Introduction and questions

I wrote the post below in the VSG forum and have been recommended to cross post it here to see what your opinions are since I am a "lightweight". I will be happy to hear your comments!! :)

Hi everyone!

This is my first post so I would like to begin by thanking you all for this useful forum. I have been researching it for a few months now and I have learnt a lot about the different WLS and what to expect post op as well as the diet and lifestyle changes I will have to make should I decide to go down the surgery path. First of all I feel I need to explain my case. I am 36 years old, I weight 242 pounds and my height is almost 6 foot. That gives me a BMI of 33. Like many of the people on this forum I have been battling with my weight for the last 20 years or so. I have tried almost every diet out there (Palaeo, Juicing, Atkins, HCG, Low Carbs, nutritionists, personal trainers, etc...) and I have always been very successful at losing my excess weight. The problem is that it always comes back as soon as I stop being super careful with my food intake. I am a fairly active person as I cycle to work everyday for a total of 1h plus I exercise at the gym once or twice a week depending on my schedule. However, exercise seems to be a small contribution to my weight loss, with the food being the major impact. My relationship with food is difficult to describe. I can sometimes be very strict with myself and then shift to periods where I really don't care and I'll eat anything that is available. I feel I am more hungry than most people around me and I can eat large quantities of rich foods in one sitting with no problem. I guess I am a bit of an emotional eater as well.

Anyway, WLS has been in my mind for a while. Today it is almost one year since I made the resolution that I was going to give dieting and fitness a one final chance and if that didn't work I would have the operation. And, yes, you guessed it, I lost the weight but work got busy last November and since then it has all come back and more. So I went to see a bariatric surgeon 2 weeks ago to investigate the different procedures and I was initially set on having a gastric balloon implanted. However, after discussions with the surgeon he indicated that given my past history of dieting he would not recommend this to me as after the balloon was removed I would most likely gain the weight again. He also told me that banding he was not recommending anymore for the reasons you all know and given by BMI and lifestyle VSG would be more appropriate than bypass if I ever decided to have WLS.

My problem, however, is the following. I do not have a very high BMI and I do not have any comorbidities. As I mentioned above I have a reasonably active lifestyle and my weight does not fully prevent me from doing any activities. I accept I will never be the best at any particular sport but I am ok with that. However, I am tired of gaining and losing weight, struggling to find clothes that fit, people making comments about my image and living permanently on either a diet or in a state of "I don't care if I am obese" anymore. The surgeon I saw was very friendly and he actually told me that in my case it is relatively difficult to make a decision as I am borderline and have no comorbidities. My biggest health problem is that I have large quantities of visceral fat and that increases the chances of heart attacks, blood clots, etc.. in the long run. I have 2 young kids who I want to see grow up and make me a grandparent.   Therefore, I just wanted to ask if anyone out there was in a similar situation as mine and decided to have the operation. How did it change your life? Was it worth it? I know the decision will be mine at the end of the day but most of the posts I see under the VSG forum belong to people who started with a higher BMI or comorbidities so I do not feel totally related to some of those experiences.

Anyway, many thanks for reading the long post above and keep up the good work you are all doing

Thanks

Phacops

first, welcome to the light weights!!!Many of us had been through the same cycles you have, losing and gaining.  We wanted to end that roller coaster.  Many of us also had co-morbitities that we wanted gone. 

Surgery was the best thing I ever did for me.  I wish I did it sooner.  I was 62 and I wanted my life back.  I would do it again in a heartbeat.  No more high blood pressure, GERD, Cpac, high cholesterol. I am 4'11" and started around 220, 5+years out I am pretty stable at 132 although I got down to 111.  I do muscle pump 2x a week and am a competitive carriage driver.

However, it is only fair to also say that keeping the weight off is a daily battle.  They do surgery on our tummies, not our heads.  If you have head issues with food, I really believe that is the first place to start.  Anyone can out eat any surgery.  Over and over we see folks we gain all their weight back.  It is common to have some bounce back of up to 10-20 lbs but many go back to how they were eating and the weight comes back.  Hate to be a Debbie Downer but it is true.  Surgery does give you a fighting chance to keep the weight off but you do have to fight.  When we are smaller and at goal, even with exercise, it takes much less food/calories to support us and we have to be willing to continue eating small amounts and the right stuff.

I'm not sure at 33BMI you will get approved by insurance with no other issues.  Ever policy is a little different and your surgeon's office is the expert in all that.

Good luck in making your decision.  We are here to support you.

The first time I considered bariatric surgery I was 37 years old. I am 4'11" so I will always be a lightweight as far as BMI goes. It's damn hard to get much heavier than I am now. Back then, I had zero comorbidities. I was active like you, felt strong more or less, but the extra weight really was a hinderance. I went to a few different docs who all just told me that my labs looked great and I was in excellent physical health, other than the excess weight. Being totally honest? I felt like crap. I had three very active teenagers at the time, so I never sat still, I also never took the time to take care of myself.

Fast forward 10 years, here I am at the same weight I was in 2006. Of course, I have lost between 40-65 lbs at least 20 times, and each time it came back and brought some friends just in case I tried that crap again. Plus I have a few of those nasty comorbidities to go along with my excess weight. Yay.  

I am now 1 week from my final nutritionist appointment required by my insurance company. All of my paperwork will get submitted for approval and I'm praying that my slightly low BMI won't be cause for denial. But if I could go back in time and give myself one piece of advice, it would be "Get that surgery and get on with your life". 

I am not saying this is what you should do, only you can decide. It's just my experience.

Welcome aboard, and best of luck to you, whatever you decide.

Thank you all for your replies. First of all I must state that I am fortunate enough to be able to pay for the surgery myself, so this aspect is not a concern for me. It seems to be the focus of a lot of people on the forum but not for me...

Price S - Thanks for sharing your experience.  I guess the head stuff is a common problem with all the WLS patients so my question would be: How do people deal with that? Any tricks? I understand they will change my tummy and not my head but my hope is that through having a smaller stomach I will be able to control my temptations better and stay committed to a healthy eating plan. I actually enjoy eating healthy and protein is one of my favorites, both fish and meat.

Lykapal- Thanks for your inspirational views, it is nice to find someone who has been through the same emotions when you were of a similar age as me.  My concern with not going ahead with it is exactly what you described- 10 years down the line I will be in the same situation and I will have been miserable... I guess better to do it now than wait to develop health problems. Good luck with your approval and please keep us updated! :)

Anyway, thanks all once again, your views definitely help me understand the possible surgery outcomes better. I have another consultation with a different surgeon tomorrow just to see other hospitals and be able to compare.

Regards

Phacops

My surgery group had a counselor and as part of the package, you had unlimited use of her.  Not everyone is so lucky.  For those without insurance or means, there is OA, Overeaters Annanomus (sp isn't my strength, lol)  Many have found them helpful.  Staying connected to a support network is important.  Some have a group with their surgeons, some use Weigh****chers although they follow their Dr plan instead of WW.  And some of us are right here every day, being accountable and helping others as we were helped.  My Dr group is 1.5 hr away but I am here daily.

My BMI is also low(er) 34.?ish because every day it fluctuates and I need insurance to cover my VSG so it's been a roller coaster. I'm honestly glad that you don't have to worry about that aspect, because it is a lot of stress added to an already stressful situation. In order for you to find out if you can have the VSG at your BMI (with your history of yo-yo diets I don't see why not, especially as self pay but I'm not a surgeon). Some surgeons I've read will do a VSG at 30+, self pay, IF you've tried dieting for years with no luck with long term maintenance. Most of us that have to turn to this route, don't really do it to lose, but mostly to maintain after the loss. That's the key with the restriction.

For what it's worth, at 34 years old and a BMI of almost 35 I too carry most of my weight around my midsection, like 90% of it. Even though I do have co-morbidities that help make VSG a more viable solution (medically speaking) than someone who doesn't have these problems, that's not to say that you shouldn't also be given the same kind of help. Just because you aren't sick now, doesn't mean you aren't at risk for later. That's not me wishing bad upon you, because I don't, that's just me being real. You already know the risks r/t visceral fat, you've already typed them out.

If I were you I'd talk to that same surgeon again and just let him know how bad you want the VSG (if you really do) and tell him your plan for using it as a tool to get the weight off and being successful in maintenance. He/She may actually be sparked by your persistence and forethought of your plan and sign off on your surgery. Generally speaking, if you do not have any current health issues other than the weight around the midsection then your risk for complication during and after surgery are as pretty close to what they define as "normal" barring unforseen difficulties and random acts of God. That plays well in your favor too. Anyway, I'm sorry I couldn't help more. I wish you well on your journey and I hope you get the answers you seek to help you make a decision that is the best for you and your family.

Hi everyone!

It has been a while since I wrote this post and I thought I'd give you an update of where I am. After my second VSG surgery consultation I decided to cool the surgery thoughts off for  while longer and think it through. At the same time I went for a full health check up with the idea that if everything came good then perhaps that would help me in making a decision against the surgery. Anyway, the check up was not too bad but I have slightly high colesterol and sugar levels, an enlarged and fatty liver and a couple of 1cm gallstones in my gallbladder. These are all as a result of my weight I was told. Doctor also said I am obese class II and need to lose a minimum of 90 lbs. By the check up time my BMI had risen to 36. Further, I have recently  been experiencing coxis pain after I spend long hours sitting in front of the computer or after riding my bike. This is very debilitating and I believe it is also related to my weight as well... On top of all the above I've recently realised that I just hate looking at myself in the mirror and end up avoiding doing so. Being overweight makes me unhappy and prevents me from doing certain activities as I feel I will get hot and sweaty and don't want people seeing me like that.

Anyway, as a result of the above I have made the decision to go ahead with the VSG surgery and 2 days ago I paid a 10% deposit to lock the dates (20th Jan) and I also booked 2 weeks off work. It was a bittersweet moment with very mixed emotions. On the one hand I was happy I was taking control of the situation and trying to fix my problem but on the other hand I felt defeated. I have lost the weight battle I have been fighting for over 20 years. I cried. Such a drastic decision I am taking, removing 80% of my stomach... I am scared too and I really hope this works and it is worth the physical pain I will be experiencing. Of course I am going to give it my 100% and have already bought 3 VSG books to learn as much as I can with regards to the op, foods and new lifestyle I will be having. I live in Thailand where I don't have the luxury of having support groups or good therapists.

Anyway, because of my health screening my surgeon has recommended to remove my gallbladder at the same time. His reasoning is that I will develop more stones after I lose the weight and we better take it out now just in case it creates problems down the line (he said 50% of his patients develop them). He has offered to remove it for free and included in the cost of the VSG surgery which is nice but I am having concerns about removing it. People say you can live without it but there are side effects which can happen. Also I feel it is wrong to remove a perfectly functioning organ that gives me no pain? What are your thoughts on this? 

I have found that in China it is possible to have a laparoscopic operation to remove your stones without removing the gallbladder and many Westerners have gone there to successfully remove then. Some people claim the stones never came back but other say they did after a few years. Since I am convinced my stones developed as a result of my weight loss and gain over the past years I was thinking that perhaps I would have VSG, loose the weight and then go to China to remove the stones? Hopefully they won't appear again and I will have kept my GB.

Anyway, that is all I got for now. Until the surgery date I will keep reading and watching youtube videos which I find incredibly helpful.  Thanks all for reading the above.

All the best
Phacops

I have been on these forums for a long time (over a decade). If your MD is recommending you remove your gall bladder, you should take that into consideration. If you search this site for Gall bladder-you will likely find 100s of posts about people that had WLS, keeping their gall bladder, only to have it removed later because of gall stones. When I had the DS, they took out my gall bladder and appendix...it was standard at the time.

As far as feeling like a failure- we all have been there. Having WLS is not an easy decision. Like the rest of us, you did everything you could to lose weight without surgery. Surgery is a last ditch effort for most of us. I am grateful that I had surgery-I only wished I did it earlier (like when I was only 100 lbs overweight instead of 300 lbs overweight).

Scott

Hi Scott,

Thanks for your reply and the encouragement provided. I know the surgery will be good in the long run as health issues are starting to appear now. If there is something that keeps popping up on this forum is people wishing they had done it sooner! I dont want be on the same boat 15 years down the line..  

Re the GB - it is good to hear you had yours removed and have had no issues. I had been reading the GB posts before I wrote mine and there is no denying that GB problems are very frequent after WLS. My point is: in many cases stones develop as a result of losing weight and if there was a way to remove the stones without removing the GB shouldn't that be an option for patients to consider? I know I can live my life without the GB but I can also live without an arm or a leg but I don't really want to! Surgeons remove kidney stones all the time and try to fix organs whenever possible so why wouldn't they do the same with the GB? Aside from the 2 small stones my GB is healthy, not infected and does not give me pain. Therefore, removing it "just in case" is something I dont feel entirely comfortable with. I know removing  it is standard practice and most in the medical community agree but some doctors disagree with this and would prefer to monitor it yearly and perhaps remove at a later stage if problems develop... Also, some people who had it removed complain about permanent diarrhea for the rest of their lives. 

I guess it is my decision to make but at the moment removing it "just in case" does not sit right with me. 

Thanks a lot for your input

Phacops

DSers have a bit of advantage to the urgency that comes after eating when you don't have a GB. Our intestines have been rewired so I don't experience issues from not having a GB.

GB and Kidneys are.2 very different organs. I know what you are saying-but you can live without your GB, but you cannot live without your kidneys. Also a Kidney stone-while painful typically can be resolved through non invasive means. GB stones can clog up your bile duct...which can lead to pancreatis...which is VERY Painful and very dangerous.

But you do have a point. Many people thought like you did and kept their GBs. I'm sure most of them have been fine- and the ones that have not-posted here...so you kind of get a "false" impression that everyone that keeps their GB is going to have to have it removed.

I think these are questions for your WLS....and you still have time to get a 2nd opinion- so you can talk to another surgeon as well.

Scott