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?

Christ, this is terrifying.

People get malnourished because they don’t adjust their diets, they don’t do it properly and they go up the doses too fast.

You can, of course, gain weight back - but that’s the same for any diet.

The purpose of taking the medications doesn’t matter. The side effects are the same.

You need to speak to a different dietician, WLIs sounds like a much better fit than surgery for your circumstances.

I would choose Mounjaro over major surgery any day! I’d also say the dietician you spoke to is really misinformed.

Weight loss jabs have been completely life changing for so many people (myself included). And the truth is, you will regain weight on any diet, even weight loss surgery/bands, if you don’t change your eating habits. There’s nothing about weight loss drugs that makes you particularly ‘pile it back on’. Loads of people are very happily maintaining their weight post jab because they’ve maintained healthy habits. Some people are choosing to stay on low doses for life.

I’ve lost 4 stone and have 2 more to go. I’ve changed my eating habits and stick to 1150/1200 cals a day plus do strength training. When I get to goal, I’ll slowly wean myself off and then up my calories to maintenance levels of around 1600. The drug just helps me mentally to not care about food in the way I used to. But I couldn’t initially lose weight without them because I was stuck in a doom loop of yo-yo dieting.

Regain after surgery is common too.

She needs to be investigated ffs.

If you have bariatric surgery you have more of a restricted food intake than you would on bloody WLI. At least you can control that to a degree with dosage options. You don’t have to be malnourished - I have lost 9 stone and apart from the first few weeks where suppression was far too high I have been able to eat around 1509/1600 calories a day. There is no risk to my health losing weight that way. There has been massive improvements to my health and long term prognosis. I do view these as a lifelong medication though, I would never jeopardise my progress by stopping the one thing in over 30 years that works.

Also why do you think there would be different long term side effects pejole using them for WL than diabetes? That doesn’t make any sense.

I have malnutrition from the sleeve. You have tontake supplements forever. I have issues with reflux and i vomit regularly.

I also reagined 3 stone and endednup taking mounjaro to get rid of it!

What did your NHS dietician friend say about doing the surgery then? I’d put money on the fact she would suggest trying them before having surgery, the thing is they do know the long term effects of the surgery and they are definitely worse than risks of monjaro. That’s why pps are so shocked you’d
try the surgery first over the jabs

In your position I would expect that risk of the surgery is higher than the risk of the jabs. You’ve read a lot about the downsides of the jabs have you done the same for the risks of the surgery?

Unfortunately there’s no easy answer really. People still get big again after bariatric surgery. I appreciate it’s all quite scary stuck between a rock and a hard place in that if you do nothing that is also bad for your health.

I had a sleeve in 2018. It’s major, life changing surgery with daily unavoidable consequences in terms of nutrition. You have to adjust in terms of being able to access food at odd times (every two hours for me) and cope with the side eye/bewilderment/judgement in social situations when you can only eat half a starter. I lost 5 stone, then regained 3. The hunger comes back. You learn to eat around the sleeve and I never stopped drinking calories. I’ve now been on Wegovy for two years. Lost all the regain and a bit more. I regret having surgery because it removes choice. You can always stop the jabs.

The dietician needs to update her practice, NICE guidelines are evidence based, they recommend WLI even if the NHS hasn't caught up yet with funding.

I agree with this.

I am constantly thinking about the fact that i missed the window of MJ becoming available by just a couple of years. I could have saved myself a lot of issues by taking WLI instead of having this surgery.

My BMI was 42 btw and I felt desperate.

I now feel weak a lot. Struggle with food intake. Get terrible pain with water. I struggle with protein intake as I feel full so quickly but any kind of protein milkshakes/yogurts etc make me feel sick (I seem to have a real issue with dairy that didn't exist prior)

And to top it all off I lost weight so quickly (and didn't exercise because I was unable to eat properly and felt so shit/weak) so now my muscle tone is ridiculous and my skin is absolutely awful. I have so much lose skin and my breast are non existent and like 2 satsumas in a pair of socks.

I honestly feel like If i would have taken a low dose of MJ i could have managed the weight loss so much better.

I lay awake at night sometimes and think that I have just taken years off my life by doing this.

I doubt any good surgeon in the Uk, private or NHS, would recommend surgery with a BMI of 30.

30 really isn’t that high to be contemplating surgery. I think your friend has been irresponsible to dismiss WLI and make you scared of them. I’m also not convinced all of your symptoms will be weight related at a bmi of 30. Sometimes apnea is anatomical and not just weight for example. You could go down quite an extreme surgical route and not necessarily see much improvement.

I would never consider surgery before trying weight loss injections. Surgery is massively more invasive, carries far more risks and has permanent effects which are life altering. Consider weight loss injections as your first line of attack, and they could well be all you need.

30 isn't such a huge BMI. Overweight range yes, but not too bad. I was in the 40s, but after a year on Ozempic I am now down to 35 and slowly dropping.

You don't need surgery, and your dietitian is talking bollocks. How up-to-date is her training? She isn't even following NICE guidelines with that erroneous advice.

I would personally think of this decision in terms of a reasonable worst case scenario. If you have try the injections and it goes wrong you can stop taking them and if you regain the weight you can start retaking them or try something different.

if you go for surgery you could be dealing with life long consequences and still regain the weight.

I think unless you do want to be on lifelong medication then you are going to need to accept that there is going to have to be some permanent changes to your diet and possibly exercise. This might involve going to two meals a day or fasting one day a week, I think you will need to try different things that work for you.

There will be exercise you can do at home and weight training can be good for arthritis, it’s just finding the right workout and buying the kit.

You’ve had very poor advice from that dietitian. No way would I have invasive surgery (which can result in lifelong issues with vitamin malabsorption, dumping syndrome, etc.) when WLIs now exist. MJ specifically has been shown to be very effective in treating sleep apnoea.

Not sure how malnutrition would be any worse with jabs than with surgery, ultimately they both restrict food intake.

Its not cut and dry that you will regain weight, lots of people have come off the jabs and are maintaining, there are threads on here about it, go and take a look.

Wow, such a lot of misinformation. Your dietician is am embarassment to her profession. Thr injections don’t cause malnutrition that’s diet and more likely with surgery and it’s now proven the meds protect against pancreatitis and pancreatic cancer.

how odd.

No way.
Weight loss injections could get you to normal bmi in 6 months

Then stay on a low dose and don’t come off, surely?

With a BMI of 30 I wouldn’t do either bariatric surgery or WLI.

Mine was 42, and I have to say I’d have gone surgery first if I’d done either. I appreciate its major surgery, but it feels more “one and done” than being on WLI, likely forever.

I only know one person who’s had a band, she’s kept the weight off for around 5 years now and apart from obviously eating far less, hasn’t had any other real issues.

The comments though have suggested otherwise, so maybe it’s a good job I didn’t go down that route!

Would you consider the tablets that are becoming available, or would you prefer no medication whatsoever?

Sorry that is just rubbish advice. Evidence is stacking up that not only will GLP1s help you lose weight, they may also help blood pressure and diseases associated with inflammation and autoimmune problems. I have psoriasis adn on thegroups I'm on for that GLP1s are helping loads of people. That's backed by emerging evidence too.

The Wegovy pill is about to come out and that will mean you can lose weight and then control your intake for a maintenance dose

With a BMI of 30, most UK private clinics still assess bariatric surgery very carefully, even with conditions like sleep apnoea and high BP.
Some may consider you case-by-case, but many will first suggest structured weight loss support or medication before surgery.
If I were in your position, I’d explore medical weight-loss options first and treat surgery as a later step if needed.

Exactly the same with surgery but with much longer lifelong effects.
What an absolutely bonkers thing to say.
I lost 6 stone on mounjaro. No side effects, no malnutrition and Ive kept the weight off.
You will only regain the weight if you eat too many calories whether you have surgery or jabs. My friend who had a gastric skeeve lost 9 stone and has put it all back on again 2 years later.
I had a gastric band prior to mounjaro and its given me no end of trouble including constant vomiting.
Im on the waiting list to have it removed and I cant wait.

I’ve had a bypass due to sleep apnea but mine was done through the nhs. Best thing I’ve ever done. I’m 5ft6 and at my heaviest I was 17st9 . 10 months on and I’m now 11st 5 and feel so much better. I still use my cpap though as I had spins of sleep apnea when I was 18 and this exact weight. I love my cpap so happy to keep on going with it.

downsides- you can end up with nutritional deficiencies. I’ve had an absolute battle with my iron levels and I’m on a double dose of life long vitamins . It can be HARD getting used to the new normal. Watching everybody else eat what they want and you can only manage a portion the size of an egg. No carbs so no bread, pasta, rice as it really hurts when it swells in your stomach and you need to prioritise protein. Also your insides have been replumbed. Some days my bathroom STINKS from my loose bowels ( but I also had my gall bladder removed).

but over all im very happy. My typical day is Greek yogurt with berries and 6-7 types of chopped nuts on top. Then a small chicken/ham/cheese salad with 1/2 a boiled egg and a bit of cheese. Evening meal is homemade soup packed with lentils/peas or mixed beans. Fish in butter sauce with peas, 1/4 of a 12 inch meat and veg pizza , 1 egg omelette with ham and cheese. Burger patty and beans. A tiny tin of sausage and beans with a side of bacon and mushrooms. Snacks are 2 a day if needed, baby bell/pepperami/cheese sting/ scotch egg/ spiced nuts/ berries. Some days I can eat more than others, some days I can barely manage a soup and might have bone broth or a protein shake instead.