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

Hi Op, I have not read all the post so I am sorry if this has already been said.

Firstly, massive hug to you for feeling like you do. I understand the feeling completely of being overwhelmed. I have many different issues that make losing weight more complicated and fiddly for me, and very much an uphill struggle, but one thing I have started doing which has made a LOT of difference both mentally and (hopefully) physically over the last three weeks is a personal trainer. I cried when I did my measurements and photo's and I could really be stricter with the calorie counting but it still feels like I am making a positive difference.

If you could find the money for some sessions a week, would that be worth looking into before exploring the surgery or other options?

There are private hospitals with ICUs. I had a sleeve 3 years ago and due to my start weight I had to go to a different hospital to my local one so that there was an ICU. As it turned out I sailed through the surgery and only had to stay in one night instead of the expected two. It changed my life, I'm not at my goal but I couldn't be happier with my 14 stone loss.

I would be very cautious due to your history and maybe look at a band or balloon instead of surgery as this is a lot less invasive and could give you great results with much less risk.

To me it sounds risky. With a child to care for I wouldnt do this, but it would spur me to lose weight in a conventional way. not easy I know, but what are the alternatives.

I'm not an expert, but to me the fact that you put the weight on over a short period under very specific circumstances suggests that your odds of reversing it by conventional means should be better than average, so you should give that your best possible shot before taking the riskier option.

But do try to get the sleep apnea treated first: it's very tough to lose a lot of weight but it's all but impossible if you're exhausted.

How many years experience do the two surgeons have and how many operations have they performed on someone with similar problem? In your situation I would only stay close to home and ensure the hospital you choose has a critical care/icu. I had the operation and it's been an amazing success I was BMI 41 and I'm now 21 for quite a long time zero dieting needed for me. Ozempic I would have piled it back on long term when I stopped the drug. I'd need it forever and private it's £150 a month. It's been totally worth it but I had no previous abdominal surgeries before.

Ive had a mini gastric bypass 8 yrs ago failed so i had a revision 5 yrs ago to a full bypass i still have issues ive lost 17 stone but left with a lot of health issues i also have a bad eating disorder x in the last 8 yrs ive had 7 major surgeries to my stomach too
its quite good they do all these weight loss surgeries but they dont tell you the long term problems u have afterward I would take advice if they say its to risky then take notice they are saying it for a reason. Good luck with what u decide

Are these surgeons in UK?

what did the 2 who said it was risky say as an outcome?

Did you tell tgectwo who said it'll be ok what the others said?

I personally would go with a surgeon eith experience of your conditions and the op. Be very clear, if it starts to look dodgy, put me right and don't do it. Be clear you want tge surgeon to err on the side of caution.

Good luck x

I had a gastric bypass in 2000, one of the very early ones and in most cases I would say, trust the surgeon, especially if they also do work for the NHS rather than solely private.

BUT having read your story I would be very very wary. It's a big op and maintaining nutrition afterwards, even with no secondary issues isn't easy.

If you are continuing to gain, despite your best efforts then maybe, just maybe - as life risks are high. If you are managing to lose weight, even slowly then stick with it - at least for a while. Maybe re-evaluate in a year by which time you will have hopefully lost 5 to 10% of your excess which, while it won't negate it, will make the risk substantially more manageable.

I know a bariatric surgeon based in Edinburgh, he also does complex abdominal wall surgery. If you really want to consider surgery then I'd recommend speaking to him, if he says it's too risky then it really is

Have you got an internal pouch now? I'd honestly be surprised if the two that have said yes understand pouch surgery as its specialised and most surgeons have never even done one.

As an obese person with GI issues I’d say no don’t risk it. I decided against as is a risk could worsen existing GI issues.

do you have Tier 3 weight loss services where you live?
you would be eligible for a tier 3 ref where I live. Involves an MDT…endocrinologist, dietician, psychologist etc and support to look into causes/ contributing factors to try and resolve long term issues.
possible to progress to tier 4 for bariatric surgery but I appreciate you don’t want under the NHS. Ours are a mine of information and support.

I’m glad you’re taking the advice on board.
Good luck op, I wish you all the best, whatever you decide x

Would your GP let you have the new drug for weight loss Wegovy? I think if you BMI is over 35 and you have another medical issue eg sleep apnoea you will qualify on NHS. You can only get it for 2 years but during that time most people lose between 10 and 20 percent of body weight. During that time you would get a lot of energy and self confidence back. You could do more without getting breathless, so could exercise. You could also really try to limit carb intake and up vegetables and fruit intake. If Wegovy does not work, go for the sleeve but I would really try to make the Wegovy injections work first.

If you had that much abdo surgery I'd not risk it unless necessary - ie you need more surgery for bowel blockage in the future.
Keep further surgery for those reasons only ...you will always be at risk of adhesions & having a bowel blockage.
Don't risk it.

Loose weight another way.

Why don’t you try a gastric ballon first , they last 5-6 months and it’s nothing so drastic or as expensive as the sleeve

With your history, I personally wouldn't risk it. The surgery might be a success as in you don't die on the table or within a certain timescale, but there are plenty of things that could happen that would make your life harder than it is now.

Speak to your GP about the sleep apnea and the possibility of trying Ozempic.

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

I'd see on side of caution.

If you have sleep apnea then you most likely aren't getting proper sleep which will also affect your weight. I'd look to get that sorted and give it a year of decent diet and exercise and reevaluate.

It also gives your current survey sites longer to heal. There's nothing stopping you doing it in the future should things change.

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.

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.

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.

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.

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.

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.

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.