I'm torn.

My college-aged daughter had to have a physical for a program she's in, and she hadn't realized how much weight she'd gained. She's up 70lbs since graduating high school. Her BMI is just at 35 (a little under or over depending on whether you think she's 5'10" or 5'11").

One thing I never knew at the time - and never suspected because she was in athletics - was that she was starving herself and yo-yo-ing her weigth a LOT of the time she was in high school. So I suspect she's done quite a bit of damage to her metabolism already.

She's seen the dramatic effects of WLS with me, and has been talking lately about getting WLS herself.

Part of my brain is saying, "no, she's too young and she can still get her weight under control." But the part of my brain that reads the latest research knows that the data shows that young people have excellent results with WLS and that having it at a lower BMI raises the chances of getting to a "normal" BMI.

She doesn't have any of the "classic" co-morbidities yet. She does share auto-immune issues and has one of two types of auto-immune arthritis (they're trying to figure out which one), asthma, and depression.

She eats pretty healthy most of the time, but does indulge in a LOT of junk food on the side, and eats very large portions. She's very active when she's not recovering from an injury, as her major is kinesiology and she referees several sports leagues with the city.

Ultimately, it's her decision, and I'll support whatever she decides. And whether or not it is even a possibility will be mainly up to the insurance company. If she has to go self-pay in Mexico, it'll be a couple years before she/we can put that kind of money together. But I'm interested to see how others who have had the surgery would view it as an option for their children.

Edit: I am encouraging her whether she has the surgery or not to start working with a therapist who specializes in food/body issues.

I look baCk to how much of my life was wasted sitting on the sidelines, dieting(unsuccessfully) and depressed and I say... HELL yes!

The fact that you're doing it will help her long term success.

I wasted so much of my life because of my weight. I wonder sometimes how my life might have been different if WLS had been a "thing" when I was in my 20s or if I had been open to it earlier in my adult years. Maybe my life would have been the same, I don't know. And it's not like I haven't been basically a happy person all these years. But I do wonder...

(edit to add: I know not everyone let's their weight hold them back from life. I happen to be one who did.)

The one things I was reading through your post looking for, was to see if you thought your daughter was mature/stable etc enough to manage the post WLS life. I assume she has no kids. Managing the post-op life as a young single twenty something is much different than a married, 30-something mother of 3. What she can handle today, can snowball as life takes it course and takes over.

That being said I would not encourage someone that young to have WLS absent a serious co-morbidity.

She's pretty mature, but she's young... so she doesn't really know what she doesn't know (yanno?). And correct, no kids.

I worry that it's a one-time shot (for most people) and if she's not ready for it, she's blown it.

That last statement is exactly what I was going to point out. My mom had WLS when I was 16, so I've always known it was an option. I'm 32 now, and only now think I'm "mature" enough to handle the drastic life choices. When I was in my early 20s I'd rather eat pizza and drink beer with my friends. Your daughter may or may not have the same mindset, but this surgery does disrupt social life in a way, which is more important at her age. Even now, I struggle to think of things to do with friends that don't revolve around food and drink, but I'm also less social than I was then, so it's less of an issue.

You said that she 1) eats junk food on the side and 2) large portions.

I think we would all agree junk food has got to go...maybe the "on the side" is more than what you think. It is fast, easy, portable, and all around us. I think most of us will agree she will not achieve maximal weightloss and a decent rate if she is eating junk food.

2) The large portions- I was always hungry pre-op. I ate healthy (no junk food) but one thing I have to be very aware of...even to this day, is portion size. I had to buy several sets of measuring cups for work, home, purse, wherever because I have no restraint and no ability to determine portion size. It is sad, but we cant be stretching our pouches and she could significantly hurt herself if she can not stick to the prescribed amounts immediately post-op.

My vote is NO. Not until she can take care of the above 2 issues.

I was guilty of all of the same up until my pre-op diet. And I didn't even do that well on my pre-op diet. But I was completely compliant with the post-op diet progression, and while I'm not far enough out to declare myself a success, so far so good. Is it the age that makes the difference, or would you apply those same criteria to everyone? Many people have WLS and resolve those issues after the surgery. Should they not have had the surgery?

I would apply it to personality type. Some adults can get their work done early and others need to have deadlines applied.

I think it is risky to find out post-op that she didn't/couldn't/wasn't motivated to "resolve those issues after surgery." Think about it, she will have risked her health on the operating table, got her insides rearranged and be dependent on vitamin supplements FOR THE REST OF HER LIFE and may not be able to do well with other forms of medication (pain-medicine and antibiotics (for me when I had lyme disease)) are just a few cons that come to my mind.

Better to go in KNOWING you can do it and have worked on the issues and have moved forward than to take all these risks and not be able to do it. In the latter case, one assumes ALL the risk, NONE of the positive outcomes.

Oh, I absolutely agree that she needs to start working on those things now, and get into therapy regardless of whether or not she ends up having surgery. :)

I'm just finding the conversation fascinating, all of the different viewpoints. I know when she came to me with it, my gut reaction was absolutely not, you're too young. But a lot of evidence is on the side of doing it - IF it's appropriate which is still yet to be determined. It's given me a lot to think about.

She has a lot of work to do before surgery is on the table, so to speak. And she's taking my advice and starting that work, so I'm not too worried about it. And ultimately it's not my call, but I will give the best advice I can. :D