Contemplating bariatric surgery.... advice?

[Seriouslyconfused3]

Hi as the title states I am contemplating a gastric sleeve. I am a serial yo yo dieter and my metabolism is fucked. I have pcos and have tried Xenical, saxenda etc- successful until I stop using and the weight piles back on.

I’ve seen an endocrinologist and he said that, in his opinion, sometimes surgery is the only viable option. I’d be paying for it myself as I don’t quite meet the nhs criteria yet.

I’m miserable- I don’t lose weight unless I starve myself ie 600 calories a day and then I’m even more unhappy. I’m worried about my health in the long term, but then the prospect of surgery scares me too.

Any advice from those who have been there before?

That would be good! I'm not sure when we'll be able to get started...

I have fibromyalgia, which may complicate things. I'd have to get advice.

@Addler would also appreciate a pm re surgeon if that’s not too much trouble?

@Seriouslyconfused3 Are you still planning to phone around today? I’m thinking of doing this later in the week, I’m in the South West, it will be interesting to see if there are regional variations in price and approach.

@MonkeysandParrots I’ve submitted a few online enquiries so am hoping to hear back from them ASAP. I’m in the north so will definitely be interested to see how they compare. What procedure are you leaning towards? I was thinking sleeve but now am giving more thought to bypass

I’ve been quoted nearly 14k for one private hospital I can’t afford that!

I'm going to wait and go through the GP.

I was on the NHS pathway for bariatric surgery but was unfortunately turned down because of my mental health.

Your calorie intake will be very low, liquid at first and then puree and liquid. It is possible to gain weight by eating slider foods such as chocolate and many do regain it.

The NHS course is 6 months long to prepare for surgery and I worry about people who go privately and don't have the intensive support before and after since it isn't a magic fix.

@gingerkittykat they declined you because of your mental health?

@Seriouslyconfused3 Still researching but leaning toward a sleeve gastrectomy. Not sure if they will be able to do it as ive got internal scar tissue from previous abdo Ops so I’m happy to be led by the surgeon.

Going to ring around on friday, will let you know how I get on.

I would disagree with much of Gingerkittykats posts Seriouslyconfused3

The only way that 'slider foods' go down and cause calorie increase is if you have a band fitted. The NHS rarely does bands these days for this exact reason. You will be offered a sleeve or a bypass.

If you pour ice cream down your throat with either of those, you will only do it once! (Have a little read of dumping syndrome) and will NEVER do it again. You shake, vomit, and have the most explosive diarrhoea that it will take you hours to clean both yourself and your bathroom (should you be lucky enough to make it there !)

An excellent deterrent and one of the reasons for the bypass and sleeve being so successful.

Mental Health is not a barrier to Bariatric surgery on the NHS . Pretty much everyone who has become morbidly obese (BMI 40+ ) has mental health issues with food at the very least.

There is a psychological evaluation at the very beginning and if the issues are very serious , a psychologist works with the patient to get them to a place where they can be put on to the surgery waiting list. This obviously means a longer weight than the usual six months. Depending upon how the patient engages with the Psychologist. Obviously, in some cases (one lady on our cohort had bipolar and had stopped taking meds) .. she was not put on the list until she agreed to go back on medication. (Obviously she can stop again now she's had it .. but it seems the Op put her in a different happier place and she seems very calm)

I have a group of ladies and 2 men who all had their Ops around the same time. St Richards runs a closed fb page for those on this journey) we meet up every month and catch up with how we are going and encourage those who are just starting down this path.

I really recommend doing something similar.

Hello. I had weight loss surgery (bypass) a few years ago. I had been obese for 30+ years since I developed binge eating disorder when I was 11.

I decided to get surgery when I came across the figures already quoted in the thread about the chances of a morbidly obese woman reaching a normal weight being less than one in 600 based on a 10,000 patient study. Chances of reaching a normal weight after sleeve or bypass, 65%.

I went from 21 stone to 10 stone. size 10. My knees work again, I run for fun now etc, Where I went for surgery, 7 of us were in that week and we made a little whats app group to stay in touch. All 7 of us got down to a bmi below 30 within 18 months of the surgery.

For what its worth this is my experience~

I would say morbid obesity is a two fold problem.

One, you have the psychological stuff that has caused the disordered eating and

Two, you have the physiological issues-obesity changes the metabolism, the body set point, the gut makeup etc.

The reason 'normal' diets, low carb regimes etc do not work well with morbidly obese people is because of the physiological changes of obesity. This is not well understood yet. Do you know if you put the gut bacteria of an obese patient into a thin one they gain weight and if you put a slim persons gut bacteria into an obese patient they lose weight....actually true.

So you get the just low carb/blood sugar diet type suggestions which don't really understand that morbid obesity has made marked changes to the body that will make it hard to lose weight and keep it off and that is why the statistics are as brutally bad as they are

Surgery works because its removing some of these physiological issues. For example, type 2 diabetics are often cured in surgery. Not by weight loss, they haven't had any weight loss at that point, but the surgery disrupts the actions of hormones like Ghrelin immediately, ending the diabetes.

HOWEVER surgery will not change point one (psychology). In fact it might be psychologically harder for you than ever as you now have the same emotional issues and not be able to use your normal crutch of food (suicide and divorce rates climb after weight loss surgery, for example).

Incidentally I have never experienced dumping syndrome, of the other women who had surgery the same week as me only 2 dump, 5 of us don't. 3 of the 7 have started putting on some weight due to eating slider foods due to unhappiness, This is inline with the follow up stats on bariatric surgery that show 40% of patients put weight back on (its called the reverse tick because its how the weight loss graph looks)

So I would say, have the surgery, it will save your life and buy you time to address your emotional problems, but they will still be there post surgery. Its not a magic wand, its a tool. Take it as your best shot and work on the other stuff.

Also is made by the head of bariatric surgery at university college hospital in London and is well worth a watch if you want to understand more.

@Seriouslyconfused3

The person i know should have been declined for mental health grounds. With the crutch of food they turned to other methods of self harm. Yes they have now lost weight but their life is worse than it was before.

I had a sleeve.

Absolutely no regrets although it was pretty tough as I had to work full-time throughout and only managed 5 days at home. It would have been easy if I could have had a fortnight at home and perhaps a reduced workload for a month or so.

Very happy though. It cost 10k which is insane. But I had my reasons and I stand by them. Right now I wish I'd done it sooner and I'm so optimistic about the future.

It's surgery, there's some discomfort and some adapting and you need to be strong and brave because life changes That was all fine with me and I felt safe and like life was changing.

I went with a company that offered driver pick up and drop off. That was brilliant for me as it was a long way to nearest place offering the service.

Thanks @excellentnotion I think I’ve booked through the same place as you. Any tips you could offer?

I think to let them get on with it! Release the anxiety,if you have any, and let them do what they do.

Try allow for some time at home if you need it. I could have done with time off work and driving but I had to go back. That said, if you don't need it, don't use it, get going and get on with life. I was so busy with life I had no time to freak about foods to eat or feeling sick or anything like that 😂 I don't think lolling about obsessing about food and symptoms helps at all. It's a new start, so chuck yourself at it, I say. But you must do what's best for you 🙂

Start learning about and planning forhigh protein food now. You're going to need it!

And good luck whatever you decide and to all of us. Nothing is very easy and it's all about long term effort and discipline. I've no discipline so that is my learning journey!!!

Have you tried slimming world ? I was the same as you but not as overweight with a
Thyroid disease to boot and couldn't lose weight for toffee. I started at the beginning of lockdown and have lost a stone already . This is after 9 years post my son of trying to lose . You don't have to starve but I implore you to give it one last try . You can sign up on line and you most definitely will not feel
Hungry !

How much weight have you lost @Excellentnotion?

@oohnicevase thanks for the advice but slimming world wasn’t effective for me

No probs, I'd be worried about the skin though .. have you a plan for that after?

I've lost 30% of my total weight and am in the healthy range BMI which I'm so pleased about.

Challenge is now keeping it off. But it is off!!

How does the surgery itself stop the type 2 diabetes?

I am not asking because I doubt the statement, just wondering how it works?

@BalloonSlayer , it's not the surgery itself, it's that most type 2 diabetics are overweight, which causes T2 and losing the weight can then reverse T2.

Thanks @invisibletoeveryone for taking the trouble to answer but a pp said that it specifically wasn't that, it goes away before any weight is lost.

Ha ha I have actually scrolled back just now and seen that the pp actually said that so I have just answered my own question! It's a hormone called Ghrelin. Fascinating!

I was wondering if it was that the stomach itself is producing hormones that cause t2 and that when a large part of it is taken out of commission then it reverses it? As I say I am just interested, not trying to challenge.

I had a gastric sleeve two years ago if anyone wants to know anything. I’m 31, can show before and after if you want. I’ve still got two stone to lose but that’s lockdown fever for you.

@Seriouslyconfused3 I’m back, sorry for the radio silence, had a work spurt on.

So ... I’ve booked a zoom consultation for Weds, I’ve also booked in the dietician & psychologist. I feel like I’m out of the starting blocks!

Cost wise, just under £10.5k all in.

I’ll update post with feedback.

@yorkshiremummyof1 definitely interested if you don’t mind sharing?

@Yorkshiremummyof1 I’d definitely be interested in any insights or before and after a you could give. Did you tell people or did you keep it a secret? @MonkeysandParrots no worries- it’s all really exciting isn’t it?