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

At her BMI I would do anything to help her. Suggest you try contacting her bank to let her know she’s vulnerable and literally eating herself to death. They may be able to cancel her debit card which should help as she would then need to leave the house to get junk food. Another option is to contact her favourite delivery places and tell them to stop sending stuff to the house (you could reject deliveries too).

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

Many more don’t.

@Anne1958

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

Many more don’t.

Have a look at the long-term data.

One example from www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/

"Although early reports described a 35% initial excess weight loss on average by most patients, more recent reports describe not only high failure rates but also high reintervention rates for both band-related complications (e.g. band erosion, leakage, slippage, port infection and esophageal dilatation) and failure to lose weight such that as few as 54% of patients may have their band in place after 10 years"

Beware OP, lots of ill informed comments on this thread about bariatric surgery.

I would let her start on the pathway and if it's decided the surgery is best thing for her then yes I absolutely would allow it. Pp
Are right about her needing to address the reasons she over eats too.

Something to think about, usually with weight loss surgery they need to see you change your eating habits beforehand, you have to go to a liquid diet and usually show you can lose 20lbs on your own. Do you think she'll be able to do this with support? Most patients think surgery great, but you do have to prove your eating has changed before they proceed and you have to go on a liver shrinking diet of liquids and milk beforehand. No judgement here OP, just not sure if it's something either of you have considered

"Although early reports described a 35% initial excess weight loss on average by most patients, more recent reports describe not only high failure rates but also high reintervention rates for both band-related complications (e.g. band erosion, leakage, slippage, port infection and esophageal dilatation) and failure to lose weight such that as few as 54% of patients may have their band in place after 10 years"

The band is rarely offered these days as a method of bariatric intervention and most people who would have had the band in the past are now given gastric sleeve surgery if their eating habits warrant it.

I feel for her. I was an on off bulimic binger between 16-22.

Does she fully understand what it involves op? She realises that it will still involve a lot of willpower, and if she still tries to overeat it will make her very ill?

I eventually recovered with 5 years of private therapy. NHS therapy is just not cut out for dealing with this kind of issue.

@Anne1958

"Although early reports described a 35% initial excess weight loss on average by most patients, more recent reports describe not only high failure rates but also high reintervention rates for both band-related complications (e.g. band erosion, leakage, slippage, port infection and esophageal dilatation) and failure to lose weight such that as few as 54% of patients may have their band in place after 10 years"

The band is rarely offered these days as a method of bariatric intervention and most people who would have had the band in the past are now given gastric sleeve surgery if their eating habits warrant it.

Okay, similar study for gastric sleeve surgery www.karger.com/Article/Fulltext/496296

"After initially good weight loss results, weight regain can be observed a number of years after SG, as in Himpens et al. [5], where the excess weight loss (EWL) of 77.5% after 3 years decreased to 53.3% after 6 years. In our previous study, 59% of the participating converted and nonconverted patients had regained ≥10 kg of their weight after 10 years "

Something to think about, usually with weight loss surgery they need to see you change your eating habits beforehand, you have to go to a liquid diet and usually show you can lose 20lbs on your own.

Not everyone has to do a liquid diet or lose any weight prior to the surgery. I think though that it’s probably down to your BMI and blood test results carried out as part of the initial process. I saw my surgeon and had the surgery a week later.

You do make a very good point though by mentioning it. I’d completely forgotten about this part of the procedure for some people.

One thing that can work although at the moment it’s only available for diabetes Is Ozempic (Semaglutide)

I agree that semaglutide might be an alternative. It's shown very good results in the clinical trial programme in people who are overweight or have obesity when used at a higher dose than for diabetes - the data from the STEP trials should be published any time now but here's a link to an older article:
pubmed.ncbi.nlm.nih.gov/30768766/

I would be worried that she'd think it will resolve all her issues. But surgery can ruin your health. It's a risk. I would want her to really weigh up the risks to possible advantages. Not just jump in head first in desperation.