Advice: Going through with the surgery

[Namiland 6]

Hi all. I'm new here (obviously lol).

I met with my surgeon for the first time a couple days ago. It was INCREDIBLY discouraging. Honestly, I'm not even sure if he was trying to discourage me or if he was attempting to make me see just how much I'll need to do to take care of myself.

He asked me what kind of surgery I wanted (btw, I'm with Kaiser Perm in NorCal, they only offer two types: Bypass or Sleeve). I told him that I'd read about both types but wasn't entirely sure which would be best for me. I'm a former smoker who quit 2 years ago. He replies with, "Honestly, I wouldn't recommend surgery at all for you."

He went on for the next 45 minutes essentially telling me that my PCOS is all in my head (I was diagnosed with insulin resistant PCOS in 2009 NOT by Kaiser and they refuse to acknowledge it because they didn't diagnose it and refuse to test for it) and my continued weight yo-yoing over the years is simply a result of me being lazy about exercise (tell that to my wallet and the gyms I've joined in the past) and make poor food choices. In the end, it felt like he was attempting to talk me out of doing the surgery because my weight issues were all my own fault because I've "self-diagnosed" myself with PCOS to blame it on something other than myself. Yep, he told me I'm self-diagnosing. He also indicated that I've likely put on enough weight just to meet the requirements of the program.

Now, I'm struggling to decide if I want to continue with surgery or if I should just crack down on myself and follow a strict diet/exercise plan for the rest of my life. But to be clear, this is 100% a surgery I want to help with my PCOS (as research shows it does). My previous doctor told me that due to the insulin resistance, my body is holding on to the weight because it thinks I'm starving myself. So it craves carbs like crazy and I have to exercise 3 times as hard as the average person to lose the same amount of weight.

I'm feeling very discouraged and spiteful. I felt, after that conversation, that I want this surgery just because of how rude the surgeon was. Part of me doesn't want it because what if he's right? What if I AM just lazy and putting blame on something as a result.

Edited October 28, 2021 by Namiland

[Tony B - NJ 485]

2 hours ago, Namiland said:

Hi all. I'm new here (obviously lol).

I met with my surgeon for the first time a couple days ago. It was INCREDIBLY discouraging. Honestly, I'm not even sure if he was trying to discourage me or if he was attempting to make me see just how much I'll need to do to take care of myself.

He asked me what kind of surgery I wanted (btw, I'm with Kaiser Perm in NorCal, they only offer two types: Bypass or Sleeve). I told him that I'd read about both types but wasn't entirely sure which would be best for me. I'm a former smoker who quit 2 years ago. He replies with, "Honestly, I wouldn't recommend surgery at all for you."

He went on for the next 45 minutes essentially telling me that my PCOS is all in my head (I was diagnosed with insulin resistant PCOS in 2009 NOT by Kaiser and they refuse to acknowledge it because they didn't diagnose it and refuse to test for it) and my continued weight yo-yoing over the years is simply a result of me being lazy about exercise (tell that to my wallet and the gyms I've joined in the past) and make poor food choices. In the end, it felt like he was attempting to talk me out of doing the surgery because my weight issues were all my own fault because I've "self-diagnosed" myself with PCOS to blame it on something other than myself. Yep, he told me I'm self-diagnosing. He also indicated that I've likely put on enough weight just to meet the requirements of the program.

Now, I'm struggling to decide if I want to continue with surgery or if I should just crack down on myself and follow a strict diet/exercise plan for the rest of my life. But to be clear, this is 100% a surgery I want to help with my PCOS (as research shows it does). My previous doctor told me that due to the insulin resistance, my body is holding on to the weight because it thinks I'm starving myself. So it craves carbs like crazy and I have to exercise 3 times as hard as the average person to lose the same amount of weight.

I'm feeling very discouraged and spiteful. I felt, after that conversation, that I want this surgery just because of how rude the surgeon was. Part of me doesn't want it because what if he's right? What if I AM just lazy and putting blame on something as a result.

With a BMI of 36, I think you could probably do it on your own....atleast give it a shot. That BMI is probably too high for your insurance to cover the surgery anyway so unless you are a self pay, it may be tough getting approved. Why not try the 800-1000 calorie diet along with increased exercise and see it it works.

[Namiland 6]

1 minute ago, Tony B - NJ said:

With a BMI of 36, I think you could probably do it on your own....atleast give it a shot. That BMI is probably too high for your insurance to cover the surgery anyway so unless you are a self pay, it may be tough getting approved. Why not try the 800-1000 calorie diet along with increased exercise and see it it works.

That's what it is currently. With my PCOS, I yo-yo a lot. Last year, it was 32, 10 years ago it was as high as 42. I've already been approved by my insurance anyway. I'm definitely going to do the increased exercise.

Thank you

[JustSJ 56]

I would seek out another surgeon for a second opinion before you give up completely.

[Sunnyway 271]

Here are two food plans that you may find helpful: A Pound of Cure, by Matthew Weiner, MD (a bariatric surgeon) and Bright Lines Eating, by Susan Peirce Thompson, PhD. I've lost 50 lbs pre-surgery following A Pound of Cure. I intend to follow it for life, post surgery.

Edited October 28, 2021 by Sunnyway

[mrsjo 67]

I will say coming from someone who has had PCOS for 20+ years it is it’s own can of worms as far as trying to get it under control. I have a great doctor who realizes the struggle with it. Since starting on my pre-op weight loss I have realized how much it affects our weight. I can literally get 10-20 g more of carbohydrates per day and cause a weight gain. And I don’t necessarily mean “bad carbs” I mean even starchy vegetables, etc. There are some great PCOS resources out there for eating specifically for that disorder. Hoping you can find a plan or doctor who understands and can better help and treat you. I know the frustration it causes.

[SoCalEm 40]

Hello! I have KP also, but I'm in the So Cal region. I am unfamiliar with PCOS, but I was referred to the Options program by a PCP I happened to see for something else. Did you go through the 10 week program with the classes and receive the guidebook? If not, you must do it. I was on the fence about surgery but learned SO much and am now convinced it's the right choice for me.

While a physician's opinions and recommendations are important, I feel we have to be our own advocate and show up for ourselves. My advice is to dig deep and be honest with yourself, and if you are ready to take this step, I'd seek another opinion. Just because this surgeon isn't encouraging doesn't mean you should call it quits.

[Elidh 188]

Wow, if you’re able to see another surgeon, I sure would.

[Jaelzion 1,090]

2 hours ago, Tony B - NJ said:

With a BMI of 36, I think you could probably do it on your own....atleast give it a shot.

I'm guessing Namiland has given it many shots over the years. Losing weight is not the problem. Most of us have lost hundreds of pounds, even before surgery. The problem is, we've gained them back, with more besides. At some point, it became clear that the long term answer was not "one more diet". A lot of insurance programs require a BMI of at least 35, or 30 with comorbidities, and Namiland has already been approved. So Namiland, surgery is a big step, you should carefully evaluate whether you're ready to make the commitment it requires. And if you are, I say go for it. And find another surgeon.

[Luna Girl 285]

4 hours ago, Tony B - NJ said:

With a BMI of 36, I think you could probably do it on your own....atleast give it a shot. That BMI is probably too high for your insurance to cover the surgery anyway so unless you are a self pay, it may be tough getting approved. Why not try the 800-1000 calorie diet along with increased exercise and see it it works.

My BMI was 36 and my insurance covered the surgery. After years of yo-yo dieting and being miserable, I opted for surgery and am so happy I did.

Namiland - I suggest you get another doctor's opinion. There are many supportive, encouraging and caring drs out there. The arrogant ones you can do without! Good Luck!

[E-mom 7]

The definition of insanity is doing the same thing over and over again and expecting different results. That's why I decided to go for the surgery. Each time I regained, my all time high weight increased a few pounds more. It is time to break the cycle.

[Namiland 6]

I want to thank you all for the encouragement!

Sadly, in my area, we only have 2 doctors within the Kaiser network and the other one is booked up. I checked yesterday. So, I'm kinda stuck with this guy. He hasn't turned me down for the surgery. I'm still moving on to the next step.

21 hours ago, Jaelzion said:

I'm guessing Namiland has given it many shots over the years. Losing weight is not the problem. Most of us have lost hundreds of pounds, even before surgery. The problem is, we've gained them back, with more besides. At some point, it became clear that the long term answer was not "one more diet". A lot of insurance programs require a BMI of at least 35, or 30 with comorbidities, and Namiland has already been approved. So Namiland, surgery is a big step, you should carefully evaluate whether you're ready to make the commitment it requires. And if you are, I say go for it. And find another surgeon.

You're absolutely right. I've been waiting for this opportunity for years now. During the orientation for surgery that Kaiser does, I felt ready for the changes and the things I'd have to do for the rest of my life. Today, I KNOW I'm ready and I refuse to let the doctor make me feel bad again.

[blackcatsandbaddecisions 718]

So I have a lot of experience with surgeons because of my career, and honestly some of them are just that way. If you don’t have an option to change surgeons I’d just move on and tell him you’re sure you want the surgery (if that’s the case) and use the forums as much as possible for your support.

The surgeon will supply you with the tool- it’s up to you to use it appropriately. If you believe in yourself and know that you’ll make the commitment and do what it takes to utilize your surgery then he can think whatever he wants.

[ShoppGirl 2,046]

I had a BMI of 35 and don’t even have PCOS and I had the surgery. I tried every diet out there and nothing worked until surgery. I say get a second opinion. Edited to add I just realized you can’t get a second opinion but I’m glad he didn’t turn you down. I agree with others. Just ignore what he says and get the surgery. Chances are post surgery you will See a nurse practitioner anyways so

hopefully they will have an entirely different attitude. If not, seek out support elsewhere. Whether it’s support groups, a bariatric therapist, or just hanging out on here A lot there is support elsewhere.

Edited November 3, 2021 by ShoppGirl

[vikingbeast 950]

I will say that I have multiple friends with diagnosed PCOS that have had WLS (two sleeves, one RNY) and they can't believe they didn't do it sooner.

But just a reminder that a sleeve is a TOOL. It basically gives you some time to figure out how to reevaluate how and what you eat, and develop not only a new way of eating, but to make it an ingrained habit. So basically your choices are diet + exercise, or diet + exercise with tool. And it sounds like you've already tried diet + exercise.