MaineDoc

My weight has fluctuated so much over the years that I had clothes in essentially 4 different sizes: XXXL, XXL, XL, and L Over the past 10 years I kept all of them because I always worried about going back even when I had successfully lost lots of weight and was comfortably wearing an L. This time, however, has been different. I *did* get rid of all my clothes XL and above once I got into an L. I finally had my surgery 3 days ago and I expect I’ll probably be in a medium when all is said and done. I’ll plan on getting rid of my Ls once that happens.

It is so interesting how we all experience things so differently. I’m day 3 post-op and it is legit work for me to get the daily fluid requirements. Drinking, even relatively small sips, can often lead to it feeling like my stomach and esophagus spasming. I’ve tried fluids at different temperatures-I think warm works the best, but even that’s not perfect. I’ve tried using hyoscyamine which has been somewhat helpful. But even with that I’m having to be exceedingly mindful of how much I’m drinking. Basically I try to make sure I’m drinking at least 2 Dixie cups of fluid each hour. Usually at first I’m ok but over the course of a couple hours it becomes increasingly uncomfortable. And in terms of hunger-I have ZERO appetite. I have absolutely no desire to eat or drink. Even seeing my family eat things I’ve historically enjoyed has not tempted me at all. It all just seems so off putting. And as others have experienced it feels like my tastes have changed. I used to genuinely enjoy protein shakes, even before I ever started in a weight loss program, but now I find them fairly revolting. I’m drinking them because I have to but it’s not easy. Anyway just sharing my experience to perhaps provide another data point in the conversation.

So I’m preop, a little under 3 weeks to go until my surgery. I’ve lost almost 70 lbs. As many of you have experienced I’m sure, a number of people have complimented me/made comments about how much weight I’ve lost. However I still myself as a “fat” person. When I look in the mirror, my eyes go to my “big” belly which I guess isn’t so big anymore but to my eyes really doesn’t look any different. Whenever I’m out and about, I still have a perception that people look at me as the “big” guy but that may not be the case. Have you all been through something similar? What has it been like to change your self-perception?

I’ve lost close to 70 lbs prior to surgery, which is scheduled for March 11. My primary reason for going forward with surgery is that I’ve successfully lost very large amounts of weight before (probably lost and gained 500 lbs in my life) but I’ve never been able to maintain it. My thinking is that the surgery will (hopefully) be the key tool for me to lock in the changes for the long-term.

My starting BMI was 39.7 (with hypertension and high cholesterol) and after about 6 months of participating in the medically supervised weight loss program, my BMI is about 29.8. During the first few months of participating in the program I thought strongly about not pursuing surgery. However after giving it serious thought and reviewing my own personal weight loss history of having gained and lost about 500 lbs in my life and discussing with my surgeon it really became clear that this is the right (and really only) decision for me. My hope is that I can finally get down to a weight I’ve always tried to get to, have come close to, but have never attained (about 185 lbs, BMI would be about 26 but I have a good amount of muscle mass). More than that, though, I hope to use the surgery as a tool to lock in long-term habits and changes so that I can maintain the weight loss long term and stop all this yo-yo’ing I’ve been doing for 20 years. Just sharing in the event this perspective is helpful.

As everyone says, things seem like they take forever and then all of a sudden you get a date! I began this process last May. The program I’m participating in is quite thorough and comprehensive so it took a couple months just to get in for the orientation session and then I’ve been formally participating since August. It’s been a combination of insurance and program requirements that have led to the progression to surgery take so long. At first I was frustrated with how long the process would take-I just wanted to get going with the surgery. But having gone through the process, frankly I’m glad it’s structured as it is. It allowed me to make serious changes that I think will be vital to the long term success of this. At this point my BMI has gone from 39.7 to 32.1, weight from 285 to 230.2. More important than the numbers though are the changes that led to getting here. I’ve totally changed how and what I eat. I feel like I’m set rrriessentially eating a diet in line with what I will have to do after surgery. I must say as someone who has gained and lost probably 500 lbs over time, I’m relieved that I have the surgery date. As my weight has gotten lower, I’ve been more tempted to return to old habits, and I think that drive to return to the set point weight is really kicking in. I’ve been able to resist falling back to old habits knowing surgery is imminent and using other tools I’ve gained since participating in this program. Anyway just thought I’d share if this as at all helpful to someone who’s been in a similar situation to me or if anyone else has a shared March 11 date!

Following up on this-just found out that I have been approved! Just wanted to let you know since I also was wondering.

Got insurance approval so it’s finally really real!

March 11 sleeve here

Awesome! Super happy for you. What a relief!! Happy vibes your way 😀

Nice job! If you don’t brag here where the hell will you?!

I’m scheduled for March 11. Just waiting for insurance approval. best of luck!

Man that is a heart breaker. I give you credit for rebounding from that and committing again to the process, not to mention having to pay out of pocket. How are you feeling about things? Do you have a 2 week preop diet?

Not trying to sugar coat things, but simply trying to offer a hopeful/optimistic perspective: The good news with your decision to take better control of your health by pursuing WLS necessitated that this pancreatic issue got worked up prior to going ahead with WLS. Perhaps if you hadn’t made this decision, the pancreatic issue would have become more of a problem if it hadn’t been discovered or if you had waited longer to have it worked up. Again not trying to minimize your anxiety and how frustrating this whole process can be for so many reasons, but just trying to maybe reframe your outlook on this as something else that will lead to improved health for you. I hope that you get an answer quickly, that it’s benign, and that you can proceed with WLS ASAP. My best wishes to you.

Good point-I haven’t received official word yet on insurance approval. I had the very same concern you expressed. According to the administrator in my program, insurance looks at 2 BMIs-one at the time the PCP makes referral to the program and one at the first appointment with the program. Based on that, I would qualify. She said she was unaware of anybody who completed the program requirements ultimately being rejected by insurance for having a BMI too low and she was aware of people with BMIs close to 30 who qualified. So at this point I’m cautiously optimistic but certainly not out of the woods yet. Please wish me luck!

I debated between sleeve and bypass-like most of us on here I suppose. The surgeon thought either would be reasonable but seemed to slightly favor sleeve, so I opted for that. Regardless, yes let’s support each other! I wish you good luck over these next few weeks. In some ways, it feels long enough in the distance that it’s still not going to happen and in other ways it feels right around the corner!

I’ve been participating in my medically supervised weight loss program for 5 months. I’ve lost over 60 lbs and got a surgery date last week (March 11). I felt like I was cruising along. The past week, however, has been incredibly hard for me. My cravings have been really intense and it’s been so tough to consistently make the right decisions. I’ve definitely deviated from my plan more in this past week than I have in the 5 months before. I feel guilty and I’m angry with myself. Honestly I feel like this is a pattern that’s always happened in the past when I’ve lost weight. Around this point, several months in and down a lot of weight, it’s become increasingly hard for me to maintain my progress and stay on track. What sucks this time is that I’ve handled things differently-I’m participating in the program, I’m taking a medication (phentermine), and I’ve gotten support from this forum. It just sucks that in spite of all that I’m still having a hard time. I feel like it’s probably a combination of factors—my set point fighting harder against my weight loss, the fact that I actually have a surgery date and on some level I’m justifying my indiscriminate eating by saying to myself “well you’re not going to be able to eat like this in a few weeks so you might as well get it in now,” and some (minor) injuries I’ve sustained recently that have made participating in my usual gym routine more difficult. Not making excuses, just trying to understand myself. Anyway, I’m not really sure of my point but felt I needed to get all this out somewhere. I’m pissed at myself but I hope I can forgive myself and just get back on track. Any of you WLS veterans struggle like this once you got your surgery date?

Thank you, this is great and helpful! I'd just add, that the "fear," at least from my perspective, is a Fear of Missing Out--it's that voice that says to you, "if you don't eat this (yummy whatever) right this instant, then you may not ever get to again! you don't want to miss that, do you?" it's similar to the other fears you mentioned and I think what you said about simply labeling these reactions as being really important makes a lot of sense, but I just wanted to add this to the discussion.

Congrats dude. Awesome and inspiring! You must feel so good!

Not that I’m a veteran by any means but I guess I’ve been here longer than you so I’ll take the opportunity to say welcome! This really is a great community ripe with knowledge and support! Congrats on your decision and well wishes on your journey.

Thanks fort the tips. I agree about the diet fatigue. Perhaps some of my problem is that over the past few weeks, I had been increasingly strict with my eating, basically limiting myself to about 1000 calories a day. My rationale was to try to prepare for life after surgery as much as possible ahead of time--I've been measuring things, eating very specific amounts, and in a quite regimented way. Honestly, it's felt good and on a day-to-day basis, it's felt totally fine. My energy level has been great even with a high exercise volume. But I think in the past week it's just caught up with me. Your suggestions to help cravings are helpful.

Thanks for the kind words. I hadn't heard about the presurgery weight loss programs serving no purpose or even being counterproductive. Where have you seen that? I'm curious and I'd like to learn more. It sucks to think that I'd have done all this work for nothing!

I’m currently taking phentermine. I haven’t noticed a huge difference-maybe about half the time it lowers my appetite about 10-15%. I’m on a relatively low dose (10 mg) so perhaps that’s why? Interestingly, I haven’t taken it the past few days and my appetite had been off the charts high. I also have encountered several side effects, nothing horrific but things that I’d prefer to avoid. My plan, if my team agrees, is to take it up until the time of surgery in a few weeks and then stop.

My insurance has required 6 months a pre-op medically supervised weight loss program. The program I'm participating in, itself, is also quite up front and says that they require multiple visits with a nutritionist and social worker, in addition to a medical work up (e.g., endoscopy, sleep study, cancer screenings if applicable, etc.) and so even without insurance requirements, they're clear that it's likely a several month process on their end. In fact, I started participating in August and just got cleared by the program last week. They will submit the prior authorization request to my insurance in the next few weeks. When I first started looking into the surgery, I wanted to get it ASAP. I was annoyed by the insurance and program requirements as I did not want any delays. However, having gotten this far, I have to say I'm glad to have gone through this deliberate, fairly lengthy process. The changes I've already made with what and how I eat, I think, will make post-surgery transition easier (TBD of course, but I'm optimistic). I basically already am eating quite similar to what I'd have to eat post-op--small meals, small snacks, high-protein, low-carb, lots of veggies. As I don't eat meat and I'm a picky eater in general, I was a bit hesitant at first as to whether I'd find enough foods that met the post-op protein requirements. I've had time over the past few months to explore a variety of food options and feel pretty good that I've identified foods that will meet nutritional requirements but also enough variety so that I won't get bored, assuming that my tastes don't change drastically after surgery. In terms of BMI requirement, you can see that I'm close to dropping below 30, having started at 39.7 with multiple comorbidities (hypertension, dyslipidemia). The program I'm participating in is confident that I'll still get covered as they have said that the insurance looks just at the weight/BMI at the time the PCP referred me to the program and my initial weight/BMI upon starting the program. Incidentally, as others have suggested above, I contacted the insurance company directly to ask this question, but got a non-answer. I am going to keep my fingers crossed that I get approval, given that I have my surgery scheduled for March.

Hi all, I have been participating in a medically supervised weight loss program for the past 5 months and I've nearly completed all the pre-op requirements to qualify for bariatric surgery. I've been really lucky and have already officially lost about 50 lbs (at my last weigh in a few weeks ago, it's probably closer to 60 now). My BMI is now probably 31ish. I have adhered to their guidance fastidiously and have made major changes to how and what I eat. I've learned a lot from these boards and I'm leaning towards going the surgery route. Far and away, my primary concern is my ability to be physically active short- and long-term after the surgery. Exercise is extremely important to me and has been for most of my life. Even at my heaviest and unhealthiest, I've still maintained some degree of regular physical activity. And for a lot of the time, I've been able to engage in quite vigorous exercise regimens (running half marathons, weight lifting, vigorous cardio 5-6 times per week). My weight gain has been almost entirely due to poor eating habits as opposed to anything else. Given the considerable calorie restriction post-op, should I expect to have enough energy to exercise vigorously? I understand if it may take some time after surgery to build up my conditioning to where it's at now given that I'll have to take time off and given how little I'll be eating, but say a couple months after should I expect that I'll have enough energy to work out intensely? My other question is how useful/effective is bariatric surgery for those who have been able to lose (considerable) weight historically, but haven't been able to keep it off. As part of doing my homework in preparing for the surgery, I actually obtained all of my medical records for the past 10 years. I charted my BMIs and weights (attached here). It was really eye opening for me to see the true "yo yo" that I've lived. I've definitely been able to have success losing weight, the issue always has been maintaining whatever changes I've made to keep it off. From what I can tell, the surgery seems immensely helpful for initial weight loss but it isn't as clear to me from what I've seen how helpful it is for those who've lost weight as part of the medical supervised plan (and who've been able to lose it historically) to help keep that weight off. I greatly appreciate any insight, advice, or guidance you can offer. Thank you!