start eating normal foods again etc.
The first few weeks/months it’s so normal to think ‘what the hell have I done to myself’ as your in pain, and can barely eat or drink but then it gets easier (although that’s when it’s important to make good food choices!)
If she’s prepared to make changes and work hard then it is the greatest tool to help and could completely change her life for the better but she’s got to be determined to make it work for her!

Definitely OP. She's 17 and that's a dangerous BMI; there's obviously a bit of help needed there. I would say though that she will definitely need some psychotherapy to address the issues why she is sabotaging herself.

Have you ever seen 'My 600lb life'? It's on QuestRed at the moment and Dr Nowzaradan is the surgeon. He's impressive and cuts no corners with his advice. Patients can't eat in the same way again and your daughter needs to be clear about that.

If this were my daughter, I would definitely advocate surgery to give her the best chance to change her life.

Best wishes to you both.

One thing about surgery as many have said it's not an easy route but it's a tool to help. Like a bit of a reset. One thing with the sleeve or bypass it it removes a bit of your stomach that is responsible for hunger signals and hormones. This will eventually 'grow' back. (I'm simplifying this explanation) so yiu have time to regulate apitite and cravings before yiu get to the stage where you can eat those slightly bigger or normal size portions

A BMI of 60 is very frightening. 4st in one year is significant eating disorder territory. She is in danger of becoming bedbound soon and her life expectancy could be around 30.

I had a gastric sleeve at 28 and a BMI of 47. It was one of the best decisions I have ever made and I got down to a healthy BMI.

However it is NOT easy to maintain past the initial severe restriction phase. I am overweight (not obese) again following lockdown and am again, dieting and exercising it off. I expect I will struggle with my weight for the rest of my life. I have PCOS and a very sweet tooth. I have struggled with binge eating but not to your daughters extent and am generally fairly stable mentally.

Having said all that, I would be wary of getting her surgery without significant work being done on her mental health first. Many people use food as a coping mechanism and when its taken away, they can spiral into drink, drugs, self harming and suicide. From what you have said, this sounds like a real danger for her so she will need intensive support before surgery is given and then more during and for at least 2 years after.

Hi OP, I've recently had bariatric surgery after reaching a BMI of 65. I also have PCOS and have been overweight since a teenager.

It a not the easy ride people think it is and it is hard not being able to use food to cope with your emotions now. You may well find she uses something else to help her manage if she cannot get her feelings under control (cigarettes/alcohol) so counselling is really important along with the surgery if she does go ahead.

On the plus side, I've lost 11 stone in a year and don't overeat at all now. Which I'd have done this years ago.

Yes 100%! Do what you can to help your daughter! No judgement here!

Has she had a Tier 3 referral? They will do a comprehensive risk assessment and plan her support - surgery may not be offered immediately
.
The criteria for surgery on NHS are;
They have a BMI of 40 kg/m2 or more, or between 35 kg/m2 and 40 kg/m2 and other significant disease (for example, type 2 diabetes or high blood pressure) that could be improved if they lost weight.

All appropriate non-surgical measures have been tried but the person has not achieved or maintained adequate, clinically beneficial weight loss.

She needs help and support but surgery may not be offered, at least until the Tier 3 clinic has been through a programme of alternatives.

It won't be your decision - she is 17, so assumed to be able to give her own consent.

Honestly, I don’t think she’s ready. I’ve struggled with Binge Eating Disorder for 15 years (formally diagnosed 10 years ago) so I really do understand how powerless you can feel in a binge-starve cycle. It’s awful and my BMI yoyos between 27 and 40 every couple of years.

I follow lots of people on Instagram who have had gastric sleeve or bypass surgery and without fail, every one of them lost a huge amount of weight followed by a gain of 20-70lbs over the following years. It’s not a magic wand and if your DD isn’t in the right place mentally, all that will happen is she’ll regain the weight but with added lifetime issues around vitamin absorption, dumping syndrome and reflux.

I have a bmi of nearly 60. I’ve been offered bariatric surgery before but I always refused. I still don’t want it. I’m trying weight watchers at the moment , only a week in and I’ve lost 1.3kg.

I’m finally in a place where I can lose weight and be confident, I’m no longer binging. I had 18 weeks of therapy surrounding food, binging and feeling bad about myself.

I would say you need to get your daughter therapy before even considering bariatric surgery. I watched a programme about bariatric surgery in the uk and they wouldn’t let her have it until she is in a better place. They should offer therapy in the process. At least that’s what the documentary showed. I’m not really clued up on all this.

But I have to say I was put off by having to permanently change your eating habits. It’s not an easy fix.

Thank you so so much for the replies. Reading people's experiences is really helpful and I'm definitely going to let her have a read of them as well.

I really appreciate all the advice, I definitely feel more positive about there being a way forward for her.

One thing I did was get on the NHS pathway before I was certain. I'm so glad I did as its been 2 plus years.

Also you can do therapy in this time if needed. But she will speak to a psychologist in this time too.

For PCOS she can contact Verity the charity for PCOS. There are Facebook groups for your local PCOS groups and the PCOS charity in general.

If you’re anywhere near the West Midlands there is a dedicated PCOS clinic at University Hospital Coventry, which is good.

Emma Guns has a podcast where she really recommends the book ‘Brain over binge’ as a way of helping ED.

Yes I would let her have the surgery. In fact I’d actively encourage it and not just because it’s highly unlikely that she’ll ever manage to lose that amount of weight herself.

I’d also very gently like to suggest that there’s way more eating going on than you know of and whilst your DD’s weight could be down to medical reasons there is way way more chance that it isn’t.

I had a MGB 18 months ago and It’s the best thing I ever did for myself. I’m now almost 63 and wasn’t always overweight but over two decades I ate my feelings and the result was 40kg to lose. Ive almost done it now and I haven’t felt or looked as well as I do for years despite an ovarian cancer diagnosis that I’m pretty sure was connected to my weight.

My son is also 16 with a BMI of 37 and is on the waiting list for sleeve surgery. Like you we tried everything and I mean everything. He is the only one with a weight issue as well. I am obviously biased because my son is having it so I would say she should go for it. Sometimes they need more intervention or than usual to get them on the right path again (weight wise).

But I have to say I was put off by having to permanently change your eating habits. It’s not an easy fix.

Anyone who loses weight has to permanently change their eating habits regardless of the method they use to lose weight.

And I suspect there’s a lack of understanding regarding just what a person can eat when they’ve had surgery.

Today for eg I’ve had

Sourdough toast, homemade hummus, 2 poached egg and cherry tomato’s for breakfast.

Lunch was homemade quiche with salad and homemade salad dressing for the healthy fats. Normally I wouldn’t have eggs twice a day but I won’t have any tomorrow in order to compensate for today.

Dinner will be a salmon fillet, bok choy, broccoli, carrots and some carb such as potato, couscous or quinoa.

Snacks were a mandarin orange and Greek yoghurt. Also had 100mls of milk.

I was diagnosed with mild PCOS, and offered metformin - I don’t know much about it but I have heard that is quite good for managing weight if you’re insulin resistant, a big part of PCOS. Might be an option.

Agree with the poster about ADHD - obviously we know nothing about your DD but it is worth looking into - it really doesn’t always present how you’d think. When I was diagnosed and medicated I lost weight at a healthy rate because my dopamine levels were better, and I wasn’t craving sugar and caffeine to sort it. I was also less impulsive so I made better decisions about food. Again not diagnosing via MN but it’s so often missed it’s worth a mention.

There's an excellent series about bariatric surgery available on Channel 4 iplayer with 6 programmes currently available called Shut Ins: Britain's Fattest People. The episodes featuring Emily and AJ (both in their early twenties and both sweethearts) might be helpful for your daughter?

Wishing you and your daughter all the very best.

I tried for years to lose weight and I’d get as far as losing two stone then I’d be too tired mentally to continue my efforts. It was soul destroying but at the same time I was anti bariatric surgery because I thought if I went down that road it meant I was an absolute failure.

One day I just woke up and thought that’s it, I’ve had enough, I just can’t do this anymore and one week later I had the surgery. I didn’t have to do the counselling because I was already having it and had been for a year so my surgeon contacted my counsellor and was happy to accept his recommendation that I was ready for it. It’s the easiest thing I’ve ever done in that I’ve not had one day where I’ve struggled with it and it was only a few months before I could feel the surgery working on my hunger hormones and my taste buds. Did I change my eating habits? Yes. But only in the respect that I stopped my secret eating that was very different from the perfectly balanced meals I ate when trying to fool people into believing that ‘I’ve no idea why I’m overweight, you can see what I eat’.

The joy I feel day in and day out from being on top of my eating, knowing that I have such a positive relationship with my food and my feelings can never be described and despite a recent health scare I’m living my best life at almost 63.

She can’t do it on her own and she needs help. I know a couple of people who had it done years ago- they are still slim and living a good life.

I'd possibly try again with SlimmingWorld. But she needs to be in the right headspace.

When I was at my worst and binge eating but determined I would eat loads of cooked chicken (like the precooked rotisserie chickens) boiled eggs, pasta in sauce, muller light yoghurts. Basically I filled my fridge with SlimmingWorld free food. I ate loads - kept the fridge stocked and only ever had a days allowance of naughty stuff.

I lost 3 stone this way!

Would she let you do this for her? She wants a pizza at 2am ok you can but let's do a healthier option. Letting her get hungry will be counter productive. Fasting won't help with binge eating.

Try to encourage her to note how she's feeling when she's hungry. Is she mistaking hunger for another emotion?

Is she drinking enough? Every time she feels hungry she should drink a glass of water and wait 10 minutes before eating.

I'd try and work on the mental health issues. Surgery won't help until they are resolved in my experience. Only once they are improving will she be able to embrace the lifestyle changes she needs to make

@GeorgiaGirl52

I gave permission when my DD was 17. We had to do it then while she was still covered by my insurance. She got gastric bypass. She had to stop smoking to have the surgery, which was a plus. She lost weight - from size 22 to size 14, another plus. Unfortunately, boys started to notice her, she got pregnant, put on a lot of baby weight and never got it all off. She eventually gained it all back plus some AND started back smoking. Surgery is not a magic spell. Your daughter needs to be committed to changing her life style too, or if will be a temporary fix.

This...I have heard that for some individuals they do put the weight on again despite the surgery.

Read up a lot carefully. It may be a short to mid term fix, but she needs a fix that’ll solve it for the next 70 years potentially

Imho, I’d say this is an eating disorder ( mental health problem) combined with PCOS.
No surgery or dieting or exercise is going to get her to maintain a healthy weight. Surgery will result in weight loss, but there are, as said earlier, cases that folks put it back on. It is no guarantee as a life long cure given her age

If she had anerexia she’d be getting mental health treatment..this isn’t any different. She is potentially killing herself slowly and deeply unhappy .
In your situation, I would be demanding psychiatric support first, and ensuring her PCOS is brought under control as much is possible.

There is also a new drug trial just completed, that has produced as nearly good results as surgery. Look into that . I’ll see if I can find link

I am so sorry she is in this situation and you are in such a helpless situation. 💐💐💐

Here’s the article
www.bbc.co.uk/news/health-56011979