First, Congratulations on making such a big decision!!! I am so happy and proud of you!

second, some of my best advice (because I was 673) is going to be hard advice.

You are going to NEED a support team someone willing to say no to you when you want to break and someone willing to say you got this when you don't believe you do. Also remember to follow your doctor's advice because he/she knows you and what is best for you and EVERYONE else just has opinions.

Remember it is easier to say no to food at a store than at home/restaurant. You do NOT have to take your leftovers home for later. In the first few years always split meal with someone. I promise your doctor is saying no for a reason and not to just be mean.

THE VERY MOST IMPORTANT THING TO REMEMBER YOU ARE WORTH ALL THIS!

Melissa

Your surgeon should give you a program to follow. It should include diet, exercise, support groups, and pre-surgery medical tests.

At over 700 lbs i need all help i can get, like what are some exercise i can do in bed because I can barely walk

I haven't tried semaglutide (ozempic), but I did try liraglutide. I think semaglutide is a longer-acting form, so I'm basing my comments on that.

My internist said that while most people only have modest weight loss with these drugs, some people are super-responders. She suggested I try it just in case. A week later, I didn't have the sense of fullness that the drug is supposed to give you, so she took me off of it and we went for WLS.

You should know if it works in a week to 10 days, so it might be worth a try for such a short term. If it does work for you, maybe discuss the side effects with your doctor and then decide if you want to stay on it.

I would have some serious doubts about it.

It is, and has been a somewhat popular thing amongst family docs to prescribe off label diabetes drugs such as ozempic or byetta for weight loss, as they do have that side effect along with their effect on diabetes. However, they are not certified for use as a weight loss drug (why it's an off label use) so the longer term effects have not been tested and verified (you're being a lab rat.) Given the size of the potential market for weight loss vs. simple diabetes, they are no doubt being tested for that purpose with the intent of being certified for it. Also, being off label, will your insurance pay for it, if you aren't diabetic? If you research it more closely, I suspect that you will find that the weight loss effect is temporary, as long as one is on the drug, and weight will come back once one is off the drug. Since you have a regain problem, this does not look like a compatible use of the drug.

Of greater concern, is in how this drug works. It slows the release of food into your intestines which helps blood sugar control, and also the insulin spikes that can lead to more rapid hunger and over eating, presumably by slowing the action of the pyloric valve that meters stomach contents into the intestines. Great. Problem is that you don't have a pyloric valve in your active GI tract - it's been bypassed along with the majority of your stomach when you had your RNY; Will this drug even work in a bypass patient, whether for diabetes or hunger control? Has it even been tested on bypass patients? Does your family doc really understand what was done to you when you had your RNY, and does he understand how the drug works (or is he just taking the word of the drug salesman that visits his office dispensing goodies in exchange for writing Rx? I don't know the answers to all of these questions (though I have my suspicions) but they are things I would seriously be asking before getting involved with this line of treatment. If it was your bariatric program suggesting it because they have used it on patients similar to you with some success, that would hold a bit more weight (so to speak) in my mind.

Another consideration is the "five year rule." This is a informal conservative medical practice that holds that one should avoid medications within five years of their certification. The reasoning is that drugs are certified on the basis if a few thousand (2-4,000 typically) patients using the drug for a few months or maybe a year or so. If all goes well, it is certified for sale and then you see hundreds of thousands to millions of people taking the drug, and that is where those occasional rare but serious side effects can show up that could cause the drug to be pulled from the market. If there are existing drugs on the market that treat your problem with minimal or acceptable side effects, one should go with them in preference to the new kid on the block; if the new drug works substantially better than those that are existing, or without notable side effects, then it can be worth the risk. But it is not something one should go into blindly, or assume that the newest is the best - it might or might not be.

Side note - I had the same pitch given to me by a doc (not my PCP or surgeon) regarding Byetta before I had my VSG. The drug has changed now (same basic mechanism, though) but the sales pitch is the same.