I've been offered gastric bypass....

[CherryPie3]

And I'm scared stiff!!

I went to the doctors last week with some minor chest pains and also to find out if I could be referred to a dietician to help me shed some flab.

He said the pains are nothing to worry about but my weight is a problem. I weigh about 19st (I know I know...) and my bmi is 41. In my family there is a history of obesity, diabetes, high blood pressure and heart disease and me being hugely overweight puts me in a high risk category (apparently). I'm 26y old, I have 3 beautiful children and I want to be here for them as they grow up - I do not want to end up in a box!!! My dad had his first (of 4) heart attacks aged 39. He had to have lots of surgery and still had 3 more heart attacks, the last one killed him on 2008. He was 68.

I have been overweight most of my life, at age 12 I was a ladies dress size 14. I have been on the slimming world diet for so long I barely remember how to eat 'normally'.

What do I do? What would you do? I'm scared to death of surgery as I saw my dad go through so much of it.

:(

Oh CherryPie sorry to hear you're having such a difficult choice to make
I would say go for the bypass - don't think it's as complicated and risky as heart surgery (did I understand correctly, is that what your dad had?)
It's probably a good thing that you were offered the operation, the doctors must think you have good chances for success especially now you're young.
In my humble opinion it's much better to do this now - the earlier the better, more of the rest of your life to enjoy with your beautiful DC :)
And think that it will save you from going through all those things that happened to your dad!

Not much advice to give but please don't feel scared of surgery - how about having a chat with your GP again or accept a referral - you'll get an appointment with a surgeon to talk things through, and you can say no but at least you will have all the info then.

have you tried any weight loss /slimming clubs ? it's probably worth doing before surgery?

Oh Cherrypie I?m so for you ? have you lost weight on SW? I looked at it when I started my diet and didn?t think I would loose anything on it due to fact that large portions of carbs are allowed. I assume you are not loosing significant amounts or otherwise the DR wouldn?t have suggested the bypass?

Sounds like the bypass is a good idea from your health point of view, if other diets have failed. Presumably you?ve ruled out (or tried and failed) with diet options that are more extreme than SW like meal replacements/no carbs? However gastric bypass surgery does have (quite big) risks associated with it, and although they are smaller risks that remaining overweight (otherwise doctor wouldn?t have suggested it), IMO I don?t think it?s a good idea unless you have exhausted all other possibilities first. Also from a practical point of view after a gastric bypass you can?t eat much, so would be much better to eat less without the surgery. Also the surgery isn?t a magic answer, some people through overeating manage to stretch the small amount of stomach and gain the weight they have lost.

Technically you could loose around 1 stone per month? (3.5lbs per week) so how about setting a day for the surgery for 6 months time, with the idea that if you loose 5-6 stone or more by then you?ll delay it another 6 months (again with a new date and a new target (another 4-5 stone). If you haven?t lost all the weight then you?ll have the surgery. That way you have a massive incentive to loose, and not really any scope to cheat. Actually set a date and have a target agreed with doctor. If you find you can?t stick to it then bring the surgery forward.

In terms of other options ? have you tried Paul Mckenna or Slimpods ? I think you need to listen at least once a day (although probably better twice a day?) for it to make a difference ? and do it in conjunction with another weight loss programme (currently I am doing Dukan & listening to Paul McKenna to help with willpower each evening & doing 30 day shred DVD, although you might need something more gentle initially). In terms of willpower I think that very low carb diets, either new atkins (nerris/india) or dukan are probably easiest to stick to but you might get better losses from a meal replacement programme. If you have tried these options with no success then perhaps yes you need to have the bypass sooner rather than later.

Thank you for your replies, :)

tryingveryhard thank you, yes it was heart surgery that my dad had, lots of it - triple heart bypass and 3 pacemakers. So many hospital stays.

diablo that's what he's recommended I do, well to see the nurse, so I have an appointment with her on Thursday morning.

lulu I have been to numerous clubs and been on a load of diets. Slimming World is my favourite as it's foods I adore and it's the only one that I was ever successful at, it did work for the first year. I wouldn't mind not losing the weight if I cheated but I've stuck to it, kept within the syn recommendations,

maybe it's the best thing.

forever I'm not exactly sure what other avenues there are - wouldn't the doctor have suggested them first to avoid costing the NHS £10k? I did do Atkins but really struggled with it and lost no weight at all. Itt exhausted me and I started craving pasta and potatoes. These are 2 of my favourite foods which is why I went for SW and it did work for a while bit I lost only a stone in a year, even though I kept sticking to it no more weight shifted.

Bit sceptical of hypnotherapy, has anyone used this successfully?

Has anyone had a gastric bypass?

DH was 19-20 stone, he's been 17 + since I have known him (7 years) but lost some with diet & exercise but got stuck at 17 7, despite really hard training 3-4 times a week. We have both started the cambridge diet - it's 3-4 shakes or soups (or porridge) a day and I have lost nearly a stone in 2 weeks and DH is on target to lose 2 stone in 2 weeks. It's not perfect, but probably safer than a gastric band. Have you been referred to a dietician/ subsidised gym memebership etc?

SW is abit rubbish to be honest, it's not balanced. You say your two favourite foods are pasta and potatoes - I used to eat alot alot of carbs and although never ate junk really, the weight crept up. Your body will burn the carbs before it burns off your weight - the more carbs, the more it has to use up before you lose weight.

Wow ASLD that's brill - well done! :)

Cambridge diet eh? Can I have a little more info please? I'll mention it to the nurse on Thursday.

X

www.cambridgeweightplan.com/?gclid=CJvW09juracCFYFB4Qod1lAqnQ

It's basically very low calorie, but with getting all your vitamins/minerals. It's max of 12 weeks on stage 1 (sole source). It's hard, but the hunger/cravings disapear and you are spurred on by your weight loss :) I went as high as 16 stone before I was pregnant with DS2, was 14 -14 7 after DS3 (8 months) and am now 12 7.

But honestly, you cannot live on mainly carbs. I went to SW and was told on the red (?) days I could eat a whole chicken if I wanted. That is alot of fat, even if it is chicken! On weight watchers you could theoretically eat mars bars all day if you stayed in your points allowance...

Our local gym is cheaper if you have a GP referral - I'm suprised he went straight to suggest gastric band , especially since you are only 19st!

No doubt whatever you do, you need to get in exercise (swimming or walking is great too) - DHs dad and grandad died from heart attacks so it scared me so much to see him at 19 stone, but now he is doing exercise he blood pressure has come right down from danger levels. His dad and grandad ended up slim, but obviously exercise will make your heart stronger and healthier whatevr your weight.

The problem with SW, is that it doesn't do anything to curb the volume you actually eat. You can eat and eat the free foods until you have eaten so many calories that of course you aren't going to lose any weight.

If you feel that you've tried and failed at various diets then the bypass could be an option, but remember that you will still have to learn new eating habits after the surgery otherwise you will end up back at square one.

Did he mention counselling or anything like that to get to the bottom of why you eat as you do?

I do sympathise - I've been overweight almost my whole adult life, although the highest I went was 15st. It is very hard when you know it is going to take a long while to lose all the weight you need to.

My job sharer is on Slimming World and I started WW at the same time - about 4 months ago. I've lost just over two stone, she's lost 3lb. I eat a tasty wholemeal and tuna sandwich, a small choccie bar and lots of fruit for lunch and she ploughs her way through a massive tupperware box of pasta with chopped tomatoes and peppers in it (no dressing!) It looks like torture to me!

I'd give WW a try before surgery. It's a good, balanced diet, with lots of variety and of all the things I've tried (and I've tried many, many things!) it's the only plan that feels sustainable to me. Very low calorie diets miht be ok for a quick fix, but don't IMO give you any kind of template for learning to eat sensibly and moderately for the rest of your life and personally I don't think it's just about how much weight you can lose now or next month, but about how you can change your eating habits for the long term.

My local authority offers free WW vouchers (12 weeks' worth at a time) through the Change 4 Life programme. They will only send you more if you've stuck to the plan and lost weight. It's a godsend for people who are worried about their weight and short of cash. Ask your GP about this.

Sorry, that all sounds like an extended advert for WW. I promise I don't work for them - just a bit of a devotee!

That should be local NHS Trust (not local authority!)

"It exhausted me and I started craving pasta and potatoes. These are 2 of my favourite foods which is why I went for SW"

Well you have answered your own question - you are addicted to carbs and thats why you can't loose weight with SW as you will gravitate towards pasta and potatoes and eat big portions, hence not loose any weight.

Ok, so low carb doesn't agree with you as you were exhausted. But have you ruled out both weightwatchers (or any other calorie controlled diet) or as ASLD suggested something like the cambridge diet. Both will work if you have the willpower to stick to them. Hypnotheraphy IMO only work (for the extreme loss you need) in conjunction with something else. I find that if I listen to Paul McKenna I can resist picking much better than if I don't listen.

I suspect the doctor suggested surgery as you HAVE to loose the weight and you haven't been able to loose it yourself.

I say all this as the surgery does have risks, and you will have to eat small amounts afterwards, it would be better all round if you could loose without the surgery. And after the surgery what happens if you crave carbs???

My weight loss wasn't as extreme as yours (BMI of 30 at start), but in some ways its harder because I didn't really HAVE to do for health reasons. I have just watched the Biggest Loser on TV all with weights similar to yours and they all lose loads with working out (I was surprised by how much they could manage) and with sensible calorie controlled diets.

I remember watching a programme about gastric bands once and there were a couple of people whose weight crept back up because they gradually ate more and more despite the bands and stretched the capacity of their stomachs . The band made them feel full but it didn't stop the cravings .

If you crave carbs then SW is not for you. Have you tried basic calorie counting programmes eg WW, as mentioned? As Forever has said, you could combine it with Paul McKenna to control cravings/appetite.

Cherrypie - it all boils down to this - do you have the willpower and determination to do a calorie controlled diet & exercise (even if you feel a bit exhausted) or do you not have the willpower and therefore need the surgery.

(That was why I made the original suggestion of booking in a date for 6 months time to give you a massive goal.)

I've been doing SW for 5 mths and lost over 2 stone, you can eat more than pasta and carbs

I think though, even if you have a bypass , once it's settled dwon , you can 'cheat' at it, and you might lose a lot of weight but also worth addressing food issues via counselling etc

whatever you decide, good luck !

Forever - I didn't realise I had asked a question . I'm not addicted to carbs and I eat average sized portions - I'm not greedy. :(

I'm interested in the Cambridge diet, is it like slim fast? Cos that was horrid! Tasted like corn or something, made me physically sick. I certainly don't have any inclination to continue with a diet that makes me I'll.

I appreciate all your replies, and please be assured I'm taking them all on board but I'm still going to see the nurse on Thursday, I've spoken to my mum about it and she is strongly encouraging me to go for it. She's as terrified as I am about me ending up dead. :(:(. I know there are risks to surgery, and believe me this is not something I thought I would ever do. I have thought a great deal and googled a lot!! At my appointment with my doctor last week the bypass was never mentioned - he called me out of the blue this morning, makes me think he think it's the best thing. I know as well as he does that the weight needs to go, but he could have just referred me to the dietician as I requested. Seems to me it's his recommendation to skip that.

Despite all I have just typed I still don't know 100% what I will do. I'll wait until after I've spoken with the nurse before I say yay or nay. If she is in favour of bypass it's likely I will agree to be placed on the waiting list.

Please understand I really appreciate your responses and will be mentioning all relevant points and diets on Thursday.

Thank you all :)

Cherrypie - I'm really sorry if I offended. I was trying to offer support. I didn't say you were greedy, just that if you want to loose weight you need to eat small portions not average sized ones, and that even on a diet that includes carbs the portion sizes if you want to loose weight will be small.

Most people are addicted to carbs, they are highly addictive, not sure why that was offended. You said yourself you crave pasta and potatoes. I was definately addicted to carbs before my diet, and TBH I probably still am. Just I am managing to control and resist the cravings.

Although I am now giving my diet a kick with dukan I started off just doing straight-forward calorie counting, 1200 calories a day.

I had 3 "normal" meals but they were small meals, eg

40g of shredded wheat for breakfast with 30g skimmed milk
banana midmorning
2 slices of bread with low fat filling - eg tuna mixed with diet dressing plus fat free yoghurt & maybe salad for lunch
apple mid afternoon
dinner 40g uncooked weight wholemeal pasta or rice plus 100g steamed chicken plus steamed veggies for dinner.
perhaps another fat free yoghurt later in evening.

As there are significant risks with this type of surgery its usually recommended only for patients who can't loose the weight any other way. The risks include risk of surgery going wrong and also the risk that the weight is put on again because whats left of the stomach is stretched.

So when deciding whether to have the surgery, and accept those risks, there needs to be an acceptance that its not possible to loose the weight within the timescale any other way. That is why its a question.

FWIW my friend had a gastic band (I know not the same) and she ate more than she should and it burst so back to square one for her.

If you go for surgery make sure you will get proper support and follow up afterwards, it is not a quick fix solution.
The NICE guidelines recommend it because it is cost effective compared to the cost of treating the disease caused by obesity.
You need to be sure you have tried all other weight loss avenues and understand the long term implications of surgery.
Good luck with your decision.
FWIW i would probably go for the surgery.

forever it's me who should be sorry! I think I'm just oversensitive with my weight, and I get defensive. I'm very sorry xx

We eat a lot of chicken and vegetables, more so than the pasta and potatoes - I think I craved them because I wasn't allowed them, not because I eat them all the time. I love shredded wheat! In fact your daily meal intake sounds yummy (would definitely have to sub the tuna tho).

2 people I know have had the bypass and they look amazing, and they're not even 2yrs post op yet! It worked better for one than other but the doctors have said it's her age age as she's 64, the other is 42. They were both in similar situations to me with medical issues, they both had diabetes and high blood pressure although neither was high risk for heart disease (which I am). The hbp and diabetes have gone now, and the older ladies arthritis has improved.

At the moment the benefits seem to out weigh the negatives. I don't want to have a heart attack in my 30's, or at all! I may not be as 'lucky' as my dad and survive 3! The first one may be enough :(. I can't risk staying this fat when I have my beautiful precious children needing me. They are aged almost 6, 5 and 8m. In fact I'm still bf the little one. I am sort of planning another baby in a few years (not set in stone due to reluctant dh :)))

FWIW my dad wasn't overweight when he had the first heart attack, but ended up very heavy because he could exercise later on due to severe breathing difficulties.

ggirl I agree with the follow ups being important, to keep you on the straight and narrow :). Thank you for your reply.

XxxxX

forever it's me who should be sorry! I think I'm just oversensitive with my weight, and I get defensive. I'm very sorry xx

We eat a lot of chicken and vegetables, more so than the pasta and potatoes - I think I craved them because I wasn't allowed them, not because I eat them all the time. I love shredded wheat! In fact your daily meal intake sounds yummy (would definitely have to sub the tuna tho).

2 people I know have had the bypass and they look amazing, and they're not even 2yrs post op yet! It worked better for one than other but the doctors have said it's her age age as she's 64, the other is 42. They were both in similar situations to me with medical issues, they both had diabetes and high blood pressure although neither was high risk for heart disease (which I am). The hbp and diabetes have gone now, and the older ladies arthritis has improved.

At the moment the benefits seem to out weigh the negatives. I don't want to have a heart attack in my 30's, or at all! I may not be as 'lucky' as my dad and survive 3! The first one may be enough :(. I can't risk staying this fat when I have my beautiful precious children needing me. They are aged almost 6, 5 and 8m. In fact I'm still bf the little one. I am sort of planning another baby in a few years (not set in stone due to reluctant dh :)))

FWIW my dad wasn't overweight when he had the first heart attack, but ended up very heavy because he could exercise later on due to severe breathing difficulties.

ggirl I agree with the follow ups being important, to keep you on the straight and narrow :). Thank you for your reply.

XxxxX

Ooops

Here, have some
xxxx

I'm coming at this from the view I think you are very brave to consider it as an generap whilst very overweight is my biggest fear and the reason my gallbladder hasn't been removed. Someone I know had one and it made me realise that if I didn't do something, I would be in the same boat and that for me was my trigger in starting to lose weight.

It always sounds naff to say weightloss is a journey but when yoy get going you realise that it is true. Mine started middle of July last year, practice nurse referred me to SW. I still go to SW to weigh but follow WW's as their Pro points plan that was launched in November suits me much better than SW or the old WW points. 7.5 months down the line I have lost 3 stone 4.5lbs, my BMI is down from 42.7 to 34.7, my blood pressure has gone down, I exercise regularly and feel SO much better. I still have a long way to go but I am going to do it. Having a bad week this week but I will keep plugging away and will get there in the end.

Carbs are a problem for me, I still have them but have reduced my portion size significantly and increased the amount of protein I eat, cooked breakfast works really well for me. I still have binges, had one last night, but they are much much less and I have learned not to let them sabotage what I have achieved.

Why don't you ask for a referral to WW from the practise nurse? You get 12 weeks which is enough to make quite a difference. There's a WW thread in here which is very supportive and fast moving which means there is usually someone around in moments of crisis to help get you back on the straight and narrow. You can do this, it's getting your head in the right place, finding the right diet for you (if not WW, then mayve Dukan, Pig to Twig, Food Focus, Paul McKenna, there will be one yiu click with) and taking it pound by pound. Doesn't sound a lot but one measly little pound a week is 4 stone in a year, lose that and you will feel fab. Surgery will remain there as an option but make sure you have properly exhausted all others first.

CherryPie - I had a gastric bypass 18 months ago after exhausting all other attempts to lose weight. I weighed 17.5 stone and paid for the op myself as I didn't qualify on the NHS. It's definitely not a miracle cure. The first few months are fine and some people find that their tastes for different food actually change, or that they can no longer tolerate certain foods. However, for me, my (almost uncontrolable) cravings for the "wrong" things have never gone away, and although I now have a small stomach and can't eat giant meals, it's a constant battle to stop myself grazing all day and consuming just as many calories as I used to.
I lost 5 stone pretty quickly, but hit a wall at that point and whilst I would love to lose another 3 stone, at the moment it's all I can do to stop the weight going back on.
I expect this will be a life-long battle for me and whilst I am grateful for the weight loss I achieved from the bypass, I'm still overweight and back to counting calories.