to think that for some obese people, its not their fault, and surgery is a really good option?

[NotMyBigFatFault]

I weigh 17 and a half stone. I am 5 foot 3. Size 22.

I am hungry most the time. I wake up with a hunger, I have breakfast, cereal, or toast, or something else if I am on a proper "diet" (done them all - Atkins, Lighterlife, Slimming World, Weight Watchers, Cambridge, calorie counting, etc). By 9am I am hungry again. By 11am I am ready for lunch. By 1pm I am ready for more. I could go on but my obesity is not driven, in my opinion by greed (which would be eating way beyond which one is hungry) but by hunger. Genuine hunger for perfectly normal, even healthy food.

I know this is not the case with all obese people. But for quite a few it is.

I remember begging my Nanny to commence lunch proceedings at 11am one day. I was absolutely ravenous. I just wanted that sandwich so much. I could; have eaten 10 of them. I was 4 years old and had no idea what comfort eating was - I knew what tummy rumbles were, though.

My dad has never felt properly full. He stops eating, because he knows he'll get really really big if he doesn't, but he always has a knawing desire to eat. He exercises plenty of self control, which is why he is about 18 stone, not 27 stone, or 32 stone, or 36 stone and dead.

My mother has been on the dieting merry-go-round all her life (well, since she was 9). She has always been hungry. She doesn't actually eat particularly large portions, she's a bit of a picker, because she feels nauseous if she gets properly hungry due to medication she is on, but I can put way more away than her, though I try not to, as I am always on a diet. Being on a diet most the time and only breaking it when I can't stand it anymore is what keeps me at 17 and a half stone. I'd weigh more if I didn't exercise this level of self control. Its driven by fear for my health and vanity.

I recently sought weight loss surgery, looked at options, decided on either a Gastric Bypass or Sleeve Gastronectomy (gastric sleeve), and saw an eminent consultant, who approved me for surgery. The surgery will be funded privately by myself. We decided on the sleeve. The procedure cuts away the fundus part of the stomach, reducing your stomach size to 25% of what it was, but most importantly, removes the part of the stomach which is responsible for secreting Ghrelin , reducing that knawing, all consuming and unrelenting hunger that makes some obese people, well, obese. Its keyhole surgery under general anaesthetic.

I go on bike rides, walks, I do trampolining, dancing, the gym, enjoy the great outdoors, and running about with my kids. I am reasonably fit considering my size.

AIBU to think that obesity is not all about "greed", lack of self-denial (we are talking a lifetime, by the way, not a few weeks), "junk food", or "lack of exercise"? Is there anyone out there who thinks, actually, this is not my fault ?

squeaky - I imagine the OP doesn't mean the sort of reduced car approach, but more the strict Dukan type approach with no potato/bread and limited types of veg?

NotMyBigFatFault what sensation do you mean when you say hungry?

I am hungry all the time too but instead of eating I'll drink a glass of water. Dehydration is often mistaken for hunger.

Everyone has a choice (to some degree) about what size they are.

Eat less and excercise more.

tocha, the loose baggy skin is the one reason why exercise is so important, and why rapid weight loss is not the best way to go. If you lose the weight steadily and slowly, your skin will adjust too. OP, at 17st, you can lose that weight, you really can.

You need to set realistic targets. Aim to lose 2lb a week. That is still over half a stone each month. It is really easy to do if you can stick to it. Get the MyfitnessPal app, and it really will help you better than any of the diet sheets can. And it is free too!

Protein costs more than carbs, Squeaky.

Aspartame, I have been without for over a year, it didn't impact my weight loss, in fact I find it useful in having "something" that has no calories, and I find it a weight loss tool.

Re my exercise, please see my original post.

You have a significant health problem and the only question you need to answer is which treatment will give you the best long term results.

The question of "blame" is neither here nor there, except insofar as getting to the bottom of it may affect your decision as to which treatment has the best odds.

I think the "just eat less" brigade are pretty misguided - dieting of whatever sort has bloody awful success rates in the longterm. A friend of mine is currently doing well after a gastric sleeve, but it's early days yet.

I see that you do exercise, but I asked what you did daily, as that makes a big difference.

Lol lol lol "aim to lose 2lb a week"

Squeaky I could only dream of doing that.

I did Lighterlife and managed an average of 1.4 pounds a week. On just under 500 calories of low carb a day with 4 litres of water and exercise. It was quicker at the start and slowed off, that was an average.

Sorry, I'm not trying to be one of those people who has an answer for everything, but I've tried it all.

I've tried eating more as well, before you say it!

Sorry.

Its an interesting discussion, isn't it. Just to reiterate I'm not necessarily looking for advice of for people to agree with me - but the discussion of whether or not there is a category of obese people out there who actually are best off with surgery, is a very interesting one. Its interesting how few people think it is the answer. Are there any out there brave enough to agree (if you do, in fact, agree)?

What do you think of the fact that 92% of people who lose weight go on to regain it all plus some? Why do you think that is?

It is a topic very close to my heart.

It's not a question of dieting - it's a lifestyle change, smaller portions and healthier options. Never forbid yourself anything as that is how obsessions start.

Okay then.

On a typical day, like today.

What have you eaten?

I used to weigh 13 and a half stone and lost 4 stone over a year. Like the OP I also used to feel hungry all the time. I don't anymore. What worked for me was taking up exercise (first the gym, now running) which regulates the appetite really well and only makes me crave good, healthy food. I also rarely eat sugary foods these days as I find the more I eat them, the more I crave them and not eating them at all means I do not want them at all. I am not obsessive about the sugar thing by the way and do not stress about sugar in ketchup, baked beans etc, etc.

I don't know. I know that if I did, it would get me to a normal weight - if I lived through it! It's a risky op, far more risky than the sleeve. But I keep telling myself that I can do it on my own, if I just try hard enough. denial probably. I'm scared.

The sleeve op was difficult, I was in there much longer than they anticipated because there were some complications. I am worried about the statistically much more dangerous bypass.

I'm not going to tell you that what you know to be hunger is not physical hunger, because I don't know you and I can't possibly know that. All I can say is that the pain in my stomach, the growling open pit in my stomach that had me constantly eating, well, I truly thought that was hunger. But it wasn't.

If you are constantly actually physically hungry, then that's not 'normal'. So if it isn't psychological, then rule out the physical.

I saw a programme a few years ago (Channel 4?) and I think it was explaining that some people in the population lack the gene that allows them to feel full and as a result their eating has no natural "off switch". I gather it is fairly rare but it's real. And if I understood it, it meant that people with this condition were going to suffer hunger on a consistent basis - which is incredibly difficult I think and not what the majority of us experience. Maybe this is a condition that you are struggling with? Would it be possible to get tested?

That programme did make me wonder if there is more/ how much more we have yet to learn about the hows and whys of weight loss and control. Variation in how people gain/lose/maintain weight is clearly (IMO) more complex than "just" calories in vs calories out, even though that is the basic equation.

At the extreme of course, eat less and the weight goes. But even there extreme diet control will trigger the body's famine response so weight loss won't necessarily be what is expected (though ultimately will "work" as the body will waste away if permanently starved).

And that is before taking into account the fact that for many (most/all?) of us there is a big emotional component in how we feed ourselves and respond to stresses through diet.

Overall, I have the suspicion that when trying to deal with obesity we may be a long way short of finding the best ways of delivering successful support.

But I'm rambling really. I wholly agree that Hecate's post was spot on - there is a huge difference between fault and responsibility. I wish you well (and luck if needed) with finding a sustainable, safe, non-distressing way of dealing with your issue.

Is this actually true though? You seem very detatched from the matter. And you still haven't said what you personally eat or do for exercise a day? If this is all true then I dout surgery is for you. If you follow cambridge correctly, though I thin it's a stupid diet, then you should find it impossible to maintain a weight of 17 stone. Not just that, but surely surgery will see you eatign about the same? So if that didn't work, why is surgery the magic answer?

Dosnt matter whether people on here agree or not OP- all the clinical evidence points that surgery is the best and pretty much only option to treat morbid obesity.

I got to the point where I thought, screw what anyone else thinks, I need to live past the age of 40 before I die of a heart attack!

But please please listen to me when I say you WILL still be hungry after surgery- probably not in the few first months but when it settles down you will feel hungry.

OP, i think you explain yourself very well.

However, I think there is a mistake in your (and many obese people's) thinking.

All people get hunger pangs. Almost all of us do! Thinner people do too.

It's just that slimmer people don't feel that a hungry feeling is something thatneeds to be addressed immediately.

That's the difference I think. Waiting an hour or two for your next meal won't kill anyone.

"What do you think of the fact that 92% of people who lose weight go on to regain it all plus some? Why do you think that is?"

It's because people don't change. Keeping weight off requires a lifestyle change. An attitude change. People lose the weight and then slip back into their old habits and the weight goes back on.

Only this time, the body is more determined to hang onto it! So it gets harder to lose again.

You have to change forever, not just until the scales say you've reached some magic number. That's what's so hard.

So if surgery makes you eat less, how will you actually lose weight, if in all the diets that you have previously followed (where you are eating less) they haven't worked?

My weight issues are totally down to me over-eating and making poor food choices.

@ Fuckity

"Is this actually true though? You seem very detatched from the matter. And you still haven't said what you personally eat or do for exercise a day? If this is all true then I dout surgery is for you. If you follow cambridge correctly, though I thin it's a stupid diet, then you should find it impossible to maintain a weight of 17 stone. Not just that, but surely surgery will see you eatign about the same? So if that didn't work, why is surgery the magic answer?"

It is true. No, I haven't said what I personally eat or do for exercise in a day, because it varies depending what diet I am on, and because if I do it sounds like I am asking for advice, which I am not, and encourages unqualified people who fancy themselves as personal trainers or nutritionists to comment or tweak what I do. Bear in mind I have a nutritional qualification already and as such am not asking for advice - the purpose of my OP was to discuss and debate the concept that there are a percentage of obese people who are "abnormal" or programmed wrong in the same way that perhaps a transgender person is, a male born in a female body...for want of a better analogy (yes, yes, I know its "not the same thing" and no, I don't want to "make light of a situation" etc etc)

If I follow Cambridge correctly, I do lose the weight eventually. I lost 6 and a half stone on Cambridge. I then got pregnant, and could not control my hunger, or use "tools" such as low carbing to try and control or limit it, as it is contraindicated for pregnancy.

I then went to lose the weight gained (4 stone) again and then got pregnant again. Yes, yes, I "chose" to get pregnant, of course. It was one of the main reasons I needed to lose weight, back then.

Of course now, I just want to be alive for my kids, but that I suppose is also a choice!

Not that detached, I guess?

*Okay then.

On a typical day, like today.

What have you eaten?*

I know that was to the OP but it certainly made me come up short. If I were to tell my therapist what I've eaten today she'd have a fit and skin me alive.

She's right. You have to keep to keep a food diary.

@ The Lovely Hecate who we all love so much, particularly me

"Keeping weight off requires a lifestyle change"

That's very true, of course.

I feel a sleeve would force a lifestyle change, by dealing with the hunger thing in a way that diets can't, and by forcing restriction.

Bear in mind I only "need" to achieve a weight loss of about 6 stone.

The stats on sleeve are very good. You can expect to lose 80% of your excess weight in a year if you are my kind of "size"

For a woman of more size they tend to do it to lessen risk and achieve initial weight loss, before converting it to a bypass. You of course know this.

I think there is a massive difference between a "healthy appetite volume eater" and a "nibbly grazey comfort eater".

Well, there may not be a massive difference in terms of size, to be fair

No, I haven't said what I personally eat or do for exercise in a day, because it varies depending what diet I am on, and because if I do it sounds like I am asking for advice, which I am not, and encourages unqualified people who fancy themselves as personal trainers or nutritionists to comment or tweak what I do. Bear in mind I have a nutritional qualification already and as such am not asking for advice - the purpose of my OP was to discuss and debate the concept that there are a percentage of obese people who are "abnormal" or programmed wrong in the same way that perhaps a transgender person is

I'm sorry, but you may have a nutritional qualification (so did Gillian McKeith... )... but you are in denial if you think that it is not your fault that you cant lose the weight.

You do seem to be trying to find any excuse at all rather than admit to eating too much, and as someone else has just said, if you dont lose weight when you are on diets, then how is surgery going to make any difference.

And if you are so clued up on nutrition, why are you wasting all that money going from one diet club to another, if you already know it all?

You do get hungry when you diet, its a given, your body adjusts with time though and the hunger subsides, even for normal sized people who aren't obese they still feel hunger, its resisting the urges to eat and having will power.

Its not an illness to be hungry all the time it is becuase your body is used to so much food it wants it all the time, it is down to you to train it that it needs less food.

Sorry I really don't see that people who are obese and can lose weight but use the excuse Im hungry all the time so I eat, should get surgery because it is the easier option.

Dieting is not easy for anyone of any size, Im finding it hard and just feel hungry and eat, but Im getting fat because I eat and I know is because Im lazy.

I would'nt expect any specific treatment though due to my own laziness, why should you get preferential treatment because you are bigger than me?

@ Squeakytoy

"I'm sorry, but you may have a nutritional qualification (so did Gillian McKeith... )... but you are in denial if you think that it is not your fault that you cant lose the weight".

I don't think its my fault I can't lose weight - I can lose weight. I think its not my fault that I feel hungry as much as I do on the amounts of food I do.

"You do seem to be trying to find any excuse at all rather than admit to eating too much, and as someone else has just said, if you dont lose weight when you are on diets, then how is surgery going to make any difference"

I do admit I eat too much - its because I'm hungry all the time. I have no trouble admitting that I eat too much. I want a solution to that drive to eat too much.

"And if you are so clued up on nutrition, why are you wasting all that money going from one diet club to another, if you already know it all?"

Well, I'm not really wasting money, you only have to go once to try out a programme and carry it on at home. I did do slimming world for several months when I was pregnant though, and I enjoyed the support of the group, but nutritionally it didn't offer anything I didn't already know about low energy density foods.

So you have lost 6.5 stone before on a diet? So you can do it. It is nothing to do with programming or some other excuse you have done it before.

BTW, I'm within my normal BMI range and feel a little hungry most of the time (except when I have just eaten). If I allowed myself to satiate that hunger ever time I felt it, I would be enormous. I don't, for health and vanity reasons.

Feeling hungry is not going to kill you. It's a completely normal feeling. Becoming morbidly obese might.