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Adding to the things that may not be accurate: BMI. BMI is an average that was reduced to a simple algorithm: BMI = weight (kg) / [height (m)]^2. In words: weight * (height * height). This calculation is intended to be a rough estimate to start with not the end all be all it has become. Such a calculation is closer to "correct" at the middle or average height and weight. Tall people skew to a lower BMI, short people skew to a higher BMI. The taller / shorter we are the more the BMI skews lower / higher. Body type also can skew higher or lower BMI. Not all of our bodies are built the same yet the BMI assumes they are. The more muscle we have the more the BMI doesn't work right. Body builders show the extreme of this effect. Arnold at his younger best would weigh in at a very high BMI. But us humans can build enough muscle to screw with our BMI. BMI is a rough starting place. Once you have the number, it doesn't really matter. How we feel, our health both physical and mental, how our eating and exercise are feeling. These are the real measures. Whew, done with BMI. But the post goes on. Then another part of this whole thing is Goal Weight. Simply, It may be wrong. If we're aiming for a certain BMI or BMI range the BMI discussion above should cause us to think. If it's a weight we were when we were young(er), our body has changed since then. If it's a weight our surgeon or medical team created it is another number intended as an idea that has been turned into a goal to measure us by. If it's based on those on-line calculators they give the average progress and result of someone with our demographics: We as individuals are not average. Goals are not written in stone. As a target to aim for when you start the process, it's fine. As you progress things change. Our bodies may tell us the original goal is unrealistic. If our body is happy and healthy at a different weight perhaps we should listen. The thing with goals, we are over the moon when we lose 10, 20, 50 pounds more than goal. Look how unconcerned we are about missing our goals by 10, 20, or 50 pounds. Why is missing goal by 10, 20, 50 pounds the other way so devestating? We misjudged our goals both ways. Ultimately, it's where our bodies that decided where to stop. If we have goals, we should continually evaluate them and change them as necessary. We have more information about our process now than we did when we started. More now than last week. Be honest. Be realistic. Good luck, Tek

Thank you to everyone who has responded! I wrote down all of these wise words. I think the hardest person for me to face is my son who BEGGED me to not do the surgery. He swore if I came and lived with he and his wife for a few months and ate what they ate and worked out like they do, he could have me in shape and down 100 lbs without the surgery. (I think he wanted free childcare as well). I’m pretty sure he hasn’t paid attention to my weight loss struggles for the 40+ years of his life. I love these responses and intend to use them with family and friends the next time one of those passively aggressive snarks are made. Thank you thank you. It only matters that I know that this is hard work butI’m doing it for ME!

Thank you so much for this detailed reply — I truly appreciate the time and care you put into it. It really helped ease some of the anxiety I’ve been carrying. You’re right, I’m losing around 1kg a month and logically I know that’s great… but emotionally I keep feeling like I should be doing more. So reading that I’m exactly where I should be was super reassuring. I also loved what you said about exercise — I know it’s not the biggest driver of weight loss, but for me, it plays a huge role in how I feel. I actually want to focus more on losing fat and toning up now, not just dropping scale weight. I’m starting to realize that body composition matters more than the number. As for protein, yeah — I was surprised when my dietitian suggested lowering it to 65g. I’ve been aiming for 100–115g all along. I have another appointment on the 20th, so I’ll definitely bring this up again and see what’s behind that recommendation. Right now, I’m not using apps like MyFitnessPal. I track my food using ChatGPT (kind of like a food journal), and I weigh things in grams to stay accurate. But I’m a bit unsure how to move forward — like, should I only track protein and not worry too much about calories? Or try to follow macros more closely? I do eat clean, mostly home-cooked meals, but I also have occasional snacks and off-plan moments (nothing crazy, just not perfect). I know I need to tighten things up again, especially with workouts — I’ve been slacking a bit lately. Again, thank you for the perspective and advice. It means a lot to hear this from someone who's been through it herself. Would love to know your thoughts on whether focusing on protein alone is enough, or if I should be tracking more closely.

Totally agree! I think people get way too hung up on the number on the scale or BMI, and expect that everything will magically change when they hit their goal weight. The non-scale victories are what really matter. Nothing is more gratifying than being able to fit your whole a$$ into one leg of your old pants. 😊

Hi y'all, I am new to this forum and just want to first acknowledge and commend the courage and strength y'all have in utilizing this fortunate tool in your journey to a healthier life. I am at a crossroads. I am a 6'2", 275lb, 39-year-old man with VSG scheduled for Jan. 16, 2025, and I am having serious doubts--some caused by my health practitioners (chiropractor and non-WSL-related psychiatrist). I am on five different maintenance pills for blood pressure and cholesterol. My highest weight was 330lb. I lost 50 lbs in 2022 for a wedding, gained 30 in 2023 and lost 25 lbs from October 31st, 2024 until now (extreme crash diet). The total down is 55. My ideal weight is 210-225, provided that weight encompasses an active lifestyle and dedicated weight training. Here is the rub: I am scared of the surgery, and that fear has really kicked my butt to get healthy. My liver no longer shows NAFLD or alcohol damage with enzymes in the normal range. That is surprising because I was (honestly) an incredible "alcoholic" from 2013-2023. It may be hubris, but I am in no way concerned about addiction transfer as I have fully recovered from alcoholism following a wegovy and booze and supplement mix that caused acute pancreatitis. Blood pressure and cholesterol are under control. Sleep apnea sucks. Mental health is good to great. Banned currently from GLP-1 ( aforementioned acute pancreatitis). I have kicked all the typical vices. Despite all that, I am cleared for surgery, and the surgeon thinks I am an ideal candidate because of the lower risk of chronic pancreatitis following the knife. My surgeon is located in America, and my insurance is on board. Meanwhile, I have had little trouble maintaining a 1600- to 1000-calorie fat-burning diet, especially since a surgery date made it a very, very real concept. My primary motivation for pursuing VSG was for my family and my 2-year-old daughter, coupled with a debilitating (but now manageable) back injury that left me sedentary for nearly 2 years, and, of course, to address my comorbidities. Now that my back is "okay," I can exercise 3 to 5 times weekly. But if I don't lose weight, spinal degradation and likely further stenosis around the sciatic nerve will continue. I was supposed to have surgery earlier in the Spring of 2024 but bailed because of a month-long family holiday to Asia and then a summer of the in-laws staying with us. Also, we are trying to get pregnant again, but my wife's self-imposed window is closing as she soon turns 40. So, what do I do? Given that my ideal weight is approximately 65 lbs away, would you pursue VSG? Would you delay it while trying to conceive (this is a big one)? Am I getting stuck on too many variables? Would VSG make global travel a different experience? Or do I buckle up and charge ahead? Should I try giving the "natural" way a shot for one more year? I have unflinching support from my family and parents to go for it, and I have little doubt that I would excel in a post-op life. But I am worried about travel, a change in taste, and, generally, pain. Pain makes me an unpleasant person at times. But I dread ballooning up to qualify for insurance if the "natural" way fails my goals. None of this was a concern until a surgery date made it real. I appreciate you reading this and thank you in advance for any comments, long or short. A simple "Go" or "No Go" would be appreciated. I am actively planning for the surgery and, regardless, look forward to the two-week pre-op diet challenge. However, I could see myself bailing like two days before. Digital prayers for all! Is anybody ever too young for a midlife crisis?

Last year, I got diagnosed with sleep apnea, and was made to start using a CPAP machine to sleep, I really disliked using it and I ever got used to it, and because of that, I made the decision to do the weight loss surgery My surgery team said I should make short term goals to keep myself motivated on my new journey Right off the bat, my only goal was to get rid of the CPAP machine, nothing else mattered, but after a few follow up appointments, I managed to really think of what I wanted to have After some thought, my goal list grew: 1. Give up my CPAP machine 2. Buy and wear a bathrobe from Macy's 3. Hit 200lb minimum I'm happy to report that today, my 1st goal has been met, my sleep apnea is under control and when sleeping my oxygen levels don't go below 92, my doctor said that if I wanted to, I can stop sleeping with it, and I happily left it behind with him 1st goal down, 2 more to achieve, I can't wait!

I had my sleeve procedure on Jan. 21st, I feel as if I have conquered some areas - cruising along through gas pain, learning how to eat/drink, and my vitamins!!! BUT I notice I have high anxiety regarding my protein intake, my exercise, food variety and my weight loss and feeling hungry an hour or so after meals as well as some constipation/diarrhea. I stress about not getting enough protein when it seems like I am getting enough in protein shakes (at least 2 shakes w/ 25 or 30 grams) and food (20g w/ yogurt), right now I'm only walking but very slow paced with upper body, and now on phase 3 that's leaving me clueless on getting again enough protein and variety where I should be avoiding high fats, sugars, carbs, high cal....I know the stress will surely limit my weight loss... I'm down 24lbs, I feel like I'm sabotaging myself with worrying - any advice/suggestions!

I finally broke the 2 month plateau a few days ago and the weight had been dropping tremendously. Today my BMI is 29.9 and I am no longer in the obese category!!!!!!!!

Most doctors wouldn't recommend Minoxidll for Acute Telogen Effluvium (the type of hair loss that happens during rapid weight loss), because there's little scientific evidence that it actually does much of anything for this condition. In addition, Minoxidll can actually cause Telogen Effluvium either when beginning treatment, and/or when stopping treatment. Keep in mind this drug was actually originally developed as vasodilator, but it was noted to promote hair growth for patients suffering from androgenic alopecia, a completely different type of hair loss. While you certainty can try it, Acute Telogen Effluvium will resolve on its own once the weight loss stops and there is some risk it won't do anything, or even might make the problem worse. I'd honestly suggest talking to a dermatologist if your hair loss is concerning enough you are considering medication. Just my .02.

Nope tea wont make you loose an ounce. A bit off topic, I have never drunk tea, the one cup I remember drinking was after giving birth. It was sweet and wet and I was drained. I saw as a child what tea did to my parents cups, yuck, no thanks. I drank the only other thing available, corporation pop. 1950's english slang for water. Them days, coffee came in liquid form called Camp Coffee. It was made from chickory. One time mother was ill and dad made a meal and used this as gravy browning. {we like brown gravy here} We ate it because it was this or nowt. It was a week till mother worked out what we actually ate. So, after my rambling, I come to the point. Here I am sat in Greece drinking Iced Peach tea like it was going out of fashion. How my tastebuds have changed. This will defo not make me loose weight as it comes with a lump of baklava at this bakery. It would be rude not to.

I got down to within about 10 pounds of my goal weight a few years ago but slowly started inching back up. I have been on Wegovy for 8 months now and I've lost those 30 extra pounds and I'm staying consistent. I am one of those who were genuinely hungry ALL the time. Like not snacky hungry but really hungry. I have no idea how long I can stay on Wegovy but I'm on 1.7 right now and will increase to 2.4 if necessary. It is a total game changer for me. Im not plagued by constant hunger. I will say though, full disclosure I've felt sick to my stomach every single day while on this drug. I mean, every day! It's the price I'm willing to pay though to not constantly feel hungry and I'm likely going to weigh what I did in high school before summer is over. If you can handle feeling sick (nausea/diarrhea) then it's worth it. You have to be sure to hydrate and eat extra protein but I'm used to that anyway. I know a lot of people are scared of it but for me it's been worth it

Yes, it was a lovely thought but … I avoid buying clothing of any sort for anyone unless I’m certain about what size they are but even that can be different label to label, fit to fit. Even someone who is about the same height and weight as you can wear a different size because of different body shapes. If I do want to buy clothing for someone I’ve snooped (helped with the laundry or checked a tag of something they’re showing me), asked a spouse, sibling, parent or child to find out what size someone wears or just asked them outright. What about asking if they still have the receipts so you can exchange them for smaller sizes?

Hi All! I'm new here, and I have a date too --January 30 gastric bypass. Took me awhile to reach this decision, but weight control has been a life long challenge -- so I'm totally at peace with this now. Took awhile to "jump all the hoops" but we're there now as insurance just approved. Bring it on!

Congratulations on your success so far! I completely empathise with the surreal feeling - it is almost like a weird out-of-body experience! I can answer a couple of your questions, obviously not the one about maintenance as I am only like 7-odd months post bypass now I think! I believe I have lost almost 100lbs now (45kg, 7 stone), and in the initial first 5 months I was really struggling to go to the gym so I wasn't very active. I have started going to the gym now and I am really enjoying it, not seeing as fast-paced weight loss currently, but that could be because of muscle gaining at the gym and normal stalling! I think my biggest challenge/lesson has been listening to my new stomach now. Understanding when it is full, and also looking at food differently - I just see it as fuel now, rather than thinking about it 24/7 which has been hard. It has also been a challenge to actually accept that I am smaller now - I still instinctively reach for my old clothing size in shops (UK 22-24), and am genuinely shocked when it is too big, or when something I see as "tiny" fits me. The changing the mind is a long haul lesson I believe! All the best for you on this journey x

Contact your surgeon's office for advice. For your peace of mind you need to know whats, what. I don't know nothing about balloon weight loss but some bariatric patients have hunger from the outset and some need secondary surgery. Some people feel hunger when they need some form of stomach medication to cope with the ammount of acid in their stomach. Excess acid can make you feel hungry

Hey sorry for being so quiet, I just had emergency surgery the night before last. Apparently, my intestines got tangled up in my hernia and caused a painful/dangerous blockage. Anyway, I'll spare you the details, sorry about before, in my first post-op post, Everything did go well the first two days then I got really sick and had to be rushed back to the hospital. But I am feeling much better, and back home resting. starting weight: 498 lbs weight loss: 98 lbs surgery weight: 404 lbs current weight: 400 lbs

Research on GLP-1 agonists suggests that up to 15% of people are classified as "non-responders", meaning they don't experience clinically significant weight loss when taking them. It's possible you'd respond better to Zepound/Mounjaro, but there's no guarantee. If you're diabetic, you may have more luck getting Mounjaro covered?

I think the best reply to that is just that your doctor is pleased with your weight and your fitness. And if they keep pressing that you’re going to defer to the one with the medical degree. I honesty believe that some people are just a tad jealous.

Hey! I'm in the same boat, as far as weight loss. I'm now having trouble trying not to snack at bedtime. I'm also trying not to graze over the holidays. Trying to either not eat or find healthier choices. Sometimes I just want a taste of something. Thoughts?

Hi! Sorry to have found your post so late! There's not a lot of NHS patients on here as this is mostly an American website. I had my surgery in October 2024 on the NHS. I remember the dietician appointment was a video call with other patients before any surgeries were finalised. I will admit that I don't feel like I got much out of it. The main message is eat slowly and prioritise protein first when eating a meal. The session with the psychologist (a ten minute phone call) was probably the least helpful as she just said I need to practice mindfulness and learn others ways to cope with stress other than eating. (Gee, thanks! Where was that advice when I was a fat 8 year old? 🙄) I had a higher BMI than you currently do and the privilege of living in London, so I think I was bumped up a few tiers and fast tracked (I don't know if this true in general, but London seems to get the lion's share of the funding so hospitals are less strict. My Gloucester based friend has a BMI of 44, but because she has no comorbidities, she can't get any weight loss referrals because her BMI isn't 50+) But I digress. Once I had the surgery, it was a year and a half from the initial referral, it's mostly been smooth sailing. I had the gastric sleeve and had no problems. So far, I've lost 39 kg and more fatty liver has improved significantly. My mother had the gastric bypass (also on the NHS). She had a complication, St Anthony's private hospital did the surgery, but the NHS covered it but once they operated again, she had no problems. She never shared exactly how much she weighed with me, but she went from a size 28-30 to a 22 and reversed her diabetes. She passed away in 2023, but if she hadn't, she would be much smaller I'm sure. I've had a great experience so far with my procedure and weight loss. I really do recommend going the NHS route if you are able to do so. Well done on making this decision to change your life! You've got this. Sometimes, just making the decision to get help is the hardest part!

My husband and I just had our 5 year anniversary. We got married right as everything was shutting down for COVID so we didn’t get to have our receptions. We decided to do a five year anniversary party to finally be able to celebrate with friends and family. I loved my dress I got for it (though I didn’t get a great picture of the whole dress 🤪). I am still hopefully only halfway done with my weight loss journey but it felt great to by a size 14 dress; it’s been a long time since I wore a size 14! Here are some picture i scavenged from people from the event to show off the dress!

Maybe check out Dr. Matthew Weiner’s pound of cure weight loss book. He goes over a handful of things that you can change and you can pick which one you want to start with. For me, the fruits and veggies was a good one because I actually like fruits and veggies. Replacing a lot of the process carbs with healthy carbs for me is the most important component to weight loss not just to cut calories in the short run but to stop cravings in the long run. For me processed carbs, make me crave sugar. One cookie and I want pasta I want cake. I want it all and I crave it for a week. Natural carbs do not do that to me and they can help reduce the cravings a little while I get through the week or so to detox from them. Once I am off of the processed carbs so long as I get my protein, I stay feeling full so it’s much easier to sustain a healthy diet. Keto never worked for me either and I have learned post surgery that is most likely because of not being able to eat hardly any carbs at or it was all the processed junk I was eating instead of natural food. They alter things by adding more fiber to cut the carbs and all of that and that may be reducing your calories to help you lose weight, but for me it wasn’t the same for my body as a veggie with fiber. It’s not sustainable because my body was still craving the carbs. I would lose weight in the beginning, but the cravings were horrible and eventually I would give in to them and then I just wanted even more. Anyways, you may not be able to replace every unhealthy carb with healthy carbs on your own before surgery, but if you can reduce some of them by trying out different recipes to find fruits and veggies that you like, it may cut enough to lose your 10% and be a good start to finding healthy carbs that you enjoy

Hi, NeonRaven! Thank you so much for your reply and sharing your experience! I find it so helpful to hear how other NHsers have experienced the process since it seems so much more elongated from the U.S. process. And you make such a good point about the London privilege - now it makes more sense why I’ve seen more internet presence and response from London NHSers. (And quite a few from the far north of England as well!) About three or four years ago during my annual diabetic review, my nurse had suggested bariatric surgery and that gave me a lot of hope - she was able to refer me for Tier 3. I had my dietitian appointment yesterday and it went really well! It was about 30 minutes and went over the Tier 3 lifestyle changes, continued lifestyle changes (balanced meals, regular exercise, blood sugar monitoring, weight maintenance, etc), medications, and then any questions I might have. She was very positive and said she would be recommending me to go forward for surgery when the MDT meeting happens 🥲 (once I meet with the next consultants - psychologist, anaesthetist, bariatric nurse, and surgeon - how soon? No one knows.) Needless to say, I am so relieved, so happy, and so excited to be moving forward even if it’s one step. I’ve found out that my hospital trust now does their “one-stop” clinic as separate virtual appointments, rather than in-person. (So, perhaps it will be quite some time before that MDT meeting?) And then the endoscopy and ECG will be done at the pre-op assessment once a surgery date is confirmed. I am so glad to hear your NHS experience has been so good and positive. I am so sorry to hear about your mother's complication and her passing, but it is so hopeful to hear she was able to put her diabetes into remission (that’s one of my big hopes!) Congratulations on your weight loss and wishing all the health and success! 💕 PS - funny enough, I have not had any group sessions whatsoever in this process. I am wondering if I’ll have a group session with the bariatric nurse?

It's valid to feel scared about this new experience and really good that you can express your fears to other people. My first thought as I'm reading this, though, is that your size is thoroughly unremarkable. It may not be where you want to it be, and you're doing great taking control of that and changing your life through having gastric bypass. But at your height and weight, surrounded by adults as you will be in college (and not middle school bullies), your weight simply isn't going to be a thing people notice about you all that much. I had my surgery when I was just slightly under where you are now, and I honestly had a friend (who is average weight/skinny) express total shock at my choice because she thought I was "only a little overweight" (while I thought I looked like a Macy's Thanksgiving parade balloon on two legs). Other people do not see us the way we see ourselves. In your mind, you seem to see yourself as worthy of being judged poorly and disliked for your appearance. I would ask, is this how you look at other people? Do you only befriend skinny people? Do you think fat people are terrible? Because if you do, that's a serious personality flaw that I would be way more concerned about fixing than my weight. And if you don't...neither do most people. Also, if they do? See my point about it being a serious personality flaw. Don't give that kind of person power over you. Your existence, exactly the way you are at any point in time, is not the problem. A person who is judging you for existing is demonstrating that their opinion is not worth considering. Most people don't notice weight first, unless maybe when someone is truly remarkable in size. Most people remember a person's confidence, humor, and overall disposition. They might remember a beautiful smile or a charming laugh, or maybe how you wore your hair or a colorful scarf. They want to be friends because they feel a connection to your personality, not because you have the "correct" size tag in your jeans. Again, if this is not the case, ask yourself why this is someone you want to concern yourself with. The person you want to be is not just a "skinny" person. At least, I really hope not. I would encourage you to make a list of 10 qualities right now that you want people around you to see and remember about you, and none of them can be about your weight or similar societal measure of physical attractiveness. Focus on that list. Do you want people to see you as smart? Kind? Funny? You can be all of those things today. You probably are all those things right now, if you let yourself believe that it's true. You don't have to lose a single ounce to make that happen. Do you want to be someone who takes care of your health? You're already doing it. Who eats right? Who exercises? You're that person now. Focus on the things you have control over. You don't get to choose your weight. None of us do. But you can make food and activity choices every day that promote a lower weight. You can't make a specific person or group like you. But you can be the kind of person many people will like. I wish you the very best of luck. I really wish I had known 30 years ago how absolutely, perfectly fine I was without changing anything, and how little other people's judgement actually mattered. It would have made so many things so much easier.

And you’re already at 2.4mg? Weird. The dose escalation schedule is every 4 weeks beginning at 0.25mg, but either way here’s an interesting article: https://amp.cnn.com/cnn/2024/05/21/health/glp-1-weight-loss-drugs-stop-treatment-real-world-effectiveness