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 ?

Change in lifestyles? Abundance? Conflicting 'experts'? Artificial foods? Adenovirus-36 virus? Lack of mental health provision?

They are all certainly bars to weightloss Kladd and there are many many bars to weightloss.

But OP if you have the surgery will the levels of the hormone that tells you you're hungry (can't scroll back!) definitely reduce? If so, surgery is the best option, but you'll still probably have to do all the 'manual' stuff of watching what you eat when.

I don't mean to be difficult I promise. I see people at my group dropping 4-5lbs a week when I've maintained, I've seen people reach target in a few months, when I've been at it nearly a year. I've also seen people with a vast array of genuine reasons achieve amazing results and one member who has had surgery who still attends the group every week and has been doing for 8 years.

I think, sort the medical issues with medical procedures, and then, well then forget what's gone before, start afresh with the weightloss/maintenance plan that you enjoyed the most.

Kladdaka...well, some of that makes sense but not all. Lack of mental health provision....I doubt there was much MH provision in the 50s?

Change in lifetsyles/abundance/artificial foods.... all could explain why there is more obesity now. Which is why I can't really understand why some people say it is impossible for them to lose weight. By that, I'm not being judgemental, I'm saying I genuinely don't understand. But I've never had to diet and I haven't got a head for science so maybe that's why I don't get it!

"But OP if you have the surgery will the levels of the hormone that tells you you're hungry (can't scroll back!) definitely reduce?"

It absolutely will - this is easily proven and there has been a lot of reasearch into how ghrelin levels are impacted by gastric sleeve and gastric bypass (its easily tested) and what effect ghrelin has on not only appetite but the body's ability to store fat.

"If so, surgery is the best option, but you'll still probably have to do all the 'manual' stuff of watching what you eat when"

Absolutely. And it will be ever so much easier to do so with a stomach a quarter of the size that it was, and without this hunger hormone raging round my bloodstream!

Do you keep a food diary? The thought of seeing CREAM CAKE written down is sometimes always enough to stop me having it.

Also, I think that you sound negative, and im not sure anything we say will change your mind. Perhaps also it has to do with the fact that you can afford surgery. So, it is seen as a quick fix. In my opinion the best results (in anything, not just weight loss) are achieved with determination, perseverance and a big dollop of positive mental attitude.

Good luck.

I have a friend who had weightloss surgery 3 years ago and it is anything but a quick fix.

You have a hard road ahead OP even with the help that the surgery will provide and I really do wish you well

Chipping - you weren't a pain at all!

The sleeve is an operation to actually remove most of your stomach, leaving you with a little strip. It's like the difference between a bin liner and a sandwich bag. No matter how much you try, you'll never fit much in the sandwich bag - and if you try - you'll split it!

If you eat too much, you will vomit. Plus I was terrified that the staples would pop.

But I tell you this - if I never ever see a pureed sardine again it will be too soon

However, in time the stomach stretches again. You don't stay full up on a pureed sardine for life. (I wish you did!)

It doesn't take willpower while your stomach is so tiny that you throw up if you eat three sardines. That comes later!

Not much success with counselling. I tried a hypnotherapist but she wanted me to visualise my inner child and I couldn't stop laughing. (clearly my inner child is a brat) I had traditional 'sit down and whinge about your childhood' counselling, which was unhelpful for me because what's happened has happened and no amount of going over your life changes anything. You just have to get the fuck over it. Sadly.

I had CBT to cure my needle phobia (seriously bad as in I would rather die than have a needle. Actually rather die. And it nearly came to that more than once - discharged myself AMA because they wanted to stick a needle in me. ) I think CBT would help but I can't afford it and the gp doesn't fund more than a few sessions which, ime, isn't helpful at all. You need more than that.

I've never found a book that helps yet, but if you can suggest any, I'm always happy to give them a go!

Drink more, often "hunger" is actually a desire for water/fluid.

Also, you can be mentally hungry despite you having adequate food intake. This is where the Paul McKenna thing works as it trains your brain to stop sending the hunger signal.

Fascinating thread, particularly the input from those who have had WLS.

OP please do come back and update us on your decision / progress.

NMBFF Wow - that's a strict diet. How long have you been doing it for? How much weight have you lost? I'm still really confused over your POV. Jac, Hec etc are saying that you will still feel hungry (which as you say is a good thing if it's 'normal') & there doesn't seem to be any guarantee that it will stop you feeling as you do now - that your hunger will be 'normal'. You seem to be placing a lot of faith in the fact that your ghrelin will be removed/drastically reduced - yet those who have already had this done, don't seem to agree. How do they test this? Where could one go to have it tested? You have proven you have what it takes to lose the weight & you are doing that intense diet now... I just don't understand why you think the surgery is necessary?

ChippingIn I did see an old school photograph, that's what I said in my post. The boy we all thought was vast, was actually probably just overweight rather than obese. Unfortunately he was noticeable because nearly all of the other children and teenagers at the school were slim.

I will accept your assertion that there have always been obese people. But why are there so many more now? And why is it that so many people blame thyroid problems? (Not the OP, but plenty do). People must have had thyroid problems in the past.

Insulin resistance was diagnosed after fasting glucose test and glucose tolerance test. I was being tested for pre-diabetes/diabetes. It was test results (which I can't remember) and assessment of symptoms that lead to diagnosis.

Symptoms of insulin resistance from diabetes.co.uk

One of the earliest and most noticeable symptoms of insulin resistance is weight gain, particularly around the middle.

Further symptoms include:

Lethargy
Hunger
Difficulty concentrating (brain fog)
High blood pressure is another common symptom which is caused by high circulating levels of insulin in the blood

If insulin resistance develops into prediabetes or type 2 diabetes, the symptoms will include include increased blood glucose levels and more of the classic symptoms of type 2 diabetes.

You stay full for the same amount of time as you do pre-op on a big binge. So that helps, but yes, you can still gain weight after surgery. You do need to take it seriously.

I would love to never eat again. Food is my worst enemy. If there was a pill you could take that filled up your stomach I would bloody love that.

The closest thing I can liken it to is something I read once - imagine you are an alcoholic and you have to have 3 whiskeys a day, every day. No more. Just three. You must have them to survive, but you have to use your will power to make sure you don't drink the rest of the bottle sitting right there in your kitchen.

You always have to take the suppliments. I can't eat how I used to - the binges are a thing of the past, thank god. I feel really sick if I stuff myself. But now I can eat what I imagine to be a 'normal' portion of food.

If we go for a meal, I can't finish it. I have taken to ordering a starter instead and asking for it to be brought out with other people's mains. I will have a pudding but that's just greed, because I can't eat it

I went out a while ago with my sister and a friend. three course meal! I ate the prawns from the starter and left the rest. Threw half my pie onto my friend's plate and still didn't finish and couldn't even finish my pud.

Pre-op I would have had all that and gone home and eaten a loaf of bread.

I am stuck stock still now and have done for yonks. I know that the sleeve was only supposed to help me lose enough weight to have the bypass, but I keep telling myself that I can get my arse into gear and lose it by myself. I keep trying. It doesn't help that I have medical problems too - PCOS, fibromyalgia and an underactive thyroid (not failed, just sluggish really!!)

"how long did it take for you to have to use 'willpower' rather than just actually 'feeling full/sated'?"

sorry - about 6 months.

/hijack

jinsel - what (if any) advice did you received after the insulin resistance diagnosis (am interested as strongly suspect I have this - v overweight raised bp, raised cholesterol, excess weight goes mostly on tummy).

hecate - does moderate exercise help at all? or is that out due to the FM? just thinking of brisk walking, nothing too exotic?

waterlego - I think a significant factor in lifestyle change/weight gain is car ownership and out of town retail parks. so instead of regularly walking a mile to the shops/cinema etc you go from home to car park.

WaterLego I did read that. I know you saw one school photo - I just don't think that's much of a sample from the 50's through to the 90's

I think things like thyroid problems are the reason there have always been some obese people. I think modern life is why there are a lot more obese people.

Jinsel thanks for that. I guess I really need to make a Drs appt. I just hate the fact that everything is dismissed and he just says 'you need to lose weight' and pays absolutely no attention what so ever to what is actually wrong with me at the time or how I feel. Would happily prescribe AD's though - I think he's on a kick back!

Hec really interesting. It's all so different that you imagine it would be. With the sleeve, is your stomach supposed to stretch again to enable you to eat a 'normal' sized meal? If you can now eat 'normal' portions of food - why do you still need to take the supplements? Could they not do another sleeve instead of a band? I definitely agree with you re the alcoholic & whiskey. Food is definitely a very difficult addiction to give up because you cannot simply go cold turkey. 6 months... hmm... I guess that's a good start.

Good luck OP.

I guess I don't think it matters whether it's your fault or not, if the operation helps you.

tocha

The official advice I got was 'to be careful with my diet'. No referral to a dietician, no reading matter and no things to avoid were suggested. This was a while ago now and things may have changed but back then the only healthy diet was a high fibre, low fat, carb centric diet.

I did a lot of reading and Barry Groves was the author that made the most sense. His take on insulin resistance is here but the whole website is worth dipping into and his books are interesting - I've got Eat Fat, Get Thin.

There are a few medically trained authors that don't buy into the healthy eating guidance that is national policy. I think it's good guidance for the majority but I also think it's worth reading around.

It's not going to hurt you to try a lower carb plan for a week or two and see how you get on. I know a lot of people worry about rising cholesterol but if it's any comfort my slightly elevated cholesterol levels plummeted to a low normal after 6 months

Have you had a hormone check? Hormonse changes and levels of different hormones are linked to appetite and control, it could be worthing checking before going for surgery.

I've only skimmed the thread so sorry if I repeat anything. I do think it's your fault Op, sorry. But I don't think it's something you have done deliberately or feel you have control over. I think you are me 10 weeks ago with an excuse for everything and someone/thing to blame for everything.

You say you are fit for your weight and that you exercise. I was too. And I exercised. And I didn't eat that much but I was just so hungry all the time. I do/did get faint from not eating enough. There were planty of times at work I had to buy myself a can of full sugar Coke (I don't even like Coke) because I was certain I was about to pass out at any point and food was not an option.

My friend asked me join a fitness bootcamp with her around ten weeks ago. She'd lost loads of weight by simply exercising more and making the right choices with food. I went. I learnt quite a few things. The main one being am I buggery fit and did I heck exercise. A gentle stroll with the hounds twice a day and fanny arsing around with exercise DVDs/trampolining/dance games is not exercise. I actaully felt like I was going to die during the first, second, third, fourth...... bootcamp session.

I am getting fit now, although I still regularly wish for death during bootcamp. Because it was icy yesterday I decided to go back to week 2 on C25k, something that would previously have had me buggered for the rest of the day but I didn't even work up a sweat, which considering it was below freezing and I only had on a hoody was not good Shred levels 1 and 2 make me feel like I have not put in enough effort for the day as I hardly break a sweat. I used to want to die during those.

When you tell us you are fit and you excerise you are lying, not to us, but to yourself. To get any benefit from it you have to push yourself to your absolute limit. If you can still talk immediately after your cardio you are doing it wrong. People who are already fit do this anyway without really noticing, for the rest of us it's sheer hell.

It has also impacted on my eating. I now have the attitude that there is no way in hell I am putting myself through that twice a week to come home and eat shit. I still felt hungry all the time but instead of reaching for a sarnie or doing a cup of soup or something (I don't like processed foods) I'd have an apple, boiled egg or banana with seeds and yoghurt.

I have recently noticed that I am less hungry and can handle hunger better. I think this because I now eat right, not an unmaintainable diet or junk food just, good, natural foods, although I tend to limit sugary carbs. I haven't felt dizzy or light headed for a good few weeks now, despite still working shifts and still having to go long periods without food or snacks. I still have my treats occassionally, just not as often.

Like you I would try this diet and that diet and would find myself loosing and regaining the same stone and half. I've done this for the last five years. I started bootcamp at (this a guess I was afraid of the scales) around 17st7. I am now 15st10, so I've still got a long way to go but I've finally beat that 1st7 mark and for the first time in almost 5 years I am under 16 stone. I actually look a lot slimmer than I have done in more than 5 years and I am loosing inches faster than I am loosing lbs.

My point is I suspect you are lying to yourself about how active you are. No matter how little you eat if you don't exercise you are never going to achieve what you want and it will always be 'too hard'.

Good luck, whatever you decide Op, but I think you are making the wrong choice if you go for surgery. You are not big enough to not be able to do this alone.

Chipping I enjoyed this book: Just Hand Over The Chocolate And Noone Will Get Hurt by Karen Scalf Linamen

Chipping on Extra Easy there's none of the red day green day guff (though you can still do it.

I can have roast dinners, full breakfasts, KFC (homemade) and chips... it takes a while to explain but is very easy and straightforward. PM me if you want more info as I would take over the entire thread with my preaching and it can get tiresome for others!

NotMyBigFatFault if it will fix something that's physically broken then I think its your ONLY option really. So I can't add much other than to wish you the very best of luck and a bright, happy, slimmer future. x

To the OP: I agree with you.

I am someone who is obese and feel that a large part of the reason why is the AMOUNT of hunger I experience. Yes from time to time I may also make bad food choices (not all the time) but when you find yourself ABSOLUTELY effing mentally ravenous 4 hours after your last meal, that amount of hunger can lead to "poor food choices" (i.e. grabbing the first big high calorie fix available).

I am also currently considering surgery, and have read up as much research as possible (the negative as well as the positive).

Found quite a few articles explaining why diets are so are hard to stick to, why the weight returns 95% of the time, and why weight loss surgery works -- having effects on not just hunger, but also the links between the stomach and brain's reward centres.

www.drsharma.ca/obesity-gastric-bypass-reduces-appetite-for-fat.html

www.drsharma.ca/obesity-bariatric-surgery-reduces-response-to-food-cues.html

Why traditional diet + exercise fails + weight loss is hard to maintain:
www.drsharma.ca/obesity-why-diet-and-exercise-is-not-a-treatment-for-obesity.html

www.drsharma.ca/obesitywhy-is-it-so-hard-to-maintain-a-reduced-body-weight.html

www.drsharma.ca/obesity-will-losing-weight-make-you-fat.html

I also am aware that whichever surgery I choose will require huge changes on my part post surgery (it's not as if it's going to be a walk in the park or magic pill because I am too lazy and weak willed to diet I have done tonnes of diets, lost and re-gained over 150 lbs now I am seeking a permanent solution to help me stick to a reduced calorie intake forever and help keep the weight OFF).

But I do believe that the surgery itself will help limit my appetite, cravings, desire and quantity that I am able to eat.

OP, a lovely post, and something many deal with. What works for one will not work for another, and I do think surgery could be good for you. So interesting to read everyone's stories. Here is mine... please feel free to contact me for further info if you wish :)

The whole 'eat less and exercise more' is idealistic for someone who is morbidly obese... one battles to do much strenuous exercise at all due to size, back pain, sore feet etc. And if you have something like asthma... actually quite dangerous to exercise if the asthma is severe. Even for me, who used to play netball, tennis and run, getting up the stairs without stopping for breath at the top, was impossible.

I had a vertical sleeve gastrectomy last October. I was always slimmish (genetically prone to putting weight on easily though, but was sporty and never had a weight issue), till I developed bad asthma... which lead to steroids (pumps no longer worked). After years of nigh continuous steroid use I had gained 100kgs. I was in a vicious circle... asthma bad... need steroids to breathe... steroids added horrendous weight... added weight makes asthma worse... till one day my GP said 'Have you considered surgery?' She had seen over the years how my asthma had caused me such angst.

We were not happy to have the surgery at the start as it is dangerous... and if asthmatic, very dangerous, to have it. The sleeve is less dangerous than the bypass surgery, and we were happy when the surgeon told me about this newer surgery, that is gaining popularity. The respiratory specialist (who works very closely with the bariatric dept) told me if I didn't have the surgery I was looking at a lung and/or heart transplant by the time I was 50 (I was 36 then). So surgery was a must have, not merely an option for me.

I went through months of nutrition/surgeon appts... the nutritionist said I actually did not eat enough food (!!!), even though so obese, but I was eating less and less to try and counteract the weight the steroids was putting on (for eg: in one hospital stay, in 5 days I put on 4 kgs). She said 15% of their bariatric patients are there for medical reasons, not eating problem reasons. I didn't need counselling as I don't have food issues. As they didn't want me to go through another winter (with steroids.... = weight gain), my surgery was fast tracked, so I only waited 5 months for it.

Having surgery meant me losing weight very quickly in a short period of time, allowing my body to be free of steroids to breath over last winter... it worked like a charm... and now, a year later, I am 5.5 stone lighter, asthma is MUCH improved (my inhalers actually WORK now... ), no complications (there are less with a sleeve than with a band/bypass), I do feel hungry, but I feel fuller quicker. My tum has definitely stretched over time, as I can handle more food than I could before. So... will power and being disciplined is important, even with surgery. I have days I still vomit. Certain foods I am unable to digest. I eat more protein than before. I am on no supplements with this surgery.. it is more natural than the bypass or band imo.

I have my life back, and am deeply grateful for the surgery that allowed this. I can go to gym now, just need to take ventolin before swimming/strenuous exercise if I feel I need it (in winter). I no longer have the chronic back pain, shakes and panic attacks the steroids gave me, I can walk for miles without gasping for breath, I don't get the dirty looks and comments from people, I can comfortably sit in a chair now. I still have a way to go but I am well on the way.

So hang in there OP. Do your research, and then make an informed decision based on the research. Only you know what you can handle.