Hello (+ seeking some advice/opinions)

Hey, thanks for responding to me! I really appreciate it!

Wow, I'm hella impressed that you managed to lose 100lbs on your own! That's seriously impressive! It's good to hear that even though you must have been significantly smaller than I am at your biggest, that you still think that the surgery was a good idea.

I'm about 99% certain that my reflux is caused by my weight, rather than a hernia or something, but I'll definitely look into that. Thanks for the head's up!

It turns out that to qualify for covered surgery in the city where I'll be living in six months, my BMI needs to be between 40-55, so I need to lose a chunk on my own first, anyway, and I have six months to see what I can do. I've looked into diets and such and think I'm going to go with the Mayo Clinic's mediterranean diet (1,200 calories per day). What did you use for your big 100lbs push?

Thanks again for your response!

I just tracked calories in MyFitnessPal and ate at a 500 calorie per day deficit. If I was going to do do a diet pre-op I'd probably try to choose one that was similar to what I'd be eating post-op, but with less strict calorie goals (because that's where your reduced stomach size comes in).

Right now, I strive for macros of 25% protein, 55% fat, and 20% carbs. I eat 3-4oz of dense protein first before anything else on my plate. Then I eat veggies. As a WLS patient, I never have room for more than that, but that's where you'd add any carbs. Personally, I don't eat grains or potatoes (99% of the time, that's not to say I don't take the truly occasional indulgence).

I eat full-fat greek yogurt, full-fat cottage cheese, bacon, butter, avocado, whole eggs, fatty cuts of meat, etc. The trade off for adding fat, which provides flavor and additional satiety, is limiting carbs!

Thanks, that's super helpful! :)

I saw your other response about boob size, too! I can't imagine losing over 100lbs and seeing no difference to the girls; I just haven't before. I've lost in the band size but not in the cup. It'll be interesting to see what happens!

Hi there and welcome!

There is a lot of stigma surrounding weight loss surgery and that's challenging to get beyond. I'm glad you're working on it and researching!

1. Permanence is scary, I agree. But.. suffering from obesity is also permanent if you don't do something to address the obesity. Some of the health complications from obesity are permanent and, perhaps, even scarier than having a smaller stomach.

2. Saggy skin is a thing, especially if you've been SMO for a long time and are older. Sometimes, it can cause rashes and, if documented, insurance (or the Canadian health care system) might cover removal of the panniculous. For me, thankfully, my excess skin was more of an annoyance than a medical (mental or physical) health problem for me. I was able to have reconstructive surgery this year to get that taken care of. It was mainly a problem for me during exercise, sometimes there just wasn't enough compression gear. Even then, prior to reconstructive surgery life was still INFINITELY better with excess skin than with excess weight. Quality of Life and Health Related Quality of Life both saw massive improvements. So please don't let the excess skin scare you away from weight loss. (And the excess skin will be an issue regardless of how weight is lost, not just if you have WLS.)

3. I'm a foodie and a hobby cook. I still love to cook, eat, and shop. I love restaurants. I never have a problem finding something that fits in my way of eating and I feel that I savor every bite more than I used to. I enjoy scouring my cookbooks to find recipes that fit in my way of eating. I still hate meal planning, but I've always hated meal planning :P

4. I've never regretted surgery.

5. We do lots of "unnatural things" in life.

Now, for the candid advice:

1. You have reflux. Please don't pursue VSG - go with RNY instead. VSG can exacerbate reflux issues and there are a number of people who post here who have had to revise from VSG to RNY due to GERD/reflux. VSG with existing reflux is not a risk that I would find worth taking.

2. You say you're active and eat a healthy diet. Yet, you are SMO. These two things don't add up. It would be worth your while to meet with a dietician, and a therapist, to figure out what's going on. The only thing surgery will do is change your anatomy. It won't change your brain and that's the hardest part of sustained weight loss followed by maintenance forever - the brain. Our stomachs didn't get us to SMO, our brains did. Many people believe they're eating healthily, but "eating healthy" is a complicated concept in and of itself and many people are in denial about things such as portion sizes and liquid calories. Working with a dietician and a therapist during these six months that you're taking (and beyond) will help you to get to where you need to be to find success with whatever method of weight loss you choose. (And, if you choose not to lose weight, these professionals will still be able to help you with self-awareness and knowledge going forward.)

Good luck to you!

Hi! Thanks for your feedback; I really appreciate it!

My doctor's opinion is that I can't exercise the weight off because it only gets so far: about half the fat turns into muscle, the other half doesn't come off, and then the instant I stop working out around the clock, the muscle turns back into fat and I never actually weigh any less. It looks like diet and surgery will have to be my route to getting healthier.

I agree completely: obesity has been seemingly permanent, yeah. And I'd really rather not have it stay that way!

You've definitely reassured me a bit on the food thing. Thanks for that, and for the rest of your feedback, too. :)

For what it's worth, no one can really exercise the weight off. Exercise is only a small percentage of weight loss, diet is 80%+ of the equation. Exercise is awesome for health in general, but when it comes to weight loss, diet is key.

Yeah, I'm learning this! It's still kind of a mind-blowing concept to me! I had always, always been told that exercise was far more important than diet. I'm rolling with it, though - down my first 2 lbs! :)

Good for you for reaching out to us and not immediately rejecting the idea of WLS. A lot of your fears and questions are quite common. If you're that worried about skin, start saving your Loonies and Toonies now. Also, if loose skin ever causes any issues such as a rash, document the heck out of it with your physician to increase the chances of insurance covering any procedures.

I agree with Gwen that if you have even a hint of GERD, VSG is not for you. I had my RNY four years ago and I've maintained a 165 lb loss for over two years now. My starting BMI was 56, which is considered Super Morbidly Obese (scary, right?). I still go out to eat, enjoy food and I spent the holidays baking up a storm. I just don't eat as much now. My chronic pain issues are much reduced for both my shoulder and my back.

Don't fool yourself into thinking that you're big-boned and that you won't reach your goal. It's all about the work you put into your new lifestyle. Plus, big-boned as most people think of it isn't really a thing. For example, my ring finger used to be a size 11 or 12. You'd think fingers are mostly, bone, yeah? Now I wear a 6.5. Not so big-boned after all! I think as you go through your WLS journey, you'll surprise yourself over and over.

Jen

Hey, thanks for your response and your thoughts - I really appreciate it!

I saw my doctor again and put a bunch of my new questions to him, and his opinion is that if the reflux is caused by the weight itself, then the VSG can fix it, rather than exacerbate it, but if the underlying reason is a hernia or something else, then the RNY would be better. We do think it's directly related to my weight, though. I'll definitely look into this down the road when we get into the specifics of which surgery, etc.

I genuinely AM big-boned, though. I was even as a child when I had no excess weight. Big shoes, and not just because my feet are fat, you know? They're long! I'm also sort of freakishly muscular for a woman - I should have become a pro rugby player or something, you know? Even with weight loss surgery, I'll be a big-boned, but hopefully much thinner woman! :P As it happens, I can't even start the process for six months because I don't live in the right city yet (it's complicated - I'm moving back to my home city in July, which is where I want to do this), and at the hospital where I'd have it done, you need a BMI of between 40-55 to qualify and mine is currently too high. So: I have six months to get my BMI down and lose as much weight as I can in as healthy a way as I possibly can, and then I can finally apply and get the ball rolling.

Thanks again for your response! I appreciate it.

I'm also big-boned (and muscular), which is why I'll probably always be at the upper end of a normal BMI (well, hopefully I can maintain that for life! I'm pretty happy here!!). I got down as low as 136, but I started looking pretty bad. When I had a DEXAscan at 140 lbs, I had 22% body fat. 22% is OK, but lean. My surgeon, PCP, and the DEXAscan technician all said I should not let my weight drop any lower. Anyway, my point is, I felt the same as you when I weighed 372 lbs. I was big-boned and muscular (and I was!), but I was also not seeing reality. I was super morbidly obese, but I never saw myself as that heavy.

I do have loose skin, but it's easy to hide, and I can tell you that I would rather have the loose skin any day than weigh 372 lbs again. ANY DAY!!! I am SO much happier now!! It was so worth it!!

btw - I had RNY because of acid reflux/GERD.