BMI is 75
Way back in the 90's I was confused about why I was always gaining weight and couldn't keep off what I would lose. I ate the (at the time) recommended diet of high carb, low fat foods. I almost ate no fat. Stayed away from fried foods. My portions were small (although often processed things like lean cuisine). But I still kept gaining. Now I know why, I was drinking about 5 to 6 cups of juice a day. I thought it was healthy. But that 500+ calories was going straight to storage as fat. Liquid calories are the worst thing for weight. Your body doesn't register it as food and it doesn't cause satiety. It will instead cause constant sugar crashes. Keeping you hungry. This goes for all liquid calories, soda, fruit juice, smoothies, coffee drinks, beer, wine, etc. I got fat eating healthier foods which is why I believe I never got diabetic or high blood pressure. But I still got fat. Whole fruit is much better but you should have no more then 2 servings a day of whole, unprocessed fruit. Really, cut out the liquid calories and log what you eat and the weight will start coming off.
Your high stress lifestyle isn't helping matters either. You should try meditation. Even if just 2 or 3 minutes here and there, through out the day. It helps. All it takes is just stopping for a few minutes and blocking out everything while you focus on your breathing. Just focus on your intake and exhalation of air. That's it.
I do understand that there are lots of people who are significantly overweight, but who don't consume nearly as much as people think they do. Sometimes, there are other factors at play. Genetics is one factor, thyroid function is another. Muscle composition and exercise are factors, too. But it is very difficult to get to 460 lb by eating a low-fat, low cal, low carb diet no matter how cursed you are in the metabolism department.
I am one of those people who was never an over-eater, BUT, after I got married I ate more than I knew I could based on my crappy metabolism. It was hard being married to someone who was eating 3x what I was eating and he was thin and I was gaining weight. Sometimes life is not fair. Really not fair. And yet we have to suck it up and deal with the cards we've been dealt because they're our cards. Those were my cards and I decided was going to be a loser...of weight!
I was in a similar place where you are now. My insurance required me to lose weight pre-op in order to get approved (then they denied me, anyway, so I paid out of pocket because I was and am committed). Remember, I am a person with ridiculously bad metabolism, but I was determined to do what was needed and I did it. You can, too, but only if you commit to it. And honestly, if you can't figure this out now, you might not be successful after the surgery. This surgery is only a tool. You HAVE to do all the work to make it successful and you have to be willing to do it for the rest of your life. It is a life-long commitment to your health.
If you are not in a place emotionally where you feel you can commit to whatever it takes to lose the 50 lbs, then you're probably not ready for this surgery. You need to be fully committed first. If you need counselling to wrap your head around things and to help you to find motivation, then you should take that leap because it will be the best first step you take. Ultimately, losing weight is really an important thing to do for your long term health and survival and starting ahead of surgery will decrease the chances of surgical complications and increase your chances of success.
I wish you all the best and I hope you set your mind to doing this.
