Scared to go through with surgery

[Softtacocrumbs 12]

I'm a bit scared to go through with my surgery. It's planned for late November. I talked to the nutritionist for pre-op and she realized something was wrong with my hormones, because I generally don't eat much and I work out a lot. She protested with my PCP to look at my hormones, and told him I needed to see an endocrinologist. Long story short I'm on meds for hypothyroidism, but my bariatric surgeon and PCP still say I need the surgery. My endocrinologist says don't do it. I've been on the hypothyroid meds for 3 weeks and I'm down 32lbs and officially under 200lbs. Am I being too sensitive and thinking my PCP and surgeon are fat phobic or should I trust them? My nutritionist is saying hold off on it because she doesn't think it's an eating problem, but a hormone problem, and I can't help but believe her since I've seen crazy results on my thyroid meds.

What should I do?

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[kcuster83 1,505]

I don't know your stats, as far as height for the weight and medical issues but I would definitely hold off and see what happens with the meds and getting your hormones balanced.

It really hurts nothing to hold off for a few months and see how it works out.

[KimA-GA 540]

talk to your endocrinologist and listen to your instincts. it sounds like you found the cause of weight gain and it is resolving.

you can always do the surgery later if you stall out!

[SpartanMaker 1,465]

11 minutes ago, kcuster83 said:

I don't know your stats, as far as height for the weight and medical issues but I would definitely hold off and see what happens with the meds and getting your hormones balanced.

It really hurts nothing to hold off for a few months and see how it works out.

100% agree. Waiting won't hurt, so I'd say wait and see what happens now that you're working with the endocrinologist.

[Softtacocrumbs 12]

I don't know your stats, as far as height for the weight and medical issues but I would definitely hold off and see what happens with the meds and getting your hormones balanced.
It really hurts nothing to hold off for a few months and see how it works out.

Thank you so much for your answer!

I'm 5'4" and my BMI went from 39 to 34.5 in 3 weeks on my meds. Starting from 230lbs and now at 198lbs. My endocrinologist asked if I considered that my PCP is fat phobic... Which is what makes me concerned. I'm just not sure if that's why he didn't want to check my hormones before sending me to bariatrics. I knew he didn't listen to my concerns much, but I didn't realize how much of an impact that would have on this outcome. I kept thinking I would be getting a vsg and it's good for me, but I've almost been nutrient deficient my entire life. Now, am I being biased to think this way about my PCP or is this me being sensitive?
If this helps put things into perspective:

Nutritionist and endocrinologist= female
PCP and surgeon = male

I appreciate everyone's replies!

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[sweetsmith78 60]

On 10/14/2022 at 1:36 PM, Softtacocrumbs said:

I'm a bit scared to go through with my surgery. It's planned for late November. I talked to the nutritionist for pre-op and she realized something was wrong with my hormones, because I generally don't eat much and I work out a lot. She protested with my PCP to look at my hormones, and told him I needed to see an endocrinologist. Long story short I'm on meds for hypothyroidism, but my bariatric surgeon and PCP still say I need the surgery. My endocrinologist says don't do it. I've been on the hypothyroid meds for 3 weeks and I'm down 32lbs and officially under 200lbs. Am I being too sensitive and thinking my PCP and surgeon are fat phobic or should I trust them? My nutritionist is saying hold off on it because she doesn't think it's an eating problem, but a hormone problem, and I can't help but believe her since I've seen crazy results on my thyroid meds.

What should I do?

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Hold off!! You will feel more energy. Your hair will grow, skin will feel good, best of all you will loose weight..

[DrinkMoreRadium 16]

Thank you so much for your answer!

I'm 5'4" and my BMI went from 39 to 34.5 in 3 weeks on my meds. Starting from 230lbs and now at 198lbs. My endocrinologist asked if I considered that my PCP is fat phobic... Which is what makes me concerned. I'm just not sure if that's why he didn't want to check my hormones before sending me to bariatrics. I knew he didn't listen to my concerns much, but I didn't realize how much of an impact that would have on this outcome. I kept thinking I would be getting a vsg and it's good for me, but I've almost been nutrient deficient my entire life. Now, am I being biased to think this way about my PCP or is this me being sensitive?
If this helps put things into perspective:

Nutritionist and endocrinologist= female
PCP and surgeon = male

I appreciate everyone's replies!

Sent from my M2007J3SY using BariatricPal mobile app

Like others have said, trust your instinct and if you aren't 100% committed to the surgery, don't do it. It also sounds like you have lost trust in your PCP. You may want to look into switching to a different PCP (if possible with insurance) not only for this situation but for the long term. No one is a better advocate for yourself than you! Find someone that you trust and respect; someone who listens to you and adjusts medical plans accordingly.



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[ShoppGirl 5,076]

Sometimes doctors are so used to hearing the same old stories day in and day out that they just assume that they have heard them all and quit actually listening. The ONLY remotely logical reason I can think of them wanting you to have surgery while you are actively losing on your own would be if they expect you to lose some and then stop losing. If you lose and get below the BMI threshold you would no longer qualify unless you gained again. My question would be how close to a normal BMI you can get on your own. If it were me I would wait and see how much you can lose on your own. Only you know how you are really eating and if it’s all related to this illness that is now being treated it should reverse itself. You can always have the surgery down the road if you don’t lose like you think you will. Sounds like your gut is already telling you to wait. I say trust it.

[Softtacocrumbs 12]

Sometimes doctors are so used to hearing the same old stories day in and day out that they just assume that they have heard them all and quit actually listening. The ONLY remotely logical reason I can think of them wanting you to have surgery while you are actively losing on your own would be if they expect you to lose some and then stop losing. If you lose and get below the BMI threshold you would no longer qualify unless you gained again. My question would be how close to a normal BMI you can get on your own. If it were me I would wait and see how much you can lose on your own. Only you know how you are really eating and if it’s all related to this illness that is now being treated it should reverse itself. You can always have the surgery down the road if you don’t lose like you think you will. Sounds like your gut is already telling you to wait. I say trust it.

Thank you so much. I was so scared I was crying. It's been a couple days and I'm down 8 more pounds, putting me at 190lbs. I'm dropping so fast it doesn't seem to feel real. My body temp is finally up from 92F to 96F which I think is contributing a lot to things, and I don't always feel cold now.

As everyone has said, I think you all are right. I'll change my PCP and find someone else. I really feel like he may be fat phobic and I'm not sure if the surgery will be good for me since my daily calorie intake is around 1200kcal normally. He said if I got the vsg I could get my calories down to 500kcal, and things just sounded off to me. I guess in my heart I felt like I had no hope and I couldn't get my PCP to take my concerns seriously because he would always say I needed to lose weight before I was allowed to discuss hormone problems with him, which turned out to be the case.

I really appreciate everyone who replied. I'll update the thread with my progress. However, at this rate I may not qualify for a vsg. At least when I reached out to my nutritionist, she said I probably wouldn't qualify by the time my hormones equilibrate.

Thank you so much everyone.

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[ShoppGirl 5,076]

On 10/17/2022 at 9:34 PM, Softtacocrumbs said:

Thank you so much. I was so scared I was crying. It's been a couple days and I'm down 8 more pounds, putting me at 190lbs. I'm dropping so fast it doesn't seem to feel real. My body temp is finally up from 92F to 96F which I think is contributing a lot to things, and I don't always feel cold now.

As everyone has said, I think you all are right. I'll change my PCP and find someone else. I really feel like he may be fat phobic and I'm not sure if the surgery will be good for me since my daily calorie intake is around 1200kcal normally. He said if I got the vsg I could get my calories down to 500kcal, and things just sounded off to me. I guess in my heart I felt like I had no hope and I couldn't get my PCP to take my concerns seriously because he would always say I needed to lose weight before I was allowed to discuss hormone problems with him, which turned out to be the case.

I really appreciate everyone who replied. I'll update the thread with my progress. However, at this rate I may not qualify for a vsg. At least when I reached out to my nutritionist, she said I probably wouldn't qualify by the time my hormones equilibrate.

Thank you so much everyone.

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Do you know what all an endocrinologist tests for? It’s not just hypo and hyperthyroidism, right?? I am in maintenance and struggling big time. I feel like the only way to maintain my weight is to be on a diet (and hungry) for the rest of my life cause I add in a few calories and I gain. I feel like there is something going on with my hormones that my primary doc is missing. I see him today and plan to ask a lot of questions. Just wondering what conditions cause weight gain that I should be questioning him about.

[SpartanMaker 1,465]

2 hours ago, ShoppGirl said:

Do you know what all an endocrinologist tests for? It’s not just hypo and hyperthyroidism, right?? I am in maintenance and struggling big time. I feel like the only way to maintain my weight is to be on a diet (and hungry) for the rest of my life cause I add in a few calories and I gain. I feel like there is something going on with my hormones that my primary doc is missing. I see him today and plan to ask a lot of questions. Just wondering what conditions cause weight gain that I should be questioning him about.

An endocrinologist works with pretty much any issue related to the endocrine system, meaning your thyroid, pituitary gland, hypothalamus, adrenal gland, etc. Basically most anything hormone related is something they can help treat. You can always ask you PCP for a referral, but depending on your doc and your insurance, they may be loathe to do so if you don't have anything showing up on your blood tests. If you're insurance does not require a referral to see a specialist, the you can always just make an appointment.

There definitely are some hormone imbalances that can slow your metabolism such that your maintenance calories will be pretty low. Alternately, it may not be a hormone imbalance at all. It may just be what's normal for you. One additional thing for you to consider is that exercise, especially strength training, would allow you to eat more without gaining. What's your exercise routine look like right now?

[ShoppGirl 5,076]

30 minutes ago, SpartanMaker said:

An endocrinologist works with pretty much any issue related to the endocrine system, meaning your thyroid, pituitary gland, hypothalamus, adrenal gland, etc. Basically most anything hormone related is something they can help treat. You can always ask you PCP for a referral, but depending on your doc and your insurance, they may be loathe to do so if you don't have anything showing up on your blood tests. If you're insurance does not require a referral to see a specialist, the you can always just make an appointment.

There definitely are some hormone imbalances that can slow your metabolism such that your maintenance calories will be pretty low. Alternately, it may not be a hormone imbalance at all. It may just be what's normal for you. One additional thing for you to consider is that exercise, especially strength training, would allow you to eat more without gaining. What's your exercise routine look like right now?

My husband says I need to exercise more too. I walk about 45 minutes to a hour a day and that’s about it. The thing is I lost the weight without doing any more than that so it doesn’t make sense that I am gaining now because of that. The doctors keep blaming my antidepressants and my bipolar I just think that there is more to it. The weight gain did all start around 25 though which is also when the symptoms of my illness began so idk. I don’t need a referral for a specialist though, so I think I am going to see one just to rule it out if nothing else.

[SpartanMaker 1,465]

3 minutes ago, ShoppGirl said:

My husband says I need to exercise more too. I walk about 45 minutes to a hour a day and that’s about it. The thing is I lost the weight without doing any more than that so it doesn’t make sense that I am gaining now because of that. The doctors keep blaming my antidepressants and my bipolar I just think that there is more to it. The weight gain did all start around 25 though which is also when the symptoms of my illness began so idk. I don’t need a referral for a specialist though, so I think I am going to see one just to rule it out if nothing else.

Sounds like a plan. I would also definitely recommend strength training. It does not have to be anything fancy, even a solid bodyweight only routine would help. You can google something like "bodyweight exercises for beginners" and use that to get started. Note that it's not unusual for beginners to see both extra Water retention and even muscle growth when starting strength training, so don't be surprised if you see a jump up on the scale.

This type of exercise will not only burn calories, but will also boost your overall metabolic rate, meaning you'll burn more calories, even at rest.

[kaylee50 61]

On 10/14/2022 at 11:45 AM, Softtacocrumbs said:

Thank you so much for your answer!

I'm 5'4" and my BMI went from 39 to 34.5 in 3 weeks on my meds. Starting from 230lbs and now at 198lbs. My endocrinologist asked if I considered that my PCP is fat phobic... Which is what makes me concerned. I'm just not sure if that's why he didn't want to check my hormones before sending me to bariatrics. I knew he didn't listen to my concerns much, but I didn't realize how much of an impact that would have on this outcome. I kept thinking I would be getting a vsg and it's good for me, but I've almost been nutrient deficient my entire life. Now, am I being biased to think this way about my PCP or is this me being sensitive?
If this helps put things into perspective:

Nutritionist and endocrinologist= female
PCP and surgeon = male

I appreciate everyone's replies!

Sent from my M2007J3SY using BariatricPal mobile app

Bariatric surgery is a major step, so I don't blame you for being scared. I just wanted to reach out and validate your feelings. I was scared, too, which is why I chose a non-surgical option (Endoscopic Sleeve Gastroplasty). It is not yet covered by insurance so it is not as popular, but in my experience thus far and per the medical literature it is safe & effective. Maybe ESG is something to keep in mind for later, if you still need a "tool" in the form of a sleeve. But I would wait until your weight stabilizes after the meds, exercise, and new healthy eating habits are established.

FWIW, I do not think your PCP is fat phobic. Obesity is a serious health risk, the older and the bigger you get. No one sees this more than a diligent PCP. Mine is 100% in favor of my new tool because she is the one who has been prescribing all my meds for hypertension and pre-diabetes, referring me to specialists, etc. I am just glad you went to see an endocrinologist and found a medical reason for your obesity.

In case no one else has said it lately, great job!! Even with new meds, losing that much weight is an accomplishment. I agree with the other suggestions here re: strength training and all. Best wishes to you.

[Softtacocrumbs 12]

Do you know what all an endocrinologist tests for? It’s not just hypo and hyperthyroidism, right?? I am in maintenance and struggling big time. I feel like the only way to maintain my weight is to be on a diet (and hungry) for the rest of my life cause I add in a few calories and I gain. I feel like there is something going on with my hormones that my primary doc is missing. I see him today and plan to ask a lot of questions. Just wondering what conditions cause weight gain that I should be questioning him about.

So, when I was first talking to my nutritionist I had already been logging all my food into MyFitnessPal for around a year. And I've always had a problem with low body temp, brittle hair and nails, exhaustion, and high body weight set point.

She tested for the standard TSH, T3, T4, Vitamin D, retook the standard ha1c, LH, FSH, cortisol, and something else I don't remember. It was quite a few vials.

My intake was typically around 1200 kcal-1600 kcal. And I workout a lot. I typically spend 2 hours weight training on odd days and cardio on even days. And I had a symptom for when I eat I get super cold and my hands feel freezing.

Hope that helps you also know what to ask an endocrinologist. That's at least what was afflicting me.

For me I ended up having pretty high TSH (upper range teetering on over) and incredibly low T3 and T4.


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