Bypass surgery Vs Wegovy advice

[Bristolandlazy]

I've got a consultation with the surgeon for a bariatric bypass later today. I've been waiting years for this and thought it was the answer. I've spoken to the dietician and the psychologist but also read more about it online and I'm having doubts.

I started on wegovy five weeks ago, I've only lost a few pounds. I don't think it's working for me yet as I don't feel any different.

I'm thinking of asking to postpone or even lose my place on the list for the operation. Has anyone got any experience that's relevant? The dietician told me it's very unlikely I would get the result I want.

I'm at a size 22 (biggest I've been is a 24) and I would like to be about a 14/16. If I lost anymore than that I think I would have a lot of excess skin. I'm 52 if that's relevant.

I want to lose weight for appearance, bodily comfort and health reasons but I'm happy to lose it more slowly if that's what it takes.

I've read of people losing amazing amounts of weight with jabs and I'm hoping that's possible.

Thanks.

Although people loose weight on the medication most regain if the medication discontinued.
Are you prepared financially to take this medication very long term?
most people loose 20% will that amount make you reach your goal?

The quoted 20% is not correct for Wegovy, and it would be an average from the clinical trials rather than an individual limit for weight loss anyway. The average weight lost on the clinical trials for Wegovy was around 16% for those people who were on the highest dose (at the time) of 2.4mg. Some will have lost more, and others less. Some won't have lost any at all.

@Bristolandlazy When you say the dietician told you that you were unlikely to see the results that you want, what did she mean? Is that in regard to bariatric surgery, or to using Wegovy or something else?

Have you checked the regain rates for the kind of surgery that you're potentially being offered? It's not the case that the surgery means you will lose weight and keep it off, as many as 50% of people regain weight. Plus there's the risk of the surgery itself, the recovery afterwards and the risk of post operative complications too.

It's a tricky situation, because if you find that you don't lose much weight on Wegovy but you've turned down bariatric surgery then you won't have that option available to you.

What weight are you now, and how much weight do you need to lose?

The dietician who I was speaking to from Nuffield who do bariatric surgery said I wouldn't be likely to get the result I want with Wegovy.
I'm 23 stones. I would like ideally to get to 12/14 stones. I also spoke to my GP who said he thinks that jabs/the pill version that's being trialled in other countries will replace bariatric surgery.

I half thought that both were the magic fix until I read more about them. I realise self control, dealing with emotional eating and eating more healthy are the answer with either.
I'm on a gastric group on Facebook and plenty of people say it's the best thing they've ever done. Also people who have regained and/had health complications.

The thought of having a permanently restricted diet is daunting.

It's a gamble I guess, will the injections be cheaper in two years (the NHS will fund for up to two years provided weight loss targets are met) if I come off the bariatric list will I regret it. It's frustrating timing to have both options at once. Thank you for your comments, appreciated.

The patent for Wegovy (injections) in the UK will expire in 2031 and that's when cheaper generic unbranded versions of it will legitimately become available. So it will be a while before they are cheaper. The Wegovy tablet is not likely to be much cheaper than the injections. There is another tablet, orforglipron which will be marketed as Foundayo, coming in 2027 which is a different GLP1, but it's also likely to be around the same cost as the injections.

Unfortunately, I wouldn't bank on GLP1s being much cheaper within the next 2 years.

Are you self funding the Wegovy or is it an NHS prescription?

Ah that's very interesting. No I'm not self funding, I couldn't afford it at the moment. Would be down to will power and exercise etc then to maintain any weight loss.

I turned down weight loss surgery for mounjaro
I've since lost 11 stone ..no major loose skin as yet
I funded it myself..I still have weight to loose .
My reasons for turning down the weight loss surgery,was I'd had my pre op assessment and been approved and told op would be in 6 Months time .
Then just before I got an email saying due to COVID /. waiting lists ,it was going to be another 5years wait .
I didn't think I'd still be alive in another 5years ..so I went on monjroro
After significant loss ,I was told I wouldn't meet the criteria if I lost any more weight.
I would never of chosen to have weight loss surgery at the weight I was when I turned it down ,as it felt unnecessary,and I was worried about not absorbing vitamins as I have a limited diet .so I chose to come of the waiting list .
So yeah ,I don't regret it ..I eat well now ,I exercise every day ,
Definitely recommend injections

If the NHS will do you a Wegovy prescription for up to 2 years, I think I would be inclined to go with it and forgo the bariatric surgery. That's assuming that the Wegovy seems to be doing something at the moment, presumably you have just moved onto the 0.5mg dose? That's when you'd expect the effects to be noticeable and for weight loss to become easier. Having said that, some people need the higher doses to get the full effect. About 1 in 10 never really get any weight loss from it, but you can't tell until you've been on the highest dose for a while and still not seen any weight loss.

I tend to take the predictions about average weight lost as a rough guide. I am taking Mounjaro and have gone way past the 20% of starting weight lost, so I know it's possible to far exceed the clinical trial results in a real world situation.

Personally I would give the drugs a bit more time as you can stop taking them but you can’t stop the surgery once it’s done.

Having seen a friend go through the surgery and then abuse it afterwards, I would personally avoid it if you can.

There is no way I’d go for surgery if I could get two years of the jabs. I can’t beleive anyone would. Surgery has a 60 percent regain rate. Either one you can regain, I’d use the time on the jabs to get in better eating habits, lose the weight. And yes things will likely be different in two years.

andive no idea why anyone would think you can’t get the result. I lost 6 and a half stone on mounjaro, most people get the result.

That's amazing, well done you, what a life change. A complete change.

Thank you for your comment, that's really helpful and inspiring.

Yes my dose increased to 0.5 last Sunday and I've only felt a slight difference. Thursday was the first day I felt a real difference and didn't eat much. On Friday I had a zoom appointment with the surgeon, so it was frustrating timing. The more I read about bariatric surgery the more I hesitant I got.

I've taken big steps with my eating. I cook from scratch most days and avoid foods that I feel difficult to control myself around. I eat more salad and vegetables than ever before so Wegovy hopefully is the tool I need.

Thank you for your comments, you seem very informed and it's very encouraging to read what you've done said.

Many thanks I sincerely appreciate your thoughts.

Thank you yes, I've thinking that more and more. It was unfortunate timing as I've only started to feel the effect of Wegovy Thursday this week and the zoom chat with the surgeon was on Friday. I told him I want to give Wegovy a good try and he thought it was a good idea.

Yes I was shocked he said that, I did have in my mind that he was speaking to me on behalf of the surgeon etc so not sure he's impartial. I have read more and more about people having lifelong health complications which is very concerning. Plus as you say the risk of regaining. It was easy to tell myself I would stick to all the rules but clearly everyone doesn't and I haven't in the past or weight watchers etc would of worked for me.

Thanks for your comment, appreciated.

Surgery is a big thing to put your body through. I would explore all options first before going down that route.

I think you need some independent advice (if you can get it!). Obviously the bariatric surgery industry has taken a hit due to the rise of weight loss injections so I think getting some independent advice outside of that setting will help.

Weight loss surgery, just like weight loss injections and every other diet going will not work long term unless you overhaul your diet and stick to it. It sucks but it’s true - none of these things are a silver bullet. They’re just tools to help you lose weight but once you’re at your desired weight, that’s where you’ll have to step in to maintain. This is why many people are thinking that weight loss injections are something they’ll be on for life.

I know of two people who had weight loss surgery and then after a few years their cravings came back and they found a way to eat whatever they fancied (mars bar milkshakes anyone!?) but the same will be true of any weight loss tool. And probably like me, you’ll also know loads of people who’ve lost lots of weight but then later regained it. I’ve done it myself several times because obesity is a a lifelong struggle and even when I do lose weight, that won’t go away. The diets and surgery are all tools to get me to where I want to be but they won’t help me stay there unless I stick to my lifelong calorie deficit.

If it were me, I’d give the Wegovy more time but also you could ask if they’d be willing to switch you to mounjaro instead. Mounjaro is more effective (in trials) than Wegovy but not every NHS authority will provide it, due to cost.

I’ve been on mounjaro for a year and have lost 4 stone. I’ve changed my diet completely and started doing weight training - something that ‘fat me’ would never have considered. I’ve self funded and it currently costs me £229 a month. It’s a lot but I always think back to when I was heavier. If you asked me then how much money I would have paid to lose weight and be fitter, I’d have said ‘any amount, I’d pay whatever it took’. So rationalising it that way helps me do it. Of course I realise not everyone has the means to do that but that’s the conversation in my head.

Only you can decide which route to take but I think it’s helpful to know that all of these methods are just tools, not magic solutions.

I think you also need to think about how you follow on from whichever method you choose. You can go through the pain of surgery and gain the weight back, or have two years on injections and gain it back, so which ever route you go down, you need to factor in how to make it a lasting change.

Injections will mean you can start exercising and eating better now and I think you do need to do some honest soul searching and work out and implement lasting changes so you aren’t back at the same weight in 3 years time. There are people who have gone down both routes who have lost and gained a lot of weight and if you aren’t able to self fund the injections eventually you will need to be in good habits when you come off them.

Obviously bariatric surgery is about to take a very significant hit, and ultimately be very few and far between , why on earth would anyone have their body cut open, sliced apart when you can take a very safe drug, with multiple benefits and lose the weight,

with the drugs it gives you space to retrain your eating habits, as the cravings go, with the surgery, you can’t eat much, but the cravings still are there, hence why you hear of people liquidising mars bars. And of course they stretch it out and 60 percent regain all the weight. Thays a huge number.

with the drugs you can stay on for life. Meaning you never have to regain, now there is a cost implication, but ultimately they will come down in price. If I was you, I’d take the two years drugs, and start saving now, for year 3. And you may find the nhs guidelines very different in two years.

I totally get that. I hadn't researched surgery properly before as it was always way off in the distance and I'd told myself it was the answer. Now there's more options and Wegovy is starting to work for me in the last few days. Like you I've lost and gained in the past. I'm annoyed with myself that I worked hard to get myself to where I wanted to be. I started running and ran most days and enjoyed it. I was silly to let it all slip. I'm older and wiser now, I also use My Fitness app to track my calories. That makes me think twice about using full fat mayonnaise for example or eating a piece of cake. When I was younger I thought I could get away with eating what I wanted but I wasn't always keeping track of my weight. Now I know there will be health implications if I don't make a change and that's scary.

That all makes sense, the cost makes sense in terms of if I was honest with myself about how much I would spend on food I didn't need when I was over eating. I don't think £200 a month, but maybe sometimes.

Yes I agree, regrettably I've got the insight in that I've been there before. Reached my target weight through diet and exercise and I thought I'd changed my life. And yet I'm now at my heaviest weight. But I'm more aware of my unhealthier habits and avoid my triggers. I cook from scratch most days and I haven't ever eaten so many portions of vegetables and salad in my life. I hardly ever eat red meat, I don't eat chocolate or crisps anymore as I struggle to stop and get obsessed. I think I'm in a good place mentally and that I'm being the most realistic with myself that I've ever been. I had the thought that I could possibly be a Mars bar drinker after surgery, it's easy to say I wouldn't be. I genuinely enjoy strawberries for example more than chocolate now. Years ago I didn't feel that way.

Yes I totally agree, and that's pretty much the decision I arrived at yesterday before I spoke to the surgeon. The thought of having the cravings and not the stomach capacity resonates with me. I would rather be eating mindfully nutritious food that I enjoy. Thank you for your thoughts. 😊

Hi there - the injections seem to work amazingly well for some and I would have considered this option myself if around 10 years ago if available - however jabs are a life long option and praps work out a similar cost but very likely to gain weight if stop - rare with bypass as long as not drinking higher fat milkshakes or ice cream all day - I had a keyhole gastric sleeve at Spire Birmingham and had amazing results for health lost 4.5 stone in 6 months but can’t exercise at the moment otherwise loss would be more size 22 to 16-14 not vanity and accepted for bypass due to other health issues otherwise it’s gastric band option for most - not much loose skin but neck more papery under chin and legs not as lovely but feel better dm if helpful

That’s not true, regain rate is 60 percent.

Interesting not heard that before - I was of the understanding this is something that statistically works better than jabs

Surgery carries risks, risks with general anaesthetic and a permanently smaller stomach along with needing time to heal with the assumption it all heals well. Then with a smaller stomach, you still have food noise but can't fit much food in so then could be vomiting excess food.

Weight loss injections are not permanent but can be taken long term. They also lower blood sugar and pressure and reduce inflammation, I've not had a single IBS flare up in 19 months that I've been on miunjaro. I was prediabetic, had high blood pressure and cholesterol at a size 14. Weight loss injections have changed my life.