Looking into VSG but not sure if it is for me.

I am new to this community, not sure if I am posting in the right section but here is a little info on me. I am a 21 year old female who is 4'11 and weighs 151 pounds as of 2/27/18. I have a family history of hypertension and diabetes. My BMI is 30.5. I went to my PCP on 2/27 and did blood work and when my results came back I am basically pre-diabetic. Now my PCP is a sweet lady and idk if she just hinted at me losing weight because she was trying to sugar coat but I think it's a serious matter. For a long time, I was considered overweight, I have recently entered the obese category. When bringing up the vsg topic with people I trust, they say "oh you're not even big, just diet and exercise." My lowest weight was 120 back in high school, and every since I started gaining weight I have been having slight heart palpitations (my PCP is aware and an echo-gram has been ordered). I also had a personal trainer and seemed to maintain my weight. Some of the exercises where too hard for me. I get a burning sensation in my chest from doing heavy workouts but my PT would push me to try harder (and quite frankly with the money I spent I was trying to get my money's worth). I only started looking into VSG since my PCP lightly labeled me as obese. I brought it up to other people and they think that I shouldn't do it. I am still researching. If I was to go through with this it would not happen until 2020 or 2021. I really want to see if I can lose the weight on my own first, but after that 6 month PT session I felt hopeless. I feel like I don't know where to start, but hopefully someone can give me an honest input. I do understand that VSG is serious and I don't have a problem with my weight. I just have a problem with the issues that it is causing me. I would hate to have to take medications for the rest of my life to manage diabetes or hypertension. I could care less about the number on the scale. I just want to be able to run down the street without feeling like dying.

Most doctors require a BMI of at least 35 with a co-morbidity (a weight related illness like diabetes) You don't qualify at 30. You want my honest opinion ... forget your personal trainer and focus on your diet. Track everything that you put in your mouth and swallow. This includes alcohol and cough syrup. Count your calorie intake. Find out what you have been eating that is causing the weight gain and try to cut back to no more than 1500, but no less than 1000. You would have to do this as a lead up to a surgery anyway .. so you might as well do it on your own. Using an app like myfitnesspal makes it easier.

One thing you can also try is using the pre-op diet 3 days a week. That diet is basically 3 protein shakes a day (using low fat milk and whey protein powder) and nothing but low calorie low fat veggies (tomatoes, celery ...etc)

Good luck ... and I hope you never need to get a surgery.

You are young, and truthfully, not that heavy now. My recommendation for you would be to see a therapist and a nutritionist and see if that works. VSG is serious and irreversible - you would have this for the rest of your life. While it was the best decision for me, at your age, weight and the amount of time you have been heavy, not sure if it is for you yet. Honestly....get a therapist. I think that may be what you need to get your head in the game and lose the weight. Good luck.

My daughter is your age and fighting her weight. She's a bit heavier than you with a BMI of about 33 or 34 right now. With my success with VSG (so far) she asked me if I thought she should get the surgery. Our insurance doesn't pay unless you're over BMI 35 with 2 comorbidities, or over BMI 40 regardless of comorbidities (I started out at 44). Thinking about how I would advise my daughter led to a lot of deep thinking and I even raised the question here to see what other people thought, and the reactions were mixed.

In the end, I gave her this advice, which I offer to you.

There is a LOT to be done before you're ready to make a decision for surgery. If your BMI doesn't get any higher, you'll very likely have to self-pay for the surgery. And I do NOT recommend trying to gain weight to meet the BMI requirement. I wouldn't say rule it out completely, but get to work on the preparatory stuff and see if you are still interested when you get the insurance/financing figured out.

First, if you have an unhealthy relationship with food (and most overweight/obese people do), I cannot recommend therapy enough. I know for a fact my surgery would have been a failure if I hadn't already been working on my food issues with a good therapist. Ideally, find someone with experience in eating disorders and body image issues.

Second, your PCP needs to work you up for a low thyroid issue. Do some research into that, because lots of PCPs do a single test for thyroid (TSH) and never look further. There is an entire panel that needs to be run because your TSH can be in the normal range, but one of the factors is low and you don't have sufficient thyroid. Thyroid issues can cause heart palpitations, so the fact that you're having those already means a complete thyroid workup is a must. There are also some more rare issues that need to be ruled out given you're having issues with strenuous workouts (mostly auto-immune, possibly some mitochondrial issues). (My family has a significant history of auto-immune, my daughter and I both have multiple diagnoses, and it's more common than many people think so I suggest a full workup for anyone having health issues.)

Third, once your cardiologist clears you, you are going to need to ease into exercise. If you have any kind of exercise intolerance, it's important to increase your workouts GRADUALLY. Don't spend money on a trainer until you can exercise strenously without one.

Lastly, you need to experiment with diet programs to find what gives you the most energy and allows you to create a caloric deficit. Some people do incredibly well with ketogenic, Atkins, Paleo, clean eating, etc. I don't, I get very ill if I don't eat more than about 80-100g of carbs a day. But you should try out different programs and find what fits you and your lifestyle. Ultimately, they all work in different ways to create a caloric deficit which is what lets you lose weight.

I do believe that you (and my daughter) are in a place where you can get back to a healthy weight without surgery. (Incidentally, that doesn't necessarily mean a "normal" BMI... BMI was developed as a statistical method to compare peoples' weights across gender and height differences, and was not intended to be used as an individual's measure of health. Don't get obsessive about the BMI... look at the other indicators of health instead.) I wouldn't say rule it out down the road, but certainly start doing the work. If you do end up going ahead with surgery later, you'll be in a better place for it to be a success.

Hope that helps, and best of luck to you!!

Many surgeons will not perform a surgery on someone unless they have a BMI over 35 and multiple comorbidities (diabetes, sleep apnea, etc.). At this point, it is entirely possible that you would not qualify, even if you went self-pay.

Before you think about surgery, whether they will do it, or not, try a version of the VSG full diet and do things like logging your meals. Honestly, meal tracking is my biggest and best tool. When I don't track as well, I snack more, OR even worse, I tend to sacrifice good foods in order to eat worse foods, so while my calories will be low my nutrition that day would be awful. I know I cannot do this, and have made very strict guidelines for myself to track EVERY day. Not missing a day or two in the week, but every day since those missed days are my worst for eating. If I want something sweet, it goes in the tracker and I get all my protein in and my calories right. Track, track, track!