I am 45 YO female. I have been contemplating the VSG for a couple years now. At five feet nine inches and 230-235 pounds my BMI is 34. Like many folks, I have lost and gained weight over the years with weight watchers, Atkins, Jenny, Slimfast and last but not least, Optifast. The latter cost four thousand dollars and I lost 55 lbs in six months then gained it all back, plus 20, over the next year. The Optifast experience was so discouraging and I feel like a failure for the regain. When I got off the 800 calorie a day liquid diet it seemed that anything I consumed was not burned by my body and was instead stored for a rainy day. It appears that the process itself had a negative effect on my metabolism.

My self-esteem has been the greatest casualty of years of obesity. I have also begun to really feel the effects in terms of quality of life. I avoid social events, had to bail out of my daughter’s college tour due to the college being perched on a hill (I became too winded and needed to rest). My LDL cholesterol is quite high, and my blood pressure is sneaking up (140/96). I ruptured a lumbar disc last year, which I think was due to age as well as the extra 80 pounds I carry around. The weight surely aggravates the back pain.

I have proceeded with the pre-op requirements and will have an endoscopy this week. The surgeon was ready to go ahead and schedule the VSG the following week but I have not been able to bring myself to the point of moving forward.

My main concerns are the post op lifestyle adjustment, aging and the irreversibility. I wonder how I will adjust to this new lifestyle of eating very little, the psychological as well as social implications? I am also concerned about the aging process. How well does one progress into their elderly years having had the surgery? Does one chronically suffer from mild malnutrition? What are the effects in one’s seventies or eighties?

I am sure this post is an echo of so many others. I appreciate your taking the time to address my concerns. I need to get off the fence and rule in or rule out this surgical option. I feel that without this option I may spend the remainder of my days as a reclusive obese woman with chronic back pain and escalating health issues. However, removing 80% of my tummy so that I will consume less food seems to be such a drastic and final measure. Why have I been unable to eat less food on my own? I have tried to eat only 200 calories four or five times a day but have consistently failed around day four. A fall from the wagon takes me several weeks to come back from before I try again. Being unable to maintain a restricted diet, losing ten, then regaining the same ten month after month is just so futile.

Thank you.

I'm younger than you (33) but my story is really the same. I waffled for a long time, and dinally decided that I was sick of it. I recently had an emergency hysterectomy and gained 40 lbs more after while trying ot get hjormones figured out. I finally said enough is enough! I've been playing the diet game since I was 11. It's never going to end. I'm getting sleeved in 10 days! In my mind, the constant dieting, heartbreaking fails, yo yo weigh ins and embarassment has just been too much to deal with. I would gladly give up the ability to eat like I do now for freedom from my prison of fat. Sorry I can't give you any post op info, but I plan to post as I recover, and I'm in your corner for sure!

Your story mirrors many of our own, yo-yo dieting, failed fad diet attempts and health that is going downhill fast. I was in just that boat about 14 months ago.

I studied out the options, bypass, band and VSG and settled on the VSG. I didn't want the malabsorbtion and malnutrition problems associated with a bypass and didn't want a NON permanent solution of a plastic gizmo floating around in my gut, the band.

I was sleeved and lost 170 pounds in 10 months. I did not reach my gaol of 180 and settled at a weight of 200 pounds. I am technically still overweight but no where near obese. Everyone says I look like I weigh 180, I have ALWAYS carried my weight well, even when I was super obese at 375 pounds I didn't look anywhere near it.

You will have to make up your mind. I too had serious reservations about food. Food was one of the real pleasures I had in life, but it was killing me and it was time to get a divorce from it and to become just friends and not intimate lovers like we were. I now eat to live, not live to eat. Let no one deceive you, it IS a difficult change to make. I still struggle with it and find myself wanting to snack when I'm bored, lonely or depressed - which unfortunately for me is quite often. The physical restriction almost guarantees I will not fall back into the shape I once was.

So as I stated, do your homework and then make your decision. It is PERMANENT, there is no turning back once you've had it done. The surgery is a resounding success in MOST cases (like mine) and in a few case a failure with complications and emotional issues. Research, pray seek counseling and then make your decision. No one but YOU should have the final say. It's tough at first but after a few months of misery you really start to reap the benefits.

We all wish you the best no matter what your decision.

Thank you for your supportive responses. Have you found any insight into my question regarding general "aging with the sleeve" or chronic malnutrition inquiries? The latter of which was brought to my attention by a therapist I saw recently to help out with this choice. However, although she practices counseling bariatric surgery clients her thoughts are totally rooted against WLS and she holds many erroneous beliefs; E.G. "One month after WLS the majority of patients will need to return to the OR to have their galbladders removed as surgery will place one at risk for stones." However, being obese and middle aged, I am presently at risk for gallstones. I assume this risk will actually decrease if I lose the weight. She also stated that due to chronic malnutrition my cognitive acuity would decrease (as in I will "get stupid"?). Needless to say I am shopping for a new therapist.

Your concerns are much like mine.....but I do think the benefits out way the fact that we have to give up the 'amount' of food more so than the 'type' of food we will eat for the rest of our lives. As to your concern about aging...I am a hairstylist so I come across a LOT of people. I was discussing my decision to have WLS with her. She asked what it would entail, so I described how they remove a good portion of you stomach permanently. She then informed me that her mother, way back in the day, always had stomach ulcers. Back in the day when that happened doctors removed 80% of her stomach. So technically she had a similar procedure done. She lived a very healthy life and just passed away at the age of 88. I hope this story helps a little with your concern of aging.

Good luck your decisions!

In high school how much did you weigh? Have you been big your whole entire life?

No June, my weight snuck up insidiously. Before pregnancies my normal adult weight was 145. After pregnancies my weight seemed to settle around 160-180. As I approached 40 things changed and the scale crept upwards, it seemed my body settled on an astonishing new weight of 230. I understand that when our fat cells fill up to capacity they split. It's just conjecture, but a suppose that during the last 6 years or so my fat cells have been doing just that, filling-up and splitting. Now I have too many and they all want a full tank, hence the new set weight.

Congratulations on losing 102 pounds, what a remarkable victory.

What happened to you in those years of gaining? You are saying something about becoming 40, but that is very vague. You were naturally thin. All of your extreme behaviors are messing up your body’s ability to regulate itself.

Yes, it sounds like your therapist is, well, NUTS! Their thinking is NOT anywhere near accurate. Yes, a lot of WLS patients end up having the gallbladder removed, and so do NON WLS patients. Whether there is an increased correlation between WLS and INCREASED gallbladder problems is something someone else more knowledgeable than I am will have to answer. If so my WAG would be that it is the result of diet change and weight loss itself and NOT the surgery.

As Trebendon points out there has been quite a few people who have had their stomachs either partially or fully removed due to ulcers or cancers. In fact goto Google and look up something like ENTIRE FAMILY STOMACH REMOVED CANCER and you can see several reports of entire families having a double whammy of a rare stomach cancer gene and them electing to have their stomachs prophylactically removed rather than take the (almost guaranteed) risk of dying from the cancer. They live(d) long and happy lives without their stomachs and with no chance of getting the cancer they were genetically disposed to getting. The stomach is one organ you can easily live without in this day and age.

As far as the "getting stupider" thing I'm afraid that remark is so inane as to not warrant an answer as you said in your post. I think it's time to shop for someone for a new psych eval.

Malnutrition is easy to avoid with the sleeve, unlike a bypass there is little to NO malabsorbtion of nutrients and a reasonable diet with plain old Vitamins should take care of you just fine.

We all wish the best for you as you seek your answers!

Thank you Rootman for the comprehensive reply regarding malnutrition, aging and decreased cognitive acuity. Your answers were very helpful. Wow, 173 pounds lost, amazing. Congrats.

June, I am sorry if my reply seemed vague. When I stated that "things" had "changed" around 40 I merely meant from the standpoint of my metabolism and body weight "set point" and was not implying something more sinister in nature. I am not sure what your are referencing as "extreme behavior". I reread my posts and did not see evidence supporting that assumption. Anyhow, thanks for your input and congratulations on your remarkable weight loss.

Hi Piper,

Me, too!

• Getting chubbier each year
  
• health problems getting slightly worse each year
  
• tried all the diets with success, then failed with regaining everything plus extra
  
• avoiding social events
  
• same weight as you, but I'm shorter
  
• endoscopy scheduled for Wednesday this week
  

but... do I really want to do this? The thing that has motivated me the most is that although there are complications you read about, I haven't read anything from anyone that they are unhappy a year after surgery! For me, that's amazing. I had my gallbladder removed a few years ago and I'm not sure I'd recommend that surgery to anyone. But this surgery - everyone ends up loving. So I guess it's just time to bite the bullet and know the next 6 months will be difficult but what's the chance we'll be the only two people in the world who regret the surgery a year from now?

Hope this helps!

Well, I must say, I was completely for the bypass, until I educated myself better. One major benefit the sleeve has over the bypas is, that you can take NSAIDS, like Motrin, ibuprofen etc...that spoke volumes to me since arthritis is an adding problem, and anti inflammatory needs are paramount to helping live with that particular disease. So, I didn't wasn't to limit my future older self, for a quicker fix today

Aging, not adding lol

You are tall and I worry if you have had the restriction I have had you will be 120 pounds when all is said and done. You being 150/160 is a perfectly fine weight for you. You are 70/80 pounds over. You will lose that before the six months is up. Your body regulated itself for many years. You gained a little with the kids, but it wasn't 60 pounds. What do you attribute your weight gain to? You are just saying getting older, but that is 60 pounds. Are you on any new medications? Did you go through anything hard? Did you lose yourself in your children (less workouts/more fast food)? I mean these are very important questions. People who are naturally thin just don't pop up and gain 60 pounds overnight just because they turn 40. Most of the people in my family are naturally thin, some of them gain weight. They can not cope with stress as two aunt's went through a divorce, but if they found out a way to take time for themselves, deal with the stress and just went for a walk the weight would come off. Then my other Aunt who was a size 2 her whole life is now a size 12 because of Crestor (Cholestorol Meds). She is in her 60's. Do not allow your poor body image (and I know what this is like) destroy you. You have something that is already working in your favor - your body. This is BIG decision, but is it the right decision for you. I would try to look for people who were the same height and needed to lose the same amount of weight as you. It worries me that you will in fact, lose too much. There is someone on her who made it to her goal weight 5 months in...Only had to lose 60 pounds or something like that. When I was 235 I never even considered this surgery even though I knew about it. I really didn't think about the surgery until I knew I could never physically do what it takes to get the weight off. If my back had healed I would have done the work, and I was up against genetics and myself (addictions). And I was hovering around 300 pounds.

linkybo,

Thank you for your sunny reply. Your observations are so true. Although folks seem to go through an adjustment period that seems to be harder for some than others, it appears as though people are quite pleased in the long run as they have finally been able to attain and sustain meaningful weight loss. I have a tendency to over analyze things and get "stuck" when making difficult choices. I guess in some ways it's better than being impulsive. Off topic, love your golden puppy picture and envious that you live in seattle. I am very excited for your upcoming surgery and will have you in my thoughts, sending positive energy your way.

June, I really appreciate your thoughtful response. I will certainly consider your points regarding my ability to lose the weight without intervention. Thus far I have only managed to gain with each failed attempt over the last 6+ years.

My weight lingers btwn 230-235 so I have about 80-85 lbs to lose if I were to shoot for 150-155. My "healthy' range is 128-168 however, I don't mind being 160, it is a whole lot better than 230....

Anyhow, based on your post I feel that you believe my BMI of 34+ is just too low for VSG and will potentially put me at risk of "losing too much". I wonder, has this been something that folks with "lower" BMIs have experienced? This concern is not one that my surgeon had expressed. In fact, he seemed to feel that it made a great deal of sense to intervene now rather than later as increased weight can increase potential for post surgical complications. I gathered that he had performed this surgery on folks with lower (than 40) bmi's and felt that the insurance companies were shortsided in their high bmi requirements. Do you know if folks have indeed experienced too much weight loss when starting with lower bmi's? It seems to me that one's body would begin to level off in terms of weight loss once they reached ahealthy weight that was supported by their caloric intake (equilibrium) rather than a specific time frame, like the six month time frame you suggested.

Thanks again for clarifying.