Should I have another go at losing weight before seeing the gastric clinic?

[TheFrenchLieutenantsMonkey]

I have sleep apnoea. Entirely down to my weight I'm told (not arguing). Because of this and the sleep apnoea I have been referred to a specialist weight loss clinic which will, hopefully, address my inability to keep weight loss off. I can diet. I just can't keep it up long term. I have problems around eating. I have never been diagnosed with an eating disorder but I think I may be very warped around my use/need for food.
The thing is I think surgery might help as I know when I cannot have something for a concrete reason I just don't have it. An example. I would eat chocolate until my stomach aches with it. Then I started getting panic attacks. I narrowed it down to chocolate and cola that caused them. Therefore I don't eat them anymore. Haven't for almost 2 years. I can remove things but not moderate. The clinic could help me address my psychological issues and doesn't necessarily lead to surgery.
So here's my idea. I will try the Blood Sugar 8 week 800 calorie a day diet while I wait for my appointment. But if I lose weight will they then say I don't need help ... should I wait? I actually feel quite motivated to do this.
AIBU to not diet when I actually feel ready to do this and succeed so I can get help in case I wobble again? I am so confused

Sorry if it makes little sense typing on my phone, with a stinking cold, inability to breathe and no sleep.

I think your OP answers your question for you - you can diet but not maintain it. If you do the 8 week 'diet' you will lose weight but it will go back on and you'll be back in this position again.
It sounds like you do need some help with the maintenance, you need something sustainable long term not just a few weeks. Good luck!

Thanks. I know it just seems to go against everything I know. Medical intervention of any type is bad. I should be able to do it myself otherwise I'm a failure.

You're not a failure, but if you want to do it yourself have you looked at exploring your relationship with food or something like weight watchers rather than dieting just for a set time?

800 calories a day is dangerously low, OP. Particularly if you're used to much higher.
Even someone starting from a healthier place would not be able to maintain a diet like that, you're setting yourself up for a fail straight away.
It sounds like you're good at cutting out foods, and have successfully done so which is motivational.
Could you identify a few trouble foods that you could cut out instead? This would be healthier overall and easier to maintain. The results would be less dramatic but would actually last.

An example is I cut out bread. Completely no bread. Simple enough to do and plenty of alternatives but such as small change made a massive difference.
You could go one step further and cut out all all bread-like things (so bread, cake etc) or even gluten completely

Even with a gastric bypass you can put weight on again if you eat too much. After 1 year your are back to eating full small meals, if you over eat your stomach will stretch again so you must deal with the overeating anyway.

Gastric bypass is not a failsafe method of losing and keeping off weight.

Why not just refrain from buying the crap in the first place? If you haven't got it there you can't binge eat it. That's a concrete reason. If you just buy salad & vegetables and healthy stuff you'll lose weight....

My friend has found overeaters anonymous a great help. She's losing weight slowly but is finding the emotional but of the meetings so much more beneficial than something like SW or WW. Maybe you would benefit from trying that as well as the weight clinic? It's a 12 step program like AA, but I don't think they pressure you to move through the steps quickly, I'm fairly sure everything is done at your own pace.

Getting help doesn't make you a failure. It makes you sensible as you've learned over the years you can't do this by yourself. I suspect that, from what you've said, any surgery is likely to be like diets you've tried - effective to a point but treating the symptoms not the cause. Your relationship with food sounds very difficult and that's where I would start if I were you - look into therapy/counselling or even online workbooks to help understand that and address what your triggers are and why you've got to the point you'll eat until you're in pain.

If you diet before you go to the clinic but explain to them what you've said in your op I can't see that they'd send you away. You need support on this, and you can't cut food out entirely so need to learn how to manage your relationship.

I have an eating disorder and one of the things I saw when I was in treatment is that professionals are starting to understand that disordered eating and eating disorders don't have to be linked with physical symptoms. People who restrict don't have to be dangerously underweight to be ill, people who binge eat don't have to be very overweight. It's the relationship with food that's the issue not the physical outcomes thereof.

Good luck getting the support you need.

Yes I've tried WW and SW but my problem is that I cannot stop thinking about food. SW/WW rely on you thinking about everything you put in your mouth. I end up hungry all the time because I'm thinking of things I can eat.

Thanks sweary. That was helpful and encouraging. I am going to the clinic more for the psychological help they offer. I'm not going because I think gastric surgery is a miracle cure. If it comes to it it may be that it is more of a Ste to reeducate my brain on how to feel full. If i cannot physically eat more than x amount i will not eat as much because i know there is a physical consequence (i.e. Vomiting/pain).
Gluten free is not something id chose to do. It is no healthier being gluten free unless you have gluten intolerance/coeliac disease.
The 800 calorie a day for 8 weeks thing isn't a random thing. Its a proven technique for lowering blood sugar which would be beneficial to me as i have PCOS and insulin resistance. Thanks for the replies they are helping.

An 800 calorie a day diet isn't a great plan. Have you tried myfitnesspal - obviously you think about food when you start off but if you do it long term then you don't. I don't even log anything now but I still feel I use the good habits I established using it. It genuinely changed my eating habits. By long term I mean months and months. When I need to shift weight I do it very slowly.

Also what happens if you ignore your eating and ramp up your exercise? It can make you naturally feel like eating less.

A gp can give you a 12 week referral to slimming world.
There's no reason to be hungry on it at all. The key is being prepared.
Do a weekly food plan including snacks and buy it all in then make snack things and pop in sealed containers in the fridge for when you get the minchies.
Fad diets only work short term and that won't deal with the problem at all.
You need to change your eating lifestyle permanently.
I've helped at a slimming world group for three years on and off. My dad has lost 4.5 stone as he had two near heart attacks and he's 68 so we are never too old or set in our ways to change things for ourselves.
He had moments where he faltered don't get me wrong and it's been a long journey but he has re trained his mind and feels healthier now than he ever has. I say he's added years to his life and that's the important part.

You sound very motivated op.
Maybe you could get a referral to a group whilst seeing a food physiologist to help you deal with the mindset at the same time?

May I ask how old you are op?

I'm 39 (clinging to my last few months of my 30s!!!)
Ad I said upthread I have tried SW and WW (several times) They don't work for me. They've worked for my sister and parents. I never found them supportive. I'm very insecure and have rather big self esteem issues and hate going. I know everyone is in the same boat but it doesn't make me feel better. I'm better on my own and had better results on my own.
I've tried MFP too. I'm not trying to dismiss your ideas. For someone who is overweight with little idea on what's out there its great. But I've been on diets since I was 11 years old in primary school. I promise I've tried everything. Its not that I need educating on what or how to eat. I'm well versed in all of that. Its the crippling guilt I feel everytime I eat anything, and I do mean anything. I hate eating in front of people because I'm so fat now I know they are watching me thinking just stop eating.

Gluten free is for people who can't tolerate gluten. It is not a weight loss method.

Op, as you recognise your issue is mental and that is what needs treating. I really hope you can get the help you need and wish you the best. BTW no one worth worrying about cares or notices what you are eating.

OP I totally hear you - I have badly disordered eating too and my weight has yo-yo'd drastically over the years. I had that thing of binging really quickly, shoving food into my face to fill an emotional hole whilst thinuking 'shouldn't be eating this...shouldn't be eating this' so I never actually even tasted food enough to properly enjoy it...I was thinking about it ALL THE TIME but never about flavour, texture or enjoyment..just guilt and self loathing.

What worked for me was reading 'Fat is a Feminist Issue'. It addresses the root emotional causes of overeating and I really identified with a lot of the case studies (fatness as rebellion, for eg). Then I did Paul McKenna's hideously titled 'I can make you thin' which takes essentially the same tack, ie diets are bullshit, we overeat for psychological reasons, and we can learn to eat normally and enjoy food. There's a book and an app that use hypnotherapy to guide you and - once you get past the fact it's Paul McKenna - it really, really works. This week I've eaten and enjoyed cheese, chocolate and pie, thought and talked about food loads, but been able to stop eating when I was full because I can now listen and respond to my body's hunger cues. I also lost 2lb.I never ever thougt I would been able to say this as food has been a bloody battleground since age 13.

This is only my experience so please feel free to sack it off, but just wanted to pass on some positivity. Good luck, whichever way you go - food is HARD and you have all my empathy!

Could you use the money it would cost to get a gastric band on therapy (Cbt) and a nutrition course?

How overweight are you? If you do the diet will you be a normal weight by the time you get the appointment?

I really don't think you should try not to lose weight because you're waiting for an appointment.

Interested in this. I have SA too, I've been told its probably not weight related although I am over weight.

In April of last year my OH was 5st overweight, had uncontrolled diabetes and was taking statins for high cholesterol. The diabetes was a particular worry because her older brother, who is also diabetic was starting to have problems with his eyesight and her condition had mirrored his, just a couple of years later, up until that point.

We don't live in the UK and have reasonable insurance, so she was seeing the dietitian regularly and attending diabetic clinic but didn't mention starting the diet to either because she'd failed with weight reduction plans so many times before. In the first two weeks she'd lost 16lbs, so then felt confident enough to bring it up.

The dietitian was delighted at what she was doing, she felt that although 800 calories a day isn't sustainable forever, it was working for her and her blood sugar results were amazing.

Many, many people told her that her diet was unhealthy but none of them were able to back it up with anything other than thinking they might have read something somewhere because there is no research that proves eating 800 cal a day for a short period is bad for you. Every medical professional she met was delighted with her, to the point where she was asked to attend a training session for dietitians.

My OH is now 5st lighter, has a healthy BMI, is off the meds and is back to eating a more normal diet. Her diabetics isn't cured, as happens with some people, but it's controlled to the point where she doesn't need medication and that's bloody amazing.

Do your own research OP, talk to real medics and ignore people who are repeating what is little more than unresearched gossip.

Good luck to you.

I'm worried that I might have made OH's achievement sound easy and it was anything but. The first four days were awful for her and anyone she came into contact with. It was proper cold turkey, with mood swings, chills and headaches. On the fifth day it lifted and she has slept better and had more energy than at any other time that I've known her.

You really have to white knuckle the first few days.

It does sound like a form of eating disorder/disordered eating. That doesn't mean you are 'stuck' like that though. You have a severe and prolonged eating pattern that is causing you physical and emotional problems, and have done since childhood. And it doesn't sound like you have had much proper support with that over the years. WW, SW etc are not equipped to provide the emotional and cognitive support for someone with a long term unhealthy eating pattern. Friends and family only want you 'fixed' and keep offering advice that you may not be in a position to take, at that moment in time.
Your pattern of eating is being supported by a way of thinking, of feeling and behaving that is all linked. So all these elements can be looked at with the proper support. You will still get your referral and I would think that referral may be a great help to you. Just because something worked for other family members doesn't mean it will work for you, we are all different. Do you think your mind is trying to make you avoid the referral by losing weight beforehand? Your mind would be doing this to protect you from uncomfortable feelings.
The way I'm thinking is, you don't want to stay the way you are, but you don't like outside interference either, nor do you like others engaging with you on the subject of your weight. This would be absolutely normal for someone in your position, as you have built up a tremendous sensitivity about it and that makes it hard to talk about it or to approach it. You would very much like to manage it 'all on my own' probably. Because again your mind is thinking that would be the best approach to keep everyone safe. You have successfully 'dieted' before but have done it alone, so the piece that is missing is proper support from outside from someone that you trust, who understands the nature of the issue and how it makes people behave.
If you have low self esteem you are probably also thinking of what will people think when they get to know you, in relation to the eating issues? Will they think bad stuff about you? So again your mind is trying to protect others from knowing you. Again this is coming from a good place, but it's doing you no good in terms of your physical and emotional health...
There is something else to notice. The difference between the warm fuzzy feeling we get from making a decision in our heads and feeling 'ready' and then what happens in real life when we are in the situation of not eating something we want to eat. The two don't match and then we have this big willpower power struggle going on, where we see ourselves as 'failing' again. The warm fuzzy feeling is a set of neurons banging together in one situation and the other is a person dealing with a body feeling a whole range of different emotions that is telling them what and how much to eat. The context we make the decision to 'diet' in is very different then to all the situations we are in when later on, when things are not warm and fuzzy and we don't feel 'ready'. It's about persisting in the face of apparent failure, falling off the wagon, then getting back again. It's about including relapse as a necessary part of the process, and having a system to manage relapses so they aren't an all or nothing.
That it's not black and white, it's not me 'on a diet' VS the 'eating free for all', it's about reaching a point of a happy medium.
First thing you could do is stop referring to it as 'dieting' because you are not going an a diet and then stopping a diet. Call it a lifestyle change. Never say the word 'diet' again because that is a stick you are using to beat yourself with. What you are aiming towards is a more healthy lifestyle.
I'm a big fan of Acceptance and Commitment Therapy which helped me no end in another situation, and I've studied it since so know a fair bit about it, there is a book recommendation here. It might start you thinking more about the cognitive and emotional side.
Self compassion is the crash mat for change, and self compassion is the crash mat for managing relapse well. So when we fall or feel we have failed, we can catch ourselves and lift ourselves up again more easily. You are going on a journey and many things will help you. When you look back in 2yrs time, hopefully from a healthier more self-contented place, you might notice a few things that helped you, not just one quick fix cure all, but a few building blocks.
The Diet Trap: Feed Your Psychological Needs and End the Weight Loss Struggle Using Acceptance and Commitment Therapy. This is the Amazon link but bookdepository etc might be cheaper.
www.amazon.com/Diet-Trap-Psychological-Acceptance-Commitment/dp/1608827097

My SIL is a disordered eater. She had gastric sleeve, lost several stone, then realised she could cheat it by eating little and very often. All weight now back on. She still has exactly the same issues around food.

Nancy, that's awful for your SIL and I wouldn't want to deny or undermine her experience in any way, gastric surgery isn't magical and doesn't cure everyone but it doesn't have the highest patient reported success rate of almost any surgery.

My own personal theory is that there are at least two types of people with an uncontrollable compulsion to eat, those with psychological problem and those with too many hungry hormone receptors in their guts and it's impossible to tell who is what until most of the gut is taken away. However, the high success rate of the surgery suggests that there might be more of the latter than the former.

It's also worth remembering that the aim of gastric surgery isn't to get into tiny jeans, it's to improve life expectancy and an overall weightloss of as little as 10% does just that.

Wow..sorry my phone died. Thank you for all the replies.
Silently that was really interesting to hear. I'm not expecting this to be easy. I know it'll probably be the hardest thing I've ever done. But I have to do it. My children won't have a mother otherwise. I hate myself so much and that is no way to be a role model for your children.
For those who asked I am 5foot 10 and about 18-18.5 stone. Varies from week to week.