Questions - Contemplating Surgery

[Devi 15]

I am hoping to have the money for a gastric sleeve surgery this year. I have been reading and watching videos and trying to take it all in. If I have failed at low carb and other diets, how will the sleeve be different? It is a tool, but it ultimately requires lifetime compliance to food and lifestyle changes. So far I have a lifetime of failure at compliance. I am sure I need to spend some time on my mindset in general. If bariatric surgery resets the set point and helps change the metabolism, how do people end up gaining all of the weight back? Will this exacerbate depression? Will it help or hurt low self worth? I see that some people end up very depressed and others feel so much better. I am pretty sure I can't take being more sad about life and my weight than I am. I will be doing this totally alone. I have no friends and no family in the place I moved to. I am hoping that feeling more confident physically will let me feel better about joining art classes. I am also planning a move to a more populated area this year. Many thanks.

[catwoman7 11,210]

you do have to comply with your clinic's program or you'll eventually regain weight (although a 10-20 lb gain once you hit your lowest weight is very common - and almost expected. I planned for that when I set my goal and went a bit under goal to compensate)

that said, I'd never been able to lose weight and keep it off. I was over 200 lbs overweight, and I lost 50 or 60 lbs God knows how many times, only to gain it all back. I got the surgery (in my case, bypass) because if I couldn't even keep off 50 lbs for more than a couple of months, I knew there was no way I could lose and keep off 200 lbs. BUT...this actually worked. I did actually lose all that weight - over 200 lbs.

Your stomach will be a lot smaller so you can't take in a ton of food AT ONE SITTING - plus, most people lose their sense of hunger for a few months (up to a year) after the surgery. Having no hunger makes it much easier to lose weight. Once the hunger comes back, though, which is does for most of us, it'll be more of a challenge. You're still not going to be able to eat a ton of food at one sitting, but you might start grazing or eating mindlessly if you're not watching yourself. So that's when you have to really make sure you're continuing to comply with the program.

people gain weight back because they stop being compliant and old habits start creeping back in. As before, you still won't be able to eat as much as can now AT ONE SITTING, but if you're snacking all day, yep - you'll be able to take in a lot of calories. The examples I always use is that before I had surgery, I could eat half a large pizza for dinner. No way could I do that now. It would be physically painful. All I can manage is 1-2 pieces. BUT...if I ate 1-2 pieces at 5:00 pm, and another 1-2 pieces at 7:00 pm, and 1-2 pieces 9:00 pm, (which would be easy to do), I'd end up eating half the large pizza. So THAT'S what you need to watch out for.

the surgery in and of itself shouldn't exaggerate depression. If you're feeling depressed, though, it'd probably be helpful to work with a therapist. A lot of us do - both for that or to deal with eating issues (unfortunately, as they say, the surgery is on our stomachs, not on our brains).

where are you living in NC? I lived there for 10 years. I went to high school in Raleigh and when to college up in the mountains. My brother still lives in NC, so I still get down there occasionally...

Edited February 19, 2023 by catwoman7

[Devi 15]

Thank you so much for the reply. I have been in therapy for a year and I luckily have a great relationship with my therapist. It really helps to hear a story like yours. I think my fear is normal. I have failed so many times before. My health is bad. I’m 5’2” and 235 lbs and I can feel the heart attack coming. I can’t live like this anymore. I’m not really living. I’m submitting the forms for Dr.Alvarez at Endobariatric. I moved from Florida to Asheville and then to Morganton. I am planning to sell my house and go back towards Asheville. I miss it there. A bit more vibrant and much better social opportunities.

[catwoman7 11,210]

11 minutes ago, Devi said:

I moved from Florida to Asheville and then to Morganton. I am planning to sell my house and go back towards Asheville. I miss it there. A bit more vibrant and much better social opportunities.

Asheville's great! I haven't been there in probably 40 years, but from what I hear, it's gotten even better since then! (it seemed pretty wonderful even back then...). I lived in Watauga and Avery counties - so about 1.5 hours from Asheville. We were about 10 miles from Tennessee and maybe 30 from Virginia - so up in the top corner.

P.S. if you're not familiar with that area - it was the Boone/Blowing Rock/Linville/Banner Elk area. Very protty - but I was in my 20s then and there really wasn't much there for young single people unless you were into skiing or hiking. i think I would have been much happier living in Asheville.

Edited February 19, 2023 by catwoman7

[Smanky 747]

53 minutes ago, Devi said:

I have failed so many times before.

We all have, which is why for most of us, this was our last remaining option. I can't add anything to what Catwoman said, but just know that we've all been there. Most of us hit rock-bottom before opting for surgery, I know I sure did, physically and emotionally.

I liken my surgery to having a co-pilot, or "the adult in the room", or my latest favourite analogy: the monkey that sits on my shoulder and slaps me upside the head any time I think I may wander off my plan. It works! I absolutely love my shoulder-monkey, which has successfully stopped the single main reason I always failed: self-sabotage.

[hills&valleys 130]

18 minutes ago, Devi said:

I’m submitting the forms for Dr.Alvarez at Endobariatric. I moved from Florida to Asheville and then to Morganton. I am planning to sell my house and go back towards Asheville. I miss it there. A bit more vibrant and much better social opportunities.

I am having VSG surgery at Endobariatric with Dr. Alvarez on 3/3/23. Dr. Alvarez's fees are almost twice that of other sugeons in Mexico but his credentials, professional memberships/affiliations and surgical success/risk rating is among the best of bariatric surgeons internationally .... I am confident in my choice!

You need to evaluate whether you are mentally prepared to make permanent changes to your relationship with food. Emotional eaters frequently go through a mourning period because it is harder to depend on food as a crutch to deal with life's problems and disappointments. WLS does not force a person's compliance. Adherence to a structured plan is essential to success. WLS is not a cure all or quick fix....it is a tool which can HELP us but we still have to be disciplined and put in the work.

Not only do we need to physically prepare ourselves for WLS, but mentally as well. Drastic weight loss can cause fluctuations in hormones which can create an emotional roller coaster ride. If you are suffering with episodic periods of depression, i strongly suggest working with a therapist before pursuing WLS, which is a dramatic life changing event. Best of luck to you!

[Devi 15]

7 hours ago, Smanky said:

We all have, which is why for most of us, this was our last remaining option. I can't add anything to what Catwoman said, but just know that we've all been there. Most of us hit rock-bottom before opting for surgery, I know I sure did, physically and emotionally.

I liken my surgery to having a co-pilot, or "the adult in the room", or my latest favourite analogy: the monkey that sits on my shoulder and slaps me upside the head any time I think I may wander off my plan. It works! I absolutely love my shoulder-monkey, which has successfully stopped the single main reason I always failed: self-sabotage.

I love that analogy so very much. It’s like a form of self parenting. I am going to journal about this and make a little sign for my surgery /weight loss success self care box. 💜

[Spinoza 1,364]

Also loving those analogies Smanky 😍

[Arabesque 7,207]

Therapy & ‘doing the head work’ is a very important part of not just the weight loss but maintaining. You need to ne mentally & emotionally ready for this surgery. Many of the benefits of the surgery are temporary or become weaker. If you haven’t done the head work, it is extremely easy to return to your old habits & regain your weight. The desire to eat can become so strong again it is possible to eat around your surgery. Remember the surgery changes your body not your head.

The surgery affords us the time to change our relationship with food. Well it did for me. For years I skipped meals to control my intake & all it did was screw up my metabolism & I was still fat. I’ve stuck to diets & lost weight many, many times but I always regained the weight. While I was losing I looked at how, why, when & what I ate & realised what I did didn’t work for me. I needed a new way.

I worked out a way of eating, not a diet, that worked for me. I haven’t been this size since I was about 12years old & have never maintained a weight loss like this ever. I have a different attitude about food & eating. It’s been sustainable, It doesn’t rely on my will power to control my eating. It doesn’t limit me or hinder me in enjoying my life as I want. Sure there are certain foods I avoid or eat very rarely because I’m careful about what I eat & it’s been my choice to do so. I feel better for it & I don’t feel like I’m missing out on anything. I still love food, enjoy what I eat & regular dine out. You’ll work out a way of eating to complement your lifestyle & meet your needs too in time.

Join that art class now. Don’t wait until you move again to look for a class. Great way to meet people with similar interests.

[kcuster83 1,504]

Your fears are normal! I would think it is safe to say we have all felt this way.

I have lost 100+ lbs multiple times! I always know how to get it off but I haven't been able to master KEEPING it off. Which was my deciding factor for surgery. I was hoping that the smaller stomach would help me. I had the same worries, if I couldn't do it before what is the difference. I know of a few people that gained most or all plus some of their weight back. So I had the constant fear of why bother if I will just fail here too.

I did it, and although I can't officially say I have been successful because I am not even a year post op. I can tell you that unless you eat non stop all day then you just can't enough enough. That is what I needed to help me. I can eat healthy but never felt full or satisfied. I hope to be one of the people here 5/10 years from now, encouraging people and inspiring them from my success alone. I wish I had done this years ago!

You got this, you can do it with the help of your tool and a new mindset.

I (we) are rooting for you!!!

[BigSue 1,359]

Welcome! You have some very good questions, and the fact that you are thinking about these things is great. Weight loss surgery isn't for everyone, and I think it's really important to make the decision with your eyes wide open and be prepared for the good, the bad, and the ugly.

This forum is a great place to read about other people's experiences with WLS so you can know what to expect. Pay particular attention to catwoman7's posts -- she is a great example of a WLS success story, who lost all of her excess weight and has kept it off long-term (and she is a true bariatric guru with lots of excellent advice and insight).

Just about all of us have had many failed weight loss attempts in the past. Most insurance companies require evidence of failed weight loss attempts before they'll pay for surgery, because surgery is a pretty drastic solution and few people would want to go through it if they could lose and maintain weight loss without surgery. But many of us who have failed so many times before have been successful with WLS.

It is true that some people gain back some or all of the weight (or don't lose as much weight as they need to) after WLS because, as you've figured out, WLS isn't magic. It still takes a lot of work and commitment and (as much as I hate the term) lifestyle changes. I get the impression that in the early years of WLS, the emphasis was on the restriction (and, to some extent, malabsorption) of surgery -- the physical limitations that made it impossible to overeat and/or that made the patient ill from eating too much fat or sugar. Patients mainly relied on eating smaller quantities to lose weight. This works in the short term, but the restriction loosens up over time (so you can eventually eat more in one sitting), and if you continue eating high-calorie foods and/or get in the habit of eating around your surgery by eating smaller portions more frequently, you can easily increase your calorie consumption back to the point of regaining weight. For me (and many others), WLS made the initial weight loss much easier than dieting alone because I had no hunger for several months after surgery, but I do get hungry now and it's a challenge to stick to my plan.

I think that these days, most WLS clinics have a more comprehensive approach and provide more guidance on dietary changes. After WLS, you pretty much reboot your eating patterns, almost like a baby. You go back to consuming only liquids, then pureed and mushy foods, and tiny bites of soft foods before you get back to eating like an adult. I think this process is the turning point for your long-term path after WLS. You can either take advantage of this opportunity to get into good habits of eating nutritious food, or you can get back into your old eating habits once you are physically able to eat normal foods again (which can ultimately lead to regain).

As far as how WLS affects mental health, that is very dependent on the individual and not necessarily predictable. I think it's safe to say that most people's mental health benefits greatly from weight loss because living with obesity is incredibly difficult, but of course there are instances of unexpected negative results. If you have a history of mental health issues, that's something to discuss with your provider as part of your decision (and most insurance companies and clinics require a psychological consultation to make sure you are mentally/emotionally prepared for surgery).

I did my surgery completely alone. I'm 2.5 years post-op and haven't told any family, friends, or coworkers about my surgery. I live alone and had no help after my surgery. I was fortunate to have a pretty easy recovery, so I had no problems taking care of myself (although I later developed bradycardia due to the rapid weight loss and had to get a pacemaker). In a way, I think living alone makes the post-op life easier because I have complete control over the food purchasing and preparation in my house. I simply don't buy foods that don't fit in my plan, so it is easy to avoid temptation.

I encourage you to continue to research WLS and read about other people's experiences as you make your decision. Good luck!

[Devi 15]

Thank you all for the in depth and very helpful responses. I think my biggest hurdle is my current state of loneliness and lack of self worth. The fear that if I can’t stick to no sugar now, how can I trust myself not to slip and use slider foods. I think I have to find some faith in myself. I am also exhausted all the time. I think I can handle the alone part as I am excellent at handling things that most people think they can’t do alone, probably because they have people in their lives. I do see how it would be very helpful for the first year post op. My friends are supportive, but visits to family are another story. My mom encourages overeating.

I actually have to pay for the surgery myself. I work for a great company and have great insurance with a Bariatric surgery exclusion. Since it is private insurance, there is no getting around it. I can contribute to my FSA and confirmed that I can use that to help pay, even if I have surgery in Mexico. A little pre-tax help at least. This is definitely a big financial commitment for me.

I actually have a before picture from 2017. I was a different person. I don’t recognize me now. I have to find the me that is hiding inside of me. I am actually afraid to post pictures online of what I look like. I am so physically uncomfortable. I remember the girl that had energy and laughed and did things. It feels so far away.

I am going to keep reading and start coming up with ideas for my post-op care box if I make the decision to go forward.

[Zuzanna 4]

Any change for health is positive and eating well is about loving and respecting you. Have the op helps you gain that confidence and change your association with food. Biggest word of advice dont take empty calories in, if it doesn't fuel your body leave it be. If you are eating out of emotional need continue seeing someone to deal with that relationship with food. After surgery you views on food will start to change.
Take one step at a time and be kind to yourself. I had my sleeve 13 yr ago and havent kept all my weight off and going for another surgury to help and fix a couple other things. However I can tell you my relationshop food is very different today to what it was when I started and it is better now. Remember this is your journey and this will help you in many ways but you need to allow yourself to explore them all don't bury how you feel, face it and deal with it. You want change and only yoy can make it happen and you will be happy you did it. Live life.

Sent from my SM-A515F using BariatricPal mobile app

[BriarRose 432]

I am so glad that you are working with a therapist and have a great working relationship with them. I had a sleeve a dozen years ago in my mid 50's. I am now (well - next month !) 67 years old. I struggled with my weight my entire life. Had this been an option years before, I would have done it ! I am also a mental health professional. The problem with depression and/or anxiety is that you can be those things when you are obese, and losing weight .... well... you may weigh a lot less, but you can still be depressed/anxious. If you are using medication to help modulate your mental health symptoms, you might check how those medications work with your specific surgery. Weight loss surgery will not "make anyone happy" - but it will help you to lose weight ! Personally, I have panic attacks. They started about 20 years ago for no good reason. My weight before, during and after weight loss has had absolutely NO effect on them. Some years are better than others. If you have weight re-gain, you have to get to a emotional/mental place where you can concentrate on going back to basics of how you lost the weight in the first place after surgery.

I did experience weight gain at about 6 to 7 years post sleeve. I lost my mother, brother and father in a few year's time. I did not pay attention to what I was eating. I became a caregiver and mourned those losses. I had too much on my mind to "see" myself. When I got myself back together, and could see past all those events; I made a conscious decision to re lose the 40 pounds I put on. ( I had lost 140 ) I took a couple years to lose the weight. I realized I did not know how to maintain my weight. So each time I lost 10 pounds or so I would stop losing weight and work on maintaining THAT weight for a couple months. Once I had that down, I would lose some more. I needed to be INTENTIONAL. And make the way I eat work for me. I got back to where I was, and then kept it stable for another year. A few months back I decided to lose some more. My thought was 10 more pounds. I have lost 12. I am at one of my maintenance phases right now.

Try not to let your weight define who you are, who you want to be, and know that there is NO time line for being your best self ! Congratulations on saving up that money to give yourself the BEST way to lose weight, and to be successful.

[qtdoll 535]

Luckily all of these things will be discussed with your doctor. At the end of the day, your end results are based on what how you choose to live your life after the surgery. I'm 5months out & I can already feel how easy it'd be to eat an order junk food at this stage but I choose no to. YOU are the biggest factor in all of this 😊