Sorry so long...but desperate for help...please read. TIA!

Hi all! I read and learn from the obesityhelp boards because my daughter who is 27 is so very heavy - A year ago she made the decision to have gastric bypass surgery. We would be self pay, so after lots of work and searching, we found a way to secure the loan to pay for her to have the surgery. After lots of research, she decided upon the doctor she wanted to do the surgery, and we went in for her first appointment, after attending the seminar, and because she is SO overweight (over 400 lbs) the doctor won't do surgery on her until she loses weight. We tried another doctor and he was going to require she lose even more weight - 60 pounds. She has made some attempts to lose the weight, also increasing her exercising, doing water aerobics for awhile, etc., in order to have the surgery, but with little results. When she went back to see the nutritionist and found out that she had gained a few pounds other than lost, she basically gave up. She is convinced she cannot do it, and that it is hopeless. She is bi-polar (on meds), but when she feels that hopelessness, she gets very depressed and quits trying - only to eat more and gain more. These last 6 or 7 months it seems that all she does is lay in bed for most of the day and night, eating junk food. With all this weight it takes so much effort for her to do anything, and there are so few things she can do. It breaks my heart to see this vicious circle happening - especially when there was a hint of light ahead when we secured the funding. We were so hopefully that she could have the surgery and have a healthier, happier life. I fear now that she will become unable to even get out of the house, fit behind a car, etc. She has a little 4 year old boy that she wants to be healthier for. Since this board is the one for body mass index I wanted to ask if any of you had gastric bypass without having to lose weight first (other than the 10 day pre-diet). Were any of you asked to try and lose for a certain number of months, didn't have success, and the doctor went ahead and operated? Also, I've just discovered the VSG procedure - it seems that might be the way to go, as a 'stage 1' for her to lose enough weight that she could then go on to have the gastric bypass or band. Any of you have the VSG? Did you have to lose weight first before that surgery? I am just looking for some type of options for her before she gets unable to function. She even talked about wiring her jaws shut. Thank you SO much for your advice, stories, help, etc.! Becky

So sorry to hear about your daughter - but it is WONDERFUL that you are in her corner and doing whatever you can to help her. I wasn't "required" to lose weight.  I did have to go on a 2 week "liquid diet" prior to surgery and had the warning hanging over my head that the surgeon would be able to tell whether or not I followed the liquid diet by the condition of my liver.  One of the main reasons for the pre-op diet is to shrink the liver so that the surgeon can see better.  This was enough to keep me on the straight and narrow. I hope things work out for you and your daughter.

I replied to your e-mail, but I thought I'd also post it here in case other lurking people are reading it and thinking about surgery.  Most of us were asked to lose weight.  I'd post this on the board (oh I checked and you did) - most people are asked to lose weight before surgery, whatever their starting weight.  It makes surgery safer, and shows your dedication.  Heavier people are asked to lose more generally.  I was 440 and my doctor wanted me to lose 40-70lbs before surgery.  Surgery was scheduled once I lost 35, and by the time I had it I'd basically lost 40.  I did it through a structured food plan and when I followed it correctly, I lost very quickly.  It was 2-3 protein shakes per day (I used atkins advantage ready to drink shakes - any very low carb shake with at least 20g of protein will do - or powders mixed with water) and then a small dinner consisting of 1 serving (3oz, or a palm sized piece, of chicken, turkey, or fish) plus all of the veggies I wanted, no butter or dressing.  Avocado and potato obviously are not considered veggies here, we are talking about low calorie options like broccoli, lettuce, tomato, spinach, etc.  The diet was hard at first, its low calorie and low carb, so I had headaches and hunger.  After a few days it got much easier as I became accustomed to it.  Unfortunately if I cheated and went off plan, I had to deal with the headaches, cravings, hunger, and feeling tired all over again.  I don't know how to put this without being too blunt, but your daughter will have to lose some weight if she wants surgery, and the only person who can make her do it is herself.  She has to be ready for it, if she's not she won't be compliant after surgery and she won't lose like she should.  Super morbidly obese people have to be very compliant, and very determined to make this surgery work, because they are statistically the most likely not to lose enough, and the most likely to re-gain some or all of the weight.  Food is an addiction, and its harder to beat than any other addiction because you can't just avoid it.  You are faced with your drug constantly, you have to deal with it every day.  This is very difficult, it takes a lot of dedication and determination.  The surgery is just a tool to help you get there, but it doesn't guarantee anything - after the first couple of months you can out-eat it if you want to.  If you go back to carby slider junky foods like chips, crackers, potatoes, ice cream, etc you can eat quite a lot of them, believe me.  They go right through the pouch.  Since you are self-pay I'd really recommend she be 100% dedicated and ready before she has surgery, otherwise your money might be wasted and she might end up looking for another solution later on.  It doesn't sound like she is ready yet to me, but maybe she is.  Losing some weight on her own is not impossible - its really tough, really really really tough, but she will have to do it if she is determined to have this surgery.  There are people on the boards who are having or have had VSG.  I hope they reply to you and I wish you both the very best!

HI Becky, I see that you have been researching the VSG as well as the gastric bypass, but have you also done research on the duodenal switch.  THere is another option out there.  It shows the best results for long term weight loss.  Check out the DS boards here on OH and also duodenalswitch.com .  I am a pre-op who is having surgery hopefully soon in MN, and I am 400 pounds.  I have been losing some weight but not much, and I have been working very hard at it.  My doctor does not require me to lose any weight, but I am trying just to make things easier for him.  There are several DS surgeons who do self-pay...one in Pennsylvania whose name is Dr Peters.  He is highly recommended and I do not believe he requires you to lose weight before surgery, you just need to pass all of the required tests.   I like your daughter was very depressed and sad and kept gaining weight....once I knew there was hope and an option for me that I knew I could succeed with things turned around for me.  THe duodenal switch is a surgical plan that I truly felt I could live with and lose the weight with.  You are able to live a more normal life...with lots of vitamins that is...but I was already taking medications so I did not feel the viatmins added would be a big deal.  THe ds allows you to eat a varied diet that is much less restrictive than the RNY and still lose 75-80% of your excess body weight.  This is the best surgery available for the super, super morbidly obese.  I hope you help her do the research and stop by the DS board.  PM me if you have any questions as I do not know where you are located there may be other surgeons close to you. Jennifer

It sounds like your daughter is very depressed.  I know it is easy to think she is depressed because she is obese.  The truth is her depression will not change from weight loss.  My strong urging is to work on getting her bipolar disorder under better control.  It is then that she will be able to lose the weight she needs to have the best surgery for her situation.  Our chemicals have to be in order for us to be motivated to lose weight and really want to and to actually be able to do it..  PM me if you want more insight.  I can relate.  Loris

Hi Becky, I'm so sorry to hear about where things are right now for your daughter.  It's wonderful that she has you in her corner.  I'm still a pre-op "newbie" myself so I don't have a lot of advice to impart, but I do want to encourage you post your question on the Duodenal Switch (DS) forum so you'll get some helpful perspective from others who've had a different type of weight loss surgery other than the RNY or VSG.  I've really been considering the DS because of my high BMI and the stellar long-term results for keeping the weight off.  Take a look and see what you think.  Take care.  I hope things work out for your daughter.