In thinking about bariatric surgery?

[cheekymonk]

I am 37. Weigh 28 stone with a BMI of 58. My Mum describes me as greedy as a baby. I was noticeably overweight from age 7. I was bullied for my size in secondary school. I was size 20 at 12. I was an 18 in year 11 then got bigger, at Uni being a 26. I have tried most diets and been most successful with WEight watchers when I lost 8 stone and was my lowest weight for years at 17 stone. However we moved house, found out both DS and DD had Autism and I lost it from there so am now 28 stone. I have been going to the priory for weekly cbt sessions and whilst me eating is better I am not losing weight. I struggle to walk and am forever scared of breaking furniture. I am scared for my health. DD is 5 and DS is 11. AIBU in considering surgery? I do have a lovely DH btw.

dumping syndrome is not pleasant

Don't get a band. I ended up having it removed when it slipped and started adhering to my liver. Gained the weight right back. :(

Have you ever tried a low carb high protein diet OP? I have yo-yo dieted all my life - weighed over 18 stone when I was 13 . But I'm currently doing Michael Moseley's 8 week blood sugar diet, and it's incredible. I'm doing it for health reasons but the weight loss has been brilliant too, and it's the first time I've ever dieted and a- not been hungry aand constantly deaperate to snack nd b- enjoyed the food. I can also forsee easily being able to keep losing weight and then hopefully eventually maintain after the eight weeks are up.

FWIW, I don't think you are remotely unreasonable to be considering bariatric surgery, but just wanted to post and suggest you have a google of this too. As PPs have mentioned, surgery can have long-reaching health consequences of its own, and if you do decide to go for it you may well want to try losing some weight first anyway.

Good luck!

In our area you have to have a BMI of 40 if you have co-morbidities and 45 if you are healthy for a referral but the first stage of that is to engage with a healthy eating and exercise programme for 6 months. Some patients, after that 6 months, are ruled out either because they are no longer at a high enough BMI or because they are deemed to have not engaged sufficiently so are likely to be not motivated enough to succeed after surgery.

I have considered it myself and would go for the sleeve (not available on the NHS) if I went for any but have been scared off so far by some of the problems I have seen people develop post-surgery, both physical and psychological, although that is with bypasses, (I work in the NHS) and some of the problems people have had with skin after major weight loss which has sometimes been more problematic to their everyday life than the weight was

I agree the key is proper research and good post-op care (in terms of dietary help, counselling, etc). Cesare makes a good point too, I always thought I couldn't diet but started low carbing on one of the BIWIs Bootcamps on here and have managed to lose a bit of weight slowly but surely so that may be worth a try too

Thanks everyone for all your input. I really don't see it as an easy option. I have to think it through. It's weighing up the cons of being the size I am vs. all the risks associated with the surgery. I know I'm a Mum so can't just do what I please. Ultimately, I want to be there for my children.

Like previous posters said it will depend on your other health problems.
The NICE guidelines are that you must engage with a tier 3 Bariatric service for a period of at least 12-24 months, but a BMI around 50 this could be fast tracked to 6 months.
In that time you'd have to engage with psychiatrists (if needed) and dietitians, and aim to lose at least 5% of your body weight through changing your eating habits, portion control etc, to show a commitment to the changes needed after surgery (eating slowly, chewing thoroughly, eating bites the size of a 20p etc). You'll also have to show sufficient knowledge of the surgery, potential risks & post operative care & agree to take lifelong supplementation.

Google Dumping Syndrome as its not nice!!

Furthermore surgery can be delayed for a number of reasons - blood tests not being right, weight regain, another consultant from another specialty coming in and saying that your other health problem means you can't have it done yet etc.

But afterwards, you may be sick at most foods, you may have terrible diarrhoea.

Those are the bad bits.

But it can change your life & improve your health drastically so I would definitely pursue it.

Some cases I've seen, the patient changed their diet & started exercising to lose the 5% but then just carried on & on & didn't end up requiring the surgery!

They may also try you on Orlistat to give your weight loss a kick start.

I'd say join Bariatric forums, ask your doctor for a referral to a tier 3 weight management service, research as much as you can & see if there are any local Bariatric support groups where you can meet both pre-op & post-op patients.

Hope this helps! It's a brave step & you should be commended for wanting to change your health.

Oh and be mindful with quick drastic weight loss - the Nhs doesn't fund skin removal surgery, and like PP have said, a gastric sleeve is usually a good option for people with a significant amount of weight to lose & also with the benefit of helping to reverse type 2 diabetes in the long run in some patients!

Do it. It's the most effective weight loss method there is. Good luck X

Dumping syndrome reads as pretty mild stuff compared to what my relative has been thru. Rushed to hospital on brink of death, major surgery required. Other problems, too.

Go for it.

Look into a vertical sleeve gastrectomy or a gastric bypass rather than a band.

Cost is the same, results are better, more evidence for this.

Yes it will require "working with it" too - but it will give you a major edge, not just for the weight loss but for not regaining when your heart isn't quite in it.

You should qualify on the NHS with your BMI, ask your GP for a referral as a previous poster has already said. You said you were Midlands - there is definitely a NHS centre in Birmingham.

Be very careful op , I have heard of ppl put the weight back on post surgery bc they can't adapt to not being able to physically eat like they used to, they miss the quantity, the amount,the binge behaviour and eat their way around the op . They stretch the stomach they have left again and they abuse themeslves by overeating the wrong food and having dumping syndrome which I believe is extremely painful and distressing

If I were you I would absolutely go for it. You have less than 5% of losing the weight and keeping it off without it.
I would never have a gastric band, the complication rate is very high. Different PCT s will have different criteria for you to meet for surgery, I think you can look them up on the wls info website.
I had a surgery called a duodenal switch which is not as well known but has a much lower regain weight. It also does not give me dumping syndrome but the downsides are that I have to take lots of vitamins every day for the rest of my life. I can live with this though.
I was getting to the stage where I couldn't wipe my own arse and 2 weeks ago I ran a half marathon.
Unsurprising they didn't operate on my brain and I still want to eat rubbish foods. However, I have found no cure for this and at least I am a damn sight healthier with a longer life expectancy.

Tbf if you manage to over stretch the band (which is difficult and would cause distressing symptoms, you wouldn't just do it by over eating and get fatter and fatter without other symptoms) you would (should) get additional medical treatment to reset the band and help you with your dietry choices. I know of patients who have had band or sleeve failure but often then have still lost an enormous amount of weight by the time the band/ sleeve is loosened which in an emergency situation when you're very overweight is a decent outcome

I think you can get a sleeve on the NHS in some areas. The hospital I work at does them (or at least I saw a patient who had had one about a month ago - I don't usually work in surgery).
The sleeve has less complications but is easier to cheat. As others have said you have to look at the way you over eat - if you like chocolate and ice cream or other soft stuff a sleeve is not much good and a bypass is better. The bypass has different downsides though like the need for life long vitamin supplements. There are also restrictions around certain medications like ibuprofen etc.
Neither are an easy road - the surgery can go wrong and there are other people who end up unable to eat normally and require feeding tubes.
I have a negatively squewed view though because the patients I see most are those with bad outcomes! I'm sure for every one who ends up back in hospital there are many who get the outcome they hoped for. I guess I'm just saying - do your research and don't go in blindly

How are you feeling about your children's autism? Might it be that now they are a little older that you have had time to mentally deal with it? I get that the diagnoses and early days (plus the house move) must have been very stressful but if the situation had 'stabilized' IYSWIM then might it be possible to get back to loosing weight yourself? Surgery is a such big deal especially when you are so overweight.

Over the years I've followed a lot of vloggers who've had weight loss surgery of one type or another. They all lost masses of weight and then all regained the lot. One nearly died of malnutrition/a particular complication first which she found terrifying.

I think these surgeries can be good. However you have to get in-depth psychological support and have an absolute change of lifestyle for them to work long term. The surgery really is just a tool. So many people find ways round them.

I would say please, before you have the surgery, go and do a Whole 30 (all info online) It just lasts 30 days but it reteaches you how to listen to your body and learn when you're hungry and when you're full. It provides you with good nourishment (lots of obese people are lacking in that). It gets you eating real food and makes you look at why you eat the bad stuff. Watch Fed Up on Netflix. Have therapy while you do the whole 30 and then re-assess. I have lost 5 stone and have had to have skin removal surgery and you do need to think of that too. It has had a major impact on me and my finances.

I wish you lots of luck. Obesity is miserable.

i was considering one and my doctor put me forward,but i had a good think and didnt want it determining my future for life (eating out etc) so i read up on low carb and started 7 weeks ago

i need to lose 3 -4 stone and so far have lost 1 and 1/2 stone in 7 wks

the first two weeks were hard but since then its been mostly amazing

im nearly down two dress sizes and im hoping im going to reverse my verging on type 2 diabetic

some great advice on here and hope you make the choice thats right for you

how can you gain the weight back if you have a band/sleeve ?

i thought the stomach was made smaller,so you couldnt over indulge

thanks

If you eat little and often, grazing on carby foods, then you will gain weight.
Even with a smaller stomach. Trust me, I've been there.

Do it. But don't get a band, they don't work. Bypasses are increasingly thought to work not by making your stomach smaller (which is what a band does) but by altering your digestive system, the digestive hormones you release in response to eating and so on. They aren't just ways of making your stomach smaller, it's much more complex than that.

Bands don't work basically because they are just about volume eaten and are easy to subvert (just eat a lot of icecream) and don't last forever. Bypasses are a totally different type of operation.

At your BMI you should qualify for referral to a NHS bariatric service.

Wow, these responses are brilliant. I will print this off and do some proper research.
I have tried to get back into dieting since we moved, Went back to weight watchers and tried slimming world. I lost a stone with SW but these diets are not helping me long term. I need something more serious. I can follow a programme and guidance. I have come to terms with their autism and am stronger than I was. Like I say I have been having cbt which relies mainly on the overcoming binge eating book by Chris Fairburn. I understand a lot more but I still eat rubbish just less of it! I can feel in my body I have crossed a line, and also struggle at times with personal huge one which is so humiliating. You have all been so sympathetic. I was worried I'd get flamed. Thank you x

I had a sleeve gastrectomy 4 years ago and have lost over 8 stone as a result. Gone from a size 24/26 to a 14. Am no longer morbidly obese with a BMI over 43, am now just overweight with a BMI around 28.

Which what you've said in your op you qualify under NICE guidelines and I'd advise taking a copy of them with you if you think your GP will knock you back - or see another go at the practice!!

i thought the stomach was made smaller,so you couldnt over indulge

It's about what you eat as well as how much. So there are people who will put fish and chips through a blender. Peanut butter is another food that can make you put weight on.

OP

I know they do this at Walsall Manor Hospital, my GP suggested it to me.

I did lose weight using orlistat (Alli), but I have some complex food issues, I think my body just can't cope because of the way it has been treated (eg force fed as a child) and when I was ill the weight came back on.

I think when you have psychological food issues these need to be addressed. If you abuse alcohol or drugs then you are recommended to abstain, you can't abstain fro food.

Thank you... When I went to gp I wasn't aware my BMI was that high and perhaps came across that I wasn't serious enough about it. That's good advice about taking NICE guidelines.Dh has said he wants to come to appt for moral support which has made me feel better too.