Newbie Here - Long Post

Hey, I'm Katie and  I'm wordy, so it's a long post, hehe. I'm in the very, very early stages of getting all of this done.  I have my first appointment with a surgeon on Nov. 5th and have been doing an incredible amount of research.  I'm pretty much set on getting an RNY.  I have a pretty high BMI at 54 - "super obese " - and I really can't imagine myself succeeding long-term with a LapBand.   I've been severely overweight my entire life, give or take clumps of a few months when I would starve myself and/or have "excercise-bullemia."  Obviously, that never lasted very long and I was still at least 100 pounds overweight at my lowest.  I've been playing the weight-loss game since I was six and I truely believe I've more than exhausted all of my options.  I wish I could see myself losing weight some other way, but I feel this is my last resort and the only thing that can truly make a difference in my life long-term. The thing is, I'm 21.  When I talked to my PCP, she said she wants to get me to see a nutritionist regularly - which my insurance doesn't cover - and "watch [me] over the next few years since [I'm] so young."  WTF.  I'm 200 pounds overweight.  While I don't have any co-morbities aside from GERD and joint pain which apparently don't really count, my father has all of them as do a large portion of my family.  Well, I went ahead and made the appointment with the surgeon but I am terrified that he will tell me the same thing.   I'm completely aware of the complete lifestyle change, the risks, and the fact that this is not a guarentee or a quick fix - it is a tool.  But I've realized that I need serious help and I'm afraid that all this weight and yo-yo dieting is going to make me sick and continue to deteriorate my quality of life.  I would like to enjoy my youth, not sit around and wait to get sick enough and old enough to be deemed "mature enough" to make this decision.   BASICALLY, I have two questions for you guys, especially the RNYers, if you've managed to read this far, haha.   First - do you ever regret doing something so drastic to your body?  I'm mostly talking about the malabsorbtion and the fact that you're going to be on supplements for the rest of your life.  On one hand it seems like it's not such a big deal, but on the other perhaps some of you feel that you cheated yourself out of having a normal digestive system that didn't require such upkeep.  I'm interested in what you all have to say about that.  Second - have any of you guys been met with opposition because of your age?  If so, what did you do to prove that you were mature enough to handle everything?  I absolutely know that I am - I'm one of those people that's acted like a 35-year-old since I was 12, hehe - but how exactly should I go about proving that?  I'm also afraid that they'll try to talk me into a LapBand since it's not as drastic, but after an insane amount of research, I don't feel that it's worth it to me. I'm sorry for such a long post, I'm just so nervous about this not happening and am trying my best to cover all of my bases and keep level-headed about the process.  I don't want to get my hopes up, especially so early in the game, just to be met with a lot of closed doors.  Thanks to anyone who actually read all of my rambling, hehe.

I can't comment on the first question because I'm still 2 weeks away from surgery, but one month ago I was EXACTLY where you are.  I am 21 and my PCP was not initially supportive, but I brought her around and the surgeon was very supportive and my insurance approved the surgery in 72 hours.  Find a good psychotherapist to do your psych eval and you'll be fine.

I know my insurance doesn't require a psychotherapist section for approval, but I'm assuming my surgeon will want me to get one.  Unfortunately, that means my insurance isn't going to cover it.  I know it's a small price to pay compared to a lot of people who have had to pay for this entire process on their own, but I'm not exactly rolling in the dough.  Do you have any idea how much a typical psych evaluation costs?  It probably depends on the therapist because I've heard anything from $100-$300.  Thanks for the info and good luck with everything :o)

Mine cost $460, but mine was not typical.  Usually psychotherapists charge between $90and$120 per hour, the evaluation takes between 1 and 2 hours and they charge you 1 hour to write the eval. My insurance does not require a psych eval either, BUT my surgeon said a good psych eval means a lot in the approval process. Good luck!

I'm sure that especially because of my age they'll want me to see a therapist first and lord knows I want to get this show on the road so I'm better off getting one.  I just hope I have the money :o\

Question one - to be 100% honest with you... I do worry about the long term effects of the surgery. I wonder what will happen 10, 15, 20 years from now... I was 27 when I had the surgery - even at my age I felt it was a MAJOR decision since I have a large portion of my life ahead of me. I also wonder what 'new and improved' surgery they will come out with and will I have jumped on the band wagon too soon. At the time I had surgery I didnt have the option of LapBand because my insurance didnt cover it... because the fact its not permant its definately something I would consider. At this point I do NOT have ANY regrets... everything has gone amazingly well for me and for the first time in my life I feel like a normal person. If something happens to me way down the road may I have regrets? Hard to say. The way I see it is like this... worse comes to worse I could have 60 more years of being fat and miserable or 30 years of being healthy and happy.... which would you choose? I am doing EVERYTHING I can to ensure that I will stay healthy... I am religious about my vitamins, suppliments and follow up care... this is something that I will have to do FOR life. Once you lose the weight its hard just not to go on like everybody else but its very important to keep up with everything so you dont suffer the consequences later. As for the 2nd question I am pretty much a dinosour compared to all you youngins so I didnt have that issue. As for your PCP wanting you to really have great nutritional follow up care... its an excellent idea.. even if your insurance doesnt cover many NUTs will work with the patient concerning price and stuff... just do your research. I saw my NUT at 2 weeks, 3 months, 6 months, 9 months and I am wanting to see her again. Her advice and guideance is so valuable to me... I do not know what I would do without her. Since previously you had an issue with not eating/exercise bulimia it may be a good idea to always have somebody looking over your shoulder and helping you out as well!

I,  too, am afraid something "new and improved" will come out.  I know a lot of people consider that to be a LapBand, but like I said, I just don't think it's for me.  Another thing is I see my dad with his giant box of pills that he has to take all day because of his diabetes, hypertension, etc. and doing that for the rest of my life can't be any better than taking vitamins.  My PCP was saying to forget WLS and just go to the nutritionist for a couple of years because I was so young.  I've already tried that when I was younger and had different insurance and it didn't do much of anything in terms of losing weight.  In terms of after-care, I know I'm going to have to go to one for awhile, although it's very unlikely that I'll be able to afford it comfortably.  It's kind of sad, but I'm hoping I'll have some blood test that shows I have diabetes so my insurance will cover it. Thanks for the insight :o)

Sounds like your PCP is very uneducated as to the needs of obese people and what WLS can do.  How very unfortunate for them, as they are doing a dis-service to their obese patients.

She just kind of brushed me off.  It took a lot of courage for me to make this decision and tell her about it and it was really a slap in the face when she didn't even take the time to consider it.  It wasn't like she was dead set against it, just didn't think it was necessary.  I'm hoping she'll turn around, but for now I'm really focusing on getting the surgeon to agree with me.

Yes, you did make a couragous and potentially life saving decision.  And you should be praised for that.  And for your PCP to essentially blow your idea off is insensitive.  I'd be tempted to find a new PCP, as this one clearly has her head in the sand.  The benefits of WLS are well known.