surgery is not those who fail on diets?

[gr8ful1 122]

Greetings, everyone. I am a serial diet failer. I've been on phen-fen in the '90s, on a weight management program while in the military, Weight Watchers, and physician/hospital-based medical weight management programs that included help from doctors, dietitians, psychologists, and exercise specialists. I learn what I need to do to succeed, start of strong, leave the formal program, and end up regaining all the weight I lost or more. I am the epitome of knowing what to do but failing to do it consistently for more than a few months at a time.

I keep hearing that WLS requires hard work and discipline, as well as a commitment to eating right for the rest of your life. Problem is, I am over 300# because I have *failed* to do these things consistently over and over again. When I go to support groups for my medical weight management program, the only ones who are keeping the weight off are the ones who have had surgery. Surgery is a tool, but I've already been given a whole toolbox full of tools from all of the professionals that I've paid thousands of dollars to visit. I want to use them but I keep putting them away and going back to my old unhealthy ways.

I can be disciplined long enough to lose 20-70 pounds at a time, but not long enough to keep it off. Am I exactly the type of person who should *not* be considering WLS? I don't know what else to do at this point. I do have an appointment to consult with a surgeon in a couple of weeks, but I don't think I'll qualify for surgery. My BMI has been above 40 for 15-20 years, and is currently in the mid-40s, but my medical records show that it has dropped below 40 whenever I've been in the middle of a weight management program and on a ketogenic shake diet, including as recently as a year ago, when I completed my last of many 12-week programs. I have no qualifying co-morbidities, but I'm heading in that direction. Use a CPAP but AHI is below 30, cholesterol high but controlled ok with statins.

Sorry for such a lengthy fist post. I have read quite a few of the existing posts and this looks like a great, supportive online community.

[FluffyChix 17,415]

Welcome! I wish I had the answers. Clearly, at 228 lbs, I do not. If this surgery were limited to people who successfully lose and maintain their weight, I would not have been approved. Like you, I've had a lifetime (since age 9) of trying to get to a "normal" weight range and maintain. I've tried almost every diet out there and pills. And here I am.

Also, those of us who lose and lose big and can maintain...well, hmmm, that's not me. I'm pretty sure that was none of us pre-operatively.

I hope someone chimes in and can give you good feedback and info. I'm just one of the schleps on the couch with you, raising my hand saying, "Me, me, me! That's me to a T!"

[elforman 234]

Your situation is precisely why there is a psychiatric requirement before being approved for weight loss surgery. It's to ensure that you will stick to the post-surgical regimen, and that's all about discipline. The difference, of course, is that if you diet on your own then go back to eating poorly, you'll just gain the weight back. With WLS, if you go back to eating as you did pre-surgery, it could quite possibly kill you. That's exactly what the surgeon told me during my initial consultation, and I replied that if I wanted to kill myself I'd certainly do it before surgery like this, not after.

So it is a legitimate concern that you will not adhere to the post-surgical requirements and that's something you should be prepared for. There's no shame in having to go to a psychologist or psychologist, since discipline is a mental/emotional issue. If you break a leg you see an orthopedist, if you're having a baby you see an obstetrician, and if you have mental issues you see a psychologist who may help you identify if there's something blocking you or if it's some form of self-sabotage.

Edited February 2, 2018 by elforman

[shedo82773 1,236]

I am right there beside you. I have been on almost every diet known to man!! I have lost many many pounds but lacked the stickim to it to maintain. Since my RNY I have lost weight and maintained my 124# loss for 4 years. Which I would have never ever in this lifetime been able to maintain any amount of weight loss. Yes this is a tool and yes it does make you stronger!! But we still have and had to work for it. You my friend are not alone in this battle, I will bet most everyone that you talk too will tell you the same thing. Follow everything your DR and Nutrition tells you and you will be successful. Hang tight this is one of the best journey you have been on. Good Luck

[Healthy_life2 8,324]

1 hour ago, gr8ful1 said:

Greetings, everyone. I am a serial diet failer. I've been on phen-fen in the '90s, on a weight management program while in the military, Weight Watchers, and physician/hospital-based medical weight management programs that included help from doctors, dietitians, psychologists, and exercise specialists. I learn what I need to do to succeed, start of strong, leave the formal program, and end up regaining all the weight I lost or more. I am the epitome of knowing what to do but failing to do it consistently for more than a few months at a time.

I keep hearing that WLS requires hard work and discipline, as well as a commitment to eating right for the rest of your life. Problem is, I am over 300# because I have *failed* to do these things consistently over and over again. When I go to support groups for my medical weight management program, the only ones who are keeping the weight off are the ones who have had surgery. Surgery is a tool, but I've already been given a whole toolbox full of tools from all of the professionals that I've paid thousands of dollars to visit. I want to use them but I keep putting them away and going back to my old unhealthy ways.

I can be disciplined long enough to lose 20-70 pounds at a time, but not long enough to keep it off. Am I exactly the type of person who should *not* be considering WLS? I don't know what else to do at this point. I do have an appointment to consult with a surgeon in a couple of weeks, but I don't think I'll qualify for surgery. My BMI has been above 40 for 15-20 years, and is currently in the mid-40s, but my medical records show that it has dropped below 40 whenever I've been in the middle of a weight management program and on a ketogenic shake diet, including as recently as a year ago, when I completed my last of many 12-week programs. I have no qualifying co-morbidities, but I'm heading in that direction. Use a CPAP but AHI is below 30, cholesterol high but controlled ok with statins.

Sorry for such a lengthy fist post. I have read quite a few of the existing posts and this looks like a great, supportive online community.

By the title of your post - Know that I'm exactly the type of person that should not have considered WLS.

Yes, I have failed on diets. I've done every diet possible. I've lost and regained many times.The pills and diet plans were not sustainable long term. That is the main reason I chose surgery. needed a long term solution.

I have no regrets that I did the hard work of changing my behaviors with food and exercise. I went from 254 to 133 maintaining over three years.

I agree with @elforman advice.

[Creekimp13 5,840]

Can you screw up weight loss surgery with a lack of follow through? Yes. Sadly, it can all be in vain if your habits regress.

That said...

it's your very best shot at success.

We all face this dilemma. It's scary...and there are no guarantees.

But it's your best shot.

And you're worth it....to try.

[NewBeginnings2018 81]

The thing that really stuck with me is when my surgeon commented that what's different with WLS is the metabolic change your body goes through. It's a physical change whereas all those things I've tried in the past were not. That is what made me decide to go for it.

[gr8ful1 122]

THANK YOU everyone, for all of your thoughtful and insightful responses. I trust that the surgeon, and even more so, my insurance company, will not allow my surgery unless the pre-surgery screening process indicates that I meet the criteria for being a successful candidate.

[Sshelton0313 2]

20 hours ago, shedo82773 said:

I am right there beside you. I have been on almost every diet known to man!! I have lost many many pounds but lacked the stickim to it to maintain. Since my RNY I have lost weight and maintained my 124# loss for 4 years. Which I would have never ever in this lifetime been able to maintain any amount of weight loss. Yes this is a tool and yes it does make you stronger!! But we still have and had to work for it. You my friend are not alone in this battle, I will bet most everyone that you talk too will tell you the same thing. Follow everything your DR and Nutrition tells you and you will be successful. Hang tight this is one of the best journey you have been on. Good Luck

Oh my! That is awesome and exactly where I want to be in 4 years. Can you give me an idea of what your post-surgery diet is like. Fo you exercise? Congratulations! That gives me hope.

[gr8ful1 122]

Yikes, I just noticed the typo and awful grammar in the title of this topic. Sorry about that, folks. If I knew how to edit it, I would. The correct title should be this:

"Surgery is not for those who fail on diets?"

[elforman 234]

Yikes, I just noticed the typo and awful grammar in the title of this topic. Sorry about that, folks. If I knew how to edit it, I would. The correct title should be this:
"Surgery is not for those who fail on diets?"

Don't sweat it. You spend enough time on the internet and you learn how to translate typos in the fly.

Sent from my SM-G930T using BariatricPal mobile app

[shedo82773 1,236]

4 hours ago, Sshelton0313 said:

Oh my! That is awesome and exactly where I want to be in 4 years. Can you give me an idea of what your post-surgery diet is like. Fo you exercise? Congratulations! That gives me hope.

Sshelton0313,

Well right off the bat I had to do Protein Drinks for 4 weeks after my RNY. I also had problems with Strictures and had 5 Endoscopes with 4 Dialations. which started in Sept 2013, Nov 2013 , Dec 2013, Jan2014, July 2014 with my last being Jan 2015. I was very limited in what I could eat or even drink at times. I ate a lot of Beans, cheese, tamales (note that I could never eat the whole thing of any of it)burritos, cottage cheese and oatmeal. I still can only eat 1/2 of a boiled egg. I just started to even eat bread within the last few months and only 1 slice. Very small amount of rice but not often. Whatever I eat is just a small amount at a time. Before I had my surgery my Dr and my Nutrtionist both told me that there are no forbidden foods, that I must learn to eat in MODERATION. My exercise is walking. I started right after I left the hospital. I had to stay in a MOTEL for 1 week because I lived 100 miles away from the Dr and Hospital. I walk around every day 2 to 3 times a day. I can now say that I have been pretty dilagent about my exercise. I now walk 3 to 4 times a week and go 3 to 4 miles each time. As I said above follow everything your Dr says be consistant and Keep your eyes on the prize!! Also KEEP ON KEEPING ON!! Good Luck.

[gr8ful1 122]

5 minutes ago, shedo82773 said:

Sshelton0313,

Well right off the bat I had to do Protein Drinks for 4 weeks after my RNY. I also had problems with Strictures and had 5 Endoscopes with 4 Dialations. which started in Sept 2013, Nov 2013 , Dec 2013, Jan2014, July 2014 with my last being Jan 2015. I was very limited in what I could eat or even drink at times. I ate a lot of Beans, cheese, tamales (note that I could never eat the whole thing of any of it)burritos, cottage cheese and oatmeal. I still can only eat 1/2 of a boiled egg. I just started to even eat bread within the last few months and only 1 slice.

Wow, it looks like you've had a tougher journey than most. I hope all of the complications are behind you. Keep up the good work!

[shedo82773 1,236]

Just now, gr8ful1 said:

Wow, it looks like you've had a tougher journey than most. I hope all of the complications are behind you. Keep up the good work!

Yes it is so much better now. I really wonder if I had not had the problems, if I would have still lost my weight in 6 months. HHHMM I'm not sure on that one.

[jcrowder 5]

So your post sounds just like me...add a few advanced nursing degrees AND the fact that I had RNY done 25 years ago to make me feel like even more of a failure. I'm back going through the process of considering a revision to my original surgery at my highest weight ever. IF insurance will approve. While it would be awesome to get a total do-over with the RNY process (not just the reducing the stomach which is essentially what I'm not a candidate for) I don't regret my decision 25 years ago. I am sad that back then there was little/no follow-up, no real rules on diet/caffeine/timing of Water intake/etc --maybe I'd have had better long term success. BUT I did lose just over 100lbs. Felt better than I had in my entire life and did more than I'd ever done - travel, marriage, shoppig in normal size clothing stores, etc. I have been morbidly obese since 6th grade and overweight since I was 7. That surgery got me closer to "normal" than ever.

No diet I did before that or since then has been so successful- a year long Protein Shake diet did result in 70lbs lost but then I regained all + some much faster than after surgery. But, I realize now that I half-assed the process and expected that it would just magically work on its own. I'm sure deep down I probably still sort of think that way.

I'm older have a couple kids that wish mom was more active and am restricted from doing things because of my weight and that makes me sad.

This time I'm throwing everything at it...sort of feel like it's my last ditch effort. After my mandated psych eval for surgery I opted to continue working with the counselor who specializes in all types of eating disorders and am seeing a bariatrician who will prescribe WL meds. I've long thought until someone fixes the chemicals in my brain WL will never be long term, so I believe in meds. I'm taking the process so slow unlike in the past where I jumped into huge lifestyle shifts that were only sustainable for short-ish periods of time. I didn't even start a legit "diet" until just this week even though I've been going through the pre-cert process since October...and it's not really a diet- just replacing one meal a day with a shake per the changes prescribed by the bariatrician. On the advice of the counselor I've been setting one really small goal each week that is hopefully attainable and I'm able to maintain.

Who knows what will happen with the WLS approval process. I'm hopeful the other adjuncts I'm working on will help me be successful for the long term. IF surgery is approved, it's really just another piece of the WL puzzle though a really nice one in terms of the ability to lose weight rapidly. It's up to me to keep it off though.