Now ye're talking - to someone who's had weightloss surgery

I've had weightloss surgery, AMA wrote: »

Thanks wanderer78, you are right, it has to be addressed in multiple ways. There is no point having surgery if you have underlying psychological needs that have not been considered. Education is important for parents and children, but also for healthcare staff as we are not all experts by any means and sometimes we unwittingly give poor information. Advertising is important too as that affects our choices. Employers could do better also, providing lunch and snack options that encourage moderation and good nutrition.

...ive always loved Chomsky's take on advertisement, 'its claims to inform us so we can make rational choices, but it in fact does the opposite, i.e. 'it misinforms us, and we make irrational choices from this misinformation'. thank you, and best of luck

I've had weightloss surgery, AMA wrote: »

Hello, yes that is an important part of the pre-op assessment. You have to show that you have tried diet, exercise, lifestyle changes and that they have failed. You also see a psychologist or psychiatrist who goes through any other issues which may affect your weight.

I spent about 20 years trying to control my weight with varying success. I mistakenly thought that it was about willpower and self-discipline and that if I was putting on weight it was my own fault. When I met the obesity consultants and dietitians they explained that willpower can help you lose a couple of kilos but that for obese people it is a physical disease that requires treatment. Like asthma or arthritis. It took me a long time to accept what they were saying - I was in denial and I thought I knew better than the experts!

I realised that I had never in my life really understood what it meant to feel satisfied after a meal unless I was uncomfortably full. That was a revelation to me. The consultants explained that obesity affects the brain's appetite control centres and so even if I tried my hardest my brain would always override my desire to diet and make food irresistible. I am simplifying it a bit here but that is the general gist.

I am ashamed to say that I bought into the idea that if people were fat they were to blame and that they (and I) were just too lazy. Having this operation and losing weight has made me realise I needed to change my attitude to overweight people and be kinder.

Genuine question, is that not just a cop-out though, that implies the law of thermodynamics is incorrect.

A calorie is a unit of energy, if you consume fewer calories than your body needs to function you will lose weight no matter what.

I accept people can have thyroid issues etc. but that would account for a very small portion of people that are obese/overweight I would imagine.

Its also down to food choices, you said you are never full and another posted said it as well. Its possible to make a salad with chicken that is under 600 calories and would weigh over 2 lbs, it would be so much food you literally would physically not be able to finish it. I think a lot of it is lazy food choices tbh

Goose81 wrote: »

Genuine question, is that not just a cop-out though, that implies the law of thermodynamics is incorrect.

I don't think anyone disputes that overweight people will lose weight if they restrict intake long term.
The issue seems to be how realistic this is to achieve.

For very many people it appears that long term obesity brings about such physical and mental changes that their continuing obesity becomes primarily driven by a physical food addiction, not very different to physical addiction to alcohol or other drugs.

The difference is that you can't give up food cold turkey long term for obvious reasons, which makes relapse into destructive eating habits all the more likely.

With regard to the "clear your plate" advice, it was sound at a time when food was scarce, many children were effectively malnourished and sugar intake was probably 5% of what it is today.
It's unfortunate that it's no longer valid but it was for all time up until 30-40 years ago perhaps.

air wrote: »

I don't think anyone disputes that overweight people will lose weight if they restrict intake long term.
The issue seems to be how realistic this is to achieve.

For very many people it appears that long term obesity brings about such physical and mental changes that their continuing obesity becomes primarily driven by a physical food addiction, not very different to physical addiction to alcohol or other drugs.

The difference is that you can't give up food cold turkey long term for obvious reasons, which makes relapse into destructive eating habits all the more likely.

With regard to the "clear your plate" advice, it was sound at a time when food was scarce, many children were effectively malnourished and sugar intake was probably 5% of what it is today.
It's unfortunate that it's no longer valid but it was for all time up until 30-40 years ago perhaps.

Agree with what you are saying but then does there need to be a new terminology.

Maybe as obese is a person who through lack of excercise, will power and a poor diet has made themselves obese.

And then another band who are referred to as food addicts, who show the same symptoms and causes but are literally addicted to eating?

Goose81 wrote: »

Agree with what you are saying but then does there need to be a new terminology.

Maybe as obese is a person who through lack of exercise, will power and a poor diet has made themselves obese.

And then another band who are referred to as food addicts, who show the same symptoms and causes but are literally addicted to eating?

I think the point you're missing is that these are the same people.

How someone got obese doesn't change the fact that most stay that way because their body and brain suffer permanent damage as a result of being obese long term.

Food addiction is one of many issues that this damage can cause and is a major barrier to returning to (and maintaining) a normal weight.

I think a key take away from this is that it would be wise to encourage those who are just somewhat overweight or perhaps approaching obesity to reverse that while it's still achievable without serious medical intervention.

I've had weightloss surgery, AMA wrote: »

Yes, the criteria at the time were

• BMI >40 or
  
• BMI >35 with a medical condition (such as diabetes or high blood pressure)

This was several years ago so it may have changed since.

Ultimately it is one of the best investments a health system can make as the cost of someone being obese is huge in the long term and the cost of the surgery is peanuts in comparison.

Thanks!!

I hear the docs can try talk you out of the surgery, make people out to be liars (in so far as having tried to lose weight) and that you need to really convince these places of your need for surgery.

Was this your experience? Did you have to convince the doctors to accept you?

funky sausage wrote: »

hi,

oh my god how do you start this conversation with your GP??

I lost six stone on a strictly paleo diet with thirty minutes boxing and skipping every day. I was 41.

Now 50 i have put 8 stone back on, I hate my self, I can't do any exercise without falling to pieces. I don't eat with my family as I'm embarrassed. Can't go for walks around the village as I'm too self conscious. Avoiding work as I can't get suitable clothes to fit.

So, living on cereal, drinking to excess once the wife and kids are in bed, to feel anything pleasant, and then binge eating whatever is in the house, hiding the packets, replacing them the day after.

I've done everything, ww, paleo, keto, sw, omad, the bloody drinks, thermoburners…

I'm not lazy, ran a few 5k's a while ago, was meeting 10,000 steps, but I'm so stuck in this.

How did you broach this with your gp, I see you've already answered this before but I'm asking again so I can pick up the phone and repeat.

Thanks in advance.

Would you beat yourself if your body's system for regulating iron levels, LDL or whatever was broken? At the weights you are talking about and your diet history your system for regulating bodyfat is set at a high point.

It's a system regulated by a host of hormones and the hypothalamus.

For someone like me, 46 and lean it has always worked. It is effortless to remain lean and without purposely adding lots and lots of junk food to diet it would be difficult for me to gain a lot of weight. If I stopped the junk it would fall of and I'd return to my set weight.

My body defends that fat level in the same way your body defends yours. Your "fat level" is just set higher.

Rationally you know how to lose weight the problem is the decisions to eat are almost entirely driven by the subconscious mind; a mind which never shuts the fcuk up. When you lose say 10kg, that subconscious mind prompted by lower leptin levels, higher ghrelin levels etc will do everything it can to make you less energetic, colder (conserve energy out) and drive behaviors which make you likely to increase energy in (thought of chips, ice cream etc etc) and they will taste better as food reward circuitry is ramped also.

Don't beat yourself over something you have very little control over. Its obviously way harder for you as extra weight is so visible while my dysfunctions are completely hidden and people don't know, won't judge me or make comments about them.

You probably have two choices
*do what OP did
*lose a little weight; no more than 10% of current mass and try and stay there and learn to be happy in your own skin.

This subject is something that has interested me since I was a child. I grew up in a house with a mother never happy with her weight (always dieting, working and walking) and a father who never gave his weight or diet a thought, had an enormous appetite and was effortlessly lean.

If you listen to Dr Donal O'Shea he says as much in relation to most his morbidly obese patients.

Best of luck

P.S sorry for going off topic