Bariatric surgery or Mounjaro- I need advise

[GingerGirl4549]

Long story- sorry 😞 this is all NHS btw.
In July 2021 following years of gynae issues I had an op to remove some very large ovarian cysts (41 at time and thinking this would then be my last chance post op to try and conceive) op didn't go to plan mainly due to my size/existing health conditions causing complications and they discovered one 12cm cyst was attached to my bowel. Upshot, need a bowel surgeon and to loose significant weight quickly before they can try again. Gynae surgeon requested bariatric surgery, took 6 months for that to go through GP etc, lots chasing on my part. Starting bariatric route early 2022, spent 8 months having various tests, meeting surgeon etc to be told due to covid backlog there was a 2 year waiting list. So I waited patiently, by January 2024 I decided to chase, it'd been 15 months with no contact at all (during this time I'd lost 2 stone through diet). So I chased, was given a phone app - i was never phoned at app time, I chased again and eventually given another phone app for March 2024 only upon having to discover was just with dietician (completely not at that point who I should be talking too, needed surgeon or doctor). Obviously I questioned delay, to be told (she was apologetic but still) that some time in the previous 15 months I had been dropped off the list due to admin issues, when pushed she cited lack of staff. I was very upset, frustrated but not the dieticians fault. She told me she'd entered me back in the system as fast track, would take around 6 months as opposed to a year plus which was current wait times (that was 8 months ago now). Had 3 apps with this dietician (so could get myself ready diet wise for surgery). Last year in prep I made significant changes to my diet as a result of this specific surgery advise and I also joined a gym. I was told that my case was being discussed and awaiting surgeon app. Between April 2024 and September I lost a further 1 1/2 stone. I'm now 45 ( and during this time have had to come to terms that all these delays to the gynae surgery i actually need means I'm running out of time - also last year i started peri menopause so the psychology aspects of all time have been drastic and devastating to me and husband) in August 2024 still no app so I chased again, told they were waiting for apps to become available. September 2024 received letter for app in December, I complained about the wait (considering it was then approaching 3 years in total) I was told I'd missed an appointment- i bloody hadn't! They said they'd sent me a text- they didn't! But they moved the app to end of October 2024. Then 2 weeks before got a letter to say unfortunately they needed to move it (ffs) and this was then January 2025 (this Thursday 16th ) I didn't have energy to complain again so thought I'd wait till now. However, since September last year and now, I started Mounjaro, mainly as I'd started loosing weight previously but very slow and as I just couldnt trust when ill get this op. I'm doing this privately as to be blunt, fed up of the waits and bureaucracy of NHS in my case. I've lost 2.5 stone on Mounjaro. So since January 2022 when first approved surgery and January 2025, I've lost 6 stone. I'm still 17 stone so very large. I now, do not want that surgery after all that, I know I can do it on mounjaro by myself but it's obviously very expensive and a struggle. I've now given up all hope of having a family. I'm scared of all the massive changes the surgery would mean. I'm scared of all the huge vast side effects associated with bariatric surgery. It's a hugely beneficial surgery but it does come with an awful lot of things to consider, for example, gall stones, hair loss, 75% of patients regain 30% of loss stuff like that, and of course it's big surgery. Apps next week, Ive said im going, but i don't think I want this surgery anymore, I think I want to stay on mounjaro. I'm a 'slow responder' and that's great, I'm don't want to loose super quick- which brings so many health issues, and is very common with the surgery. I know there are potential side effects with mounjaro, I've had very few and I'm using it as a tool. I've completely changed my relationship and association with food, diet, exercise and wellbeing over the last 12 months. I don't see it as anything but a tool. I've never been healthier or fitter. I gym 5 times a week. I was an emotional eater, I've worked very hard on controlling that with the help of mounjaro - this is something the surgery doesn't do - you can still eat slider foods and emotional eat on that.
But i can't shake 'would i be stupid not to have this op' ??
I phoned the hospital yesterday just to make sure app was going ahead, as now that whole situation just gives my so much anxiety, was told yes and if goes OK I will go on surgery wait list - so surgery would be in approx 3/4 months.
I need to decide what to do. I don't want to waste NHS resource if I don't have too, I don't want major surgery, I think I can do it with Mounjaro.
Also if I have surgery, they would make me wait 2 years for weight to stabilise before going back on gynae wait list for the surgery I actually need...all the while walking around with huge cysts inside me and by then I'll be 48, it's over and for me all I'm concerned about now is being healthy and fit.
Do I just cancel the op and go it alone or go, see what the surgeon says? Do I just right now say no, not having surgery or am I silly to consider not having it?
Sorry it's so long, please be kind, this has been an awful long stressful fight and would appreciate advice

Sweetheart what a long wait you've had and how frustrating! You have done amazingly to lose the weight without surgery. I think mounjaro is a wonderful support and a tool but it still doesn't do the work: you've done the work. (I did a short time on Wegovy).
My thoughts are don't put yourself through bariatric surgery, it doesn't seem necessary. Go to the appointment and discuss it but keep doing what you're doing.
I wish you well.

I was listening to a podcast about bariatric surgery vs weight loss injections- take a look on YouTube, the interview was with a bariatric surgeon.

I think the issue with the jabs is you have to stay on them for life. Once you’re off, your appetite will return. However with bariatric, whilst you have to work hard, it’s a more permanent change.

Im so sorry the timing has messed up your family planning. I would probably go to the appointment and discuss this with them. It’s possible you’re not too slim anyway for the surgery.

If you have a lot of love to give still, would you consider fostering or adopting? You can still have your family

Your doing fantastic with out surgery , if it was me I would continue with mj and the gym

I just wanted to say you've done so well and I think stick to the Montjaro now as you've used in the right way as a tool to retrain your thinking around food. 17 stone is really close now to getting there.

I would keep the appointment as you might as well, explain where you are at. It sounds like you can also ask how much more weight loss before you can have the bowel operation that you need.

Possibly a blessing in disguise all these missed chances on the bariatic surgery.

I would 💯 stick with mj vs bariatric surgery

Hi
I had weight loss surgery in 2006 i was 130kg got to about 65kg, stabilised for years after DC birth at around 72-78kg and from 2020 My weight started creeping back up I'm now 106kg.
I would advise you not to get surgery and it's actually worked out in your favour all the delays.

My weight loss surgery had my gallbladder removed at the same time and I'm still suffering with side effects of my malabsorption with the shame of having regained. I have anemia and GP's are useless in refering me to infusions. My teeth suffered badly. I have so much loose skin from losing so much so fast. I develipped bulimia because I still needed the emotional aspect of food so would force my stomach then throw up.

You sre losing so much on mounjaro, the hypothetical surgery is in about 4 months then thr nhs wants 2 years weight stabilitu, i am sure you could drop the weight with monjaro on your own in that time or less. 17 st is obese obviously but look how far you have done.
Monjaro i believe also suppresses alcohol craving, when i couldnt physically eat more to numb my feelings i turned to alcohol and became an alcoholic binge drinker which affected me in other ways like losing my career. Weight loss surgery isn't necesssry if you can take weight loss injections in my humble non medical opinion.
If i could turn back time i would not had it because im constantly tired from anemia, my hair is always dry despite care and it just created new problems like hypoglacimia and dumping syndrome where i vomit and have diarrhea if i eat certain things. Even if you don't drink alcohol anyway, WLS takes reduces your ability to digest and absorb nutrients and minerals forever. This is not to be taken lightly because the tiredness, teeth and bones, hair loss and low energy levels are not a way to enjoy life.
I also feel socially you are judged more for the weight loss surgey than injections there is bigger stigma to bariatric surgery. Injections even skinny celebs take them but with weight loss surgery people get more judgmental of how big you must have got and then the scrutiny of what you eat and whether you put weight back, basically the gossip about it is awful.

In short , since your goal is health, stick to monjaro and keep monitoring your health on it. You are doing great.

I'd much rather stick with injections than go through invasive surgery.

Excuse all the typos! 😂

I wonder why a bariatric surgeon would slate weight loss injections and suggest... Bariatric surgery? 🤔

There’s no way I’d get the surgery if I had any doubts or could see another route.

You’re doing really well! Stick with the jags is what I’d do

That’s not what I said and not what she did.

NICE needs to update its guidance urgently for people who need to loose weight before vital surgery doesn't it.

It's astonishing how quickly things have changed but the case is now pretty inescapable for GLP-1 injections to be prescribed on the NHS in those circumstances. (Unless contraindicated for specific reasons)

I had a gastric sleeve prior to starting ozempic. I am glad I had it. Recently I have finally got to goal weight and started a maintenance dose of Wegovy. Over Christmas I did get my script filled so had a two week gap. I have been so reliant on Wegovy supporting my food choices that I forgot how too much food can make me feel really awful. This episode has helped me recommit to working with my sleeve. I'm signing up to a weightloss surgery dietian program again. This is significant cost but I promised myself once I hit goal I would sign up to progri to help me stabilise and maintain.

This is I guess a long way to say it doesn't thave to be either or. It can be both. Also the way you lose weight is only one factor how you maintain the loss is also important.

Good luck. Losing large amounts of weight is bloody hard work.

What a shitshow OP, sorry to hear all that

I had a sleeve. I had tried injections but was funny about actually injecting and started to avoid it each week so they sat for longer and longer in the fridge t the degree it was a farce and I wasnt using it!

If I had been able to continue on injection I would have and I dont think needing to be on them for life (if thats true) is a problem, lots of people have life long medication needs. And you might find you can maintain without it anyway.

Surgery has pros and cons. Some of what you're worried about
You mention gall stones, weight loss doesnt cause gall stones, being overweight does (mostly, there is the odd slim person that gets them), but the lack of fat tends to then aggravate them during the weight loss and thats when they're discovered. Unless you have been scanned and its determined you definitely dont have gall stones, its very likely that you already have one/some sitting there or sludge that might kick off during more weight loss.
You mention hair loss, yes, hair starts falling out around the 3 month mark, then stops at the 12 month mark, mine was like clockwork. My hair was thinning anyway due to peri menopause.
In terms of regain that can happen with any weight loss tool, CICO, low carb, slimming clubs, low cal diets, food replacement diets, injections, surgery. The stats for surgery are better than any other method but as we are human, its not 100% and some of the regain is 'some' regain, some of the regain is 'most of the loss', some of the regain is 'all of the loss'. yOu have to work hard at it, its not a magic wand, you have to constantly adapt to habits you had or see creeping in. Its a diet for life as I feel about mine.

You're doing well, you can always have surgery later down the line by getting a loan out, thats what I did and 2 years on Ive nearly paid it off. Private providers offer a lot of ongoing support, mine is for life.

One of my old colleagues is a bariatric surgeon and he’s really pleased about GLP’s. For the last 10-15 years demand has outstripped what he can supply in terms of surgery and by the time he operates patients have many complications from obesity: joint problems, heart problems, diabetes etc. He has seen patients become desperate and go to other countries for surgery which is botched and then need him to fix. He is looking forward to GLP’s being the norm and his services being available for those who are resistant (this is thought to be 1/10).

Can you discuss with your gp about which option he/she thinks will be more suitable.?

Carry on with the injections I would say.
I know the cost as I'm doing them myself. But don't put yourself through that surgery when you have got a grip on it.
I'd go in and question their basis of the 2 years etc. Really understand it. I get the risk vs reward of any op but if you have lost 6 stone on your own, I'd be a but chippy about it tbh.

Absolutely avoid surgery given the mj is working for you. Well done OP

I too am on the NHS list for bariatric surgery. I've had two calls in three years.
I'm now too light with a bmi of 29. I was 43.
I stopped drinking first then used nutracheck. I'm 59.
I didn't have a weight problem until twenty years ago when I developed rheumatoid arthritis. I was treated with steriods. At one point I weighed over 21stone. It was the steriods or go blind.
I have used wegovy for less than a month. It inflamed my gallbladder. I'm now having that out. I've been very unwell.
However I have friends that have lost four stone on WLD and another who had a gastric sleeve at 64. The WLD seem to be winning in terms of diet (the surgery lady can't eat and needs infusions), the wegovy ladies just eat much less.
Fwiw I had massive gynaecological cysts and went on to have two children.
I'm now doing a 1456 calorie diet and I lose 1-2 kilos a month or so.
Good luck.

I only know one person who has had bariatric surgery and she gained the weight back over time and is now morbidly obese but starting on WLIs. I think one day you'll look back and see this delay as a blessing. I don't mean to sound harsh but given your age and weight the chance of conceiving was low anyway even if you'd had the surgeries quickly after they diagnosed the issues. Losing the opportunity to have children is very sad but your health and life is more important. You had a significant obesity problem and that is being addressed through this wonderful medication. Focus on that.

Thank you, it has been very frustrating and very stressful. And you are completely right, I think often people think mounjaro etc are easy routes but I've worked very hard. Cal deficit, protein intake, macros, I do 4 cardio sessions a week and pilates - that's just the big changes I've made.
Thanks for your advice and wellbeing wishes. I think you're right 🥰

Thank you. I'm a big podcast listener so I will take a look

100% I am committed to taking maintenence on mounjaro after I reach my goal, that and all the other changes I've made are lifelong. I don't look at it as a diet but as a life change.
Thanks for the advice, I will go to the appointment.
Yes, adoption is something we have discussed and fostering is still something we might consider, in the meantime we have fur babies and I love them immensely

What a dreadful wait, but how wonderful that you have done as well as you have, stay on the list. Stay on MJ and re think it nearer the time. Hopefully you will be able to delay the surgery and see how you go and maybe still have the cysts removed

Thank you so much. I must admit, there have been times when I have also thought this could have been some sort of fate. I really don't want surgery unless it's absolutely necessary

I agree. When I started on this journey, jabs weren't even a thing. It's amazed me the last 6 months how things have changed in this field
And I agree, ive been so shocked how long it's taken considering it was for a medical reason and I was actually requested to have it by a gynae consultant, it's not like I rocked up one day and said 'oh can I have this please'