New Member Considering Weight Loss Surgery

Hi all! I am beginning my journey of determining what to do about my weight and seriously considering weight loss surgery. A little about me:

• 29 years old female
• No kids unless you count an adorable little doggy :)
• 5' 5", 265 lbs (BMI: 44.1)
• Been overweight my whole life, as is my entire immediate family
• Other health conditions: Hypothyroid (controlled via meds), high cholesterol, asthma (controlled), benign heart murmur. My gallbladder was removed about 10 years ago. Allergic to peanuts/ tree nuts and shellfish.
• History of losing 20-30 lbs, then gaining it all back plus some, then losing, etc. Never had sustained weight loss.

In the past, I had a PCP that recommended weight loss surgery. I was going through a lot of grief at the time (my mom had just passed away, at 51, from COPD and obesity related illnesses) and didn't really consider it - I also ballooned to 294 lbs during that time. Two years later, I am living in a different state, in a stable relationship, near family, have a good job, and recovering from my depression and grief, lost 50 lbs and gained over 20 of it back. Recently, my endocrinologist told me that I should consider weight loss surgery. For the first time, I am seriously considering it, which brought me here.

My motivation: I don't want to be my mom. I want to have kids and be healthy for them and see them grow up and have kids. I want to be able to do a flight of stairs without being out of breath and my knees/ ankles hurting. I want to be able to travel more freely and experience life. I want to be able to embrace life without planning for how big I am or how out of breath I get or how much Tylenol I need to take so my knee doesn't hurt. I am too young, I have a whole life to live. Mostly, I don't want to die at 51.

My insurance (Cigna) covers weight loss surgery, but I still need to find out the specifics of the plan's requirements. In the meantime, I am trying to find a therapist in my area that specializes in weight loss/ eating disorders and need to talk to my current PCP, who has not mentioned weight loss surgery. I am also attending a seminar next week at a local bariatric surgeon's office just to get more information. I have so many questions though, which I am hoping you all can help me with.

1. I am terrified of failing at this. In the past, I have dieted for a week or two and then fall off the rails. I am scared I do not have the willpower to go through short term liquid diets and longer term dietary restrictions. I know therapy will help with this (since I am an emotional eater and am sometimes compulsive), but has anyone else faced it? How did you overcome it? I know the surgery is a tool, not a solution, but I am scared it won't be enough for me and I will continue to eat like I have my entire life.
2. How do I talk to my family (dad, sister, serious, live in boyfriend) about this decision? I am most worried about my bf. He is naturally thin as is his whole family, and I don't know if he is going to understand this. I also don't know how he will take the dietary changes I will have. He is a big foodie. How can I get him to understand why this is necessary and what it means for my (our) lifestyle? I think my dad and sister will understand more, but will be worried for me more than anything.
3. What do I do if my PCP is opposed to surgery? She is big into food and exercise being the solutions and I don't know her philosophy on WLS. I expect that I am healthy enough for the surgery, but don't know how to tell if her objections will be because of a concern for my health or an opposition to WLS generally.
4. What will the long term ramifications/ impact of the surgery be on my life? I am particularly considering the sleeve since the malabsorption of the bypass scares me. I know I will need to take vitamins forever and get regular blood tests. I will likely experience thinning hair (hopefully temporary) and loose skin. Are there other physical effects? What about mental effects?

I am sorry for all the questions, at this point I am trying to find everything I can to make an informed decision. Thank you for reading all of this and helping me as I begin this journey.

Most of the people whose lives would be so much better after weight loss surgery never even have the opportunity to do it. Finances, insurance, fear, and believing that they can do it with diet and exercise keep people trapped in overweight bodies and only living a fraction of what their lives could be.

There is no right answer. Do your research and become an expert on this surgery.

For most of us, our biggest regret was not doing it sooner.

I am terrified of failing at this. I didn't truly believe the surgery would work for me! Even when I started losing weight, I figured that once I got past the one year "honeymoon period" the weight loss would stop. But I'm at one year out, I've surpassed my surgeon's expectations, and I'm still losing! I still have to watch what I eat, but now my body now co-operates with me instead of fighting me every step of the way.

In the past, I have dieted for a week or two and then fall off the rails. I am scared I do not have the willpower to go through short term liquid diets and longer term dietary restrictions. This is something to be concerned about, and one reason to have counseling prior to surgery. If you can't stick to the pre-op diet, then you may not be ready. However, the pre-op diet is short-term; knowing there's an end in sight makes it easier to be compliant. After surgery, your body will help you stick to the diet.

How do I talk to my family (dad, sister, serious, live in boyfriend) about this decision? Before the surgery, I recommend that you only tell those who need to know. Otherwise you may have some well-meaning people who have heard a few scary stories about the surgery, and are trying to talk you out of it. After surgery, this is usually less of a problem because the deed is already done.

What do I do if my PCP is opposed to surgery? You can either stand firm, or find a new PCP. It is your body!

What will the long term ramifications/ impact of the surgery be on my life? Medically, the changes are generally all good, and you just need to take vitamins for the long term. If food is a big part of your social life, you will need to adapt. You can still go out to eat, but you'll be leaving half the food on the plate, so it may not seem worthwhile. If you have the kind of family that has big family meals, and whoever cooks will feel hurt if you don't stuff yourself, you'll need a strategy for dealing with that. It's best if you give up alcohol altogether, because there is a risk of transfer addiction.

Welcome! You have a lot of valid questions and many people who come here have the same concerns as you do. In my own experience as a weight loss patient, I worried that I would be a failure as well as do a lot of people. I can remember many times people stating, including myself, that they feared the surgery would not work for them. However, what we have to realize is that the surgery is a tool and you are the one who is operating that tool. You have to change your mindset and you have to realize that surgery is just one component of WLS. You also need to work on your mental aspect of how you view and approach food. Counseling is a good place to start out, learn to redefine your relationship with food, so you can be a long term success.

Talking to family or friends about surgery is always hard. For your Dad and sister, I would show them the statistics that outline the benefits of the surgery and the likelihood that if you do not do something, you will continue to gain and eventually have even more health problems. Your boyfriend, this is a hard situation because he is thin to begin with, but you have to educate him on the changes you have to make in order to be successful and he can't ask you to go to someplace that isn't going to support your post-op eating goals. It is easy to find something on a menu that you can eat anywhere, you might have to make some adjustments, but if he is someone who pressures you to "try" something - that is where you are going to have to be sure he understands, you can't. My husband adapted to my eating habits and even took on a healthier eating plan because of my surgery. Our meals consist of dense protein and non-starchy veggies. The fried chicken and mashed potato are no longer welcome in our home. If he gets a craving for it, I let him do his thing, but I do not indulge in his choice.

Depending on your policy plan, if you are an HMO you are going to require a referral from your PCP for surgery. So, either way, you will have to have this conversation with them because they will also be the ones to follow you as you get further out from surgery. I would do your research on the surgery and what all it will entail you having to commit to. I would then show her you have done your research and how you are committed to making the change, yes even the dietary ones. If she says you can do that without surgery, you can be honest and let her know you have worries considering your Mother passed at 51 and you need this tool to help you. But, definitely show her you know what you must do to be successful.

On the long term ramifications, those can vary from person to person. No one has the same outcome, other than weight loss. Vitamin deficiency is one issue. With the bypass malabsorption is another and reactive hypoglycemia, to some extent is a definitive thing for most, but not all. As I stated earlier, changing your mindset is the biggest key to success, so I would definitely recommend support groups, counseling and making sure you realize that there is a lot of help out there in many forms, you just need to find it and embrace it.

Wishing you the best of luck!

Addressing each of your point:

1-- Your success with WLS is 100% up to you. There are many of us here who have dealt with regain to varying degrees, and plenty of folks who never made it to their goal. But if you work hard, follow the guidelines given by your surgeon, and address your mental/emotional issues, the statistics say that WLS gives you the best chance of losing weight and keeping it off. It will almost certainly be physically impossible to eat like you used to after surgery, and that is completely motivating.

2-- As someone who hasn't struggled with his weight, he probably won't/can't really understand. For me, telling people that "this is what my doctor says is the best choice" really carried a lot of weight and helped reassure my husband and family. But ultimately, it's OK to say "my body, my decision" if they don't understand or aren't supportive.

3-- If your PCP is opposed, there is nothing wrong with finding another PCP. Some people, including doctors, wrongly think that WLS is the "easy way out." Your surgeon knows more about WLS than your PCP, so I would be more inclined to trust the surgeon's take.

4-- In addition to the physical effects you've mentioned, you'll likely be very tired for the first few months after surgery. I had to take a nap nearly every night for the first few months as I felt like I'd been hit by a bus. It did get better, though!

The mental effects are an entirely different ballgame. If you're an emotional eater, you'll need to find a new way to deal with your feelings; for some people, this takes the shape of "transfer addiction" and they drink too much, develop shopping addictions, and the like. As you lose weight, many folks also deal with body dysmorphia and have a hard time reconciling what they see in the mirror with the way they perceive themselves. If food has been an important part of your social life, that will also change a bit as well. Working with a therapist or counselor is very important and can help you be successful.

I just want to start off by saying it sounds like you've already read a lot about the surgery and are taking all the right steps to educate yourself so that is amazing.

when I first decided that I wanted to pursue WLS I started following a lot of people's posts on social media (instagram and YouTube mostly) and it was incredibly motivating being able to watch their progress over the course of a year or 2 starting at the beginning of their journey and even later on, going into skin removal surgeries and maintaining their new healthier lifestyles with eating plans and workout routines.
They are real people with similar situations and they talk about the realities, the struggles, successes and failures and I feel like that gave me a realistic expectation while also giving me so much HOPE that this could be the thing that finally worked for me.

You already have the forethought to start therapy and that is probably going to be the most critical part to overcoming that fear of failure. starting before surgery will help prepare you for what is to come which is important because at least for the first couple of months, you won't physically be able to use food as a coping mechanism...your body won't let you. you are going to need to find other ways to deal with emotions or you may have transfer addictions that are just as bad if not worse than food.
A therapist can also help you decide what you want to say to your family and friends (if you decide to tell them) and how to deal with any negativity or how to answer their fears.
My family was afraid for me when i told them. They didn't try to talk me out of it but they expressed their concern for my health and safety...but I told them I had made the decision for myself and I was not going to change my mind. I felt like I was prepared because I had done tons of research.

I know that in the past when I had successfully lost weight and been able to maintain a diet plan, it was due to seeing fast results, but when results don't happen fast enough I'd lose motivation and it was easy to regain and fall back into old habits. With the surgery, you will see results...you will likely see them very rapidly at first and it will be a huge motivator.
The surgery will also not allow you to overeat, which is why it is such a great tool...it will physically force you to learn to eat smaller portions and healthier foods. Depending on the surgery you have, you may not be able to tolerate fatty or sugary foods which are many of our biggest downfalls.
You will have a window of time after your surgery to re-train your brain how to eat, how to move your body, and learn a new normal routine that you can maintain for the rest of your life....it's not going to last forever but it is a lot easier to learn to eat less and eat healthier foods when you're not hungry all the time.

like others have said, if your PCP is opposed, find another one! there are plenty of doctors out there that are knowledgeable about WLS and bariatric patients and will be more than willing to bill your insurance and take your money.

as for long term impacts--the good outweigh the bad 1000%.
You'll have to take extra vitamins, probably need a few more blood tests per year than you might have, you'll need to eat more protein, less junk food, exercise more.
Hair loss happens--it grows back. get a cute pixie cut for a while...you may have lots of loose skin...it's waaaaay better than all that fat and you can get it removed if you can save the money or your insurance may pay for it if you're willing to go through the surgeries.

mental effects--you will probably feel more confident. you may have weird insecurities you didn't even think about before but you will also probably feel more empowered to overcome them. Your relationships with EVERYONE will change- some for the better, some for the worse. You will have ups and downs. you will struggle. you will rejoice, you will cry, but you will likely laugh a lot more. you will be able to walk up stairs without difficulty, you will be able to have a healthier pregnancy if you choose to have kids, and you will be able to PLAY with them. you will be able to shop in any store without worrying if they carry your size, you can travel comfortably without seat belt extenders or worry you're making the person next to you uncomfortable. You will not be discriminated against for being obese.

if/when you commit to the surgery, keep coming here to OH and read daily posts and menu threads on the message boards to keep yourself accountable and make some like-minded friendships. it helps me stay on track knowing I have a support system even if they are online strangers...they feel like a family.

I also have Cigna, and they cover all variations of WLS. If you have surgery, you will be successful - it's close to a guarantee as long as you're ready to try. You don't have to be perfect, just committed to trying.

Do the research and talk to a qualified bariatric surgeon. Select a wls procedure you feel good about and the surgeons office will guide you thru the process.

Your PCP is not really very useful here so don't rely too much on them. It's your opinion in conjunction with your surgeon.

Your family also will not understand so ask for emotional support but not advice.

Good luck - as a nurse at the surgeon's office told me prior to the surgery; No one has ever asked for the weight back.

Just wanted to clarify your first statement in case it confuses anyone. Your Cigna policy may cover WLS, but that doesn't mean my Cigna policy will. Policies differ based on what employers select, so policies differ by company and insurance carrier. People looking to see if their policy includes WLS need to read or contact them directly and not assume Cigna automatically covers it.

I had RNY over 11 years ago. Before WLS I never could keep the weight off, and I would lose, then over 2 -3 years I would gain every nig back plus a few pounds. And repeat - lose weight, gain it back. Everytime losing as more difficult, gaining was easy and faster as I aged. There was time that I couldn't lose any weight. I would diet, exercise, lose 2-3 lbs, go on a business trip where my eating was limited, and gained it all back. I was frustrating.

In shear desperation I had WLS. I was sick and tired of being MO. I was healty fat person. Good BP, sugar, cholesterol, etc. But I knew "things" would catch up with me.

Post op RNY - I lost all excesive weight within 8-9 months, and I lost 10-15 lbs more.

Over the 11 years I had some regain, 2 times, but I gained app 30 lbs above my personal goal, and even with the gain - my size was consider "normal". And when I started having the familiar " more pain doing just about anything due to too much weight carrying around" I got back on a proper WLS diet and I was able to lose the regain within 4-6 months.

I think RNY gave me the tool plus metabolic changes that allow my body maintain normal weight.

I do have issues, but I think my issues are due to a very specific conditions that I probably had before RNY. I think RNY made them worse, and brought them to surface, but I don think it really caused the issues.

It is good you question things. I know people, on here, or in real life (IRL) that are maintaining. And I know people who gained significant weight back, some probably all of the weight, and stopped even trying. They don't believe the "surgery is working for them". Unfortunately some of them believe they should be able to eat almost anything just smaller qty and maintain. I sow them eating rice, bread, candies, ice cream, etc etc. And some of them drink alcohol. Not to excess, but enough to cause weight gain. The 2 times I had regain, I indulged in alcohol. A few times a week. Alcohol is not only empty calories, but IMO it can help digestion and absorbtion of food we eat, and in my case, I could eat much more if I had a glass or 2 of wine. My pouch became less sensitive to full - empty signals.

As for your BF - his concerns could be valid. WLS changed my life. For better and for worse. I met my guy a few years after I had my WLS. He loves me "thin or thick"

He supports what I do and eat. He supports me even when I make stupid food choices, and later on deal with gut pain, or other issues. He is there for me when I am crying pain because my body hates some of the food I sometimes insisted on eating.

We like food, and we like good food. I still enjoy high quality, tasty meals, and I cook bunch, even if I would not eat it. But - my guy and I - we seldom eat the same dish, and often - not at the same time. That takes pressure from me to gave to eat when I don't feel like eating, or wait for him when I get hungry. But - at our age, we are mature to know it is ok not doing things "together".

I hope your BF can understand. Unless he is the guy that is attracted to larger sizes women, you may hit a tough spot, but you relationship can grow stronger from that.

Good luck

The life change. Think about WLS because your cardiac problems. My surgery increased my arritmias and I had take ablation and an I had a dificult posoperatory. I'm happy with my choice, but today I see: the life pos WLS dont is a life with more health for all.