My GP gently mentioned surgery as the next step

[WonderTheWhale]

I’ve struggled to lose weight, and need to shift 4 stone to reach the middle of the healthy BMI range. I’ve tried but even when I’m careful with food and do a lot of exercise I just can’t seem to shift it. My BMI is currently 33.

My GP has said maybe it is time to consider barbaric surgery as an option and said they could refer me, knowing I have genuinely tried other options.

It’s something I really worry about though, how does it fit in with an active job and two young children? I feel disheartened that this seems to be the way forward for me now.

I did think you had to be BMI over 40 but was told there are exceptions and my situation would probably be one of those.

Feeling sad but do want to be healthy and lose this 4 stone for good.

That seems quite drastic for a BMI of 33, unless you have other issues on top?

Check the threads for this but surgery is not a magic bullet, if you have an emotional dependance on food it may not fix your problem. That said, for some people it does.

I’d do more digging -

Has your GP referred you to a dietician / NHS weight loss services? If they haven’t they should do that before surgery is considered.

Has anyone got to the reason that you try to loose weight but you don’t? It’s either a physical reason eg thyroid, in which case that needs sorting, or it’s emotional - ie you cannot consistently stop eating too much so you can’t loose weight.

• if it’s the latter, it’s worth exploring your emotional relationship with food. Ranjan Chatterjee’s loose weight feel great is a good general guide to weight loss that takes in some emotional content. Shahroo Izadi’s the last diet is very good on emotionally managing yourself and weight.

Often people can’t stick to diets because they haven’t sorted their feelings out (and/or because they are doing crazy unsustainable diets) so it is important to work out why weight loss hasn’t worked for you.

It’s also important to really research surgery - some people end up where they started.

I have a feeling your GP may be washing their hands of the problem which isn’t great. Do some research and ask for other referrals if you want them.

I am also quite surprised given your BMI. At my heaviest, mine was about the same as yours. I was deluded as to how much I weighed but I never thought I was in bariatric territory! Do you have comorbidities like high BP or diabetes? BMI 33 is classed as mild or stage 1 obesity. Morbid obesity is over 35.

I am not one of those people who is anti surgery. I think that for many people, it’s the right option and I think that once you get to a BMI over 40 or so, you have quite a low chance of getting down to a healthy size so should probably explore surgical options sooner rather than later.
But… for someone with your BMI, I think natural weight loss is possible if that is what you want to do. What have you tried so far? It has to be something you can do forever. There is no end to a diet. That’s why anything with meal replacements is likely to be a no. I recommend low carb and intermittent fasting. It attacks the root cause of the obesity which is high insulin levels and it eliminates food cravings.

FYI, I was 14 st 7 with a BMI of 32.8.
I am now 11 st 13 with a BMI of 26.7. My target weight is 11 stone (BMI 24.3) but happy with a few pounds above that too. I should also mention, because it makes a difference, that for most of my adult life (I’m 38), I have not been overweight (or not by more than half a BMI point anyway). My weight crept up a lot over the past 5 years due to being sedentary, taking anti-depressants and finding it hard to control my binge eating. If you have been obese for a lot longer, it can be much harder to lose it.

Whichever path you choose is valid.

You don’t want barbaric surgery my lovely.

Do you have other health issues in that they think this is the option you should choose?

I don't think you can have bariatric surgery on the nhs with a bmi of 33. I thought it was 35 with associated health problems or over 40 without. Unless things have changed recently?

I feel really down that she felt that was the option.

I was on antidepressants but have come off them now. I am type 2 diabetic and she said anyone with a BMI over 30 can potentially be referred for surgery if they are also diabetic.

I do a lot of exercise. I cycle, lift weights and run; I have done for a while now and typically will do a half marathon every six weeks.

Food wise I’ve tried numerous diets; low carb, replacement meals, calorie counting, fasting etc. I’ll lose weight for a few weeks but struggle to exercise and then my weight plateaus and I give up. The rest of the time I don’t eat perfectly but equally don’t eat terribly. I do drink too much Diet Coke but it’s not helped giving that up in the past. I will have chocolate most days (the ones where I’ve given up) but never more than one.

I know I’m obese but feel very upset it’s come to this.

Don’t feel down.

If they are suggesting it for your health then listen to what they have to say. It isn’t what most d we oils want but health comes first.

Nothing short of removing everything south of my belly button would make me a normal weight.

I feel your pain. It is hard

D we oils?

That should read ‘of us’.

@SheldonesqueGoddessOfTheMoonah

You don’t want barbaric surgery my lovely.

Do you have other health issues in that they think this is the option you should choose?

What's this advice based on?

Type 2 here too and struggled with getting it controlled, I mean it was very very bad and things were starting to become an issue such as peripheral neuropathy and eye problems.

Went from 18 stone .3 to 12 stone .1 - some I lost by myself but was also prescribed a new medication for diabetes which saw the weight fall off.

Ask your gp about semaglutide or Ozempic as it's brand name. It's changed my life, bmi still 28 but hba1c down from 120 to 60 and still dropping.

It's really new over here but it'll be way less cost to the nhs than bariatric surgery and a lot less dangerous too,

My husband has had it prescribed off label via a private clinic for weight loss as it's being used for that as well as for those of us with diabetes, he's lost 2 stone so far with another 1.5 to go.

I hope this helps a little bit op, I was desperate to lose weight and get healthier as well as extend my life because of the out of control diabetes and I can't say enough how my life has been transformed by this drug. Nothing was working, not insulin, metformin, jardiance - now I take half of the former along with the semaglutide and my bloods have transformed as long as the side effect of losing weight.

I believe it slows down your digestion so you aren't as hungry which is why you are full after eating half the amount you usually would.

Flat disco
No one needs barbaric surgery.

Sounds like the OP has been recommended bariatric surgery.

Different things

The second part of my post was a genuine question.

There’s quite a few of us on a different thread who’ve had surgery so have a read through that. It might give you a better idea of what surgery involves, outcomes etc.

If you’re being offered it on the nhs I’d probably take the offer seriously. I had a BMI of 43.5 and had a flat out refusal from my gp to refer me.

@Flatdisco an amusing typo perhaps?

Use my fitness Pal to record everything you eat and drink. Weigh your food. What's going wrong will be clear pretty quickly.

Your fitness levels sound fab btw!

I discovered an account on Instagram the other day Fatdoctoruk which was like a revelation to me. I really recommend you having a look at it (think they’re on Facebook too) - it opened my eyes to the ways in which weight is used as a tool against you by the medical profession often unnecessarily.

A BMI of 33 is unlikely to see you be accepted for bariatric surgery even in a private setting.

@SheldonesqueGoddessOfTheMoonah

Flat disco No one needs barbaric surgery.

Sounds like the OP has been recommended bariatric surgery.

Different things

The second part of my post was a genuine question.

That’s not true. For some, surgery is the only option because they are unable to lose weight. Type 2 diabetes is incredibly dangerous and surgery nearly always reverses it, almost immediately. It’s not for everyone but the idea that nobody needs it because everyone is capable of losing weight if they set their mind to it is nonsense and is usually based on a misunderstanding of both the surgery and the success rate of normal dieting. Diabetes can lead to blindness and limb amputation and costs the NHS millions.

In private settings you can normally have surgery with a BMI of 30 or above.

OP, it sounds like you’re quite fit with all your half-marathons, so that must be a good thing at least. Could the level of activity be fuelling your appetite? I actually found I gained a lot of weight when training for a run and that walking suits my body better.

To be honest OP, if you have tried everything and your GP is suggesting this for your health, I would look into it seriously and decide whether it’s an option. It’s absolutely not the easy way out but it will kill the hunger cravings that mean that most dieters are doomed to fail in the long run.

@GCAutist

I discovered an account on Instagram the other day Fatdoctoruk which was like a revelation to me. I really recommend you having a look at it (think they’re on Facebook too) - it opened my eyes to the ways in which weight is used as a tool against you by the medical profession often unnecessarily.

A BMI of 33 is unlikely to see you be accepted for bariatric surgery even in a private setting.

No, OP should stay the hell away from accounts like fatdoctoruk. That account is a revelation because it’s so insanely and dangerously stupid. It preaches HAES (health at every size) which is delusional nonsense because there is nothing healthy about being obese. No, the OP’s doctor and the rest of the medical profession is not ‘fatphobic’ - she realises that OP needs to lose weight to be healthy. OP has type 2 diabetes ffs. It literally destroys your body.

For a dose of reality and exposure of how dangerous HAES is, read r/fatlogic on Reddit instead.

Barbaric was indeed either a typo or autocorrect! Bariatric was indeed my GP’s suggestion. My tiny GP is certainly no Conan! I’m 14 stone and she is likely half my weight so I must be huge to her.

I looked at Ozempic which I haven’t heard of before but it seems quite new and untested with caveats that might not be for me.

I had a look at FatdoctorUK and that’s not for me, but thank you. I need to find a way to lose weight. I want to be a healthy BMI because the risks of being obese are well documented and also because it will make me better at what I love most - sport. I will be able to run, swim, cycle better and faster. I want to be a better example to my primary school age children. While fat prejudice DOES exist, and I’ve suffered from it (people will assume Im greedy/lazy but I work out at least two hours a day - I get up 5.30am everyday to start training at 6am and then do an hour after work too), being fat isn’t good for you. It’s not about body positivity, it’s about health. My GP wasn’t being unkind but it still shocked and upset me.

I’m 14 stone and age 46. I’m heavier than I was full term pregnancy with my first 10 years ago. My target weight is 10 stone 7 lbs to be a healthy BMI. All my weight is on my middle - I have lean muscular legs, my arms are also muscular and defined. The weight is all on my front, I’m like an apple extreme!

Hello Wonder I couldn't read and run so just wanted to say losing weight is definitely doable without resorting to surgery. I have gone from BMI 34.7 last October to 27.7 now. Still officially overweight, so still some way to go, but so much more healthy. I can enjoy my hill walking, Pilates and gym again.

I have done it by cutting out all processed foods, and cooking everything from scratch.

Also eliminating sugar and wheat to a large extent and no veg oil, apart from extra virgin olive oil. I've also stopped drinking any alcohol for health reasons. That's not essential.

The weight just melted away. Over three stone gone, a stone and a bit more to go. That will take as long again I think, but I am fine with that.

I then stumbled across a thread on here that is following the same principles ( Why we eat too much) set out in the book of the same name by a bariatric surgeon Andrew Jenkinson.

I hesitate to mention this, because I personally find anything that feels a bit like ' the latest thing' off putting and a bit evangelical. People on here have picked up on it and it has come in for criticism. But the principles work, and are backed up by the latest scientific thinking on weight gain and loss.

@WonderTheWhale Ozempic is fully tested and has just been licensed for weight loss in the US as well as for its primary function which is to help people with both type one and type two diabetes. The same will happen here re licensing for weight loss pretty soon.

My consultant endocrinologist at Bath hospital put me on it because all of his patients have had so much success on it, it's literally bariatric surgery in a pen and you only have to inject it once a week.

I am only suggesting it as it's a lot less intrusive than the surgery - I was desperate and like I said I've lost 6 stone and now am on my way to nearly normal BG levels.

Good luck whatever you decide.

OP, I do a lot of exercise too now, following weight loss a few years back - I was heavier than you. I wonder if you are exercising too much, as pp said? HAs your GP commented on why your weight isn't shifting? It is all very personal but my weight loss came through being careful what I ate and mainly cutting down loads on sweet stuff and booze. I walked masses and built up other exercise slowly. I now train hard - calisthenics (pull-ups etc), running, bootcamps, but tend to lose weight if at all when I am on holiday or taking a break from the intense exercise although I always walk loads and run a bit.

wonder

I wish you well going forward with whatever you decide to do.

Sometimes we just need the extra wee bit help and if it helps your health long term, then it will be worth it.

P.s I love a rogue autocorrect - I’m sorry if I inadvertently upset the balance of your thread. May your petite Conan guide you to where you need to be

I think that's crazy at that bmi, which is also my bmi although I appreciate you have diabetes. Do your research and make your own choice based on the evidence and your feelings. There's a lot of emerging evidence that our gut bacteria influences obesity - and they speculate this is one of the reasons surgery works actually - and there will be better information coming online in time. I would focus on trying to maintain your weight in the lower part of the range your body 'tends to like', so aim to lose 5% and maintain that loss say (achievable and good for health).

Have you tried FAST 800?

@SheldonesqueGoddessOfTheMoonah

Flat disco No one needs barbaric surgery.

Sounds like the OP has been recommended bariatric surgery.

Different things

The second part of my post was a genuine question.

Yeah I'm dyslexic. This can't be cured. But your ablesism can.

Might wanna check yourself. Very embarrassing for you to make fun of disabilities.

How could you have known I had a disability? You couldn't. Which is perhaps why you should refrain from this behaviour.

Hope you feel vastly superior and got the validation that you are most definitely better than me. You obviously need it.

It's weird but despite being ancient I have never encountered anyone saying something gently to me in my whole life. Is saying stuff gently a Mumsnet thing?