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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!

I just want to respond to the issue with iron. Depending on the type of iron, you only actually absorb a certain percentage of what's in the tablet. I take carbonyl iron, of which the body absorbs close to 100% ("elemental iron" is the amount you actually absorb, vs the total amount of iron that's in the tablet, and I believe carbonyl iron is the only version with that high of an absorption rate). In other versions, the body may only absorb half, or 20%, or 60%, or whatever, of iron that is in the tablet. That would explain the incongruence of the numbers that you're seeing (e.g., 45mg tablet when the required amount or iron is 18mg). I just cut & pasted this from an article I just googled: No, 65 mg of iron is not the same as 325 mg. Ferrous sulfate tablets are often labeled with both the amount of ferrous sulfate (the actual pill) and the equivalent amount of elemental iron (the usable iron). A 325 mg ferrous sulfate tablet typically contains 65 mg of elemental iron. So, while 325 mg of ferrous sulfate contains 65 mg of usable iron, they are not the same in terms of their total weight.

I can totally relate to this, 2 years out from surgery. I was beginning to think I might not see my end goal weight of 150. Until a couple weeks ago. I was bouncing around 155-160 for the longest of time and was resigned to the fact that the rebound weight everyone talked about here had happened or maybe my goal was just off. I was perfectly happy to remain in the 150s, but I'll admit I'm pleasantly surprised. And fitting into a size 6. Sometimes a 4 depending on the clothing item. Dreams really do come true. LOL This forum has been such a help to me during the whole process. I'd like to thank you all for your advice and encouragement. It was and is priceless to me. Will periodically check in and I continue to wish everyone here much success and boundless health. ❤️

@Dub "Androgenetic Alopecia" (the hair loss you have now), is different than "Telogen Effluvium", the hair loss that most of us have immediately after weight loss surgery. You hair loss is not the result of diet issues. The good news is there are treatments available if you want to pursue them. Probably your best bet is to talk to your primary care doc to start the process. They'll know which specialists to refer you to in your area.

Timely seeing this thread topic. Hair loss concerns here as well. Not simply from weight loss, but from getting older and fighting the DNA that threatens to thin my hair severely. I tried the head shaving thing a few years ago and it wasn’t for me. Got outa the shower looking like I had been in a cage match. Bleeding from some new cut all the time. Some dudes rock the bald look. I will do it if forced to, but in the meantime I am gonna throw money at it and hope for the best. Currently taking daily vitamins, iron, fish oil, potassium and started the collagen caplets this morning. Protein intake is good. Drink BCAA’s daily, too. I really noticed it when getting a haircut recently. The gal cutting it was cracking jokes about trying to work with my Donald. I was laughing, too….but geesh. Dis getting ta be serious bidness.

There are calculators that will help you ballpark estimated weight loss. I loved doing that before my sleeve. They're based on large numbers of people who have the various surgeries, but they are just averages. So some people will lose tons more and some tons less, for various reasons. Based on those my average predicted end point (based on thousands of people with the same starting BMI/weight but with a multiplicity of different variables, as Spartanmaker says) was around 200lbs (I started at 276 and would have honestly been thrilled with that). In the end I bottomed out at 138 and have maintained for a couple of years at 6-14lbs above that (albeit with a degree of effort because I like this weight and have invested a lot of money in a wardrobe that I just don't want to replace one size up, LOL). Sounds like you're already doing amazingly with your pre-surgery loss and that's all weight you won't need to use your sleeve to lose so you're ahead of the curve. The exercise you're doing sounds great too. I think you've got this. Can't wait to hear how well you do!

A few new wins! I just bought a size 8 🤣🤣. Like WTF I was not a 8 even at my smallest. Also I have been able to jog 3 to 4 miles without stopping. It took me a year but I finally unlocked that power and I credit strength training/weight lifting it helped me with endurance and strength to run long distance! Major wins !

Your worry is going to give you a stroke or higher blood pressure if you are not careful. I'm concerned about that so here are my thoughts. At 61, I finally had the RNY. Initially I wanted the GSleeve, but was educated by my surgeon about RNY and that made the most sense, it is well researched, it is done laparoscopicly and if you need the other part of the stomach removed, you can ask your surgeon to do that. The Y portion of the RNY might need to be attached somewhere else. I'm not sure. I had no pain and have been able to tolerate all of my walking and light housework during my 2 weeks off work. I tolerated the clear liquids and the full liquids well and now I am on solid foods and doing well. With RNY you tend to lose more, but it is dependent on you and what you eat. With RNY, I was taken off more than half of the medications I was on, and taking none of my diabetes meds and insulin. Having a fear of the GERD with GSleeve, I also opted for RNY. Because you are already on pantoprazole and still have issues, I would suggest the RNY because there is a higher risk for those who already have indigestion issues or suffer from too much stomach acids. RNY you can't have NSAIDS, but with my arthritis, I am allowed to take it only as needed, and I take a capsule of Celeobrex, and it works fine for my painful arthritis. Just talk to your surgeon about that. Being down 40 pounds already with the GLP1 medication is good, and it will reduce fat on your liver as a side effect. I too have renal problems, stage 3, but was encouraged by my kidney doctor to have the RNY, and yes, the kidney doc also doesn't want me on NSAIDS, but allows me to do so. I need to get down in weight so I can have a hip replacement. Then, I might not need NSIADs any more. I hope I have been able to give you some information and encouragement to re-look at the different surgeries. RNY is just one step further than the sleeve, and with the history of your family, I'm sure the surgeon will be able to compromise and do a revision to the typical RNY as needed. Having stomach cancer history in your family would be one reason to just take the stomach out that is cut off, like in the sleeve and attach the Y end of RNY elsewhere. A modification should be easy to contemplate and do. Just another thought, your surgeon may want to meet with you because the ulcer in your stomach is evident on the series of pictures taken, and wants to move quickly to get that part of the stomach taken out? It is possible? Already having an ulcer starting may also be the reason they postpone the surgery and put you on healing meds, and get you to "calm down" because worry makes ulcers worse too. There are all kinds of reasons and things to factor in, but I would say you definitely need to find out what the surgeon wants to talk about, and go in with some knowledge. I suggest you take a look at some of the YouTube videos by BariNation. You may find out that they help you. I wish you the best, keep us posted after you talk to your surgeon.

The doctor responded to my question in writing a few weeks ago that there is no good answer because there is no way to know, but saw the value of having access to my stomach to monitor, i don't think she had a chance then to review the EGD pathology report and now suddenly I have a meeting with her. The program coordinator couldn't explain to me why it was so early. 15 years ago I had a bladder cancer scare, and the urologist reacted the same way after they got a pathology report. In that instance they had access to my bladder and did a scope and did not find anything really abnormal. I know the risk is rare, and I look forward to learning about the alternative ways to monitor. And I hope you're correct. RYGB in general would be something I'll have to warm up to because of the increased complications associated with it. The great news is there is a lot of data on it, and surgeons are very familiar. Sinceit's not novel, and if I move I will surely find a doctor familiar with it vs SADI-S or even BPD/DS. For example in my area very few surgeons do either of those two. My insurance doesn't cover SADI-S or OAGB. My preferred surgery is SG. If I'm not a good candidate for it, then I'm glad I'm waiting because I need to do some deep thinking. Dumping sounds terrible. Arthritis runs in my family, and at time even at my age my knuckles and joint hurt. Nevertheless the nephrologist advises against NSAID but they are not off limits with RYGB they would be mostly off limits. I'm not SG or bust really, but I just had a relative share they have precancerous cells in their stomach. That two of my father's siblings with either stomach cancer or precancerous cells. It is a little too close to home. I may be, however, more at risk of dying by slipping in the bath tub, or driving on the highway than getting stomach cancer in my remnant stomach. So I have to be realistic. If I do nothing and get kicked off of Zepbound my weight will return, and my heart will enlarge, and I could die of heart failure or a stroke (in the last 5 years 3 close family members had strokes, and my grandfather die of a stroke years ago). Those are conditions I have now. The enlarging heart may not get worse, but it likely will. My cardiologist is why I aggressively started losing weight to lose 40 lbs since my bariatric first appointment weight-in in February. I've now been taken off one of my four hypertension meds, but I'm still on three. My other concern about RYGB is how will it impact my ability to take sustained released meds. all this I'll talk to my surgeon about in my meeting Tuesday. I've been considering bariatric surgery since 2018, and i put it off. 2022 after a few health scares and being diagnosed with mild but concerning LVH I started seeing a dietician and working out. Later I battled shame to start Wegovy in 2023 and worked with an obesity specialist's practice. In 2005 due to insurance I switched to Zepbound. After my cardiology follow up in January I went for my first bariatric consult. I briefly considered ESG, but after researching decided against it and insurance doesn't cover it. I witched Weightloss clinics and aggressively started tracking and living in a calorie deficit. I'm under no illusions about being able to keep this weight off w/o surgery long term. I don't know if the co pays next year will be even higher already $500 $360 with a coupon, or if my financial situation will change. ifI do nothing, the I'm not sure if I'll make it to my mid sixties if I go back to 315-320. So I have to do something, the question is what.

My purpose of doing this surgery so late in life (I'm 46) is to be healthier. I have multiple co-morbidities including hypertension, left ventricular hypertrophy, sleep apnea, CKD 2, and hyperlipidemia. There is a family history of stroke and cancer, including colon a stomach cancer. I meet with my surgeon for the second time Tuesday. The staff said the surgeon wanted to meet with me because had questions, but that did't make sense because they've responded to my questions. The only new information was from my EGD pathology report. My EGD found asymptomatic HP negative gastritis. The GI Doc didn't know what may cause it but tossed PPIs at me and I will learned Tuesday if I need another EGD or what. If I have contra-indicators for Sleeve Gastrectomy I'm considering backing out of surgery because that means my only option, anywhere would be RYGB. I'm afraid of having a remnant stomach that could continue down the path of inflammation. Apparently I was on the path to stomach ulcers. Maybe I'm being unreasonable, I'm just afraid of my remnant stomach being a time bomb. I'm also concerned about dumping, not being able to take NSAIDs, and perhaps having to change my other medications. I've committed to having a procedure including buying vitamins, typing protein shakes, losing weight in advance, learning more and more about the procedures, my relationship with food, and continuing to exercise with my personal trainer, and attending support groups. But I have this fear of RYGB and maybe it's silly. I know people, good friends, with RYGB. I get the sense they like the results, but not the down sides. One even told me they are surprised hospitals still perform RYGB because of the issues they had. I don't really know what I'm walking into on Tuesday and I am nervous. I've been taking 80 mg or pantoprazole daily. I learned my insurance company will only pay for 90 pills, so my refill was tricky. I don't know how longer I will have to take it or what that all means, and i don't know what impact all this will have on the surgery (if any). I'm terrified of having come this far, made peace with the decision to have surgery, over come the shame, had to deal with the doubts and fears of other people including my own spouse to find myself with the possibility that it's all a no-go. I won't have surgery until the fall, and normally the second appointment with the surgeon is closer to the the surgery point. Even the program staff weren't sure why it was being scheduled. My RD follow up, last week as also much sooner than it should have been, and after the meeting the RD said it wasn't the actual required follow up. I'm left scratching my head, being coming anxious, and I feel some slight indigestion which is wild since I've been on the PPI since early last month. I doubt my experience is unique so I open to learning from others. I'm currently on Zepbound and losing weight, but it's expensive with insurance and the insurance could decide to not cover even with the insurance and a coupon it's about the amount of a car note every month. So that's not sustainable for the rest of my life. Ia also need to lose more than the 20% max it would get me to. So if surgery is a bust, I I don't know. The gastritis is a contra-indicator for Endoscopic Sleeve Gastroplasty and it's not covered by insurance anyway. Thinking about all of this makes me kinda nauseated.