So... I had an appointment with my primary care physician to get clearance for surgery. I was hoping to have sleeve surgery in November. He was very reluctant to give me clearance and said that he does not agree with the surgery. Instead he put me on an injectable medication - Victoza.

I love my doctor and I generally trust him and I was very surprised because he knows how hard I've tried over the years to lose weight. I've tried virtually everything although I have not tried medication to lose weight. He talked about how many patients he has that have had complications from weight loss surgery. And those who have gained the weight. Anyway, now I am conflicted and just wanted to get some opinions from all of you. Did any of you try weight loss medications or try the one that I mentioned? When I look online, it seems that people only lose about 5 to 10% of their excess body weight with the medication I have been put on.

Just wanting your thoughts, opinions, comments. I am so, so sick, tired and despondent with being overweight my whole life and I am now 50 years old. I need to lose 100 pounds. I really don't know if medication will do it. I had my heart set on having the surgery in November after spending a long time thinking about it and trying to make the decision and now that I have finally made the decision my doctor says it's not a good idea. Aaarrrggghhh....

Edited September 11, 201510 yr by BHopeful

My bariatric center is a Center of Excellence (just 5 min from my home so happy about that) and they need clearance from my PCP. I know I could find another PCP and get clearance but I was just wondering what your opinion was about my PCP saying no and wanting me to do injectable medication instead.

Your doctor seems to have it backwards. He works for you, he cannot tell you how to live your life. You tell him you will be having the surgery and he needs to know that only for treatment in the future. He may not agree with your decision, but it is not his to make

.

My insurance and bariatric center required a referral from my PCP. Maybe this is the case with the OP? That could make things trickier.

Honestly, I don't quite understand why your doc is against WLS. I could understand if he/she was being conservative and suggesting you try medication first, but it sounds like your doc wouldn't approve of it under any circumstances.

Complication rates for bariatric surgery are similar to comparable surgeries. That says a lot about WLS because most of us would be considered high risk outliers among the patient populations having comparable surgeries. In bariatric surgery, we all have the high risk factors of obesity and often other comorbidities.

To just completely dismiss it from ever being an option (I am doing some assuming here, btw, based on your post) doesn't make sense to me. In my experience most doctors recognize the immense health risk of being very obese, have heard the surgery works well and wouldn't say it's a bad idea to consider whether it's a good intervention for a very overweight patient. I mean, if medication gave results anywhere near surgery, a lot of us would probably be using medication instead.

Switch to a different primary Dr that cares about your health more than the extra workload he might have if you have a complication.

I'm surprised that you haven't tried a weight loss medication at this stage. Surgery shoul be reserved when there are no other options left.

I'm surprised that you haven't tried a weight loss medication at this stage. Surgery shoul be reserved when there are no other options left.

I have always been too scared to try medication because it would have to be long term. That's why I'm wondering if anyone here has ever tried medication? My assumption is that it might be somewhat successful but then anytime I am not on the medication I will just put on weight again.

I'm surprised that you haven't tried a weight loss medication at this stage. Surgery shoul be reserved when there are no other options left.

I have always been too scared to try medication because it would have to be long term. That's why I'm wondering if anyone here has ever tried medication? My assumption is that it might be somewhat successful but then anytime I am not on the medication I will just put on weight again.

And I think you are correct in that assumption

I'm surprised that you haven't tried a weight loss medication at this stage. Surgery shoul be reserved when there are no other options left.

Surgery should be when it's the best option, period. I never took a diet pill in my life. You have to weigh all options and the side effects were never something I was willing to risk.

@@bhopeful

Can't answer that - only meds I ever tried were illegal and it was 20 years ago.

Is there a justification other than weight for you to be taking victoza?

If it were me, here's what I would do. I would make another appointment with my pcp. I would tell him the statistics on victoza, that I am 50 years old, and I've had difficulty with my weight for my whole life/however many years. I'm not asking for his approval of the type of surgery I'm having. I'm asking for a medical clearance for surgery. I would tell him that I have always highly respected his opinion in the past. I've done my homework on this, and at this stage of my life (particularly post-menopausal), surgery is my best option of long-term success, and I respectfully disagree with his personal opinion.

Then I would say, "Please give me the medical clearance for surgery, or explain to me why it is medically a bad idea based on my medical condition, not the experiences of other people, and what I would have to change to get medical approval for this surgery."

If he says no, then I would tell him that I'm sorry he has allowed his personal bias to interfere with my healthcare, and I'll have to find a new doctor.

I was on phentermine for 6 months. I did lose weight, but I hated that drug so much. It made me feel anxious and "wired" and irritable and I worried constantly about the side effects. As soon as I stopped taking it, I gained all the weight back.

Not sure what advice I have for you -- I do listen to doctors' expertise, but I also advocate for myself -- I guess I might consult another doctor. Like most people considering this surgery, I researched it thoroughly and had YEARS of trying to lose weight through every means imaginable, including WW, Jenny Craig, weight loss "camp," personal trainers, and medication. When I resolved to do this thing, it was because I knew my life and future depended on it. I'm glad my Primary Care doctor supported me in that. If she hadn't, I probably would have found another.

My primary care doctor is not a fan of the surgery I had, gastric bypass so I got my letter of recommendation from my endocrinologist. I'd look for another doctor.

Edited September 12, 201510 yr by zackly

Your Primary seemed very biased. Some primary doctors allow their personal feelings and beliefs affect their work. Its not about what the doxt agrees with or believe, its about working in conjunction with the patient, and satisfying you the patient preferences. I would totally get another primary. I have Kaiser and the Kaiser network is is so great and supportive.

I tried phentermine bad ended up with A Fib for the rest of my life .. that medicine is like speed and my heart started working overtime .I only lost about 30 pounds and do not recomend this to anyone

@@bhopeful

I am so very sorry that your primary care physician is not supporting your decision. At your age and the amount of weight you need to lose should absolutely be supported.

I am 52 and yes, maybe you will be successful in losing it but the issue is about keeping it off. I would not take any weight loss medications whatsoever. There are side effects that come with that as well and ultimately the minute you stop them the weight comes back. I have tried so many that I know from my experience that this is the case.

If I were you (and I know I am not), I would either ask your primary care physician to support your decision or find a new primary care physician.

Or have your bariatrician have a peer to peer consult with your primary. That may help as well.

That being said, I don't know if there were medical reasons to not support it. Many times if you have heart issues physicians will push back.

I hope you are able to get resolution and move forward.

I challenge anyone here to tell us that ANYONE -- a single person they know -- lost weight using diet medications and has kept it off.

I know hundreds, literally hundreds of people (myself included) who lost significant amounts of weight and who gained it all and more back. Every single time.