Would you consider private bariatric surgery with a BMI of 30?

[Miababe]

I've been recently diagnosed with severe sleep apnoea and have a CPAP machine. This has been a big shock to me and scary. I also have high BP which is controlled with medication and osteoarthritis in my hips/hands though mildly, but does feel uncomfortable every day. I know I need to lose 3 stone in order to have a chance of coming off of CPAP for good. I have a BMI of 30.

I find it really difficult to stick to any diet because I have complex needs kids and get tired etc. I know I should persevere and lose the weight with will power but it would need to be lifelong.
I understand that private hospitals/clinics do not have to stick to the NICE guidelines when it comes to BMI eligibility for bariatric surgery so with my BMI at 30 but with co-morbidities I could be accepted for the band or sleeve. Do you know anyone who has gone private and had these done with a BMI of 30? Would you if you were in my position?

Dont bother with a band. Mine didnt work and I know loads of others the same.
A sleeve will leave you having to take lifelong supplements including B12.
People just arent doing the surgery now and lots of units have shut down.
I lost 6 stone on mounjaro it was brilliant.

I would absolutely NOT have bariatric for a BMI of 30. Have you considered weight loss medications - the benefit of them is that you can stop them if you struggle with side effects. Surgery might give you side effects for life!

I know someone with a band who had it done privately and she has had lots of issues with this and kept having to have it adjusted and was in a lot of pain so then had it removed!

I’ve contemplated it in the past but I’d have to put it on finance and I’m just not sure - me and my sister do Slimming World and I’ve lost 3.5 stone and my sister 4.5 stone it can be done and we love food. Also nothing is off limits you just have to count it.

My friend had a band and initially lost loads of weight but has now gained most of it.

I've never heard of anyone getting it even privately at 30 BMI. Was there much demand at that level even pre WLI era?

No. Get on the jabs.

I had a sleeve in 2021.

Don't do it. Do mounjaro instead.

I have severe obstructive sleep apnoea, and use a cpap (which I absolutely love - it gave me my life back!).

I wouldn't go for bariatric surgery because my daughter had a gastric band a few years ago (which she periodically has top ups for). She still feels really hungry and has food cravings. Too much food (a tiny amount!) and she has to vomit. It's very restrictive. She said if MJ had been available she would have had that rather than the surgery.

I lost 4 stones on Mounjaro with no side effects. When I stopped I put two back on, primarily because I'd just relied on not wanting to eat to lose the weight. Even after losing the 4 stones I still needed my cpap machine.

I'm now on a clinical trial for MET097 which is a new, long lasting glp1. I don't have to pay for the drug (although I might be on a placebo), but it's made it much easier to actually calorie count. I don't feel hungry but can still eat. I also get reimbursement for my time (by the end of the trial it's about £3500). The BMI requirement if you have a weight related co-morbidity is 27 or over (30 or over with no comorbidities).

I decided to go down this route because having lost weight then regained I decided it would be good to have the support of dieticians and clinical staff. If you can't afford to pay for MJ it's worth looking into these. I did feel more confident having already tried weight loss injections - I knew what to expect.

Good luck with whatever route you decide to go with.

My BMI was 36 and is now 20, using Mounjaro. Go for the jabs.

Why are you considering surgery rather than weight loss injections?

TellMeMoreOrLess - I was speaking to a Dietician (NHS) I know and she said whatever you do don't go on the jabs. She says she sees people with malnutrition associated with them. People can't come off them without piling on the pounds really fast and no one knows the long term affects of taking these for slimming purposes (used for years for diabetics of course but tiny amounts daily).

As someone that’s had a sleeve and is also on weight loss injections. I’d take the injections before I did the sleeve with that bmi. I was morbidly obese at my heaviest and the sleeve had given me a huge jump start but it’s not a magic wand and you can put weight back on with it Google slider food). I had no issues really with my sleeve but vitamins twice a day every day for life. B12 injections every 12 weeks for life, permanently malnourished and always thinking about food. Have I drank enough, have I eaten, did I get enough protein, fibre and carbs in. Contraception is also a big thing. I can’t take the pill due to malabsorption issues. Also Google dumping syndrome this is FUN! My stomach goes haywire depending on the day, some days I’m great and can eat anything others I can’t even stomach a cup of tea before it sets off.

i lost a huge chunk with the sleeve but have chosen to go on mj with the support of my consultant over having the bypass as a 2nd part operation to help me get the last chunk of weight off. I work out, I’m diligent in tracking my protein and tracking what I eat, it just doesn’t want to come off and I need help so the injections have been brilliant. I still eat a decent amount of calories, the food noise has gone and it’s doing things internally to my body that the sleeve and bypass couldn’t have done. The weight loss is slow with it but it’s coming off as I’m eating a decent diet, yes some days like yesterday and today I’ve barely ate but have made sure I drank my calories and protein as I can’t stomach food on injection day or the day after.

my blood work for my hba1c has never been so good, the rest of it still shows malnourishment and low on everything but my blood sugar is finally going down and I’m loosing the weight again which is the main thing.

im 8yrs post sleeve, coming up for 2yrs on mj.

No, I wouldn’t consider it for a second at BMI 30. My BMI was 50 and I didn’t want to have bariatric surgery. Mounjaro was ideal for me and my BMI is now in the healthy range. Surely it makes sense to try medication first before risking surgery?

Goodness that NHS dietician is misinformed.

I came off them 8 months ago after losing 3 stone and am neither malnourished nor has the weight come back. I treated my time on jabs as a time to retrain my eating habits and start weight training and it’s been the best decision I ever made.

The dietician you spoke to probably only sees people who have had issues, and with 3 million in this country alone who have used them it would be shocking if there weren’t a few that they didn’t agree with. But for those like me who never had any problems, a healthcare professional wouldn’t ever even see me in their clinic.

Was it a long time ago she trained? Has she been keeping up with her CPD? Are you sure she is actually qualified?

I understand your concerns. First time round I really just ate minimally, and felt great until I came off them and the weight went back on.

I have a work colleague who had lost 6 stone on Mounjaro in the last year, but she's stuck rigidly to around 1500 calories a day, and looks great. She's now reducing the dose she's been taking to slowly wean herself off now.

On my clinical trial they've set my calories at 1546 - I feel constantly full, but I'm still losing weight. I might be on a placebo, but no longer have food noise because I'm eating a much bigger quantity of food for the same number of calories.

TheAlertBee - Well done you. Working really hard to lose the weight.

I worry if i use the jabs i will lose the weight come off of the cpap and then be lost if i start to put weight on again and don't know i have apnoea again.

I'm terrible I read too much and then worry about all of it. Pancreatitis with the jabs rare I know but possible.

Strange input from your dietitian acquaintance. I would have expected a dietitian to point out that malnutrition (on wli or in general) can be avoided by, you know, eating a healthy nutritious diet. Which can easily be done on wli.

You start on the lowest dose (or even lower than 2.5mg the starting dose for MJ), and only need to increase if you are not finding your dose is giving you some appetite suppression. No-one should be taking a dose that stops them eating properly and if they are doing, they are not using the drugs properly.

I’ve lost 5 stone on 2.5mg. Have now stopped and am not gaining weight (so far). If I find I do, I’ll restart the wli.

I find it odd that so many people talk about wli as if they are an irreversible decision. You can try them, and if you don’t get on with them for some reason, you can stop.

There is lots of information on the wli board on MN, including on the health side effects, which are hugely outweighed by the health benefits. I think you might find the information on the wli board somewhat more helpful than your dietitian’s viewpoint.

Bariatric surgery is way more risky than mounjaro. Malnutrition is much much more likely with the surgery. Not to mention a whole lot of other terrible risks and side effects. Even at my biggest I would never have done it.

With the jabs, if you're struggling to eat enough then you just lower your dose. Simple. If you start gaining weight after stopping then you go back on them.

Mounjaro changed my life. Over 18 months (10 losing weight, 8 maintaining) and the worst side effect I've had was a bit of constipation. There are so many studies being done on all the benefits of GLP-1 injections, not just weight loss. Pretty exciting, really.

I can’t believe you’re considering major surgery before trying the jabs

Bariatric surgery is renowned for people getting malnutrition! I know several people who've had it who've piled on the weight due to 'chesting' so the dietician is only giving one side.
Frankly, I also find it hard to comprehend a dietician would be saying this.

Not a chance. Those surgeries are so dangerous and do not always give the expected results.

Try a meal replacement diet or keto, if you're struggling.

Sometimes, we just need a good reset with our food relationship.

How do you think you lose weight after bariatric surgery? It's essentially similar to GLP1s, reduced food intake snd the effect on satiety hormones. Loads of people regain after surgery. I predict a lot of unemployed bariatric surgeons in the future. Go on the meds, eat protein and do weight bearing exercise and micro dose the meds for life

Watching keenly.. I also have high BMI - currently 32 and have severe sleep apnoea.
I have tried WLI . An earlier version about 4-5 yrs ago and I vomitted and felt awful.. I may try MJ
I think your dietician is right.. the studies show over time with WLI weight is regained.
I think the key is high protein and building muscle .. I am just not very good at doing this!
I have also considered a sleeve but at 61 I am worried about malnutrition as I age .. there are no real studies re this .
I am currently trying to eat a really big breakfast .. when I did that previously it seemed to ‘ reset” my appetite for the day.
I really sympathise .. I hate CPAP and will often throw mask off at night when semi asleep.