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.

[Whowhatwherewhenwhy1]

It did not work for my partner. He had endless post op complications and ultimately it was a dangerous waste of money. In hind sight we would have been better spending the thousands it cost on a personal trainer and dietician.

[cakewench]

I personally would not take a risk if two surgeons have said no. All surgeries have some level of risk and you sound as if you have a higher risk than others.

[Marblessolveeverything]

Personally I wouldn't. You have been through a number of abdominal surgeries and until a surgeon opens may not have an idea of how much scar tissue etc. Not to mention the risk of surgery.

Take the money you would spend and invest in yourself after you find a gp to investigate the possible sleep issue.

Take your time and identify what will work for you, counselling, weekly support sessions, gym sign up, a food ordering service to control intake and give you back time.

[Peridot1]

I was going to suggest Ozempic too. Come and have a look at the threads in Weight Loss Chat.

Ozempic and Wegovy are the same drug - both semaglutide but Wegovy is marketed for weight loss and Ozempic for diabetes. Wegovy is a higher dosage and isn’t yet available in the UK.

I’ve been on it for over a year and have lost three stone. I’ve had a few breaks and I’m taking it slowly.

It’s a game changer. And yes you will put the weight back on if you eat the way you ate to gain it in the fist place. Like any diet or weight loss method.

I had about six stone to lose. And I’d been trying for 30 years. Ozempic has been fab.

I know of someone who has lost seven stone using Ozempic alongside Slimming World.

[Sarvanga38]

Good luck, OP - you sound positive with a plan, fingers crossed all will work out well and get you feeling better!

[weightlosssurgeryprobs]

Thank you for all the comments. I had actually called my GP for months ago and begged him to refer me for help with sleep apnoea but he refused and said he didn’t believe I had it because I was far too young to have it. I stopped looking for help because I felt silly, but I’m happy to say I called my GP today for help and she has put in an urgent referral for sleep apnoea as she believes I definitely have it. She had also referred me to the specialist weight loss team to also discuss ozempic. I have bought two pens to try over two months alongside a reduced calorie diet so I am hoping to lose some decent weight over the next six months.

i did have another call with a surgeon today because it was already pre-booked. He has said he is also confident in doing the surgery because he has experience performing gastric sleeves on people with the same history as mine as well as those who still have stoma bags with success and incredibly minimal complications in a tiny amount of patients, but I think I will revisit in the future.

thank you all very much for your help!

[Ourlittletalks]

As someone who was formerly morbidly obese after developing severe hypothyroidism and PPD after the birth of my daughter, I absolutely sympathise with you right now. It is SO easy to gain the weight and SO difficult to lose it. And I can see the appeal of a gastric sleeve/band, but it isn’t without its risks. Particularly at your weight, the risk of complications is so high even for a routine surgery, so undertaking an unnecessary surgery would likely be unnecessarily risky.
it took me four months to lose all of the weight I had gained and go from a size 22 to a size 8-10, and I did it by following the diets I saw people on TikTok who had a gastric sleeve following. I obviously increased the portion size slightly as I didn’t have the sleeve, and I would have been SO hungry all the time, but I got results. I would estimate I was eating around 1000-1200 calories a day, although I work a lot and some days I was eating less, some days I was eating more. I don’t promote unhealthy eating habits, but I’m just trying to show that it is possible to achieve the same results without going through the surgery.

[bellac11]

Have you looked into the gastric balloon?

[villamariavintrapp]

Honestly I'd be really concerned about the surgeons who are willing to operate on a woman with your history. You've had a normal healthy size/lifestyle up until very recently during which time you've had a baby and suffered with depression and exhaustion and sleep apnea, as well as various physical health problems and surgeries. There are lots of factors going on in your life right now impacting your weight, which won't be fixed by surgery. I really think you should give yourself time to recover and heal from everything you've been through first. And even if surgery were the best option, I'd be worried about the risks for you-you've already had bowel removed, will have lots of scar tissue, it might impact on absorption of nutrients. It feels like a very drastic life long solution to a recent problem.

[KarmaStar]

Listen to your instincts,your intuition.
I would suggest you don't do it.
You can do the weight loss yourself with exercise and healthy eating.do you have anyone to partner up with to keep you motivated?
you absolutely can and will be successful.You could even ask for sponsorship from family and real friends to help.
🌈do a positive affirmation daily and meditate when you feel like you need comfort.
you'll be thrilled with the results of your hard work and be running around with your son in the sunshine.

[Ericabro]

I really think you need to get your sleep aponea sorted as lack of sleep isnt helping you make a good decision and also when you have had a decent nights sleep you would feel more like excersise. I hope you realise that sleep aponea leads to strokes as well as car crashes this is where you need to start your journey good luck op

[LeaveIt]

I don’t understand fully, sorry. What’s wrong with using either of the two that said they would do it? Also, what a previous poster said, not all private hospitals are set up for emergencies if something was to go wrong or if you needed extra care. If you went private in an NHS hospital, like St Thomas’ in London, they would have all the facilities.

[Throwncrumbs]

I’ve worked in this area and would believe the two surgeons who say you are high risk. I’ve seen this type of surgery go very wrong, one patient I looked after spent 10 months in hospital after problems arose. I would never go down this route especially if you have also had a sub total colectomy… people think it’s a quick fix, it isn’t!

[Mirabai]

I would always want to have complex surgery done on the NHS (even if I could afford private) because private hospitals don’t have the full facilities that NHS hospitals do in case something goes wrong.

If two surgeons say they’re experienced in this type of complex issue and are confident it will be fine, that’s perfectly valid. It can just come down to experience.

Have you considered asking NHS surgeons who have nothing to gain financially from the operation?

[Dodgeitornot]

@WhereIsMyRefund

You have ‘only’ been overweight for three years. There is a chance you could reverse most of this without surgery, given specialist advice and support.

I would spend the money on nutritionists and psychologists who can work together with you to address the underlying issues. With the tablets others have mentioned if needed. Good luck.

This.

[Nn9011]

Absolutely no judgement but I would spend the money you would spend on the surgery and get therapy.
Weight loss surgery doesn't change your mental health and most people who have it still put the weight back on, just at a slower rate than those who don't.
You will still want to comfort eat and have to deal with all the emotions you have even if you have the surgery unfortunately.

[TequilaNights]

Ask to be referred to a weight loss programme through the NHS

[1AnotherOne]

I work in private healthcare. The two surgeons that have said yes doesn’t mean that the surgery will go ahead. We often have surgeons agree to do the surgery but anaesthetic clinic will then refuse on grounds of being high risk. It is not just the surgeon who has to do the operation, the anaesthetist is also putting themselves through a lot of hard work. Anaesthetists often refuse risky patients despite a surgeon wanting to go ahead.

[olympicsrock]

I’m a surgeon. Don’t do this. You are definitely very high risk . You are young enough to consider other options.
personal Trainer, coaching , CBT , ozempic etc.

[Dymaxion]

Saxenda and Ozempic are not sustainable, the weight comes back on as soon as you stop them

Ozempic is supposed to be used as an adjunt to lifestyle changes anyway. If people use it as a 'magic bullet' and make no lifestyle/diet changes, then stop using it and go back to their previous diet and lifestyle then yes they will of course put the weight back on.

[Luredbyapomegranate]

@weightlosssurgeryprobs

I don’t have a pouch I had a straight rejoin small intestine - rectum. I am looking into ozempic now - anyone got any experience they could share with me??

Honestly OP please attack this in a logical order.

Try a healthy eating coach first, and therapy if you want that.

Then consider medication if you think you need it.

I know you want quick results, but you will loose a lot pretty quickly regardless, and the trouble with medication is the weight often just comes back on because you haven’t got your healthy eating and exercising habits straight.

[Fifi0000]

I would look at other stuff first but it's been absolutely life changing for me. I don't need to diet and I stay slim. I wouldn't have kept the weight off with ozempic, I have zero regrets.

[Fifi0000]

@weightlosssurgeryprobs

I don’t have a pouch I had a straight rejoin small intestine - rectum. I am looking into ozempic now - anyone got any experience they could share with me??

As long as you have a sleeve and not the bypass I can't see the issue. The sleeve only changes the stomach size it does not reroute the intestines , but you would have to be super careful and ensure you absolutely get no constipation afterwards. I had it really bad post surgery , but I wasn't given anything by the hospital when I got the appropriate stuff it went away.

[Luredbyapomegranate]

If you’ve got the money for private surgery then spend some of it on a healthy eating coach.

Surgery is a risky last resort - especially for you.

Until just a few years ago, you had OK eating habits. You aren’t someone who has long term trouble with compulsive eating or an emotional dependence on food that makes it impossible to loose weight. I realise you have done in the last couple of years, but they haven’t been ingrained for ever, the chances are you can reverse them and sort yourself out.

BEAT is a good place to start if you think you need some therapy. I can recommend a healthy eating coach if that’s of interest, just PM.

You do owe it to yourself and your son to stay in one piece so please give other options a go for a couple years. It might take a few goes but you will get there. Do get some support.