Salazar

Hi Folks, I am new to the forum, but have gotten a lot of good information over the years from you folks, so thank you! A bit about me, I am a corporate attorney in the D.C. market (I live in northern VA), an author, an avid outdoorsman, a husband in about as perfect a marriage as I could dream existed (I got together with my wife when we were teenagers), and the dad of an adorable toddler. I have finally settled on a gastric sleeve as the right surgery for me, but I have been quite disappointed to learn that insurance will not likely pay for the procedure, and at least at the first level of contact at different institutions that perform such surgeries tell me that they will not likely even consider me, even if I pay out of pocket, which I am quite prepared to do. My BMI is right now at 30, and although I know this is not as high as is generally the case for bariatric surgery, I have made Herculean efforts to lose and maintain a good weight for the past 14 years (since I was 16), and no matter how hard I tried, nothing worked. I was a high school athlete (football, lacrosse, daily weightlifting), and am used to pursuing physical goals in a very disciplined way. Some examples of ways I have tried to lose weight have been running 28 miles per week, extreme dieting, even bulimia, and basically my body just seems to want to be between 210 and 230lbs, regardless of what I do. I still lift freeweights every day, hike, fish, and do lots of physical activities. My mind boggles that I have such high physical endurance and strength - I am, if anything, more athletically able now than I was as a high school tight end/linebacker - and still cannot get down to what is considered a health weight. I know that my BMI is partly artificially elevated by the fact that I have been lifting weights since I was 12 and have a very large amount of muscle mass, but I still have a noticeable gut and I know that I will have a healthier future if I can drop about 70lbs. My goal for weight loss is not to look great like I did at 15 again - my awesome wife is very supportive of me and met and fell in love with me when I was 19, so she has never seen me at my trim, 6'1 165 figure from high school football - but to decrease my risk of obesity-related illnesses. For that reason, I want to get moving on this as quickly as possible. I have researched and tried weight loss procedures, including reading all the scholarly articles I could find on bariatric surgery since I was 24, and I think that now, while my blood pressure, cholesterol, and heart rate are all excellent, is the best time to slim down, as it is harder to correct these health problems once they start than it is to head them off. I am particularly hoping to hear from folks on where they went and how they went about getting a gastric sleeve done when they were below the 35-required BMI. I do have sleep apnea (I've had it since I had a BMI of 22, so it is not obesity-related), so I would be able to get insurance coverage if I got to 35, but I do not feel like gaining 40 pounds in order to qualify for a surgery I can easily afford out of pocket. I know that Mexico and Brazil are options a lot of people use due to their low cost, but my wife really wants me to spend the extra money and get it done in-country. For those of you that have gone the foreign route, what were your experiences with it, and is there anyone in particular you would recommend? For those who have had it done in this country, are their doctors or clinics around that are willing to hear you out and accept that you have made the decision that you need it? I understand that doctors have to be gatekeepers for people who want this kind of thing for a vanity goal on a whim, but I have been dieting, exercising, meeting doctors and nutritionists, and researching all possible weight loss methods for 14 years, and now that I have decided on a gastric sleeve, I do not want someone to patronize me or condescend to me. I hope to find a doctor who will listen to me, then take my money, and cut off part of my stomach! Thanks again, and I look forward to hearing your thoughts.

Thanks for the great advice, everyone! I figure I can clarify a bit; I don't currently run 28 miles per day (I barely have an hour to myself on an average weekday, and that is part of the problem), and I have tried plenty of diets, ranging from tame to extreme. It has become obvious time and again that when I am on a diet that is strict enough for me to consistently lose weight, I am so miserably hungry all the time that within a few weeks I am quite sure I no longer wish to be alive if I have to feel as starved and miserable as I do on those diets. Also, I am married into a big, traditional Chinese family (I am a Chinese-speaking white guy, and only my wife in our family speaks English), and it is absolutely impossible to overstate to someone who is not from rural China just how important food is to people there. Where my wife was born and in her family, food is not everything, it is the only thing. To show your family members love and affection, you do not hug them or tell them how much they mean to you, you cook for them and they are obligated to eat it. You do not engage in intellectual discussions of current events or history with your family; you eat with them with the only topic of conversation being how much money you made that day and what you think of the food. I am able to be part of this culture (I use Chinese at home and basically live a Chinese life outside of work, despite being a country boy from the South) and just eat very small amounts of the food that is so critical to the cultural existence of my wife's family, but it makes it that much more difficult to diet when food is a topic that is given such importance and discussed constantly. Also, it sure does not help that my wife can eat massive amounts of whatever she wants, and yet in the 10 years we've been together, she has stayed between 110 and 120 pounds, with a height of 5' 6". It is obviously very nice to be married to someone so stunningly and effortlessly attractive and thin, but it is maddening that I have to be so careful with what I eat and still be on the overweight-obese borderline, while my wife can stuff her face and still look like a model. Heck, she only gained 15 pounds in her pregnancy, and within a week of giving birth she was 10 pounds lighter than when her pregnancy began! I have actually never been denied by a doctor, and I do have 1 co-morbidity factor; the pretty severe sleep apnea, although I was diagnosed with that at 14, when I was no-kidding 118lbs at my current height of 6' 1"!

Congrats! My wife just had the same conclusion, and I am excited to go on that road as well. Best of luck to you!

Congratulations! That is such great news, and it gives me hope as well. It is so annoying that folks like us who have done our research have to be approved by a doctor who thinks they know us better than we know our own needs, but that must make it extra nice when approval finally goes through!