What a wonderful post and replies! My main reason, is because I am a dialysis nurse, and seeing my patients sitting in my chair three times a week for 3 and 4 hours at a time showed me the harsh reality of diabetes and high blood pressure, the two leading causes of kidney failure, both of wich I had! I have struggled with weight issues since puberty and even though if I put my mind to it, I could lose weight, but I have never been successful at keeping it off. My sugars were not getting any better, and my blood pressure just kept creeping up as well as the meds to control them without much better numbers. I knew I had to do something and I tried three years ago and ran into insurance issues and I honestly believe that it just was not God's timing. I wanted to get healty then as well, but was not nearly as bad off as I was in the past year with my numbers, but I wanted to lose weight and not have to work so hard all over again. I don't think I was in right mindset at that point, not that those are not valid reasons, I just don't think that I would have been as successful or had as much drive as I have at this point in my life. Fast forward three years and after being on a successful program and getting down to 218 from 247, I made it through the most stressful semester of school in my life, because I was working full time and going to school full time, so all I could do and afford was the dollor menus from fast food places, so back to 255 I was by the end of the semester!!! I knew that I would not be able to make it through my LPN to RN transition program and not be over three hundred pounds by the time I was done if I didn't make some changes. My husband had told me I was going to have to quit work because it was just to much, but I love being a nurse so much, it was hard to leave my family, but I knew he was right and I quit in the spring to spend the summer with my family and take my last couple of labs I needed for my pre-recs. I went to the doctor for my regular diabetic appointment and my numbers again were not good and she increased my meds and I ask her if she could write a prescription for Adipex to help me lose weight, she said nope can't do it an so I decided I would take a chance and ask about WLS one more time. She came back after running my numbers and said you are an excellent candidate, (when I quit my job, my primary insurance switched from what I had to what my husband had) So very quickly everything fell into place and I knew that this was the time that was meant for me to do it. I had been praying about my weight and medical conditions for so long, I know God answered my prayers and for that I am truly thankful! I am no longer on any of my medication and my numbers are perfect!!

 I bombed this question when it was asked of me at the psych appt.  I don't remember what I said, but I remember his reaction-somewhere between boredom and disbelief (as in yeah, sure, diets don't work).  Upon further thought, this is why I am hopeful WLS will result in better results.

1.  Metabolism issues, mostly related to PCOS (I think) and prior dieting.  It took me a year to make my pre-surgical visit weight loss goal of 40lbs.  And I was "on plan" most of the time.  But, the frustration after going 2 weeks on Medifast, for example, and not seeing more than a one-pound loss, would then result in self-loathing and anger.  I still think my weight loss is slow, considering my size.  Since surgery, 4 weeks ago, I have lost 19lbs.  For someone with a BMI of 54 (now), I was thinking the loss would have been greater.  Oh well.

2.  Anxiety and back issues.  Not on any medication for either, but probably should be.  I suffer a bit with agoraphobia, mostly related to my weight.  The heavier I got, the less I wanted to leave the house.  The less I moved, the more my back hurt, which made moving even more painful, which then increased my anxiety, because I knew any activity I would do would be agonizing. 

3.  Unrelenting hunger.  I was always hungry, almost ravenous. Going just a few hours between meals would leave me so irritable because I felt I was starving. I was hopeful the reduced ghrelin levels would help me get through a normal day.  So far, so good.

4. Established habits.  I needed something that would force me to change my unhealthy relationship with food.  I would go on a diet, but there was no immediate consequence if I fell off the wagon.  I've read a lot of self-help books this summer on emotional eating and I am making myself track food and stay engaged in WLS communities, because I am afraid complacency will result in going back to my established habits.

Thanks for the question, Kelly.  Interesting reading.

The psych guy might not have liked these answers but they make perfect sense to me.

 These weren't the answers I gave him.  I was not prepared for the question and I think I said something like, "diets don't work for me" or "I can't seem to stay on a diet," something that made him eyeroll, lol.  

I can see how not being prepared for the question and not having much time to think it through would make it hard to answer.  I had to think about it for a few days before I even posted the question.  It takes some honest self exploration to understand it, I think.

Hi Kelly:)
  I am pre-op, hoping for a late Sept/early October date.
 There are several reasons why I need surgery...
  I need the surgery so that I can reclaim my life. Over the past 10 years I have gained well over 100 lbs, putting myself at over 400 lbs. (I am 5'2") I have had both my knees replaced and my career as a chef has come to a grinding halt due to my weight causing physical limitations. I am at the point now where my mobility is greatly affected..I don't do the fun things that I used to because of my weight.
  I need the surgery to help correct the health isssues that have sprung up due to my weight. I have severe apnea (my machine's setting is 20) I am borderline diabetic (my a1c is 6.9..as borderline as you can get!) I have high blood pressure (what a shocker). The weight aggravates the pain from spinal fusions I had when I was younger, plus a few lesser issues  
  I need the surgery because I am afraid of dying before I hit 50 (I am 45). A big eye-opener was when my younger brother, who was obese, but seemingly healthy (well, as healthy as one can be weighing 315lbs) died of a heart attack. 
  I need the surgery because i can't do it all by myself.

 Lets see I had this surgery because I tried endless diets as did everyone here. Nothing worked I would lose then gain even more back. I was 36 and put on pressure meds. In my family heart problems are rampid as well as diabetes and a slue of other troubles. 

I am an emotional eater I hide in my food as it doesnt hurt you or mentally F with you. ANd I dealt with that my whole childhood. It needed to stop so that my kids didn;t start to pick up my habits. 

truthfully I was just sick and tired of being fat and feeling like **** I wanted to see my babies graduate and get married and the path I was on I would not have made it without this surgery.

I just knew I wouldn't have the ability to do it without the surgery. The surgery was going to be life changing - it would force me to eat less for a while. It would force me to go on a liquid diet then soft foods then regular. I knew without this outside force working on me there was no way I was going to make any permanent change. I knew that I'd just keep creeping up and I was already over 300 pounds, not able to walk to my car after work without being winded, not able to walk up and down stairs, I was pre-diabetic and other co morbidities. I had no idea when I was full. I only knew when I was so stuffed I couldn't eat any more but I had no idea what just 'full' felt like.

I'd always thought that if I found out I had diabetes THAT would be the thing to shock me into compliance with a diet. but nope, as I got closer and closer I realized I'd need outside intervention.

And finally, when I found out that less than 5% of morbidly obese people are able to lose the weight and have it stay off while about 80%  of those witrh RNY surgery are able to keep it off I knew I had to have the surgery.

Mine was due diabetes and sleep apnea. 
I was on metformin, levimir, AND byetta and my numbers NEVER registered under 250 to 300 for over 6 months.

Im a caterer so Im a volume eater.. if I see it or know it's around Im gonna eat it.  I needed the restriction more than anything to help me gauge not to eat a whole pizza or my former mcds meal of 6 piece, double cheese and medium fry with large soda. 

I was always an athletic active child who had HORRIBLE eating habits.  I wouldn't touch a vegetable with a ten foot pole.  I lived off PB&J and Doritos, soda, cookies - all the things I shouldn't be eating.  I stayed pretty active until late high school and starting putting weight on slowly...my eating habits caught up with me.  Unforunately - these foods were all I knew.  My mother would always tell me not to eat them, that one day I would end up fat...yet she would buy them?  That has always been a bit confusing to me - she was my "enforcer" - unwillingly...

College I ended up over 200 pounds - and started yo-yo dieting.  I tried the "Slim-Fast", the Lean Cuisines - I'd lose 20-30 pounds, then go back to my "comfort" and junk food habits.  Of course I'd gain back 50.  This continued until I had my children...lets just say after that my metabolishm went to hell in a handbasket along with my horomones.  I ended up with hypothyroidism after my second daughter - got on synthroid (which I thought was my cure all - this is why I'm fat?!).  I joined weigh****chers and lost almost 60 pounds (which got me to 224).  Wanna guess what happened when I stopped going to meetings?  What happened when my husband had an affair?  When stress happens to me - I went right back to what I knew - comfort and junk food.  So I decided while my marriage was falling apart I was going to take control of my health and do something fo rme (for once in my life) and had WLS (got the lap-band).  I'm not going to BS you - I did it soley for selfish purposes:

1.  To get back at my husband and to be attractive for once.  He told me that I discusted him - and of course blamed me for his straying - because I was so fat. Yes he is and always will be an asshole.  Do I believe it now - Nope.  I left him and was the best thing I could have ever done for me - even before WLS.

2.  To be able to shop for regular clothes...I noticed that the larger you get the uglier the clothes became - this too ties into #1.  I was so ashamed of myself at a certain point - I wanted the surgery for vanity reasons alone. (I wasn't in a good place at that time in my life)

3.  So my children weren't ashamed of me...my eldest daughter asked me a few months before I had my lap-band WLS done if I wouldn't come to one of her school functions.  She never would tell me why (she was 7 at the time) - but of course I assumed it was because I was so big.

I knew my health was a risk but it wasn't key - at the time I was 31 years old and had no co-morbidities or diabetics...but I couldn't play with my kids, could barely tie my own shoes and had no energy for anything.

Since having WLS in 2008 - I have found myself (along with gaining all my weight back), I left my husband and got my children out of an abusive household (mentally and physically), met my best friend and married him.  I found a strength in losing the weight with lap-band and remembered who I was.  Yes, losing the weight helped me do that.

As for today - I'm one month post op from revision to RNY.  The reason I decided to do the revision:

1.  To feel alive again.  I gained my weight back (lots of band complications) and my health or lack of health was finally catching up with me.  Back to not being able to walk, move, to be happy.  I became so tired so quickly and knew I had to have help to get the weight off and keep it off.

2.  Lack of funds for a new wardrobe.  I ended up throwing all of my "fat clothes" away with my first WLS.  I'd go into my closet that fit me a few months back and it'd be too tight.  Do you know how frustrating that is?

3.  To do the things I've always wanted to do.  I love to hike, camp, walk, swim, travel, take my kids to a water park, go to the beach...I couldn't do that at 280 pounds - I found even swimming, my lung capacity was gone...I was so upset that I let mself get this way again.

I know many of you have many many more health issues than I do and that is your primary reason for surgery.  I'd began to develop them as well (diabeties, high blood pressure) - I wanted to stop that.  I also want to be "normal" as well...