Search the Community

Did you have any psychological input during your Tier 3? (I don’t know if you had to go through Tier 3?) I had about 4 sessions with an NHS bariatric psychologist, but I believe I’ll still be having a Tier 4 psychological consultation to sign me off 🤞 for the MDT. Also, two weeks post-approval for the LRD! That is AWESOME! I think my trust tends to do the two-week milk diet. Even though I currently eat fairly low calorie keto, I think the milk diet would help lose a bit of pre-surgery weight at least. 💗

Hello, Wendyjane! The NHS is the National Health Service - socialised tax-funded medical care provided in the United Kingdom. The tier system is basically various levels of care for varying conditions. For those seeking weight management help through the NHS. Google AI summarised it really well for me: Hospitals are grouped into governing bodies (trusts), and each trust, I believe, decides how to invest in the tiers, which in turn impacts just how much and what kind of support is given. For example, when I went through Tier 3 in my trust, I was given 1:1 virtual support (zoom meetings) once a month for a year with a nutritionist to help me implement healthier lifestyle changes, and during that time, I also met with an NhS psychologist for 3-4 months to work through any issues I may have regarding food and mental health. I really enjoyed the support I received from my Tier 3 programme (“Weigh Ahead”). I was also held accountable for my weight, blood pressure, and body measurements. Tier 3 aims to help you lose 5-10% of your total body weight in order to be referred to Tier 4. The current Tier 3 service in my trust now allows patients to receive prescriptions for Ozempic and Mounjaro to help with weight loss. (I’m sure you can imagine I was sorely sad to find out I missed that opportunity! Whereas I think the injectables will be available to me only in Tier 4 and from the bariatric surgeon?) Also, in Tier 4, if you so desire to go forward with bariatric surgery, then you have multiple appointments with various consultants: the bariatric dietitian, bariatric nurse, bariatric psychologist, the anaesthetist, and finally the surgeon. Once your appointments with each of these completes, then they meet together as a “Multi-Disciplinary Team” to discuss each case and decide if that patient is a good candidate to go forward with surgery. If yes, you’re then placed in another waiting list. According to my trust, I am not meant to gain any weight from the time of my Tier 3 referral until surgery. This has been really, really challenging… and at times, frankly speaking, exceedingly discouraging. I hope this helps as an explanation. ☺️

Hi, NeonRaven! Thank you so much for your reply and sharing your experience! I find it so helpful to hear how other NHsers have experienced the process since it seems so much more elongated from the U.S. process. And you make such a good point about the London privilege - now it makes more sense why I’ve seen more internet presence and response from London NHSers. (And quite a few from the far north of England as well!) About three or four years ago during my annual diabetic review, my nurse had suggested bariatric surgery and that gave me a lot of hope - she was able to refer me for Tier 3. I had my dietitian appointment yesterday and it went really well! It was about 30 minutes and went over the Tier 3 lifestyle changes, continued lifestyle changes (balanced meals, regular exercise, blood sugar monitoring, weight maintenance, etc), medications, and then any questions I might have. She was very positive and said she would be recommending me to go forward for surgery when the MDT meeting happens 🥲 (once I meet with the next consultants - psychologist, anaesthetist, bariatric nurse, and surgeon - how soon? No one knows.) Needless to say, I am so relieved, so happy, and so excited to be moving forward even if it’s one step. I’ve found out that my hospital trust now does their “one-stop” clinic as separate virtual appointments, rather than in-person. (So, perhaps it will be quite some time before that MDT meeting?) And then the endoscopy and ECG will be done at the pre-op assessment once a surgery date is confirmed. I am so glad to hear your NHS experience has been so good and positive. I am so sorry to hear about your mother's complication and her passing, but it is so hopeful to hear she was able to put her diabetes into remission (that’s one of my big hopes!) Congratulations on your weight loss and wishing all the health and success! 💕 PS - funny enough, I have not had any group sessions whatsoever in this process. I am wondering if I’ll have a group session with the bariatric nurse?

Nope tea wont make you loose an ounce. A bit off topic, I have never drunk tea, the one cup I remember drinking was after giving birth. It was sweet and wet and I was drained. I saw as a child what tea did to my parents cups, yuck, no thanks. I drank the only other thing available, corporation pop. 1950's english slang for water. Them days, coffee came in liquid form called Camp Coffee. It was made from chickory. One time mother was ill and dad made a meal and used this as gravy browning. {we like brown gravy here} We ate it because it was this or nowt. It was a week till mother worked out what we actually ate. So, after my rambling, I come to the point. Here I am sat in Greece drinking Iced Peach tea like it was going out of fashion. How my tastebuds have changed. This will defo not make me loose weight as it comes with a lump of baklava at this bakery. It would be rude not to.

Been drinking green tea for about 24 years now and believe me it never did a thing to help with my losing weight. Was drinking it when I had my greatest weight gain periods. Only reason people may notice a little weight loss over time is you drink it plain without extras so no milk, cream, creamers, syrups, sugar, honey, etc. that many add to their coffee so fewer calories. I began drinking green tea for one reason: caffeine was kicking my butt specifically sleep issues & reflux. Tried decaf for a while but felt it was a sacrilege and it would make me a little nauseous. Interestingly the smell of the leftover coffee dregs in a cup turned my tummy too. I also thought if I get any anti oxidant benefits yay but not really a factor. I enjoy it. However, I don’t like the grassy, grainy texture of matcha nor any of the green and fruit blends: bit of a purist. Don’t miss coffee at all. Not all green teas are the same in regards to caffeine content but generally it’s about 1/4 the caffeine as coffee or black tea. So if I have a cup/mug too late it can affect my sleep as it will if I drink more than two a day. Personally I prefer Tea2 green teas (sencha and Buddha’s tears). I believe you can but them online in the US. They have a cleaner taste and tend not to get that bitter dry taste that some brands do. Note the tea bags are large and a single bag gives me a good strong 450ml (almost 2cups) mug. Funny story: Back about 20 years ago, my hairdresser asked an apprentice to make me a cup of green tea. He went out the back & was gone for a little while. He returned and asked how do you make tea green? He was being serious. Still makes me chuckle. Never forgotten his name either: Luke. Bless him.

I tried the green tea thing back in the 90’s. It made me regular. That was it. If you like the taste try using it to have less coffee because there’s less caffeine. I love the flavors Celestial Seasonings had, but my favorite is a minty green tea. Sometimes I use to use it after a meal to signal to my brain that eating done. It was the minty taste like toothpaste that was the signal. It’s an old weight watcher’s trick, use a minty thing like gum, tea, toothpaste to learn to stop. It hurts to drink after eating now so not a good choice. Trader Joe’s had some nice green tea choices too.I like a bag in my water bottle to add flavor. It doesn’t cause weight loss. It could make you drink more water.

As a general rule, the effects of supplementation of any kind on weight loss will be extremely minimal. If I had to hazard a guess, I'd say for most people, 90-95% of weight loss is calorie intake alone. Other factors like exercise might make up a few percent, and supplements would be down at the bottom of the list probably only making 1% or less of the impact. Since 1% might mean something like 20 calories a day, you can see how it would be really easy to overcome that effect just by eating a tiny bit more. Keep in mind there is no overcoming basic physics. If you want to lose weight, you have to consume fewer calories than you burn. Things people worry wat too much about in my opinion instead of placing the focus where it matters on calories: Types of diets: Things like keto, low fat, low carb, intermittent fasting, etc. may help with compliance, but otherwise make no appreciable difference in weight loss. Bottom line, eat the way you want as long as you meet your nutrient goals and eat less than you burn in a day. Exercise: Exercise is critical for overall health and fitness, but as a general rule, you are not going to lose much if any weight from exercising. The reason is that your body is really good at stabilizing your overall calories burned in a day/week/month. What I mean is that studies show that for the most part, your body will slow down other processes to "make-up" for the exercise calories you burned, so whether or not you exercised won't actually mean you burn more calories per day. Exercise CAN help in weight loss for some people, but as a general rule, you'd probably need to be doing something that burned more than 400 calories a day, every day for you to see any impact at all. One place where exercise really comes into its own is in weight maintenance post-weight loss. Here the data is super clear. Those that exercise at least 1 hour per day were significantly more likely to maintain their weight loss than those that don't exercise. Supplements: As I pointed out above, at best, supplements might have a very small impact on on weight loss and this impact is really easy to negate by simply eating more. Typically weight loss supplements fall into two categories: Thermogenics (things that increase metabolism), and Appetite Suppressants. Some claim to have both effects. Without going into too much detail, the vast majority of thermogenics work simply because they are stimulants. Caffeine is the most well known and well studied (and frankly probably the most effective), but since you already are a coffee drinker, you're pretty unlikely to get any additional benefit from switching to another source such as green tea. Appetite suppressants are really a mixed bag. These sometimes work for some people, but again, the effects are really small. This is a little old, but I still think worth taking a gander: https://pmc.ncbi.nlm.nih.gov/articles/PMC8406948/#:~:text=A total of 1945 participants,morbidity%2C costs or patient satisfaction. It's a meta-analysis of the impact of green tea on weight loss. The conclusion they came to after looking at 15 different studies: "Green tea preparations appear to induce a small, statistically non‐significant weight loss in overweight or obese adults. Because the amount of weight loss is small, it is not likely to be clinically important." Best of luck.

Anyone who has ever flown commercial has seen the safety briefing, right ? "In the case of cabin pressure drop....an air mask will lower itself in front of each passenger.....put your own in place before helping those beside you" Took me quite a while to realize that our own personal health condition is no different. The WLS provided a wild ride for about three years. Surgery yield excellent weight loss results. Faster than I was ready for. I didn't make the best of decisions and never missed the opportunity to go have fun. One day....I woke up from the hubris and took inventory. My marriage had somehow survived...as it had survived tough times well prior. I was a dad to an insanely gifted son. I had a good job surrounded by great people. Mostly, though....my wife was there at my side and patiently waiting for me to get my head extracted from my arse. I did. We then had what can only be described as the best years of our marriage....like we were dating again. I was blessed and the first to acknowledge such. She had some health issues arise and we discovered it was worse than we were expecting. Diagnosis was cancer....treatment began right away but it was a terminal diagnosis. She fought hard...superhuman efforts. Her pain tolerance was simply beyond my compression. Cancer took her in April of 2021. I maintained my promise to her to keep on with the sobriety. I failed in most other ways. I had zero desire to cook as it was too painful. Anytime I'd try the sense of loss would be overpowering. We had so many fun times in and around the kitchen....I'd cook and she'd help me clean up my mess. Music always on....every day together was alike a date night. I remain so very grateful to have been given those recent great years together....but I chickened out when it involved anything we'd once do together. No cooking of anything other than maybe a quick breakfast.....no music....no movies or shows we once enjoyed, no gym, no maintaining of friendships......just went to work each day and came home....existing off fast food and vending machine garbage at work. Three and a half years went on like that. As the fourth anniversary of her death loomed, I once again took inventory. What I acknowledged was ugly. The mirror sucked, the way most of my clothes fit sucked, my annual checkups with our primary care doc sucked....and I owned every single bit of it. I owned all that suck. I also knew that she would kick my ass for letting myself give up like I had. I've never quit anything in my life....yet there I was....quitting on pretty much everything. I pissed myself off so badly. I made the decision to crawl outa that hole and do what she would have me do if she was here to push & pull on me to get my shyt together. She fought so hard to live....and there I was... giving up...no fight, no attempt, just giving up like a punk. So things began to improve greatly when I started jumping on what I could gain control of. My health was a perfect place to start..... And so it has been going the last few months. Daily macros are improving more each day. Essentially keto but am supplementing with fish oil, fiber, turmeric, powdered greens, multi-vitamins.....trying to shore up every aspect of daily good stuff taken in. I flipped the collective bird to all the fast food restaurants and their drive thru windows. Screw 'em all. Found the stereo again....whether in the truck or at the house. There is music. Took over the yardwork....and there is a pile of it needed. Joined a gym. Bought some new ear buds and gym clothes....and a heap more new music. In short.....I acknowledged that throwing my own health away was what had been selfish......taking control of it was imperative. The loss is still there....but my response to it is now different. Now I am doing much more to honor her by living as she wanted me to. She wanted me to live....all aspects of living. Health first, foremost and always.......and the other aspects of living are becoming more clear each day. Life is a gift. Squandering that gift is a crime. Longwinded answer.

I'm putting this here in the supplement section....hopefully this is a good spot. I've been a coffee lover my entire adult life....if one dared categorized me as an adult. I have no plans in quitting my coffee, but I may substitute some of my daily mugs with green tea. I keep seeing it referenced as having weight loss benefits. Skeptical but willing to try something different. With coffee, I"ll generally buy pre-roasted beans and grind them just prior to brewing each pot. Are there certain brands, types, forms of green teas that you've tried and enjoyed ? Is there a little caffeine boost from it ? 😁

Hi! Sorry to have found your post so late! There's not a lot of NHS patients on here as this is mostly an American website. I had my surgery in October 2024 on the NHS. I remember the dietician appointment was a video call with other patients before any surgeries were finalised. I will admit that I don't feel like I got much out of it. The main message is eat slowly and prioritise protein first when eating a meal. The session with the psychologist (a ten minute phone call) was probably the least helpful as she just said I need to practice mindfulness and learn others ways to cope with stress other than eating. (Gee, thanks! Where was that advice when I was a fat 8 year old? 🙄) I had a higher BMI than you currently do and the privilege of living in London, so I think I was bumped up a few tiers and fast tracked (I don't know if this true in general, but London seems to get the lion's share of the funding so hospitals are less strict. My Gloucester based friend has a BMI of 44, but because she has no comorbidities, she can't get any weight loss referrals because her BMI isn't 50+) But I digress. Once I had the surgery, it was a year and a half from the initial referral, it's mostly been smooth sailing. I had the gastric sleeve and had no problems. So far, I've lost 39 kg and more fatty liver has improved significantly. My mother had the gastric bypass (also on the NHS). She had a complication, St Anthony's private hospital did the surgery, but the NHS covered it but once they operated again, she had no problems. She never shared exactly how much she weighed with me, but she went from a size 28-30 to a 22 and reversed her diabetes. She passed away in 2023, but if she hadn't, she would be much smaller I'm sure. I've had a great experience so far with my procedure and weight loss. I really do recommend going the NHS route if you are able to do so. Well done on making this decision to change your life! You've got this. Sometimes, just making the decision to get help is the hardest part!

Thank you. Seems like there are wins occurring every single day. I am finally in a place where I can see them for what they are and appreciate them. A pile of these little wins are funny in some way, too. Back in the timeframe surrounding my sleeve surgery the weight loss is what drove my happiness. Getting rid of the unwanted bulk was awesome and it was the spark that ignited a powderkeg of fun, adventure and a small bit of misadventure. I had no plan or goal for what life would look like....I simply jumped onboard the train and was okay wherever it took me. Now it is different, but I believe in a better way....perhaps. I know what lies ahead in terms of carving off the unwanted weight. I'm familiar with trodding that ground and know where some of the pitfalls may be. I think having my head screwed on correctly has made the daily discipline easy to achieve. The weight loss is more of a symptom of everything else falling into place. It is not its own thing, but a part of the overall improved state of mind. Hard to verbalize, but there is a goal for daily life...and I am getting closer to being in that spot and living that daily. I still get a kick out of hearing the scale make its new lower reports, but I don't get pissed if there isn't some big drop or even an uptick from the day before. I know this for the long haul. There will be a steady drop and there may be a few days here or there where it'll be in a holding pattern before resuming the loss train. One aspect of life...one that will take care of itself so long as I follow through on the straightforward nutritional steps. One thing that makes it SO freaking much easier this time around is the supplements available to us now. Essential greens in a powder, turmeric capsules, fiber-filled products, protein products with zero sugars, vitamins galore, etc, etc. Life is good....and getting gooder.

Routinely knock out 60hr weeks. I think I took three weeks off after the sleeve and that was largely due to a massive abdominal hernia that was repaired at the time of the sleeve surgery. It was my 3rd such repair...and has held up great these last 9 years. You may be able to flip the script......and make those 80hr weeks your best weight loss weeks. There is going to be a time when the protein shakes are the ticket...then maybe those small foil packs of tuna and salmon. Food won't be an issue that occupies your thoughts. You'll laugh at the vending machines and shoot 'em the bird. Make sure you buy all your necessary supplements & shakes and tuna packs and load up your desk or locker. Having those on hand will be one more way to keep food off your mind. You'll not be wondering what you are going to have for lunch every day. You'll have that covered. 8 weeks will be a great amount of time to recover and acclimate. You'll lose a pile of weight in those 8 weeks, too. Those 80hr weeks are going to feel much, much shorter from this point forward. Congrats. Go kick some ass. You got this.

my 2 (or 5) cents about plastics: - first, as mentioned above, there is no absolute timeline in regards to losing (or gaining) weight post wls. i am 7 yrs post op this year. i lost what i wanted to (110 lbs) in 7 months. then had a net loss of another 10 lbs over the next 5 years. THEN i lost ANOTHER 15 lbs in the past year alone. for those keeping track that 25 lbs since calling goal back in 2019. lesson here is that it's not the surgery that dictates your weight, is your lifestyle and genetics. - second, i had plastics 1 year after wls surgery. i would have had it earlier, but my surgeon of choice was booked. from the time i booked plastics to when i eventually had it done i was 15-ish lbs lighter. so there was no "stable weight for six months" requirement for me. - third, my plastics removed a total of 400g off my body weight (it was basically just skin and little to no fat), so depending on what your body composition is like before plastics, it may not make a difference on the scale afterwards. - fourth, i weighed about 115 lbs at plastics time, and today i weigh about 100 lbs (dont be alarmed, i'm like 5'2" tall, probably shorter as i'm shrinking in my old age, lol, i also eat lots and admittedly, badly, but i exercise like a crazy person, so it all evens out, ha) my plastics results did not suffer in any way, in my opinion. if anything, the places where i DIDNT get plastics look so much worse at my lighter weight (i'm looking at you inner thighs and butt). my arms (lift), boobs (lift) and stomach (tummy tuck), where i did get plastics, still look fabulous. - fifth. for me, i didn't get plastics for anyone else, or to impress them, or to snag a husband/wife. i still never really understand why others think i do all my shopping and dressing and med-spa-ing for THEM. i do it cuz *i* want to. i want to look in the mirror and think, daammmmmnnnn. my confidence was re-instated after the weight loss (i can do anything! AND i look hawt!) , with the plastics and the exercise, my confidence level is thru the roof (i can do anything! AND i look SUPER hawt!). aint nothing wrong with wanting to look and feel great. i mean, who WANTS to NOT like how they look or not like how they feel about themselves?? and if liking how you look/feel means you get rid of some extra skin, or pump up your boobs, or lift your ass, so be it. you wont find any judgment here. be awesome. good luck! ❤️

I'm glad you found something that's working for you. I tried Contrave years ago and it worked for a while, but then the effect faded. Hopefully that won't happen for you. I also wanted to comment on sugar. There's a lot of evidence that our bodies were designed to seek out calorically dense foods (like fat and simple sugars), since historically food was a lot harder to come by. We see this even today in traditional hunter-gatherer societies. Honey is sometimes a significant part of their diet. Imagine having to climb a tree, meanwhile getting stung multiple times, just to pull out a few handfuls of honeycomb. Interestingly, these people know to only take a part of the hive because they want the bees to stay at this location so the hunter can return to it over and over. My point in telling you all that is that it's perfectly normal to crave sugar. If avoiding it for the rest of your life is something you're able to do, then I think that's great. If you know it's not something you can do forever, then you may need to make peace with the cravings and find a way to have some when you can, but be sure to "leave some of the hive alone" till next time. Personally as an endurance athlete, I do consume a lot of simple carbs and so completely avoiding sugar just isn't really something I could do. Keep in mind that glucose (a simple sugar), is the primary fuel that your body uses. It stores glucose in the form of glycogen, but the reservoir is somewhat limited. This means that for longer, harder endurance efforts, it's important for me to consume simple sugars during those runs or rides that will help replenish my dwindling supply of glucose. My normal diet also consists of about 65% of my daily calories coming from carbs to help keep my glycogen supply as topped off as possible. This is a combination of both simple sugars and more complex carbs like fruits, vegetables, bread, pasta, potatoes and rice. If I didn't do this, I simply could not exercise for the duration or at the intensity that I do. My point here is that I've had to come to grips with the fact that for me, carbs are not the devil. They are in fact a necessary and healthy thing. This was a big change for me since historically as an obese individual, I tried to eat low carb most of the time. I now believe there are no bad foods and the best thing for me is to eat a wide variety of foods like most normal weight healthy folks do. Please don't think I'm trying to tell you what you should do! If what you're doing is working, that's fantastic!. I'm more responding to the comment you made that sugar was bad and we shouldn't eat it. For you that may be true, but it's not true for everyone, and certainly not for me.

I feel so much better! Yes, i did it for health reasons, but I won't lie and say it don't look better now. The only heath problems I realy had apart form the obesity were PCOS os NAFLD (nonalcoholic fatty liver disease). I don't know if the PCOS symptoms have really improved or not since I was asymptomaticfor a long time, but I have been told my liver function has improved significantly because of the weight loss! I used to cycle everywhere when I was bigger, but I couldn't conquer the hills on the bike. (I live in North London, which is basically i smal mountain range compared to the rest of London) Now, I cycle everywhere and I can make (most) hills my b*****s. Just one left that I am training to climb on the bike. I have no reason to take that route except pride at this point. Yes there is long term damage to my knees and hips, but that wasn't all weight related, I just have flat feet and had problems with my posture that was exacerbated by my weight problems. I'm glad I did this and the health benefits are definitely the main ones.

💪Huge congrats on your results. Looks like you'll be in the driver's seat and have the options available within your desired timeline I'm ignorant to the intricacies of the skin surgery but do have experience with your other question...in getting below the "obese" BMI labeling. It was a major rush...almost surreal. It was especially noted when I would go shopping for clothes. Being 6'4" and obese my normal stores were simply big & tall stores. Upon hitting closer to the normal height-weight range my options opened up exponentially. Felt pretty damn good to roll outa a dressing room and hand stuff back because it was too large. Too Large...wow. Life was a pile of fun living at that weight. A family health crisis occurred and it completely changed every aspect of life as I knew it. My health was such a distant concern as to have been off the radar for a few years. Getting back on the road towards normal height-weight range has been like riding a bike. All the tools, principles and prior methods are familiar and fairly easy to resume. The hardest part was getting my head wrapped around it. One thing I had to get firmly set in my mind was this: It is not selfish to focus on your own health, it is selfish not to. That is now hardwired in my noggin. . Keep on hitting those home runs. Winning always feels GREAT . 👍

I actually got below my goal weight around 7–8 months post-op—down to about 161–163 lbs—and stayed there until I got my boobs done (lol). I had the surgery just before hitting my 1-year post-op mark, and honestly, I wouldn’t change that decision for anything. I know people often say to wait until your weight stabilizes, but my plastic surgeon only required that I’d maintained my weight for at least 6 months, which I had at that point. Right now, I’m sitting on the higher end of my weight, around 170–173 lbs, but I’m also lifting a lot more, so some of that is definitely muscle (and the implants, of course). I still fit into size 4 pants and S-M tops, so I’m trying not to stress about that number. (Easier said than done) I work out consistently, with a mix of heavy lifting and cardio. Eventually, I’d love to get a 360 body lift, but one thing at a time, plastics are pricey! Even if I could afford it right now, I’d still want to wait at least another year. I had to take seven weeks off lifting weight after my surgery, so I’m focused on rebuilding and seeing how much I can tighten up on my own before committing to the next step. You're doing amazing! keep it up!

I LOVE that you're losing at a sustainable rate. There is so much data to suggest that crash diets almost never work, so losing ~1-3% of your total body weight per month is the sweet spot. I'd take it even further and say 1-2%, which is right where you're at. If I could give advice to anyone either trying to maintain after initial weight loss, or fighting regain like you are, it would be threefold: Focus more initially on learning to eat a healthy diet and less on the weight loss itself. People that follow the fad diet du jour when losing weight almost always regain because they very quickly go back to their old eating habits. If instead you focus on first learning to eat like a normal weight person that eats a healthy diet, you'll be setup for real success. Many people find that if they do this first, they don't really have to "diet" because their bodies actually start to self-regulate calories. Part of this is because when we eat a wide variety of foods that are nutrient rich, our bodies don't fire off signals to eat more. If that doesn't happen for you, there are strategies to slowly reduce intake while still maintaining your healthy diet. The second thing is to focus on instituting a regular physical activity routine. I feel like way too many people skip this, but the data is clear: up to 90% of people that have lost a lot of weight and successfully kept it off for years do a lot of exercise. In fact, the average for those successful losers is ~1 hour per day on most days of the week (roughly 300+ minutes a week.) This is twice the minimum recommended amount to stay healthy, and twice what someone needs that was never significantly overweight. I want to be clear, this is not really a huge factor in weight loss, but in weight maintenance, it's critical. Finally, focus on behavioral modification. Let's be honest. Most of us got as big as we did because we had an unhealthy relationship with food. We may never actually "cure" ourselves of that, but we can learn to fight back. Probably the best thing to do is work with a therapist that specializes in behavior modification, especially regarding weight. I realize this is not an option for everyone due to cost or availability, but there are also lots of good resources available online. Anyway, best of luck and keep up the good work!

Your post gives me great hope of making it to a “normal” weight - with a sigh of relief that it’s really possible! I thought I’d also be settling for overweight.

I took 2 years to get to my weight of 180, then 12 months to master maintenance. I had some issues and needed surgery and my weight then dropped to 165. I thought at my age I looked shocking and so much skin. I decided to increase my weight back to 180. Just some extra cals a day did the job in 3 months. I feel better at this weight. I am living with my skin, I dont really have a choice, as I could only afford one round and I feel I would look stupid half fixed. In the UK, we wear lots of clothes most of the year and I look ok in clothes. Its just now when on holiday, I wish I could.

As @SpartanMaker said don’t compare yourself to others. Doing so can lead to much angst as it messes with your head. But being human I get that you might want to have a bit of an idea of what you might expect. Your team can advise you on this too. if you use a calculator to try to predict your weight loss and you understand it’s based on averages and only gives you an idea of how much you MIGHT lose then it’s okay. A calculator is not a guarantee of how much you WILL lose. So don’t use it against yourself and you don’t match those numbers especially those giving time frame losses. For example I’ve done a couple of those calculators & I beat them on both weight loss (more) & time frames (faster) but that was me. Generally the average weight loss after a sleeve or bypass is around 65%. Averages for other surgeries are higher (70-75%). Of course factors like age, gender, height, medical history, current medical status, genetics, lifestyle, activity levels, etc. will influence your final weight loss. And even those aren’t guarantees. My advice is to count every pound you lose as a blessing & celebrate their loss.

First of all, great job so far. You're doing fantastic! My understanding is the same as @catwoman7 regarding insurance companies. They typically don't want to pay for anything they don't absolutely have to and that definitely includes anything they consider purely cosmetic. Aetna may be different, but I doubt it. Up front, I wanted to mention that not everyone actually even needs plastic surgery. The younger you are and the less weight you had to lose, the more likely it is that eventually your body will adjust to the weight loss. Yes, it can take a few years, but you may find in the long run you're better off not going down that route. I also wanted to comment on your timeline. I think there's a bit of a misunderstanding that we somehow stop losing at 1 year, 2 years, or some other defined date. That's rarely true, so I would suggest not thinking that your weight will stabilize at 12 months. You may get to 12 months and decide you'd like to go lower. Heck, I'm 2.5 years out and still losing (albeit really slowly). I'd suggest waiting until you you feel like you want to start maintaining, rather than just going by an arbitrary date. If your weight stays stable for a while (I personally would go longer than 6 months, but that's me), then looking to plastics may be appropriate. I mention this because I think it would be awful to have plastic surgery, especially if self-pay, then lose even more weight and still end up with sagging skin that you dislike.

I sort of hate to mention "averages", since everyone is different, but most people end up "overweight" or "class 1 obese", which is not very obese. But you'll always find a few who make it to normal weight (about 13%) or who never make it down to "class 1 obese". But that might at least give you an idea..

I personally have a somewhat pathological dislike for those calculators. I just tried the one @Bari_Hopeful posted and supposedly I should have stopped losing around 225 lbs. Even using the interquartile range listed, I shouldn't have made it past 200. I don't think of myself as exceptional in any way, though this calculator might make it look like it. If anything, I'm maybe just more stubborn and was willing to do whatever was needed so I could finally get to a normal weight. Settling for just overweight instead of obese was not really an option for me. I guess it just seems to me we set our expectations too low when we use an average like this. I know it's hard, but everyone can potentially make it to a "normal" weight range if they are willing to work at it.

I recently came across this expected weight loss calculator/predictor: SOPHIA Bariatric Weight Trajectory Prediction. Thought it was pretty neat! Sounds like you’re off to a great start!