Want to get weight loss surgery but am not getting approved

[shonna1989 2]

I've had a long history with weight problems. By the age of ''4'' I was already 68 pounds despite having the diet of the typical child. By the time I was 15 I was in the 180's and eating honestly no different from my peers. By 17 I had joined a teen fitness group and failed to lose any weight what-so-ever. I resorted to starvation about a year later and by 19 I was 150 pounds and subsisting on 500 calories per day, taking diet pills and using tea laxatives. This lead to a cardiac issue which lead me into an Anorexia treatment center by 20. I cleaned up my act and began a ''healthy eating journey'' but sadly for me that resulted in a slow creeping weight gain of about 7-8 pounds per year.

Sometime in 2014 I had reached ''180'' again and decided to join a gym. Worked out for months and lost nothing. I reduced my sugars, cut out processed food.. somehow I ended up weighing even more. I was 186 by the end of that year.

By 2021 I was ''210'' pounds. My doctor weighed me. I was in shock. Literal shock.. could not even believe it because I was working with a nutritionist at the time and following through with everything. This last year I have worked out constantly, eaten no carbs and I am 208. I have only lost two pounds. I am nearly 33 year old and my weight has been a seemingly life long struggle and close to resistant to change unless extreme measures were taken (Anorexia). I am very disappointed with this.

I have been tested for PCOS, Cushing's, NCCH etc many times and nothing showed up. I had severe acne (took accutane three times) and mild hirsutism as well but all blood tests come back normal, ultrasound reveal no cysts and I've gotten a monthly period since 13 years old. No doctor can explain this. I feel as though they do NOT believe me when I tell them what I eat. I just had an appointment with an endocrinologist and he said what I was telling him was ''impossible''. I have asked my doctor to refer me for weight loss surgery but at 210 pounds and 5'7 they just won't do it.

I am at a loss.

[kcuster83 1,504]

Sorry you are struggling. We all know how frustrating that can be when it seems you are doing everything right.

With your height and weight, you have a BMI of about 32 which will not meet the insurance requirements anyway. Probably why they won't bother referring you. You need to have a BMI of 35 or higher and at least weight related health issues. (High BP, diabetes, etc) or have a BMI of 40 or higher without the related health issues.

The only way you will be able to have any type of WLS is to pay out of pocket if you can even find someone to do it with your current BMI. I am sure, there are surgeons out there that would do anything for the money, but I am not sure you really want "that kind" of surgeon being trusted with your life.

With that said, have you discussed medical weight loss with your doctor? Prescription meds to help with weight loss? If not, you could try that.

I feel for you and wish you the best!

[liveaboard15 1,293]

1 hour ago, shonna1989 said:

I've had a long history with weight problems. By the age of ''4'' I was already 68 pounds despite having the diet of the typical child. By the time I was 15 I was in the 180's and eating honestly no different from my peers. By 17 I had joined a teen fitness group and failed to lose any weight what-so-ever. I resorted to starvation about a year later and by 19 I was 150 pounds and subsisting on 500 calories per day, taking diet pills and using tea laxatives. This lead to a cardiac issue which lead me into an Anorexia treatment center by 20. I cleaned up my act and began a ''healthy eating journey'' but sadly for me that resulted in a slow creeping weight gain of about 7-8 pounds per year.

Sometime in 2014 I had reached ''180'' again and decided to join a gym. Worked out for months and lost nothing. I reduced my sugars, cut out processed food.. somehow I ended up weighing even more. I was 186 by the end of that year.

By 2021 I was ''210'' pounds. My doctor weighed me. I was in shock. Literal shock.. could not even believe it because I was working with a nutritionist at the time and following through with everything. This last year I have worked out constantly, eaten no carbs and I am 208. I have only lost two pounds. I am nearly 33 year old and my weight has been a seemingly life long struggle and close to resistant to change unless extreme measures were taken (Anorexia). I am very disappointed with this.

I have been tested for PCOS, Cushing's, NCCH etc many times and nothing showed up. I had severe acne (took accutane three times) and mild hirsutism as well but all blood tests come back normal, ultrasound reveal no cysts and I've gotten a monthly period since 13 years old. No doctor can explain this. I feel as though they do NOT believe me when I tell them what I eat. I just had an appointment with an endocrinologist and he said what I was telling him was ''impossible''. I have asked my doctor to refer me for weight loss surgery but at 210 pounds and 5'7 they just won't do it.

I am at a loss.

5'7 and 210lb. You are great honestly right there. Yes a little overweight. But i am 5'4 and 205lb and i am so happy at this point tho i would love to loose a little more. Eat healthy and exercise. As for the surgery... you could always pay for it yourself. as many of us have who insurance wont cover it. Yes its expensive. Many on a budget end up going to mexico to have their surgery. Its about half the cost if not cheaper there. My surgery i paid around 20 grand for it. But in Mexico it would have been less than 10. I didnt do it because i just wanted to be near my home after surgery. Also maybe getting a sleep study done. You may have sleep apnea??? That is one qualifying way to get approved for surgery once you get your BMI just a little higher.

[ChubRub 1,702]

You are likely a good candidate for Ozempic, which is available in Canada. Google and if you think it's right for you, talk to your doctor about it.

[shonna1989 2]

21 minutes ago, ChubRub said:

You are likely a good candidate for Ozempic, which is available in Canada. Google and if you think it's right for you, talk to your doctor about it.

Yes that was recommended. I forgot to type that.

I am hesitant though to start it. I went on Spironolactone in 2015 (yes a completely different medication) as one endocrinologist suggested it would help my acne and other symptoms but it was a total nightmare. I was fainting and vomiting weekly until I was taken off of it. After the whole Spiro disaster I'm more than a little frightened to start another medication, especially an injection.

[Possum220 230]

I do feel for you. I take it that the endocrinologist ordered hormone levels to be checked. If not that it a place to start. What causes hirsutism? No something does feel off. Hope you can get to the bottom of it all.

[SpartanMaker 767]

22 hours ago, shonna1989 said:

I am at a loss.

Sorry you're struggling so much!

Based on what you're describing, neither weight loss surgery, nor GLP-1 receptor agonists like Ozempic/Wegovy/Rybelsus would do anything for you. Both WLS and these meds work by helping patients reduce caloric intake. You've already said that doing so didn't work for you, so I see little point in either approach.

Here's the deal. While this is a slight over simplification, you can't overcome basic physics even if there's some sort of hormonal imbalance. If you eat less than you burn, you'll lose weight. If you eat more than you burn, you'll gain weight. There's no way around that.

This makes me think you may be asking the wrong question? I think instead of asking how can I reduce my food intake further, the question you should be asking is why is my metabolism so low and what can I do to increase how much I'm burning?

Based on what you've described, there really are only two explanations: Either you are eating a lot more than you think you are (it's common for people to dramatically overestimate caloric intake), or your metabolism is unnaturally low.

My first recommendation would be to have a baseline metabolism check done. This is sometimes called resting metabolic rate (RMR), resting energy expenditure (REE), or Basal Metabolic Rate (BMR). Do some Google searches and you should find a place near you that can test this. Even if you do nothing else, knowing how many calories you burn at rest will help you understand what you should do to get to a normal weight.

Next, I'm going to guess that your previous fitness attempts were focused primarily on steady-state cardio. While that's great for heart health, it's not what I think you need. I would strongly recommend finding a reputable trainer that can help you add muscle mass through proper diet and exercise. Simply put, the more muscle mass you have, the faster your metabolism. In your case, where you've likely severely negatively impacted your metabolism through a starvation diet/anorexia, you may have to "reset" things with this type of training regimine.

One final point: stop obsessing with the number on the scale. This is a poor analog for how fit you are. Your body weight is comprised of lots of things other than fat (muscle, bone, Water, organ weight, etc.), so you could actually be really fit at 180, or carrying too much fat at 160. For example, you made a point of saying that after months of working out in a gym, you ended up weighing more than before you started. That's actually somewhat common and not necessarily a bad thing. That extra 6 pounds may have just be Fluid retention, or muscle (likely some of both), so the number on the scale was not a good way of tracking your overall health. This is one of the reasons we strongly recommend also periodically checking your body measurements, as well as potentially checking body composition. You can buy a BIA scale to check that, or there are plenty of commercial places that will do it for you.

Best of luck.

[Fred in Pa 234]

32 minutes ago, SpartanMaker said:

Sorry you're struggling so much!

Based on what you're describing, neither weight loss surgery, nor GLP-1 receptor agonists like Ozempic/Wegovy/Rybelsus would do anything for you. Both WLS and these meds work by helping patients reduce caloric intake. You've already said that doing so didn't work for you, so I see little point in either approach.

Here's the deal. While this is a slight over simplification, you can't overcome basic physics even if there's some sort of hormonal imbalance. If you eat less than you burn, you'll lose weight. If you eat more than you burn, you'll gain weight. There's no way around that.

This makes me think you may be asking the wrong question? I think instead of asking how can I reduce my food intake further, the question you should be asking is why is my metabolism so low and what can I do to increase how much I'm burning?

Based on what you've described, there really are only two explanations: Either you are eating a lot more than you think you are (it's common for people to dramatically overestimate caloric intake), or your metabolism is unnaturally low.

My first recommendation would be to have a baseline metabolism check done. This is sometimes called resting metabolic rate (RMR), resting energy expenditure (REE), or Basal Metabolic Rate (BMR). Do some Google searches and you should find a place near you that can test this. Even if you do nothing else, knowing how many calories you burn at rest will help you understand what you should do to get to a normal weight.

Next, I'm going to guess that your previous fitness attempts were focused primarily on steady-state cardio. While that's great for heart health, it's not what I think you need. I would strongly recommend finding a reputable trainer that can help you add muscle mass through proper diet and exercise. Simply put, the more muscle mass you have, the faster your metabolism. In your case, where you've likely severely negatively impacted your metabolism through a starvation diet/anorexia, you may have to "reset" things with this type of training regimine.

One final point: stop obsessing with the number on the scale. This is a poor analog for how fit you are. Your body weight is comprised of lots of things other than fat (muscle, bone, Water, organ weight, etc.), so you could actually be really fit at 180, or carrying too much fat at 160. For example, you made a point of saying that after months of working out in a gym, you ended up weighing more than before you started. That's actually somewhat common and not necessarily a bad thing. That extra 6 pounds may have just be Fluid retention, or muscle (likely some of both), so the number on the scale was not a good way of tracking your overall health. This is one of the reasons we strongly recommend also periodically checking your body measurements, as well as potentially checking body composition. You can buy a BIA scale to check that, or there are plenty of commercial places that will do it for you.

Best of luck.

Spot on! Great advice!

The only thing I would add is finding the right Endo. There are a LOT of things that can effect metabolism. Finding the right doctor to go down those paths could make the difference.

[shonna1989 2]

On 12/7/2022 at 12:09 AM, Possum220 said:

I do feel for you. I take it that the endocrinologist ordered hormone levels to be checked. If not that it a place to start. What causes hirsutism? No something does feel off. Hope you can get to the bottom of it all.

I've been to three and one OBGYN. They don't know. Hormones are normal on every test.

Very slight hirsutism began at 14 (faint hairs on my abdomen). But by 21 I was growing a beard and my body hair was wolf man level. No answers for that or my severe acne which was practically all over my body. They can't figure it out. They say ''genetics'' but not one parent has those kind of characteristic's. Both parents are fair haired, thin people. My Mother only had to shave her legs once a week or longer and I don't ever recall her having facial hair. Both parents are thin too with no history of adolescent or adult acne. A total mystery.

Edited December 16, 2022 by shonna1989
added more

[shonna1989 2]

On 12/7/2022 at 8:23 AM, SpartanMaker said:

Sorry you're struggling so much!

Based on what you're describing, neither weight loss surgery, nor GLP-1 receptor agonists like Ozempic/Wegovy/Rybelsus would do anything for you. Both WLS and these meds work by helping patients reduce caloric intake. You've already said that doing so didn't work for you, so I see little point in either approach.

Here's the deal. While this is a slight over simplification, you can't overcome basic physics even if there's some sort of hormonal imbalance. If you eat less than you burn, you'll lose weight. If you eat more than you burn, you'll gain weight. There's no way around that.

This makes me think you may be asking the wrong question? I think instead of asking how can I reduce my food intake further, the question you should be asking is why is my metabolism so low and what can I do to increase how much I'm burning?

Based on what you've described, there really are only two explanations: Either you are eating a lot more than you think you are (it's common for people to dramatically overestimate caloric intake), or your metabolism is unnaturally low.

My first recommendation would be to have a baseline metabolism check done. This is sometimes called resting metabolic rate (RMR), resting energy expenditure (REE), or Basal Metabolic Rate (BMR). Do some Google searches and you should find a place near you that can test this. Even if you do nothing else, knowing how many calories you burn at rest will help you understand what you should do to get to a normal weight.

Next, I'm going to guess that your previous fitness attempts were focused primarily on steady-state cardio. While that's great for heart health, it's not what I think you need. I would strongly recommend finding a reputable trainer that can help you add muscle mass through proper diet and exercise. Simply put, the more muscle mass you have, the faster your metabolism. In your case, where you've likely severely negatively impacted your metabolism through a starvation diet/anorexia, you may have to "reset" things with this type of training regimine.

One final point: stop obsessing with the number on the scale. This is a poor analog for how fit you are. Your body weight is comprised of lots of things other than fat (muscle, bone, Water, organ weight, etc.), so you could actually be really fit at 180, or carrying too much fat at 160. For example, you made a point of saying that after months of working out in a gym, you ended up weighing more than before you started. That's actually somewhat common and not necessarily a bad thing. That extra 6 pounds may have just be Fluid retention, or muscle (likely some of both), so the number on the scale was not a good way of tracking your overall health. This is one of the reasons we strongly recommend also periodically checking your body measurements, as well as potentially checking body composition. You can buy a BIA scale to check that, or there are plenty of commercial places that will do it for you.

Best of luck.

I'm not eating extra food. I'm careful of Condiments and own a food scale. I have every base covered as far as that goes. I even make my own Salad Dressing. This is not a nutritional miscalculation.

[SpartanMaker 767]

5 hours ago, shonna1989 said:

I'm not eating extra food. I'm careful of Condiments and own a food scale. I have every base covered as far as that goes. I even make my own Salad Dressing. This is not a nutritional miscalculation.

It may not be, but please don't ignore the rest of what I mentioned.

1. You need to get your RMR tested or you can't really know how much you should be eating.
2. You also need to find out your current percentage of body fat, start tracking it, and stop guessing how much you should weigh based strictly on what a scale is telling you. % body fat will be a much better way to measure your health.
3. Finally, start strength training. The first 2 recommendations are tools to better understand where you're at today and where you need to get to, but strength training is likely the "fix" for your issues.
4. I didn't mention it before, but you may be a good candidate for intermittent fasting. There are plenty of resources online so I won't go into details here, but it's worth a try.

[ms.sss 15,601]

...another thing i would suggest is to weigh and measure yourself often (if u can handle it...some can't). you mentioned a couple times in your post that you were surprised at your weight at certain points in your life. by keeping an eye on it, you may be less shocked and even may be able to avoid it altogether by taking whatever measures you decide on.

further, if you combine regular weigh ins/body measurement noting with food tracking (and even track activity level, mood, sleep, etc) you may be able to collect some useful data to help troubleshoot your situation....but again, only if its your cup of tea. to lots of folks this level of involvement is not ideal. i can only say that my own penchant of detailed tracking has helped me identify many things specific to me.

Good luck! ❤️

Edited December 16, 2022 by ms.sss

[qtdoll 535]

I feel that even if they do end up finding you have PCOS or another hormone related issue, they might still not refer you to the WLS program as you're only two BMI points away from being out of the 'obese' category.

However I would fight your endo a little bit more. While you may not have full blown pcos it's obvious you ARE dealing with some symptoms that could possibly be adjusted with medication.

I would also ask your doctor about meds like Ozempic! You're close to being at a normal weight got your height & I feel that could help jump start it for you!

[Jeanniebug 473]

At 5'6" and 233 pounds, I *barely* met the criteria. And that's with diabetes and high cholesterol. Sad to say, you might actually need to gain some weight in order to qualify. It's all about your BMI.

[Possum220 230]

On 12/17/2022 at 12:50 AM, shonna1989 said:

I've been to three and one OBGYN. They don't know. Hormones are normal on every test.

Very slight hirsutism began at 14 (faint hairs on my abdomen). But by 21 I was growing a beard and my body hair was wolf man level. No answers for that or my severe acne which was practically all over my body. They can't figure it out. They say ''genetics'' but not one parent has those kind of characteristic's. Both parents are fair haired, thin people. My Mother only had to shave her legs once a week or longer and I don't ever recall her having facial hair. Both parents are thin too with no history of adolescent or adult acne. A total mystery.

What about your grand parents? I am sorry that this is happening to you. With the raft of things going on I wonder if weight loss surgery would bring about the changes you want?

You have searched very hard to get answers. I wonder if asking Dr Phil for help would get you the help you need? He seems to have many specialists that are able to get answers, 🤗