Attended Initial Consultation and Primary Care Visit

[MattS 5]

Hello all,

New member here! I decided I needed to make a lifestyle change and investigate all my options to improve my health/lose weight. As a Veteran I use the VA for my care (have BCBS insurance as well) and scheduled a PCP appointment before my initial consultation for surgery. While I got some really good advice and support in checking out my options for weight loss (including surgery), they were not too supportive of gastric surgery as an option although encouraged me to explore it. They also had focused on the negative and complications that could be associated with it and some general misinformation (i.e. have to lose 50 lbs before you are able to get the surgery and at that rate, you might as well keep going to lose more weight).

The initial consultation with the surgeons office couldn't have been more polar opposite. Obviously supportive of surgery as an option, dismissed the prevalence of the complications that the PCP brought up (almost all the surgeries end up in perforations and leaks, a lot of people who get the surgery gain the weight back, etc). They answered every question I could think of and scheduled me for more appointments in the next month. I made sure to tell both the PCP and surgeon that i'm not rushing into something that is such a life changing decision. The surgeon mentioned with my age "low" BMI and metabolism it *should* be very effective.

My body composition (for context): 33 years old, 260 lbs, 5'6, have sleep apnea and acid reflux that may be more related to weight and diet than GERD on its own.

Other than sharing my experience, questions I have for everyone here is

- If you have had a similar experience with your PCPs when discussing bariatric surgery?

- Given my body composition, does bariatric surgery seem drastic? How many people between 35-40 BMI have had the surgery and do you think it was a good move?

Thanks in advance for your input!

[Ed_NW 684]

The best way to determine if WLS is a better choice for you than loosing the weight by dieting is to ask yourself, can I keep the weight off long term with just will power. WLS is a tool for those of us that answer no to that question. The goal for most people is to live a long life with as little discomfort and illness as possible. I personally use food as a coping mechanism for what ever stresses me out or depresses me etc. I know without this drastic measure (WLS) I decided to take, I wouldn't live as long. WLS for me was just a tool to help me deal with otherwise self destructive behavior. It's best if you can take measures early to prevent long term damage to your health. Good luck with your decision.

[MattS 5]

6 hours ago, Ed_NW said:

The best way to determine if WLS is a better choice for you than loosing the weight by dieting is to ask yourself, can I keep the weight off long term with just will power.

Ed_NW, that is a very good way to look at it. If I am being honest with myself, I have always had a hard time managing my weight and using just will power alone. I know its not easy either way you slice it. Strangely enough, I eat when i'm happy or bored. When I am stressed out, the thought of eating turns my stomach and I have to usually force myself to eat.

My biggest fear with the weight I am carrying is the health problems that are getting worse in my case (sleep apnea, acid reflux, lack of energy, and joint pain/snaps). My concern with moving forward with WLS is how drastic of a change is it going to be long term. Like would I be able to have things like ice cream or other things like that (in moderation of course) with my family or would I be on a special diet the rest of my life? Hell maybe if I got to my goal weight, I wouldn't even want to touch that stuff!

[Ed_NW 684]

52 minutes ago, MattS said:

would I be able to have things like ice cream or other things like that (in moderation of course) with my family or would I be on a special diet the rest of my life?

My sister-in-law had the gastric bypass over a decade ago and can eat and drink the same things as she did before surgery. The amount she can consume in one sitting is limited and with RNY you also have the added benefit of malabsorption. People do find ways to gain their weight back even with RNY so the psychological conditioning has to be there as well. You will read on this and other support forums that WLS is just a tool and that has to be the mindset going into this. With all that said, I think it's an awesome tool and can help a lot of people from going down the slippery slope of obesity. I'm 51 years old and have always been active (almost hyper LOL) and it got to a point where my body hurt so bad from the weight that I became more sedentary and that snowballed my weight. I admire people that take action at a young age before the damage becomes irreversible.

[New&Improved 1,780]

On 2/17/2019 at 2:07 AM, MattS said:

Hello all,

New member here! I decided I needed to make a lifestyle change and investigate all my options to improve my health/lose weight. As a Veteran I use the VA for my care (have BCBS insurance as well) and scheduled a PCP appointment before my initial consultation for surgery. While I got some really good advice and support in checking out my options for weight loss (including surgery), they were not too supportive of gastric surgery as an option although encouraged me to explore it. They also had focused on the negative and complications that could be associated with it and some general misinformation (i.e. have to lose 50 lbs before you are able to get the surgery and at that rate, you might as well keep going to lose more weight).

The initial consultation with the surgeons office couldn't have been more polar opposite. Obviously supportive of surgery as an option, dismissed the prevalence of the complications that the PCP brought up (almost all the surgeries end up in perforations and leaks, a lot of people who get the surgery gain the weight back, etc). They answered every question I could think of and scheduled me for more appointments in the next month. I made sure to tell both the PCP and surgeon that i'm not rushing into something that is such a life changing decision. The surgeon mentioned with my age "low" BMI and metabolism it *should* be very effective.

My body composition (for context): 33 years old, 260 lbs, 5'6, have sleep apnea and acid reflux that may be more related to weight and diet than GERD on its own.

Other than sharing my experience, questions I have for everyone here is

- If you have had a similar experience with your PCPs when discussing bariatric surgery?

- Given my body composition, does bariatric surgery seem drastic? How many people between 35-40 BMI have had the surgery and do you think it was a good move?

Thanks in advance for your input!

I've been researching RNY BYPASS religiously for months.

The way I see it if you can afford it and want help for long term success why wouldn't you go for surgery? RNY is great for people who sometimes lack the control because of the dumping issue with fatty foods and it limits calories absorption.

That's the way I look at it. If I can get a little helping hand to fix my health issues and control my life a little better so that I can have a chance at a longer life a healthier life WHY NOT TAKE A CHANCE?

I'll tell you this I've lost weight before on my own in my mid 20s I lost 90Lbs in 6 months all by myself but that was gym 7 days a week and very strict 1200cal diet, it was great but after a while it slowly creeps back on so that's why I've finally decided to save up to get this RNY BYPASS to help me live longer!!

Edited February 18, 2019 by Mikeyy

[MattS 5]

13 hours ago, Mikeyy said:

I've been researching RNY BYPASS religiously for months.

The way I see it if you can afford it and want help for long term success why wouldn't you go for surgery? RNY is great for people who sometimes lack the control because of the dumping issue with fatty foods and it limits calories absorption.

That's the way I look at it. If I can get a little helping hand to fix my health issues and control my life a little better so that I can have a chance at a longer life a healthier life WHY NOT TAKE A CHANCE?

And that is what ive experienced my whole life, if I am going to be honest. Even when I was working out constantly and in the Military, I have always struggled with maintaining consistent weight loss and been overweight/obese. I guess my apprehension is making such a long term change.

[KCgirl061 1,533]

I was one of those lower BMI patients. My BMI was 39.6- 40 depending on my Water weight that day. I did get a lot of people telling me I wasn't big enough to need WLS. But for me it wasn't about my size, I was about my struggles. I felt like I had been dieting all my adult life and only getting heavier as the years passed. "Why don't you just diet and exercise?" they'd ask. Well thats what I tried to do when I was only a BMI of 33!

I don't know if that helps. You have a lot of good responses on this thread and my two cents might just sound like white noise. But it seems to me you are doing the right thing by getting on forums and learning about people's struggles and successes and how WLS has changed their life.

One resounding theme that keeps coming up is that people only regret not doing it sooner.

[New&Improved 1,780]

My BMI is between 42-43.5 but still want to get rid of at least 130-140lbs and change my metabolism and my life going forward. I'll be 35 this year.

[Recidivist 1,141]

Hi, Matt. I had surgery about 13 months ago. I am male, 5'8" and weighed 150 at my highest. When I had my initial consultation with the surgeon, I was 137 and had a BMI of about 35.5.

I had all the same questions as you have. I thought I was not overweight enough for surgery, even though I had yo-yo dieted for most of my adult life and was never able to keep weight off long-term. I was honestly a little embarrassed to be thinking about surgery compared to some of the other people I met who had 200+ pounds to lose. The only reason I was approved with a 35.5 BMI is because I had co-morbidities (sleep apnea, high BP, pre-diabetes.)

RnY seemed really drastic and I couldn't imagine never eating the foods I loved again. Maybe if I just tried to diet one more time....

Fast-forward 13 months. I'm down to 140 pounds and a BMI of 21. Having the surgery was the best decision of my life, and my only regret is that I didn't do it years earlier. (I was 59 at the time of my surgery.) I feel wonderful and have so much energy. I'm off my BP and cholesterol meds, my sleep apnea is gone, and no more pre-diabetes. I can eat anything I want, but in much smaller amounts. However, my cravings for unhealthy foods--especially sugar--have disappeared.

I won't lie to you: the first several months are really hard and you'll wonder what the hell you have done. By the maintenance phase, however, it becomes pretty easy when your life returns to a new normal.

Good luck, and keep us posted!