Tier 3 weight management? Surgery?

[lossie1993]

Hi all,
I've been refered by my doctor for the 3 tier weight management course, he didn't really tell me what would happen and what is involved in this. I am 21 stone with a bmi of 50 and have always been very obese from a young age. I am only 24 and Ive been on so many different diets, I do initially lose some weight but always end up putting more on after and they never seem to be a long term thing that I can stick with. I would like to have surgery but not sure what the waiting time for surgery and the requirements to get on the list is? Can Anyone help?

Lossie1993 How exciting! I have just travelled the same road you are about to embark on. I had my operation in December and can honestly tell you it was the best thing I have ever done for my own health.
I was nearly 19 stone at the beginning of December . I am now just under 12 . Having lost over 7 stone in 7 months. I can now walk without pain in my knees , red raw chafed thighs and back pain so excruciating I could only walk 100 feet without having to sit down. I am no longer diabetic. I know longer have high blood pressure. I am no longer a miserable blob living on anti depressants.
I exercise EVERY day. I ride, sail and walk. I do not miss huge meals. I haven't had a cake, sweet or high fat food for nearly 8 months. I have genuinely no interest . Go for it OP. It is scientifically PROVED to be the ONLY long term SUSTAINABLE weight loss method for those with a BMI over 35. You are not alone in not being able to sustain diet and exercise. At your BMI less that 1:640 will succeed and of that tiny percentage. 78% put it all back on and more within 5 yrs..

Tier 3.
The NICE clinical guidelines requires weight loss surgery to be a pathway . In which you are supported and educated about food, your food issues , and the practical side of surgery . Tier 3 involves a 6 m- 12m programme of appointment involving dieticians to discuss your current food likes/dislikes . Good nutrition. You will have an appointment with a clinical psychologist to look at your underlying issues that cause you to over eat. They will discuss the different types of surgery the NHS offer. 1) Gastric Bypass (the NHS gold standard and most suitable for those with a sugar addiction) and my one ,2) Sleeve gastrectomy. Most suitable for people who aren't sugar addicted but for whom portion control is the issue.
At the end of Tier 3. If you have kept to the commitment to attend all appointments- and as long as you don't have major issues with an anaesthetic- they will offer you surgery. They will normally advise which they think is best but you also have a choice.
Following surgery (for which there is a lot of information) the NHS provides 2 yrs follow up.

As your BMI is 50 you may be on a shorter Tier 3 path way.

The very best thing you can do now is to join your TIer 3 hospitals private Facebook group for weight loss surgery. It was invaluable to me. We all support each other along the pathway and post op. Meet up. (Do join a group and meet others who have been through it)
Do NOT listen to ignorant twats who will bleat about it being 'the easy way out' .. 'you just need to move more eat less'. They obviously haven't looked at any of the research by respected academic institutions such as Imperial, Kings and UCL who support this surgery as both the MOST effective method of weight loss as well as a huge saving to the NHS where diabetes treatment alone costs £1m a day.

Good luck OP. You are on the path to a much happier life !

Whatever you decide op good luck, just a bit of advice that I hope doesn't come off as patronizing. The surgery is just a tool, not a magic wand. We see people all the time who weigh more afterwards because they're going back to old habits.

Hi OP. My GP referred me to tier 3 weight management last March. I started the weight management group sessions in around August, and I have just been referred to MDT for them to decide whether I'm eligible for surgery. I was exactly the same weight and BMI as you, and I have very slowly lost about 1.5st since I started the group sessions. It is a long and difficult process. I'm hoping to have a bypass.

@fontofnoknowledge thankyou for your very informative reply! This excites me as I have never ever been able to lose that much weight and I really need to. I've had 2 children in the past 3 years also which hasn't helped with trying to diet or exercise, I know it's a long process and not just a quick fix and I am willing to put everything into trying to lose weight myself but I just know in my heart I will never lose the amount of weight I want and need to. How long were you on the 3 tier management before you were put in a list for surgery and how long did you have to wait on the list before you got the surgery. A friend of mine recently payed privately for the gastric sleeve and Ive researched slot and think this would be my best option, also where did you have your surgery. Thankyou

Hi Lossie1993 .
I was on the Tier 3 for 6months. I was fairly unusual in that I had only put on weight over the last 8 yrs due to steroid medication . I became very depressed about it and was put on an anti depressant called Mirtazipine which is now used as an appetite stimulant in the elderly ! This stimulates the desire for carbohydrates.. and I became a massive over eater of starchy carbs. At age 46 I was 10st where I had been all my adult life. After 3 years of predisalone (steroid) I was 14 stone. After 4 more years of steroids and mirtazpine I was 19stone . It was awful. I had been at weight watchers and slimming world and lighterlife and xenical ... lost 2 gained 3. Lost 3 gained 5.. and so on . ..

I was on Tier 3 for 6 months. It took 8 weeks for the appointment and I had my MDT (multi disciplinary team) meeting in August and had my Sleeve gastrectomy in December. At Chichester. St Richards.

I had also done a LOT of research. I also had no issue with admitting that I was fat due to my own over eating.

I advise above all to educate yourself about nutrition AND the two types of surgery. Do not be tempted by a band. They slip.. and if you are a sugar addict you will find a way round it by liquidising chocolate/ice cream/bad stuff. If you have a sleeve or bypass you will only eat bad stuff once unless a diabetic hypo-type reaction and explosive diarrhoea are things you want to live with for life.
Last night at work I literally sat next to a massive chocolate cake. All I could do was think how horrible being fat made me feel.. never tempted . In fact repulsed ...

How refreshing to have weight loss surgery on Mumsnet..I think it's far more popular here in Australia.. I had a gastric sleeve done 18 months ago. Best thing I have ever done!! Love it.
Go for .. best money I've ever spent is all I can say!

I’m booked in for a sleeve on the 19th September. I think weightloss surgery gets some unkind comments here on mumsnet, which is a shame as I know it can be a great place for support.

Thankyou so much for all of your kind responses, @sammi38 how long was your whole process from being referred to being put on the list? If you're going with NHS?

@lossie1993 I’m actually going abroad for surgery ( frowned upon I know), but I’ve done my research and am happy with the choice I’ve made.

I wouldn’t have qualified for surgery in my trust, and privately was over £10k, and I couldn’t afford that at the moment.

I had a MGB 9 weeks ago and its the best thing Ive ever done for me. Within days I was off my pre diabetes medication and Im feeling and looking better than I have done for years.

One thing though, I know its common for people to decide what operation they'll have but personally I'd leave it up to the surgeon to suggest what would be the best thing for you.

I don't live in the UK and I had my surgery done privately two weeks after making the decision to have it done. I was fed up getting up every day and thinking of food and losing weight from the moment I opened my eyes. It was making my life a misery even though Id lost 12kgs over a year. Granted I still wake up and think about food and losing weight but its now in a very positive way.