Rejected by two bariatric surgeons but approved by two others - what do I do?

[weightlosssurgeryprobs]

In a bit of a dilemma and would appreciate some anonymous, impartial advice if possible.

I’m 28, and up until I gave birth to my son in 2020 I have always been a size 10 - 12. I developed really horrendous postnatal depression and stopped exercising and looked to food as a comfort.

I am finally better but in three years I have gained almost 10 stone. I am now 20 stone with a BMI of 44 and I feel awful. Not just because of how I look but I get out of breath walking up the stairs, my back hurts standing too long, I snore incredibly badly and likely have sleep apnea.

I am eating healthily and trying to move more currently because I am determined to get back to my healthy weight. I have never felt so awful and I want to be healthy for my son as I am terrified of the consequences (I know I only have myself to blame).

I am looking into a gastric sleeve currently because I feel I really need help. However I am high risk as in 2015 I had my appendix and my colon removed in a sub total colectomy, a stoma bag for a year in open surgery & then another open surgery for a reversal and to close the stoma hole.

i have no issues since then; and in July 2022 had my gallbladder removed with no issues other than more pain due to the scarring.

I have consulted four surgeons so far - two have refused saying I am too complicated for the private sector and too high risk, however two surgeons have said yes, are skilled in operating on patients with experiences like mine and are confident it would be fine.

I don’t want to do it on the NHS as I have had a multiple failing by them in that my condition could have been treated with medication without surgery had they listened to me the entire year I was begging for help with my symptoms. I just can’t.

I’m not a silly person and I am concerned that two surgeons have said no. They both recommended I get other opinions which is why I have spoken to four but I don’t want to make the wrong decision and end up with complications or even death.

So I’m just looking for advice on if you were in my position what you would do. I know it’s ultimately my decision but any input would be much appreciated as my mind is mixed.

thank you.

[Minfilia]

It sounds risky and I wouldn’t want to do it personally.

Is your sleep apnoea being treated? That would be my first step.

Second step would be finding a diet and exercise regime you can stick to. At your BMI just walking will burn lots of calories. And you won’t have to starve yourself because you’ll lose weight on reasonably high calories.

I would say surgery was an absolute last resort with your history.

[ReallyReallyRealThings]

I’d trust the two that say it’s too risky personally.
All surgery is risky anyway really, but the fact that there are people telling you that you would be too high risk doesn’t mean they are not experienced, it means they don’t think it’s worth risking your life for.

[SpideyCraw]

Unfortunately OP, I think this is a time to err on the side of caution. If 2 surgeons have said it is not only risky, but it is so risky they are not prepared to operate, then I don’t think it’s worth the risk.

[Sunnysunbun]

I trust the ones who say they wouldn’t risk it. You’ve been through a lot and I really feel for you. Would you consider therapy to help with dealing with everything you’ve had to cope with? That might help you with weight loss.

[HappyHolidai]

Ask to speak to the high-risk success stories of the ones who said they would be happy to operate.

Understand what the actual risks are and ball-park likelihood.

Then make your decision based on more facts.

Are you actually losing weight on the diet/exercise regime? Do you think you could keep it up? Even if you lost (say) 5 stone you might feel a lot better. Weigh that up against the surgical results & risks.

[Nocutenamesleft]

Don’t do it

i had a friends who nearly died from that surgery and weren’t high risk. One has developed a really high risk rare disorder from the op and actually campaigns for people to not have it!

[WiddlinDiddlin]

Treat the sleep apnea first - even if that means private.

Once you're getting the sleep you need you may well find that your energy levels and mental health improve to the point where you can tackle losing weight in the traditional manner.

Given your history, fucking up your digestive system further and risking more surgery seems like high risk for what would likely be short term gain really, and long term side effects.

I was astonished at the difference CPAP meant to my energy levels, I have gone from zombie to approaching normal (and the bits that stop me approaching normal are the other health issues I have that don't apply to you).

[googgodno]

Nope. You can lose it all through calorie counting and exercise. Be strict, look forwards and do it for yourself and your son. You can do it.

[KleineDracheKokosnuss]

They’ve told you whether they can do it. Two think they can, but two weren’t happy. You can investigate the positive ones further, but remember that even if they have the skill, all surgery is risky.

coyld you try something else first? Ozempic?

[Sarvanga38]

I am saying this as a life-long yo-yo dieter 😣, so do know that I know how difficult it is and am not saying this lightly.

What have you done to try and lose the weight? As others have said, I do think with your medical history it should be the very last resort, and even more so when two surgeons that you were offering large sums of money are declining to operate.

Slimming World gets bad press from those who claim that all people eat are processed foods, but (when I do it properly!) the diet works, without feeling like I am depriving myself, and I don't eat any processed food - lean meat, fish, controlled carbs, loads of fruit and veg, with treats in controlled levels.

If you've not tried something like that (and I say 'something like that' as I believe that so much of dieting is in the head, not the programme), then I would honestly give it a go.

Perhaps make a deal with yourself that you'll apply yourself 100% to it for six months, and if it's not working sufficiently then you'll look back at surgery. Worst that would happen is that you would lose at least some weight and then be a safer prospect for surgery.

[CharlotteSometimes1]

I wouldn’t do it in a million years, far too risky.

You could reverse all the issues you’re having by eating a varied, healthy diet, looking after your gut biome and exercising. I’d read Forever Young by Dr Mark Hayman for lots of great scientific advice. It will be a much more sustainable way of living your life.

[limes6]

@googgodno

Nope. You can lose it all through calorie counting and exercise. Be strict, look forwards and do it for yourself and your son. You can do it.

This is such a simplification and shows no understanding of the social emotional and biological issues as to why people get fat and stay fat. If it was as simple as just eating less, far fewer people would be fat.

[Singularity82]

Two surgeons have said it’s too risky to do outside the NHS, which should tell you everything you need to know. The surgeons who have approved you, how much are they earning from this? Doesn’t that speak volumes?
To be honest it doesn’t sound like you’ve given yourself a chance to lose the weight yourself. You’ve only just recovered from a horrendous mental illness, why not give yourself time to improve your physical health too? It’ll be a longer road but so much safer and healthier for you. I understand you are desperate but consider the implications of the surgery ends up with complications.

[MelchiorsMistress]

Two surgeons saying it’s too risky shouldn’t be ignored. Private surgeons don’t turn down work without good reason and I’d be worried that the other surgeons are in it for the money rather than the good of your health.

I think you are right to avoid the NHS for this type of surgery because it’s not essential and there are other methods of you achieving the same goal without cost to the NHS.

[FiveGoMadInDorset]

The problem going privately is that most if not all will have the facilities that an NHS hospital have if it all goes horribly wrong and you need Intensive care. I would listen to the ones who set no

[2022again]

The question you would need to ask is if it does go wrong, what would happen? The problem with private hospitals is that generally they have no equivalent to icu/critical care so if something did happen it would be a 999 to move you to an nhs hospital….how close is the nearest one? On the other hand, surgeons often work BOTH in the NHS and the private sector….potentially the surgeons who have said yes may be indeed very highly skilled and do equivalent work within the NHS…you may need to ask a lot more questions.

[Toottooot]

Are these surgeons based in the UK?

[acrimoniousone]

If you have two surgeons willing to turn down private work, I'd listen to them.

[DelphiniumBlue]

Why are you considering surgery at all?
You say you are better so that hopefully that means whatever was causing you to overeat is no longer an issue, so eating healthily should not be too much of a problem.
You put on the weight quickly, 10 stone in 3 years, and so losing it might not be as hard as it would be had you alway been big. But it will probably take almost as long to loose it all safely and permanently. It's definitely doable by having an eating and exercise plan.
Having support really helps, I found Second Life invaluable to kickstart the first few months, with daily virtual checkins with a group leader and ongoing chats with other members of the group. You might find Weightwatchers or Slimming World helpful, some people find the accountability keeps them on track.
Your GP might be able to refer to you to a dietician or therapist, there are lots of avenues to try before even considering surgery.
You can do this, don't risk the surgery!

[2022again]

P.s. just to may sure you are aware, gastric sleeves are not a cure for emotional trauma that has caused over eating….even after surgery the emotional drive can be still there….have you been in therapy at all as you have gone through an awful lot in the last 2/3 years and seeing as you maintained a healthy weight b4 these events, it might be worth trying to seek some in depth help first.

[NeverDropYourMooncup]

Two specialists who make their living out of performing these surgeries privately have said that you are too high risk to operate on. That means that they think you are likely to die if you have this operation, taking into account your other surgeries and diagnoses.

I'd listen to them and look at using the money you have available as a result to invest in medication, private hydrotherapy (often available at hospitals at surprisingly low cost) and then specialised, tailored exercise rehabilitation so you can cope with increasing your fitness and strength.

[weightlosssurgeryprobs]

Thank you everyone. I do see the red flags and you’re right I do feel desperate. Yes they are U.K. based surgeons and are all highly reputable and recognised surgeons in the medical world. I’ve only contacted those I have in-depthless researched. It terrifies me that two have said no and I do have a bad feeling. This thread only furthers this feeling so I’m glad I wrote it. I
guess it’s time to look into other avenues…

[BlueSeaWave]

GP can refer you for a sleep apnoea assessment. Look into a proper keto diet or Michael Moseley fast 800. Once you find the weight starts coming off and your energy improves you’re find a huge difference. Weight loss is more diet than excercise. Even intermittent fasting or only eating 12-8pm will be a huge help to you

[Lavendersquare]

I think you should listen to the two surgeons they are the experts and this is not minor surgery maybe think of other ways to lose weight.

A lot of us are using Ozempic, it contains the same ingredient as wegovy that's been all over the news recently and really helps you lose weight. I've been taking it for just over 2 weeks and have already lost 10lb without really trying. The drug works by slowing down food leaving your stomach making you feel full for much longer - similar to a gastric band so you eat a lot less.

If you're interested have a look at the Ozempic threads, on the weight loss board, it might be worth trying before going in for a major operation and probably a lot cheaper.

[MarieRoseMarie]

Why not Ozempic? It has comparable results and it’s way less risky!!!!!