Bypass or weight loss injections

[strawberryhearts2]

I have been on the NHS weight management programme and have worked with them for over a year, then I have had 7 months on my own, when I was referred and scene by the tier 4 team.

In 19 months I lost 3st 7lbs with changing my diet/eating habits and exercise. I then have been on mounjaro for 3 months on a low dose and lost a further 10lbs.

I have been offered a bypass on the NHS and I can have it within the next 3 weeks. I had to have some tests before the surgeons decided on which surgery, as I have problems swallowing and have been diagnosed with a lazy oesophagus (achalasia). They have said they I am suitable for a bypass and I can now book in and have in 3 weeks.

I have been overweight almost all of my adult life and I am now 50 and post menopausal (I went through menopause in my early 40s). I currently have a BMI of 35 and wearing a size 16 (UK) clothes. I did have a BMI of 48.

I really don’t know what to do, whether to have the surgery, as I am lucky to be able to have it on the NHS, but I have worked to get to here (nearly 3 years from referral)? Or to carry on with self funded Mounjaro, which I on a low dose due to my achalasia and slow digestion, losing about 1lb a week? I am happy with a further 3.5 stone loss and will get me to a BMI of around 28, which I will be happy at. I do feel like I am in the right place now do it myself, but just worried that it has been slow progress and only now at a 4 stone 3lb loss I am able to see the weight loss so far. Looking at photos though, I still know I have a long way to go. I am also thinking what will be best for me long term? I also worry about complications of surgery.

Is there anyone else had a similar dilemma?

Thanks

I've been referred for a sleeve on the NHS, having paid privately for years for weight loss injections.

I've decided the surgery is the best option for me.

I did lose weight on the injections but I was an extremely slow lower. So slow that it felt like I was still at risk of obesity related incidents, and would be for years more until I'd managed to shift the weight. I only lost 6kg average over 1 year, and I'm doing this for my health, so I need to shift this weight faster than that.

Another reason I chose the surgery is that a majority of people on WLI regain the weight and the NHS only subsidise the WLI for 2 years in my area. That's again no good to me.

My DP also developed pancreatitis while on WLI. I don't want to say it is entirely down to the WLI, and theres also a risk of developing it with WLS too, but again because I was having to take them at such high doses for so long, it felt like a matter of time before that became an issue for me too.

There are so many pros and cons to weigh up it's very person specific, but I feel like it's time for a permanent change, and that means drastic measures.

I wouldn’t have the bypass , you’re no longer morbidly obese and size 16 is an average size. The. bypass is something that’s going to impact the rest of your life , much better to stay on Mounjaro and continue to work on healthy eating patterns and exercise

My bmi is 38 and I got the call on Wednesday to say I’m going in for a bypass and gall bladder removal on the coming Wednesday, so just 6 days of liver reducing diet. I’m looking forward to starting the next stage but I did have a few wobbles on the journey. For me I’ve always been able to lose weight, but never been able to keep it off long term. But this offer of surgery has pretty much matched perfectly with a diagnosis of ADHD so I’m really hoping that things are about to change for the better.

No judgement but It sounds like you could lose much more on WLI if you ate better ( more protein, veg, less rubbish), exercised (which isn’t mentioned at all), and perhaps upped the dose. I would personally do this over surgery x

Thank you for the advice, that is the way I am leaning towards. I only have 4 days to decide now. As the hospital is going to take me off their list.

Superstar22, yes I exercise swimming mainly. I haven’t been very active since I started mounjaro as I have had surgery 1q weeks ago, but have been given the ok to start again. My diet is good now and has been for the last 22 months and that has been the main reason I have lost the weight, but I know I can do better still.

I’d think of the long term and have the bypass, I say that as someone on Mounjaro as well.

You should look at insta for stories about gastric band stuff
it’s a big life changing thing to do and your new belly might not tolerate some of your normal foods
its up to you

I absolutely wouldn’t do the bypass in your situation. Mounjaro is working for you, you might still be overweight but a size 16 isn’t likely to be life threatening and you’re heading down. I really wouldn’t take as bigger risk as surgery at that size

What did you decide to do

I decided to cancel my surgery and I am going to try Mounjaro for a few months and up my exercise. I have given myself until November and if I am not successful I will have the bypass surgery.
Thank you all for your advice :-)

I think that it’s a good idea because surgery is a permanent solution so you need more head space to think about it

How are you getting on, I spoke to a surgeon today from weight management service, they're offering me a bypass, told me to try jabs first. Curious how you're getting on. Thanks

I only ended up staying on Mounjaro for 3 months, as it was making me poorly. I have been doing well just with the lifestyle changes I made, by the change of my diet and exercising. I have now lost 5 stone 12lbs and my BMI is 32. I am slow and steady and will be happy losing another stone and a half. I also have quiet a bit of lose skin on my body, so know that counts for some of my weight.

Great that you have been offered the bypass, how are you going at the moment with your weight loss?

Just to update mine on this for anybody that’s stumbled across this.

i had surgery on the 13th August. I was scared and oh so nervous but its the very best thing I’ve ever done. And thank God I did as my gall bladder was in a terrible state. I was just a day or so away from sepsis and I was so used to feeling under the weather I didn’t even realise. It was about to burst as it was filled with infection and jammed/blocked with stones and had gone necrotic and caused adhesions etc. Very very lucky.

Anyway, recovery was great. Back to driving at 12 days after surgery, back to pretty much normal by week4. I have struggled at times/stages with introducing new foods and had to go back a step for a week. I’ve had dumping once and the foamies 3 times . My main source of protein now is prawns, lamb and cheese/yogurt. Beans/peas for fibre with fruit. Chicken can be oddly hard to digest and desire being almost 7 months post op my portions are still pretty small. I can’t eat rice, bread, or airing that Is likely to swell in my stomach as it just refuses to digest and causes pain.

A day typically looks like a a heated tbsp of Greek yogurt, a small handful of berries and a heaped tbsp of mixed chopped nuts. Lunch is soup or king prawns in sauce and possibly a small piece fruit. Evening meal is shepherds pie and veg/fish in butter sauce with peas/ chick pea or butter bean curry . Snack is max twice a day peperami/cheese string/dunkers/fruit.

I’m now down from 17st9 to 12st1 and gone from a 22 to a 12. I’m just 15lb from a healthy weight range and I feel amazing. I look 10 years younger and my entire body is grateful for the change, my blood work is great too. I am just sorry I didn’t do it a decade before.