3 options: which one would you choose?

[mtlmiracle 4]

Hello,

Over the course of October I will meet with three different medical professionals to choose a weight-loss option.

First I will meet with a coach from The Fasting Method. She specializes in Fasting regimens and Behavioural Therapy. The cost is around $1000 for 4 online coaching sessions and an online support group. Most of the fasting I will do myself and will need a lot of determination to stick to the 36-hour fasting protocol they recommend.

Next, I have a consultation with a surgeon at a private clinic. The cost will be 14,000 for a gastric sleeve and the surgery would be completed before the end of the year. They provide all of the medical services for surgery plus 3 months of nutrition counseling and medical follow-up at 1 month, 3.5 months, and 1-year post-op. They also have an online Facebook support group.

Finally, I have an appointment with a new General Practitioner who could provide me with a referral to a bariatric clinic within a hospital. This process would be covered by the province if I were accepted into the program. However, the process could take several years (1-4 years) before I received the surgery. Yet they would provide the most support both before and after surgery in order to be successful.

I am really unsure of which option is best for me and I wonder if other people might have insight into what could work for them knowing what they know now. The first option, fasting, I have tried on my own and was successful for 8-12 months but gained all the weight back and then some. The second is the quickest way to put in place a permanent tool that I will have to use on my own to lose weight. It is also the most expensive. The third option would provide me with a lot of support and I think I probably do need some type of talk therapy. I'm expecting this surgery and the dramatic weight loss to be like an emotional rollercoaster for me. However, I do not have many obesity-related complications just yet (such as diabetes, hypertension, etc.) although my BMI is around 40.

How much support did you need? Which option would you choose knowing what you know now?

[lizonaplane 1,612]

I would not spend $1000 for someone to "coach" me through fasting. What are they going to tell you? Don't eat? Also, fasting is not a long term plan to lose weight and keep it off. The only thing with a lot of evidence is surgery, although it is certainly not an easy fix. I'm 2.5 weeks out and I'm pretty miserable.

I would go one of the two surgery routes, personally. Which you choose is up to you. I'm guessing you are in Canada. I'm in the US and I had private insurance, and waited about 7.5 months for my surgery. The wait was hard, but I spent the time working on eating better and exercising. However, waiting 1-4 years would have been unacceptable to me and I would have paid out of pocket. To be honest, the support I'm getting now from my supposedly top of the line surgery center is pretty lousy, so I wouldn't assume that you'd get amazing support from HealthCanada. I've heard from people in the UK that NHS provides really lousy follow up, too.

But, I don't know how much resources you have available to devote to this process, and you definitely don't want to bankrupt yourself to have surgery. I know many people have gone to Mexico to have the surgery and been very successful, but it wouldn't be my choice.

There are so many resources online, both these message boards and also I love the Facebook group "my level 10 life" (the person who started it has a ton of YouTube videos but she's not always to my taste). You can also hire a bariatric therapist, and that's probably a good idea regardless of which path you choose.

Good luck and keep checking in!

[Sleeve_Me_Alone 656]

I have tried about a million online coaching/nutrition programs and failed at every single one. I just did not find that it was structured enough or supportive enough to help me make permanent, impactful changes. That may not be true for everyone, but that was my experience.

As for the surgery options, my insurance (US) covers bariatric surgery and I've consulted 3 times over the years but always chickened out. The time commitment to get through the program, the insane amount of tests and pre-op appointments, and the sheer number of hoops to jump through always became overwhelmingly discouraging and I gave up. So, I opted to go the self-pay route in Mexico. From first consult to surgery was almost exactly 3 months. The cost out of pocket including flights, hotels, meds, etc. was less than what my deductible and co-pays would have been had I used my insurance. Additionally, I met with my primary care doc prior to surgery and secured her support. She will be doing all my post-op labs and can provide ongoing dietary guidance in conjunction with my surgeon's RD. I am only a week and a half post-op, but I am SO glad I finally did it.

You need to weight the options in light of your own needs, what kind of support will help you be most successful, what are you willing to commit to as a timeline, what fits in your finances, etc. Ultimately you just need to get gut-level honest with yourself, and then decide. Whatever you do, I'm sure you will find success!

[laurenantics 76]

What are your stats?

The last thing I’d do is a fasting coach, personally.

[ShoppGirl 4,798]

I am almost seven months out and knowing what I know now the first thing I would do would be to start seeing a bariatric therapist. I didn’t realize until AFTER I had the surgery that I struggle with emotional and boredom eating and no special diet, fasting coach or even surgery was going to help me lose weight and keep it off without the help of a bariatric therapist. And personally I wouldn’t have benefited from a fasting coach. I would have lost the weight and then gained it back like everything else I have tried and failed. That being said the two surgical options are both good it just depends on which one is right for you. Personally I could not have paid that much out of pocket so I would have had not choice but to go with the second option but only you know if you can afford to do it self pay. I wouldn’t base it on the follow up though, because you can seek out help from a nutritionist or dietician on your own and hopefully you will already have been working with a bariatric therapist if you need one and you can just continue to see them As needed. That’s basically what the continued care consists of. That and follow up visits with the surgery center to check labs for Vitamin

deficiencies and check in with how you are doing. You can always call and ask up Front but I’m sure if you are willing to pay you can see all those people as often as you want. All that being said I wouldn’t have wanted to wait years for surgery but if you are committed you should be able to start losing weight while you wait and it’s just less to have to lose later.

[mtlmiracle 4]

1 hour ago, laurenantics said:

What are your stats?

The last thing I’d do is a fasting coach, personally.

I'm a 34 year old woman with a current weight of 260 height is 5'6. I have lost and gained over 60lbs at least 3 times. I was never able to maintain the weightloss for longer than 6-8 months at a time. I have done strict Keto, Fasting, and intense exercise routines multiple times in my life. I was successful in losing weight every time so it wasn't that I couldn't commit myself or apply weightloss techniques that work for me. I would just simply go back to overeating every time.

I really don't know if fasting will work for me longterm if I add coaching. I certainly want it to work but I have small children and a husband who likes to eat big hearty meals so cooking and shopping for food are part of my regular daily activities. I find when I'm fasting it is really difficult to cook a hot delicious meal that I simply cannot even taste. So I end up cooking a quick meal for my family which is not the healthiest.

I will keep exploring the surgery option. I really appreciate all of the feedback so far. The new ideas like searching for my own bariatric therapist and using my family doctor to do my bloodwork after surgery has given me some hope that I can do this. 😊

Edited October 1, 2021 by mtlmiracle

[vikingbeast 987]

I wouldn’t pay one percent of that fee for a “fasting coach”. How ridiculous.

You have a fourth option, which is bariatric surgery in one of the border cities in Mexico; most are in Tijuana. You fly to San Diego (now that it’s allowed), then it’s 20 minutes to the border and your clinic picks you up on the Mexican side. It’s much cheaper than self pay in either Canada or the US, and the doctors tend to be US-certified as well as obviously qualified in Mexico. You’d want to talk to your PCP in Canada before going this route to make sure she’s comfortable with ordering labs (for Iron, Vitamins, liver function, lipids, metabolic panel, etc.) afterwards.

I am two and a half weeks out and having the sleeve has already given me so much of my life back. Between pre-op and post-op loss I am only 5 kg from the halfway point of my journey.

[catwoman7 11,212]

I would also choose option 2 or 3 (depending on your finances and how long you're willing to wait). Fasting isn't a sustainable method - most (if not all) people end up gaining it all back.

[RickM 1,747]

I lean toward the long term solution, as this is a long term problem (you didn't get this way overnight.) you should expect it to be a long term effort to solve it. I like to think in terms that this surgery, whichever you get into, is not a cure but more of a "do over" where you get set back more or less where you should be physically and you get to start over again. You need to learn how to avoid the traps that got you where you are now, and how to live to maintain a healthy weight in the long term. Many post op bariatric patients repeat the same process that they did when dieting - lose weight and then start to regain when they start going back to "normal" eating - it just takes longer, as it 2-3 years or more rather than just a few months or a year with basic dieting. We need to learn how to eat and live to maintain like a "normal" person, and that takes time

More later, but I have a lap lane reserved at the pool at the gym in a few minutes. Time to work on that maintenance some more.

[Danpaul 42]

2 hours ago, mtlmiracle said:

I have lost and gained over 60lbs at least 3 times. I was never able to maintain the weightloss for longer than 6-8 months at a time.

The fasting coach will probably not be a good stand alone tool. I've gained some weight and struggle to take it off. I'm fours years out. One of my tools is to fast. I fast 12 hours a day. I'm trying for the 36hrs 2x a week but that's a tall order. The point is, you will need to combine tools and not just depend on one. The surgery option is a good one combined (later on ) with the fasting option. As you've stated before you have achieved great success only to digress back to your starting weight.

Weight Loss Surgery(WLS) is a great tool to "jump start" your weight loss but it is no means a stand alone tool. After 8-12 months we begin to revert back to , as I say being mere mortals again. No longer are we able to lose weight while sleeping or just by being alive. Our weight loss superpowers are gone. It now, takes a mindful and consistent maintenance program. This is where fasting, exercise, being conscience of what we eat and how we really changed our lifestyle during the first 8- 12 months.

WLS is a great tool but it is not the golden bullet to lifelong weight lose and health stability. I'd say, go with the WLS, get that big jump start, start a mindful maintenance program consisting of many tools. Good luck to you and I wish you the best of health.

[Arabesque 7,257]

My first reaction to the fasting option was sustainability. Can you sustain such an eating plan for the rest of your life? Because losing weight & keeping it off is a lifetime behavioural change.

Personally, I fasted for most of my high school years. No Breakfast, no lunch, 4 multi grain crackers for afternoon tea & a healthy dinner nothing else all to try to maintain my weight. Did it work? No! I put on almost a stone every year & I was way more active then too. All it did was kill my metabolism.

The sustainability aspect was the game changer for me. I can follow any restrictive diet for a few weeks or months & did many, many times. But as soon as I reached the weight loss goal I gave myself or when the diet became too hard to continue, I’d just go back to eating how I did before & start gaining again.

As some posters above have said weight loss surgery is a tool. If you use it, take advantage of the benefits it affords & make changes to how you eat, what you eat & understand why you eat you can be successful in losing weight & maintaining. The time before surgery & after while you are losing are the time to work through the answers to the what, why & how you eat & to begin establishing new behaviours. Don’t be afraid to seek help from a therapist & a dietician. Just make sure the changes you make are sustainable & will complement your lifestyle & how you want to live your life. It’s something you will have to do forever.

I am biased though, the surgery has been a successful experience for me. From deciding to have surgery to actually having the surgery was a very short period - less than two months from GP referral to theatre (much easier process here in Australia though). Don’t know if I would have gone through with it if I had to undergo 1-4 years of pre requisite steps & approval processes. I’d choose the shortest & quickest path forward. Though you know yourself best & know how much support you will need. But it is your decision.

Good luck whatever you choose to do.

[canadianpopcycle 77]

Hello!

I'd opt for surgery..either through the province or privately. My personal belief is that fasting, along with a host of other 'diets' are fads that don't have long term success.

I had my surgery in Calgary, Alberta, Canada through a bariatric program, and was covered by healthcare. If you have specific questions, let me know and I'd be happy to answer what I can

Edited October 2, 2021 by canadianpopcycle