How to have the talk?

Hey guys, I am a newbie here. I am from Toronto, 38 years old and on the last few weeks of my EI since my job closed its doors last year.  I have been looking for work but its been VERY hard because my town is very small, and with my weight being 420lbs, my BMI is 69.9, my back can not take the pain of standing more then 10 mins without needing to sit down.  Its also affecting my knees, my feet are HUGE and even walking more then 2 mins leaves me in incredible pain and so out of breath.  I sleep so much, even after sleeping 8 hours, I could be up for 2 hours and need to go back to bed again because I am not getting the proper rest my body needs at night.  Just everyday living is become so hard to do, even having my daily shower leaves me in terrible back pain and out of breath after I have finished.  Most ppl assume that you only get to this weight from eating crap food, but I know from experience its NOT always true.  I like to think i eat health, I almost never eat anything processed and I don't eat fast food. The only time I don't eat food that I prepare is at Christmas when I go to my family.  But almost all of what goes in my mouth is real food and once I'm full I do stop, but its alot of food before I finally feel full.  Im an emotional eater.  Even though I am careful to include a lot of healthy fibre I am usually hungry.  I have tried and tried to diet with no luck.  My weight has gotten to the point that I dread waking up and facing my day because I know what's going to happen and how I am going to physically feel, and that alone becomes very depressing.  

So its not that there is lack of work in my community as to why I am still unemployed, its more of the issue of myself not being able to physically handle most of the common jobs that are available to me.  I'm not looking forward to applying for Ontario Works because I know they will FORCE me to take any job.  But if a job that doesn't involve a chair, come available soon, I will have no choice but to apply for OW.  I have been on a 1 year waiting list for a family physician as I have not had a family doctor in years, my old one moved to another city about 5yrs ago.  But I was finally contacted about a month ago about a new doctor accepting new patients, so I had my first apt with her 2 weeks ago, she sent me for blood work, referred me to a sleep clinic for a sleep study which I have in 2 weeks time, and I have another apt with a dietician in a few days.  Today I have a follow up apt with my doctor about the blood work that was done and she wants to do a physical.  I'm so scared, I'm so huge :( and so embarrassed of my size.  Im afraid of even the thoughts of her seeing me like this without my clothes.  Its 5:13am and I haven't been able to sleep all night because I have developed so much anxiety over this but I know it has to be done.   

I have been reading and researching WLS for a few weeks and especially over the last few days, its all I have been doing.  I truly feel that this is the right decision for me and even though I have read some pretty frightening stories about what can happen, risk factors, long term effects and some negative reviews from people who have had it done, I have also read the positives from it.  And at this point in my life, I am not living anymore, I feel so trapped.  I now make excuses as to why I cant make it to a family dinner because I fear about hiding the pain so no one notices, and I am so embarrassed about what I have done to myself and how I look because of it.  Even as I type this I am in tears because of the physical struggle this has become and the limitations that I have given myself because of my weight.  I feel like I have nothing more to lose but my life if I do not make this choice.  So today when I go to my appointment I want to talk to her about WLS but how do I say it?  Like, do you just come out and ask her to refer you to a surgeon?  What if she says no?  Do I have other options about how to talk to a surgeon who will consider me for surgery if my doctor wont give me a referral?  Any help or info would be greatly appreciated.

My doctor suggested the surgery to me. If I were you, I would just ask my doctor. Maybe go in with a list of positive reasons why you want the surgery. 

Good luck and welcome!

Welcome to the site.   There's no way in heck your doctor would not recommend you for WLS, how could you even be worried about that?  If she doesnt give you a referral, then find a new doctor.  you definitely need surgery.

Secondly, I need to point out that you say you eat "Healthy" and still wound up 420 pounds.  That is not possible, no matter what you say.   Case in point, you say "you always eat just until you're full and then you stop."  That's your problem #1.  Eating until you're "full."   You dont have to fill your entire stomach organ, which, the average is the size of a football.. and that holds quite a mound of food, but an obese person's stomach is stretched even further, especially after a lifetime of eating until full.  You are over-eating.   We need to learn to eat to live.  Eat proper portions.  My husband is the same way, he thinks he has to eat until he cant eat another bite.  That's bad eating habits.  You measure out a healthful portion, you eat it, you get up from the table and go do something else.    :)

Let us know how the doctor goes. 

First, I want to say as someone that started this whole process at 444 lbs with a BMI of 63, I know exactly how you feel. I too felt the embarrassment and shame all day, everyday. I felt the emotional pain - as well as the physical pain. I felt sick and tired all of the time. I was still able to work;however, I would dread walking to meetings or doing anything that required me to stand for more than five minutes at a time. I really feel for you, as I would say most of us that visit this board have been in the exact same situation.

Here are my thoughts on the other parts of your post. First, the most important step you can take at this point is to "get real" as I always like to say. You say that you did not get to 420 lbs by eating unhealthy food. This is just not possible. I'm sorry if that sounds harsh, but it's true. If you were eating a very lean, healthy, diet then you would have to eat an ungodly amount of volume in order to do so. I know this because I was required to do a 6 month supervised diet where I ate completely lean protein, veggies, some fruit, and yogurt and I was eating a tremendous volume to hit the 1600 calories per day that I was eating. I'm guessing that you are either lying to yourself or you are in need of nutrition education regarding what "healthy" food is - and if that's the case... that's all right. I needed the same thing. All calories are not created equal. Fat is not the enemy. Simple carbs and sugar are the enemy and it's really important to pay attention to that kind of stuff.

Also, Lisa is 100% correct in her post above, you should not be eating until you feel fullness - slight or extreme. While a weight loss surgery can help you with restriction... it does NOT help with restriction that well when you get 6+ months out and you don't stick to lean protein. You'd be amazed at the volume you could still eat after weight loss surgery. So, it's important for you to start changing your habits now, including therapy to address the eating issues that you have... because let's face it - we don't get to be 400+ lbs with a BMI of 60+ because we're feeling hungry all the time - we're eating for other reasons.

I can say that I am 10000% happy I did this - and that I lost a significant amount of weight before surgery. Life is 10000% better and I know that it's something you could experience too if you put in the hard work and start addressing any emotional, mental, and physical issues!

I know very well the anxiety you describe. It seems like a lot of times, I think things through so hard that I'm already defeated before I even start something. First of all, sleep apnea is a real pain in the ass, and it sounds like you might be suffering from some sleep apnea. You will be amazed at the difference after a full night of real sleep being treated for sleep apnea. Secondly, you are already doing so much for yourself! YOU scheduled the doctor's appointment. YOU researched weight loss surgery. YOU found a group of people on the internet who have been in similar situations to yours and some who are still fighting that battle. YOU are stronger than you realize. Chances are, your doctor will agree that you need weight loss surgery. You're already on the path to getting your life back. I had my VSG performed in late October and I've lost 67 pounds already. While you're going through it, it feels so slow, but I'm wearing clothes that I haven't worn in years, I'm swimming 3-5 times per week in the indoor pool at my local YMCA. My skin has cleared up. My lymphadema in my feet and ankles has reduced (not gone away completely, but reduced significantly. I no longer get what I referred to as "superfoot"). 

What I'm trying to say is this: The anxiety is there, and it sucks. But you said it best, "I have nothing more to lose than my life if I do not make this choice." You clearly need a change and a new life. You're already on the path to feeling better and being less embarassed. PM me if you want to talk. I'm a good listener. 

I was practically crying when I finally got up the nerve to ask my doctor for a referral for WLS. I had already done a lot of soul-searching and reading, but I was so afraid of saying, out loud, how I wasn't able to do it on my own and terrified that she'd say no.  She was totally cool about it and just said "sure, yup, let's do it". I think it helps (both her and me) that she has a couple other patients who've had it done so we won't be both walking down this path without any signposts.

I hope you found your courage to ask for what you need to be healthy. 

You will have to be brave. I read a lot of posts about being disciplined and dedicated, and that is very important, but before you can do that you have to be brave. You have to advocate for yourself, and don't be afraid to brooch the subject.

I have had the same doctor for 13 years. She delivered three of my children, I see her at least five or six times a year for my visits and the kids' visits. She knows my history, she is wonderful, kind, and generous with her time. I still had to be brave, because it is hard to hear the words, even from your own mouth. I teared up, I'm not going to lie. It is an emotional time.

Now I'm a couple of months into the process, and it is getting easier to talk about. Heck, I told my boss about my future surgery today so he would be aware that I would need to take two weeks off to recuperate. For me, keeping it a secret doesn't make sense. I am an extroverted social butterfly stuck in a bulky and unwieldy body. I know it is time for a change. I've been eating very healthy and eating the correct amount for the past 16 days, and I have lost just over 9lbs already. You'll note I'm a couple of months into the process. It took me the first month to come to terms with the changes, accept that I needed to make them, and to then implement them. It isn't easy. My surgery isn't for another few months, as I have a six month diet and exercise program to complete. I already feel healthier and happier.

You can do this. You just have to do the work, and it is a lot of work.