Confused!

I have hypertension, high cholesterol, sleep apnea, depression, and chronic lower back and leg pains. So I basically a number of co-morbidities except for diabetes. As for my back, after my fourth back surgery the neurosurgeon advised me to do a fusion surgery, which I have been trying to avoid, or to have some aggressive weight loss in the hopes that this may considerably reduce the stress on my lower back to the extent that I won't need fusion.

Ahh it all makes sense now, thank you for elaborating! As for your cardiologist and GI doctor, I'm sure they have the best of intentions, but only YOU know if you can maintain the weight loss without the help of surgery. If you think you can, and if you don't have a history of multiple loss/gain scenarios, then don't have the surgery. If, however, you have been a yo-yo dieter like most of us here, and you think you need the surgery to keep the weight off, then do it. Only you can decide what is best for you. Good luck!

Confused! - Page 2

Hi Cathy, I have posted a reply from my phone but it seems it didn't go through, so I am re-posting.

I have a number of co-morbidities (hypertension, high cholesterol, sleep apnea, depression, in addition to the chronic lower back and leg pains), hence the insurance qualification at BMI of 35.

My highest weight was 240 lbs. The neurosurgeon after the fourth failed back surgery suggested a lumbar fusion to (potentially) fix the back pain or to have a dramatic weight loss in the hopes that it would (also possibly) alleviate the pain and avoiding the fusion surgery.

My program allowed me to continue with monthly nutrition appointments until I was ready. I've been doing my program for 1 1/2 years now. I finally gave the go ahead to be submitted to the board and was approved. This may give you the option to stall for time, while keeping your foot in the door.

My insurance approval expires in January 2018 and if I plan to go for the procedure September would be the best time since I will start an extensive program of travel for work early next year, hence my statement that it is now or never.

Pretend you're Nike. Just DOOOOO it. :)

I too was on the lighter side for surgery. I am 5'4" and I started at 240 in January and by just reducing my starches and upping my exercise I was at 235 at my first surgercal meeting. But part of my motivation was my cholesterol and blood pressure required medication as of my January appointment also my nurse practitioner marked me down as pre-diabetic.

For me that was it. I was done with dieting to loose as much as 30 pounds, then gain back 35 to 40. I had my surgery on June 29, and while it hasn't been easy, I am delighted with my progress so far. Yesterday I broke the 180 barrier! I had stalled there for several weeks, but again today I was below 175.

I find it interesting that my body does not want, like, or is repulsed by anything sweet. (It does make protein shakes a challenge, but luckily there are options.) I have more energy, and my arthritic knees are happier.

My thoughts for you are:

a) are you really mentally ready to permanently change your relationship with food? The diet of "allowed" foods you progress though post surgery will help with the retraining. But you should already have some ideas about what you will choose to not eat going forward.

b) Are you willing to do the work required to strengthen your body as part of rapid weight loss? You will then need to make that part of your new norm.

c) What reason did your cardiologist give as to why YOU were not a good WLS candidate? The fact that your internist feels you can loose the weight with out does not mean a great deal, as many believe that healthy just requires eating less and weight magically comes off. However your cardiologist may have some medical reason why your body would be damaged by WLS surgery. If they couldn't explain it to you, or their explanation was that you can do it without, then they are in the same camp as way too many PCPs.

I hope that those questions will help you consider the choice for you.

Best of luck!

I had 2nd thoughts during the pre-op diet as well. From my journal:

"MyFitnessPal informed me after I closed it out last night that if I continued eating like that, I'd lose 15 lbs in the next 5 weeks. Well, heck. I should just do that, then, instead of having 75% of my stomach cut out, right? I mean, isn't this really just a way to get out of having to have discipline and self control?"

http://www.theantichick.com/2016/08/05/the-easy-way-out/

But if you read the rest of the entry, I walk through the rest of the decision process. I have lost and regained weight many times over the years. Most of us here have. The challenge we face is KEEPING it off. And the deck is stacked against us. It's not impossible, but it's an uphill challenge with a lot of factors weighing against us. WLS is an extra tool in the kit that betters our odds.

You have to make the right decision for you. My starting BMI was just over 45, and I had several comorbidities, so there was really no question from anyone on my treatment team. My primary, my rheumatologist, my cardiologist... everyone was advocating for the surgery, even people I expected to object. I don't know if I'd have made the same decision at a BMI just over 35 or not. Evidence is showing that the people who have WLS at lighter BMIs tend to get a little lower final weights and have outcomes just as good, if not a little better than, those with high BMIs. It's possible that by having surgery before getting to the higher BMI avoids some of the wear and tear on the body, so you start out a little healthier and maintain a little better health.

My only regret is that I didn't do it years ago.

Losing weight is less of the question...maintaining the weight loss is what usually eludes most of us as well as getting all the way to goal.

Is 3-4 shakes a day and 4oz lean protein and veggies a sustainable plan? My plan was pretty similar and I also did it for 3-4 weeks. Reality was I could do it because I knew it was a means to an end.

Your Docs are looking at and questioning the need at your lower end BMI, but you have lots of comorbidities effecting your health...

Only you can decide ...but most people do not come to this lightly... I am sure there had to be a lot going on to even start this process. Will you he buyer's regret if you don't follow through?