What to do, am in a very difficult situation with my weight and options

[Angieee 6]

Here we go, currently 35 F. Since I was 21 I have seen an endocrinologist for what seemed like an unknown hormone disorder. They didn't diagnosis with anything but monitored me for years. I had severe cystic acne, Hidrianitus suppurativa hirsutism and I struggled with my weight (always). My weight was not that much of a problem at the time (I was 160, 5'7) but I felt like I was heavier than I should be for what I ate. I was not diagnosed with PCOS because I had regular periods and normal test results. But the doctor told me he wanted to continue to see me.

Years later in 2022 my weight skyrocketed to 230 pounds in about a 18 month period. It was shocking, never have I been that heavy. It was awful. I didn't change me diet. The sent me to a nutritionist but I didn't lose weight. It was like weight-loss was impossible. The endocrinologist has no answers and I got a second opinion. Again no answers.

Then in 2024 I was the same weight but my asthma was becoming incredibly severe. My lung function was down to 70 present and I was frequently hospitalized last year. They told me my weight was worsening my asthma. I told them I couldn't lose weight. I got desperate and from June to November I ate 400 calories a day and only drank Water. I lost 30 pounds. I had no choice but to do this. It was crazy, it was dangerous and I passed out twice but I had no choice. I was dying anyway.

By December I started upping my calories to 700 and by January I was eating 1200 calories. My lung function improved to 86 percent and my asthma was suddenly improving based on test results.

The troubling thing recently is in the last two months I've regained 11 pounds. I'm only eating what my nutritionist recommends.

I'm now at the point of wondering if Gastric Bypass is for me. I clearly can not lose weight easily on my own, worsening obesity makes me sicker. The weigh comes back far too quickly.

Would this be the right decision for me?

[SpartanMaker 1,273]

1 hour ago, Angieee said:

Would this be the right decision for me?

At the end of the day, no one here can tell you if it's right for you. Keep in mind that obesity is a disease and it definitely needs a treatment plan, just like your other conditions. The right treatment for any given person varies based on a lot of factors, so don't automatically decide yourself what the right treatment should be. The best thing for you to do is seek out a GOOD bariatric center that has lots of options available to you and not just surgery.

Personally, my gut tells me that it's too soon to go this route since obesity is such a recent issue for you. I'm not a doctor, and certainly not a bariatric surgeon, but just thinking through how recent this obesity disease is for you, I personally would want to try some more conservative treatments first?

[WendyJane 49]

I differ from what SpartanMaker says, I wouldn't try any more of the options that are out there. Obviously you first need to recognize that obesity is a disease and it never goes away. You tried to starve yourself to death and the body will automatically save every morsel you put into your body and store it as fat, especially on a 300 calorie diet. Increasing the calories is not necessarily the fix either, you need to look at the foods you are eating. Is it Protein heavy or are you still eating salads, which are carbs by the way? Are you thinking that a baked potato is a veggie, it is not it is a carbohydrate, then add all the stuff you put on the potato. Diet wise, you may be choosing the wrong foods. And certainly the amount. You passed out probably because your glucose levels went into the basement with such a low calorie intake.

I agree with SpartanMaker, and seek out a Bariatric center that has a whole host of options. Surgery is a tool that the obese person uses and it is a life long commitment to make lifestyle changes. You may need to see a therapist and nutrition expert both to help you, and maybe they have other options other than going straight to surgery, but for certain I feel you need better education on what is an appropriate "diet", and not all "diets" are really diets but ways to spend more money that is just wasted. You obviously have the willpower and stamina to take hold of a new life, it won't hurt to inquire. I would also urge you to watch some of the YouTube videos from BariNation, they have Podcasts with bariatric physicians and other healthcare providers every week and most recently there was discussion about Obesity being a disease and using something other than weight or BMI (Body Mass Index) to determine if someone is obese.

My plan has always been to go the cautious or conservative route first. In my case I jumped right in and happy for it. I had an excellent surgeon and team that all worked together to ensure I had a good experience and did. Never had any pain with my surgery, and have had good results so far and today is Post op week 3, day 1.

I wish you the best in your journey to seek out further information and a good bariatric group!!

[summerseeker 2,361]

If you opted for the surgery - you would loose weight for sure. BUT once at target you would still need to increase your calorie levels to a maintenance amount. Without much exercise my maintenance level is around 1500 - 1600 cals a day. To eat more I would need to increase my exercise drastically or I would gain.

So when you maintain on similar calories, you will gain if what you say is true. If that is so, baritric surgery is not a fix for you.

[SpartanMaker 1,273]

For clarity, I purposefully chose not to go down the rabbit hole of discussing diet since you mentioned being under the care of a "nutritionist". (I hope by that you mean an RDN "Registered Dietitian Nutritionist".) None of us here are qualified to promote one way of eating over any other, especially when you have multiple disease states you're dealing with.

Let me explain. I'm currently working to become a certified sports nutritionist, and one of the most important things that was drilled into me early on was that I needed to stay within my practice guidelines. This means ONLY physicians and RDs can develop a diet for the treatment of specific medical conditions. If you want to know how to maximize your diet for athletic endeavors, I can help. If you need a diet to help with managing or treating a medical disease, I'm woefully underprepared and will always advise seeking out an RD or RDN. The reality is that dietary options abound, but medical conditions greatly impact not only what your dietary needs are, but also how you respond to various dietary options and even what's potentially safe (or not), for you to eat.

[Angieee 6]

2 hours ago, SpartanMaker said:

At the end of the day, no one here can tell you if it's right for you. Keep in mind that obesity is a disease and it definitely needs a treatment plan, just like your other conditions. The right treatment for any given person varies based on a lot of factors, so don't automatically decide yourself what the right treatment should be. The best thing for you to do is seek out a GOOD bariatric center that has lots of options available to you and not just surgery.

Personally, my gut tells me that it's too soon to go this route since obesity is such a recent issue for you. I'm not a doctor, and certainly not a bariatric surgeon, but just thinking through how recent this obesity disease is for you, I personally would want to try some more conservative treatments first?

I should say it's not such a recent issue. I was borderline obese by 2016 weighing 186 pounds (I should have mentioned that).

But by 2022 I gained almost 45 pounds in a year out of nowhere. Before that the weight issues was more creeping up on me

It went something like this:

I was 150 pounds at 18 years old. By 21 I was 160. By 25 I was 180. You get the picture. Something like ten pounds d year gained no matter what. But then at 32 and battling COVID my weight exploded and it wouldn't come off. Nearly a 50 pound gain. I had long COVID and couldn't exercise for five months but didn't eat any different but the damage was done. That weight wasn't coming off for nothing even after I recovered. And it worsened my asthma horrendously. Just the COVID but gaining so much weight.

That's why I had no choice but to starve.

Edited Monday at 03:46 PM by Angieee

[SpartanMaker 1,273]

19 minutes ago, Angieee said:

I should say it's not such a recent issue. I was borderline obese by 2016 weighing 186 pounds (I should have mentioned that).

But by 2022 I gained almost 45 pounds in a year out of nowhere. Before that the weight issues was more creeping up on me

It went something like this:

I was 150 pounds at 18 years old. By 21 I was 160. By 25 I was 180. You get the picture. Something like ten pounds d year gained no matter what. But then at 32 and battling COVID my weight exploded and it wouldn't come off. Nearly a 50 pound gain. I had long COVID and couldn't exercise for five months but didn't eat any different but the damage was done. That weight wasn't coming off for nothing even after I recovered. And it worsened my asthma horrendously. Just the COVID but gaining so much weight.

That's why I had no choice but to starve.

Thanks for clarifying. This may become important if you do go down the surgical route. You didn't say where you live, or what it might look like in terms of paying for surgery, but this may also play a role in your decision-making. What I mean is that if you're in the US, whether or not your insurance plan covers weight loss surgery is an important thing to note. Almost all insurance plans that cover surgery also require some prerequisites that may include a history of previous weight loss interventions. Of course if you're not in the US or you don't have coverage with your insurance plan, then YMMV.

@summerseeker makes an important point for you to consider as well. ALL medical and non-medical interventions for weight loss work by reducing calorie intake (for the record, I'm including malabsorption in that bucket since it also reduces the number of calories you functionally have available for your body.) Whether it's surgery, pharmaceuticals, or specific dietary plans, they all work by creating a negative energy balance.

With that in mind, it's not so much which is "best" for everyone since they all can work, it's about which is best for you individually to safely lose the weight and keep it off long term.

Edited Monday at 04:02 PM by SpartanMaker

[Angieee 6]

40 minutes ago, SpartanMaker said:

Thanks for clarifying. This may become important if you do go down the surgical route. You didn't say where you live, or what it might look like in terms of paying for surgery, but this may also play a role in your decision-making. What I mean is that if you're in the US, whether or not your insurance plan covers weight loss surgery is an important thing to note. Almost all insurance plans that cover surgery also require some prerequisites that may include a history of previous weight loss interventions. Of course if you're not in the US or you don't have coverage with your insurance plan, then YMMV.

@summerseeker makes an important point for you to consider as well. ALL medical and non-medical interventions for weight loss work by reducing calorie intake (for the record, I'm including malabsorption in that bucket since it also reduces the number of calories you functionally have available for your body.) Whether it's surgery, pharmaceuticals, or specific dietary plans, they all work by creating a negative energy balance.

With that in mind, it's not so much which is "best" for everyone since they all can work, it's about which is best for you individually to safely lose the weight and keep it off long term.

Not from the U.S. I'm from Canada. I might meet the criteria given my co-morbid factors but here they generally do it on a BMI greater than 35. I am currently trying to get a referral to a bariatric center.

[ms.sss 15,809]

1 hour ago, Angieee said:

Not from the U.S. I'm from Canada. I might meet the criteria given my co-morbid factors but here they generally do it on a BMI greater than 35. I am currently trying to get a referral to a bariatric center.

hiya! fellow Canadian here!

yes, either BMI 35 + 2 co-mobiditory factors, or BMI of 40 will qualify you for provincially covered WLS. Also depending on your province residency, the wait times vary greatly i hear. I'm from Ontario, and there was a "waiting list" of about 8 months from referral to surgery, back when i had it done (2018).

good luck! ❤️