Advice for VSG, dispelling anxiety and fear, pre-op

[kotopolish 3]

Hi y'all,

I am new to this forum and just want to first acknowledge and commend the courage and strength y'all have in utilizing this fortunate tool in your journey to a healthier life.

I am at a crossroads. I am a 6'2", 275lb, 39-year-old man with VSG scheduled for Jan. 16, 2025, and I am having serious doubts--some caused by my health practitioners (chiropractor and non-WSL-related psychiatrist). I am on five different maintenance pills for blood pressure and cholesterol. My highest weight was 330lb. I lost 50 lbs in 2022 for a wedding, gained 30 in 2023 and lost 25 lbs from October 31st, 2024 until now (extreme crash diet). The total down is 55.

My ideal weight is 210-225, provided that weight encompasses an active lifestyle and dedicated weight training.

Here is the rub: I am scared of the surgery, and that fear has really kicked my butt to get healthy. My liver no longer shows NAFLD or alcohol damage with enzymes in the normal range. That is surprising because I was (honestly) an incredible "alcoholic" from 2013-2023. It may be hubris, but I am in no way concerned about addiction transfer as I have fully recovered from alcoholism following a Wegovy and booze and supplement mix that caused acute pancreatitis. Blood pressure and cholesterol are under control. sleep apnea sucks. Mental health is good to great. Banned currently from GLP-1 ( aforementioned acute pancreatitis). I have kicked all the typical vices.

Despite all that, I am cleared for surgery, and the surgeon thinks I am an ideal candidate because of the lower risk of chronic pancreatitis following the knife. My surgeon is located in America, and my insurance is on board. Meanwhile, I have had little trouble maintaining a 1600- to 1000-calorie fat-burning diet, especially since a surgery date made it a very, very real concept.

My primary motivation for pursuing VSG was for my family and my 2-year-old daughter, coupled with a debilitating (but now manageable) back injury that left me sedentary for nearly 2 years, and, of course, to address my comorbidities. Now that my back is "okay," I can exercise 3 to 5 times weekly. But if I don't lose weight, spinal degradation and likely further stenosis around the sciatic nerve will continue.

I was supposed to have surgery earlier in the Spring of 2024 but bailed because of a month-long family holiday to Asia and then a summer of the in-laws staying with us. Also, we are trying to get pregnant again, but my wife's self-imposed window is closing as she soon turns 40.

So, what do I do? Given that my ideal weight is approximately 65 lbs away, would you pursue VSG? Would you delay it while trying to conceive (this is a big one)? Am I getting stuck on too many variables? Would VSG make global travel a different experience? Or do I buckle up and charge ahead? Should I try giving the "natural" way a shot for one more year?

I have unflinching support from my family and parents to go for it, and I have little doubt that I would excel in a post-op life. But I am worried about travel, a change in taste, and, generally, pain. Pain makes me an unpleasant person at times. But I dread ballooning up to qualify for insurance if the "natural" way fails my goals.

None of this was a concern until a surgery date made it real.

I appreciate you reading this and thank you in advance for any comments, long or short.

A simple "Go" or "No Go" would be appreciated. I am actively planning for the surgery and, regardless, look forward to the two-week pre-op diet challenge. However, I could see myself bailing like two days before.

Digital prayers for all!

Is anybody ever too young for a midlife crisis?

Edited December 15, 2024 by kotopolish

[NickelChip 1,300]

Personally? Yes, I would have the surgery. Why? Because losing weight is only half the battle. Obesity is a disease. The vast majority of people will gain back all the weight they lose through diet and exercise alone within 5 years. Weight loss surgery changes your metabolism so that it works with you instead of against you. I knew from too many attempts to lose in the past that I would not be one of the lucky ones to lose and maintain on my own. Every time I lost weight, I gained it back, plus a few pounds.

To address a few of your fears, I can say from my experience that my pain lasted about 5 days. I never took anything stronger than Tylenol once I was discharged from the hospital. My tastes have changed in that I now find certain foods are less pleasant to eat. More than a small piece of bread gives me an unpleasant heavy feeling in my belly. Very fatty foods will make my heart race a bit so I avoid them. Certain sweets like cake frosting and cheaper milk chocolates seem much too sweet and I don't want more than a bite or two.

The adjustment period in terms of learning what you can eat lasts about 3 months, at least it did for me. Even after the first month, I was able to eat in restaurants. I just chose to split a meal with a companion and stuck with simply prepared items like a grilled chicken salad. I've gone on road trips, spent a few weeks away from home in hotels, and did just fine. I eat mostly healthy foods, I don't count calories, I get reasonable exercise but don't go out of my way for it. And at 50 years old and not quite 10 months out from surgery, after a lifetime of struggling with my weight, I am back to the size I was my first year of college and still slowly losing. I would do it again in a heartbeat.

[Arabesque 7,401]

Only you know the answer as you have to be ready, mentally, physically and emotionally, for the surgery and the changes you will have to make to be successful with the surgery in the long term.

I was healthy, no comorbidities at all yet I knew at my weight and age (almost 54) the chance of them developing was very high. I also knew I could lose weight myself as I had many, many times before (though it’s much harder as a menopausal woman) but I also knew I could put it all back on again which I always did. The decision was easy. Woke up one morning and said enough. Made an appointment with my GP and 6 weeks later I had my surgery (no or very few hoops to jump through in Australia if you meet the criteria).

Yes, the first couple of months aren’t easy: restricted diet, temporarily changed tastebuds and interesting discussions with yourself around food, eating, hunger, etc. (the head work we talk about begins). Pain was gone after 4 days though if you have surgical gas pain it can linger a week or so.

You’ll discover and decide how & what you want to eat in the long term to maintain and that may be different from others. It’s all about what works for you & your lifestyle. Many people still eat ‘unhealthy’ food but it’s all about the portion they eat and how often they eat it. Everyone travels & then it often comes down to making the best choices you can and not beating yourself up if you do indulge while away. I just came back from a short girls trip and ate an obscene amount of cheese & drank more than I usually do. I’m okay about it and got back on my usual path when I got home.

Like @NickelChip there are things I avoid. bread, rice, Pasta sits heavily in my tummy too. Foods can be super sweet so I generally avoid sweet things (I do indulge at odd times like at Christmas). I don’t find it hard to avoid or reduce my intake of those foods I struggle to eat or choose not to eat rarely. I don’t want to waste the opportunity I’ve been given.

And yes, I’d do it again in a heart beat.

All the best whatever you choose to do.

[kotopolish 3]

@NickelChip

&

@Arabesque

Thank you both for taking the time to respond. I am sure this is common, but trying to rationalize a way out when I have been so pumped for so much longer than being nervous is annoying, to say the least. Important and reassuring points you both made! I need my metabolism on my side, and it would be a mistake to pass up what is likely one of the most positive and important health decisions I will ever make. I need to stay focused on starting 2025 out with a bang!

[Bypass2Freedom 831]

What you are experiencing are very normal worries - I think we all would have had some form of concern or anxiety leading up to the surgery!

Just my personal experience, I started talking about surgery YEARS before I even booked a consultation with a surgeon. I am talking like 3 years worth of "umming" about whether or not I should go for it, and subsequently talking myself out of it. I would berate myself saying that I should be able to do it the natural way, I should be strong enough and surgery is risky etc, but I think I was just making excuses for myself really! I'd tried to lose weight since I was a teenager to no avail, and I honestly wish I had just had the surgery sooner!

It was my first operation as an adult, so I was definitely scared of the pain and of the whole experience itself but honestly, it was all manageable and it didn't last long!

You'd be so surprised how quickly you get used to your new way of living - and genuinely this forum has been an amazing place to just not feel so alone in your experiences.

So, ultimately, think about the pros and cons for each potential decision and make sure it is the right one for you. You've got this!

[FifiLux 493]

I was the opposite in a way, I blindly went into the operation having being told the standard bit about possible complications but was confident in the team and was excited to start a new life so didn't over think it it all. Then suffered severe post op complications, spending months in hospital and having numerous procedures and only finished treatments 10 months after original op date BUT all of that said if your medical team are happy you are a suitable candidate I think it is worth it.

You have done good work already to get to where you are and you sound like you could reach the 65lb loss yourself over time but the surgery would be a boost to that and if you work with the tool correctly over the years you should be able to maintain. That is how I looked at it, I had no problem being strict and loosing weight but it would just go back on and I would be on a yo-yo cycle. Plus who is to say what will be in a year, maybe your surgical team will change and you have to start the process again, maybe insurance coverage changes.....

Travel wise I haven't had any issues, been to the US and other EU countries in the last few months and usually been able to find something suitable to eat though I always carry a few Protein Bars and powdered Protein coffee with me just to be sure I meet my goals. A bonus on the travel is that I now fit comfortably in my plane seats and can do a little sprint through the airports if running late

With regards to waiting for your wife to conceive, not sure about that one but recovery time is only a few weeks for 'strenuous' activities and wouldn't it be great to be over the surgery and well on the road to a fitter healthier you when she becomes pregnant so you can help her out more?