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

I've had weightloss surgery, AMA · 19-05-2021 2:21pm

cloudatlas wrote: »

It's strange to see something that is a compulsion being described as a disease.

A compulsion can be a disease. We are conditioned by society to separate mental health from physical health but when we are sad our eyes produce tears and when we are nervous we sweat or feel nausea. The brain is part of the body, so if it contributes to obesity that doesn't make it less of a disease.

There is no denying that obesity has serious effects on health. The causes of obesity vary from one person to the next and the reason is rarely (if ever) a lack of willpower. That is a myth that we have all bought into without examining the evidence.

It is also a myth that we always need to treat problems in the brain through therapy or some other non-medical method. Some people need anti-depressants and it changes their lives. Some people get dementia and the anti-dementia drugs help them to live much better lives. Bariatric surgery may be done on the stomach but the evidence is that it causes a reset in the hunger centres of the brain, so it is doing much more than changing the physical act of eating.

There is a tipping point when someone goes from overweight to obese. Physical activity becomes more difficult, muscle mass decreases, and then you have the background natural changes that affect our metabolism as we age - for example, it is much more difficulty to build and maintain muscle in our 50s than in our 30s. Muscle mass is key as muscle burns more calories so if you are more muscular you can eat more.

A friend of mine who has always been slim made some really good points about this when I asked her opinion on the surgery. She said it is so hard for average weight people to lose even 1 or 2kg. Why? Surely people should just be able to eat a bit less? The answer is that our brains and our various endocrine (hormone) systems decide for us whether we are hungry and whether we are the right weight. If people are a little bit overweight, losing the few kilos can be hard - if people are obese then it can be almost impossible by "willpower" alone.

If we try to cut calories, our bodies can ramp up the hunger signal until we are overwhelmed and give in. For some people, that system is perfectly balanced and they have a modest appetite that they can easily control. For others, the system is off kilter and even when they eat an adequate amount their brain and body insist that they are still hungry.

If I break my hip, I will not just be able to overcome the pain by willpower alone. I will need painkillers and an operation to fix it. When I was obese, it was taking a huge amount of my mental energy to eat less and I was frazzled by all of the other things life required of me. The surgery removed a huge amount of that mental strain and can now focus better on family, work, etc. It also allowed me to exercise more, so I now have more muscle mass to burn off calories and help me to control my weight.

I've had weightloss surgery, AMA · 19-05-2021 2:36pm

Deleted User wrote: »

10-15 years ago it may have been, but studies have come on a bit since then.

For what it's worth, I've a higher BMI than the AMA guest, and although I don't think I wholly subscribe to the "it's all a disease and beyond your control" approach, I do understand and agree with a lot of the argument in favour of that.

For me personally, and this is where I'd like to put a question towards the AMA guest, I would characterise myself as having a sugar addiction of sorts, coupled with an ability to never feel full.

I can sit down to a massive takeaway, and although it may start to be uncomfortable, I will manage to eat it all, or of i do have to stop, within 15 minutes, I'll be back eating the remainder again.

I'd often have been in restaurants with people, and we'd order similar/same things, and everyone else would be busted after the dinner, some not finishing, whereas I'd be thinking "will i look bad if i get two desserts.. pretending i want to just see what they're like".

I've an insatiable appetite.

Did you, AMA Guest, have any of these issues at all? From reading your posts here, and I'm not trying to be a smartass or anything, it seems like you didn't really eat all that much (you mention going 24hours without food, and then the food you mention is mashed spuds and stuff, which on the surface of it, doesn't sound like the kinda diet that would leave you overweight, unless the portions were just huge?)

Also, I've lost significant weight before (for short periods), and gained it back (and more). Have you been through these cycles much, and did the people you were talking to about the surgery comment at all on these things?

Also, you mention loose skin not being a big issue - can I ask what weight/height you were, and your age? From looking online, joining facebook groups, etc. it seems a lot of the people that eventually cave and go for the surgery are nearing 50 by the time they've done it, and they get a bit of loose skin.

I've come to the conclusion that the younger you are, the more chance you have of not being afflicted with the loose skin issues, would you agree with this?

(I'm also considering Sleeve surgery, but I've been thinking about it for 12 months now and still haven't done a thing!)

I have had the same experiences as you. I always left restaurants feeling like a pig for eating so much and yet I was hungry again a short while later. It is only since the surgery that I actually know what people mean when they say "No thanks I have had enough" without being full to the point of discomfort. For example, yesterday I had half a sandwich and that felt enough. It is still a bit weird when I look at the plate and I just wrap the rest up for later on. A few years ago I would just have eaten it.

I wasn't going 24 hours without eating by choice, that was because work was so busy we didn't get breaks. When I had time off I was constantly eating.

I had lost large amounts of weight before but I always gained it back. I went through that cycle many times and that is the typical pattern for obesity - my body pushed me back to that higher weight and then I would plateau.

The obesity team went through all that with me and we discussed in detail the reasons for this and the risk of weight gain in the future. I check in with them every year to ensure I am on track and can see them more frequently if I need to.

The extent of loose skin depends on many factors, including age, gender, BMI, genetics, etc. I have plenty of loose skin but I just don't care very much. It would probably bother others but I'm not a naturist and anyway I think I look much better in the nip now than when I was bigger. To be honest it's a nice reminder of the success of the surgery and how much better off I am.

Everyone is different but for me I realised that the longer I left the surgery the fewer the benefits. Every year I was overweight meant more damage to my heart, kidneys, etc.

I've had weightloss surgery, AMA · 19-05-2021 2:43pm

FGR wrote: »

Well done OP! That took strength and courage especially as a Doctor knowing the risk involved in surgery. It's no easy feat and appreciate you taking the time to answer questions.

May I ask if you were always overweight or did the urge to eat come as you got older?

Also - can this option be available for someone in their 40s or 50s?

Thanks again.

Thank you, it was the hardest personal choice I ever had to make. I asked a lot of opinions and advice, I was really trying to convince myself I didn't need it! One of the shocking moments for me was when I was at a talk and a colleague mentioned someone younger than me with a lower BMI having had the operation. I knew I was fat but I had never really considered myself obese before.

I was overweight my whole life but it was hidden by my frame and muscle mass. I always ate more than I should but I could get away with it in my 20s and maybe early 30s.

I was almost 40 when I had it done and I was towards the younger end, so certainly people in their 50s and older can be suitable.

I've had weightloss surgery, AMA · 19-05-2021 3:05pm

greenbicycle wrote: »

You have definitely made me think while reading your answers, thank you!

One thing I wonder though, you have had to change your diet significantly, you have changed the types of food you eat, the quantities and the frequency, and for that reason you have lost weight. Is it purely the side effects of not eating like that, that have forced you to change. As in, post op, you tried to eat a bag of chips but you felt sick if you did so, so you trained yourself to not do that. Is that an accurate summary?

I wonder is it a case of needing something that just means you have no option but to eat correctly. It is the ultimate form of motivation when all else fails.

Like others, I'd love to know your stats too like age, height and weight and the process of getting surgery done. would also love to know if you have amazing health insurance or is it just a standard kind of plan.

I very rarely drink soft drinks but when i do, it is a treat I enjoy, do you have things you miss?

I very rarely drink alcohol but admittedly I am probably a binge drinker so I wouldn't drink all year but if I went out two or three times a year I would have a good few drinks and enjoy myself, would nights like that be totally out for you now?

I suppose, ultimately I am asking, do you have any regrets at all?

No regrets, except maybe not making the decision sooner.

I was in denial that I was obese. I had fooled myself into thinking that I was some sort of superhuman who could lose weight and keep it off by dint of effort, as if I was somehow so different to everyone else who had tried the same and failed.

The surgery has a mechanical effect and a hormonal effect. It restricts my intake so I get full with less food. I didn't really have to train myself to stop eating but I did have to learn which foods were best to start eating (protein first) and to chew everything well. My taste in food changed, so I don't have the same cravings. I still eat chips and enjoy them just as much but I eat 5 or 6 instead of a whole bag.

My health insurance is something below VHI Plan B, middle of the road, costs about €100 a month. I was in a room with other patients, so not the full private experience. I think many of the insurance plans cover it but you do have to check with them beforehand.

I don't want to give too many descriptive details so that I can remain anonymous and give honest answers. I would just say I was around 40 at the time of surgery and had a BMI of over 40. Average in every other respect...!

Bingeing of any kind is out, whether food or soft drinks or alcohol. They go through that with you beforehand to make sure that you are safe for surgery. There is nothing off limits though, it is just about quantity. So I would have occasional coca cola, ice cream, and so on.

I've had weightloss surgery, AMA · 19-05-2021 3:12pm

SimonTemplar wrote: »

I think that is fairly out of order from your patient. He may have been correct but it was also inappropriate in a patient / doctor relationship.

I can see how it might sound like that out of context but this was a patient I knew very well and she said it in a gentle manner. The doctor-patient relationship is two-way and it was the moment I realised that my own appearance was affecting how well I could connect with patients and gain their confidence.

I've had weightloss surgery, AMA · 19-05-2021 3:20pm

air wrote: »

Clearly when you eat the the point that it's "uncomfortable" you're full, your body knows it and you know it.

This would indicate that you don't have any issue with satiety, or indeed appetite, you are just wilfully choosing to over eat when you know you've already had more than enough.

Similarly, it's not a shortcoming of your body that is causing you to order two desserts.
You know this isn't normal behaviour at any level but yet you go ahead and do it for some reason.

I can't speak for the poster you're replying to but this is an important point to clarify. Now that I have had the surgery, I get that feeling of satiety early. When I was obese, I got it too late, so by the time I was uncomfortable I had eaten way more than I should.

On paper we can measure out our calroies and eat the exact amount but in real life the body itself is the "some reason" that people overeat - the brain's hunger centres keep shouting for more. It's an unconscious desire similar to tiredness or thirst - very hard to ignore for long.

I've had weightloss surgery, AMA · 19-05-2021 3:24pm

Deleted User wrote: »

I would feel uncomfortable, not 'full'. I'd still have a feeling of being hungry enough that I'd continue to eat.

For what it's worth, I'm not trying to pull the "it's everyone's fault but mine" victim card - I have lost weight before. Large amounts. I'd hover about 20st, and have gotten down to 14st before. In theory you'd assume that a smaller body would require less energy to keep it ticking over, but, as above, I still just always felt hungry.

I was very much 'swimming against the tide' in that after a period of time you'd just cave in and have to eat. binge like a mad man. Which is why I am looking at the bariatric surgery options, as they (supposedly) will physically restrict the amount of food you can swallow.

My obesity consultants explained to me that as I lost weight my body would see it as a bad thing and would try to conserve energy by burning less. So as you said, when I dieted in the past I used to expect to use less energy as I became lighter but that in turn meant that I soon found my weight loss slowed down. The surgery helped me to get over that hump and to maintain my long term weight loss without the constant hunger.

I've had weightloss surgery, AMA · 19-05-2021 3:39pm

RedXIV wrote: »

Like KKV, I've always been a character known to "enjoy" his food and as I've gotten older and less mobile, the food I was eating has lead to me getting to the point that I need to look at a plan sooner rather than later. For me though the problem seems to be taste rather than what I'd believe I'd pinpoint as emotional eating.

I had dinner a few hours ago but about half an hour ago I got it into my head that I'd love a curry and I'm sitting here trying to convince myself I don't need one.

I am interested in what the OP was saying about starting with psychologist/dietician before going any further as, while I don't believe I'm able to blame anyone yet other than myself, if there IS a trigger or something I can use to help address the issue, I'll take all the advantages I can.

I spoke to a GP about issues before and he mentioned weight and had some printouts about Mediterranean diet but that was it. OP, is there a better set of resources to look at? I have health insurance and a decent job so I don't mind paying for something that will give me a better chance.

I used to judge other overweight people all the time while convincing myself that I had legitimate reasons for being fat. It was a weird form of denial combined with internalised fat shaming. Everyone who is overweight knows that they are overweight, although many of us are not aware of the extent or of the consequences. We also overestimate how much control we have over all of this. I now go out of my way to be kind to people about their weight and it is so much more constructive. People are sick of being judged for everything in their lives, we need to give each other a break.

Once I copped that I was dangerously obese my thinking changed from "Am I at fault?" to "How can I lose weight and keep it off?". The psychologists and dietitians were kind but ruthless - I had to be totally honest about my habits, feelings, motivations, etc. We were then able to deal with each one and make sure that whatever weight loss method I chose was safe and sustainable. In my case, surgery was an option and I was happy with the risks and benefits involved.

I cannot give you medical advice but there are several obesity management clinics in Ireland who are expert in this. If you have private insurance you should have most of the costs covered and your waiting time would be significantly reduced. My first step was to get a GP referral to an obesity surgeon who then linked me in with the full team for assessments. Some of the hospitals also run talks where you can get more information.

I've had weightloss surgery, AMA · 19-05-2021 3:53pm

Bili wrote: »

During the calorie-restricted diet to shrink your liver did you ever think that you could continue to lose weight yourself and not going through with the operation?

(I ask as I'm a nurse with a BMI of 40+ but too ashamed to go for bariatric surgery because with all my knowledge I feel that I should be able to get control of my eating myself.)

Also, did you have any hair loss or thinning at any stage?

The pre-op diet was the hardest bit! I didn't even manage to do it properly for the short duration required and it reinforced that I could not do it by diet alone.

I didn't have hair loss but that is something they discuss as a possible side effect.

I know what you mean about being ashamed. It used to eat me up inside because I was disgusted at my weight, how I looked, how much I ate, the effect on my health, and then I was angry with myself for not just eating less. It was awful and it affected everything I did.

When I saw the surgeon I was half hoping to be told I was not a candidate but when they said yes and gave me a date, I actually cried like a baby. It was out of the blue and mortifying but they said it happens all the time.

Even though there were no guarantees I felt like I finally had a chance to be healthy, that I could exercise and be comfortable in my body. I had been doing the same things for decades and suddenly there was a new option. I think society attaches huge stigma to bariatric surgery to the point where people are missing out on a potential lifesaving treatment.

I don't want to come across as a true believer - it is not the solution for everyone but for those who are suitable it is important to know it is there and what the pros and cons are.

I've had weightloss surgery, AMA · 19-05-2021 4:07pm

seamus wrote: »

We're hijacking the thread a bit here, but I think for anyone who has never had any kind of compulsion or addiction, this "swimming against the tide" feeling is hard to explain.

It's the same feeling you get when you fancy a drink even though you know you shouldn't. But you've got two in your belly and you fancy a third, so you give in. Or you're trying to cut down smoking and you know you shouldn't have another smoke, but it's just there and it "just one more".

It's the figurative "monkey on your back". Even while your rational brain is telling you that you don't need this, it's all in your head, you have the monkey whispering in your ear that if you just give in this time, he'll go away.

Ultimately, yes it is all in your head. It is a choice that you consciously make. But it comes so close to feeling like a physical *need* that fighting it feels as futile as trying to convince yourself that if you ignore the need to take a piss, that it'll just go away on its own.

I am a skeptic in terms of the surgery; in that it seems crazy to intervene surgically when the problem is in your head. But I say that from a position of privilege; I have lost huge amounts of weight using only willpower. That doesn't mean others can. However, the data is pretty clear that it's effective, and if someone is so at the end of their tether that they're willing to have such a major procedure, then it's a bit dismissive of me to say, "You just haven't tried hard enough".

It is amazing when people can lose weight through diet and exercise. I have a friend who has done this and kept it off.

Unfortunately she and you are in a tiny minority of people who can maintain the weight loss. It is exceedingly rare for someone to go from a high BMI to a normal BMI in this way and keep that going long term, which is what matters for health.

The other thing to consider is that willpower is finite. The more we have to use maintaining our weight the less we have for other things. Most of us do not have the mental energy or resources to sustain this.

I've had weightloss surgery, AMA · 19-05-2021 4:11pm

big syke wrote: »

May I ask why it was covered by your health insurance?

Was it to do with BMI?

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.

I've had weightloss surgery, AMA · 19-05-2021 4:16pm

shesty wrote: »

Hijacking a bit here too, but as a parent I find some of this extremely interesting. I fully believe that our parent's generational attitude of "you must clear your plate" has fed into some of this - as you say AMA you felt like it was almost a "sin" not to clear the plate. I absolutely refuse to insist this of my own children, I want them to realise when they are full, and that is the point they should stop eating at, and that it is ok to leave some food there.

There is huge psychology behind eating and weight loss, having struggled with it myself a lot over the years, I have learned this. I know somebody locally who had the same surgery as you OP, and the result is amazing. I think it is quite a brave thing to do in a way.

Thanks shesty and it's good to hear you are passing on good habits. Not only did we all religiously believe in clearing the plate but the portions were often totally weird. A child would have a similar big plate of food to an adult who was doing physical work all day. I think we are much better now but it's hard to shake off old habits and ideas.

I've had weightloss surgery, AMA · 19-05-2021 4:20pm

Wanderer78 wrote: »

I'd like to jump in on this to, apologies shesty, obesity is deeply psychologically based, I fear not enough is being done to address this aspect of the disorder, and we default towards the more physical aspect in regards treatment. I have major issues with well known weight loss programs such weight watchers etc, even though I appreciate and acknowledge they do help many, but don't go far enough in their treatment, particularly psychologically, which in fact may cause some to engage in other maladaptive coping strategies post weight loss, such as other addictive behaviours, what are your thoughts, and well done on your weight loss achievements?

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.

I've had weightloss surgery, AMA · 19-05-2021 4:24pm

Wanderer78 wrote: »

how is the IT crisis directly affecting your job? its a bloody nightmare, and disturbing at the same time

It's off topic but it has been very difficult. I'm really impressed and thankful for how calm and understanding patients have been - when you are unwell the last thing you need is uncertainty and delays. Healthcare staff have been so good, everyone is working extra hard, coming in off leave to help, and being so polite and collegial in the process. I am old enough to have worked in a purely paper-based system so I am reliving my younger days, except we now have mobile phones at least.

Wanderer78 · 19-05-2021 4:26pm

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

Segotias · 19-05-2021 4:57pm

Bili wrote: »

During the calorie-restricted diet to shrink your liver did you ever think that you could continue to lose weight yourself and not going through with the operation?

(I ask as I'm a nurse with a BMI of 40+ but too ashamed to go for bariatric surgery because with all my knowledge I feel that I should be able to get control of my eating myself.)

Also, did you have any hair loss or thinning at any stage?

Just on the hair loss thing, I did lose a lot of hair apparently it's the initial shock of oestrogen drop from the fat drop. It did grow back though

19-05-2021 5:52pm

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

judgejudyrocks · 20-05-2021 1:29pm

Hello

I've been overweight all my life - can't recall a time when I wasn't.

I had gastric band surgery in 2005 when 35 and it failed miserably - I'm told 8-10% of band recipients never lose weight with it and to be honest I've had 16 years of not being able to eat a meal, sadly the only things that don't cause nausea and vomiting is junk. I paid privately for this - 7,000 sterling back then.

Thank you for doing this - I have been recommended for gastric bypass surgery and I am meeting my surgeon next month. Ny BMI I think is around the 53 mark.

Can I ask a few things ?

I'm happy to go without alcohol for the six months after surgery but is that it forever ? Would a couple of beers every now and then be possible ? Keeping an eye on the calories of course.

Are there any really "scary" side effects ? I'm on a pre-surgery diet that is meant to replicate the post-surgery needs (its pretty much liquid - SlimFast shakes, soup and the odd Rich Tea biscuit for a bit of fibre). It is so hard to follow so I know that although I have lost some weight it is not sustainable at all. So I'm not scared of a restrictive diet - but I wonder about getting enough nutrients from a small amount of food.

Can I ask how much you lost each month ? What's a good amount ? I don't want to be disappointed with what I lose only to find it's perfectly normal!!

Finally, skin removal may be a ways down the road but my surgery is being done through VHI, I wonder do you know if skin surgery would be too ?

Thank you for talking about this - sadly most people I know have the attitude that I got myself into this and should get myself out but it's not that simple.

air · 20-05-2021 3:07pm

Brynn Zealous Poltergeist 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.

SimonTemplar · 20-05-2021 6:48pm

I've had weightloss surgery, AMA wrote: »

I can see how it might sound like that out of context but this was a patient I knew very well and she said it in a gentle manner. The doctor-patient relationship is two-way and it was the moment I realised that my own appearance was affecting how well I could connect with patients and gain their confidence.

Thanks for replying. For some reason, I thought it was a more snarky comment by a rude patient in the same way people can be rude to retail staff. I've had a few rude customers comment on my appearance during my time in retail so I was thinking about that. Thanks for providing more context.

20-05-2021 8:57pm

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?

volchitsa · 20-05-2021 9:56pm

Brynn Zealous Poltergeist 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 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?

Ah. Good fat people that we want to help, and then bad fat people that we can shame?

We had that for years with pregnancy and abortion, let's try not to do it with obesity. It's pointless and counter productive.

air · 20-05-2021 11:06pm

Brynn Zealous Poltergeist 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.

noplacehere · 21-05-2021 12:15am

How long did it take?

From when you asked the for the referral to first appointment?

From first appointment to actual surgery?

How was the follow up afterwards? Do you get enough guidance? Do you still touch base?

Boards.ie: Niamh · 21-05-2021 6:03am

Brynn Zealous Poltergeist, volchitsa and air can we get back to asking questions of the AMA guest. If you want to have a general discussion about obesity, there are other forums for that. Thanks.

volchitsa · 21-05-2021 8:34am

Okay sorry about that, Niamh, I got distracted.

OP: Maybe this is too “technical” a question, but why did you choose the type of surgery (gastrectomy) you finally went for? Why did you eliminate the bypass version?

I presume it was your decision but it is also about what the surgeon advises and maybe what s/he is used to doing?

Or does it depend more on your own personal factors and if so which ones? (If that’s not too invasive a question)

big syke · 21-05-2021 10:11am

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?

manonboard · 25-05-2021 8:33am

Just wanted to thank you OP for sharing all this information. I'm now recovering 4 months from a 36 year eating disorder. It's going great with new treatment after i met a fantastic specialist in my needs. I was super skinny so hearing about it from the other end of the weight spectrum, is fascinating to hear how absolutely similar it is. Thank you for the great education.

I would like to ask please. How did you feel or how did you balance your feelings about the comments people made after your surgery/recovery? were they welcomed? (the positive ones). Did you find that you came across perceptions of your own that turned out to be valid or invalid once you started to lose alot of weight?
eg: Did the social value you placed on weight/size, turn out to be accurate or inaccurate for pre/post weight loss?

Doctor DooM · 25-05-2021 9:25am

OP, this has been a very interesting thread for me.

I would have been in a very similar boat to you. I had a similar BMI of around 40.

I began exercising around the beginning of the pandemic and without too many changes to my diet (which I think I'd kind of addressed somewhat anyway) I'm now floating around 28. That translates as around 6 stone or thereabouts.

Still, a lot of what you said rings very true for me, and I'm finding it tough to move beyond this.

This thread scares me somewhat as now I'm a little worried this isn't a permanent change, that I'm trying to willpower myself out of a hole you can't. But I feel like this is a permanent change for me. I'm here 16 months now. Perhaps I've reached a new plateau my body is happy at.

But I feel I have more work to do, I'm still overweight. I'm curious how to research further. You said above you were talking to your GP about it and it sent you down the right path with a psychologist etc. I think that might be a healthy option for me too. But anyway, related question!

In the past I've gone researching on the internet about weight loss. I don't like following non scientific advice for this kind of stuff, but I've found my brain does like to look for an easy way out for weight loss when I do that. Did you end up looking down any rabbit holes that you shouldn't despite being a Doctor? Any false starts?

funky sausage · 29-05-2021 2:21am

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.

Large bottle small glass · 29-05-2021 12:16pm

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

I've had weightloss surgery, AMA · 31-05-2021 1:02am

Brynn Zealous Poltergeist wrote: »

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

The problem is that as we lose weight our bodies see that as a bad thing and respond by trying to get us to eat more. So our metabolism can decrease and it becomes more and more difficult to lose weight. This happens even for people who are not obese - losing the first couple of kilos is fine but then you hit a plateau.

Yes, in theory we can all fill our plates with low calorie food but we are not robots and it requires a huge amount of will power to maintain a diet like that. It is a very poor use of mental energy to fight our appetites 24/7. I am delighted that I can enjoy life again, eat a healthy amount of any food I want, and be satisfied. If people think it's lazy I don't give a hoot, this works for me and I'm happier than ever.

I've had weightloss surgery, AMA · 31-05-2021 1:13am

judgejudyrocks wrote: »

Hello

I've been overweight all my life - can't recall a time when I wasn't.

I had gastric band surgery in 2005 when 35 and it failed miserably - I'm told 8-10% of band recipients never lose weight with it and to be honest I've had 16 years of not being able to eat a meal, sadly the only things that don't cause nausea and vomiting is junk. I paid privately for this - 7,000 sterling back then.

Thank you for doing this - I have been recommended for gastric bypass surgery and I am meeting my surgeon next month. Ny BMI I think is around the 53 mark.

Can I ask a few things ?

I'm happy to go without alcohol for the six months after surgery but is that it forever ? Would a couple of beers every now and then be possible ? Keeping an eye on the calories of course.

Are there any really "scary" side effects ? I'm on a pre-surgery diet that is meant to replicate the post-surgery needs (its pretty much liquid - SlimFast shakes, soup and the odd Rich Tea biscuit for a bit of fibre). It is so hard to follow so I know that although I have lost some weight it is not sustainable at all. So I'm not scared of a restrictive diet - but I wonder about getting enough nutrients from a small amount of food.

Can I ask how much you lost each month ? What's a good amount ? I don't want to be disappointed with what I lose only to find it's perfectly normal!!

Finally, skin removal may be a ways down the road but my surgery is being done through VHI, I wonder do you know if skin surgery would be too ?

Thank you for talking about this - sadly most people I know have the attitude that I got myself into this and should get myself out but it's not that simple.

Fair play to you for considering this even though you had a bad experience with banding. I had read about the high complications from gastric bands and that actually was something that put me off bariatric surgery at the beginning until I learned about the other options.

It is certainly possible to have alcohol again. The surgery makes it difficult to drink large volumes of anything but that just means I sip instead of guzzle. I never ever feel like I am missing out.

I didn't have any scary side effects. I did vomit once at the very beginning when I had some bread a bit too soon. I also had dumping syndrome 3 times when I drank some very sugary drinks - I got the shakes for a few minutes and had diarrhoea. But that's it in all of these years.

You do have to take daily multivitamins for life but I have a very varied diet now anyway, eat salads and fruit as well as protein, so it's no issue.

Everyone loses weight at a different rate as it depends on your age, muscle mass, starting weight, etc. In general I lost 2-4kg per month, more in the summer as I was more active.

I was told that private health insurance will pay for some skin removal but there are some specific rules that you would have to check with your own company. I think they will do 1 or 2 areas but not everything.

The very best of luck with your surgery!

I've had weightloss surgery, AMA · 31-05-2021 1:21am

SimonTemplar wrote: »

Thanks for replying. For some reason, I thought it was a more snarky comment by a rude patient in the same way people can be rude to retail staff. I've had a few rude customers comment on my appearance during my time in retail so I was thinking about that. Thanks for providing more context.

It's amazing that people feel it's ok to comment on appearance. I have definitely noticed how much better I am treated now. I remember a lot of times when people I barely knew would give me "advice" or blatant insults as if that would do anything except make me feel worse and probably have a biscuit to cheer myself up! One thing I have started doing recently is that if someone says I look so much better now I thank them but also reply that I think I have always looked great - being fat didn't stop me being attractive and we need to counter that idea.

I've had weightloss surgery, AMA · 31-05-2021 1:26am

noplacehere wrote: »

How long did it take?

From when you asked the for the referral to first appointment?

From first appointment to actual surgery?

How was the follow up afterwards? Do you get enough guidance? Do you still touch base?

I don't remember exactly but I think from my first GP visit to day of surgery was about a year. I had half a dozen or so appointments and assessments in between and then I had to arrange a date that I could take off work.

The follow up was fairly straight forward, I think about a month afterwards, then 6 months, then a year. Annual check ups long term. Plenty of guidance and I can contact any of the team any time. There are also group sessions available but I haven't tried that.

I've had weightloss surgery, AMA · 31-05-2021 1:32am

volchitsa wrote: »

Okay sorry about that, Niamh, I got distracted.

OP: Maybe this is too “technical” a question, but why did you choose the type of surgery (gastrectomy) you finally went for? Why did you eliminate the bypass version?

I presume it was your decision but it is also about what the surgeon advises and maybe what s/he is used to doing?

Or does it depend more on your own personal factors and if so which ones? (If that’s not too invasive a question)

I chose the sleeve gastrectomy as it had the right balance of effectiveness and risk for me. I liked that it is a less complex procedure than the bypass with a quicker healing time.

My surgeon gave me the option of both and went through all of the pros and cons in detail, including expected weight loss, risks of complications, etc.

The differences were minimal but the surgeon had done a lot of sleeves and I was inclined to go with the surgery they were most experienced in doing. They tend to do bypass for people who have a history of heartburn but that wasn't an issue for me.

I've had weightloss surgery, AMA · 31-05-2021 1:34am

big syke wrote: »

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?

No, I had no issues like that. My GP knew my weight history and the obesity team were very supportive and understanding. They went through all the options: diet, exercise, psychological treatment, medication, surgery. The final choice was mine and there was no judgement or pressure.

I've had weightloss surgery, AMA · 31-05-2021 1:51am

manonboard wrote: »

Just wanted to thank you OP for sharing all this information. I'm now recovering 4 months from a 36 year eating disorder. It's going great with new treatment after i met a fantastic specialist in my needs. I was super skinny so hearing about it from the other end of the weight spectrum, is fascinating to hear how absolutely similar it is. Thank you for the great education.

I would like to ask please. How did you feel or how did you balance your feelings about the comments people made after your surgery/recovery? were they welcomed? (the positive ones). Did you find that you came across perceptions of your own that turned out to be valid or invalid once you started to lose alot of weight?
eg: Did the social value you placed on weight/size, turn out to be accurate or inaccurate for pre/post weight loss?

Thank you and it's fantastic that you are doing well. We are so focused on weight and appearance when good mental and physical health should be our goals.

Before I had the surgery I was looking forward to some compliments - we all have egos I suppose! Strangely in the end I didn't really care. Most people were fairly subtle, some did ask me directly why and how I was losing weight, and a couple of people asked me if I was sick. I would say 95% of comments were complimentary and well intentioned. The other 5% were mainly people telling me I was too skinny but I just shrugged that off.

It was really, really weird to go from being the fattest person in the room to being one of the slimmest. I can't really explain how strange an experience it is. People just treat you so differently. At first I thought it was my imagination but several friends and colleagues have said it to me also, that people treat me and talk about me much more positively now. It is nice to benefit from that but it is ridiculous how much a person's weight affects our view of them.

I've had weightloss surgery, AMA · 31-05-2021 2:01am

Doctor DooM wrote: »

OP, this has been a very interesting thread for me.

I would have been in a very similar boat to you. I had a similar BMI of around 40.

I began exercising around the beginning of the pandemic and without too many changes to my diet (which I think I'd kind of addressed somewhat anyway) I'm now floating around 28. That translates as around 6 stone or thereabouts.

Still, a lot of what you said rings very true for me, and I'm finding it tough to move beyond this.

This thread scares me somewhat as now I'm a little worried this isn't a permanent change, that I'm trying to willpower myself out of a hole you can't. But I feel like this is a permanent change for me. I'm here 16 months now. Perhaps I've reached a new plateau my body is happy at.

But I feel I have more work to do, I'm still overweight. I'm curious how to research further. You said above you were talking to your GP about it and it sent you down the right path with a psychologist etc. I think that might be a healthy option for me too. But anyway, related question!

In the past I've gone researching on the internet about weight loss. I don't like following non scientific advice for this kind of stuff, but I've found my brain does like to look for an easy way out for weight loss when I do that. Did you end up looking down any rabbit holes that you shouldn't despite being a Doctor? Any false starts?

That is amazing work! I was never able to lose so much but you have obviously got a great system in place.

Seeing the psychologist was really helpful as it helped me think about how I set myself up for success before I ever take a bite. Also recognising the importance of getting family/friends on board to support me was huge so they are not constantly offering me treats.

I didn't go down any unusual weight loss paths. I tried Atkins a couple of times but I ended up putting on weight. I also tried a medication for weight loss which gave me awful bowel upset, so that was short lived. Ultimately I realised none of the quick fixes or weird diets were sustainable for me.

Well done on your success!

I've had weightloss surgery, AMA · 31-05-2021 2:14am

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.

The yo-yo of weight loss followed by big weight gain upset me so much and I had similar feelings of guilt and embarrassment. I really hated having to shop for clothes based on the sizes available, particularly back in the days before online shopping where sizes were fairly limited. It was soul crushing and I actually don't know how I did it for so long.

I have a good relationship with my GP so I was comfortable talking to him about it. I told him that I had been trying for over 20 years to lose weight and the number had only ever gone up and that I was feeling defeated. He said if I was curious about surgery he would give me a letter for a surgeon that would go through the options with me.

He handed me the referral letter and I sat on it for a couple of months then I just said flip it, I am not getting any younger or healthier so what's the harm in chatting to them about it? I was very nervous meeting the obesity team but they were brilliant and explained it all so well.

I think most GPs would be glad to help people get more info. The surgery is not for everyone but the only way to know if it's for you is to discuss it and get the details. It's your body and you only have one life, so don't feel bad about wanting to explore all the options.

volchitsa · 31-05-2021 6:24am

When you say people treat you differently now compared to before, do you think there's a difference depending in whether they know you've had bariatric surgery or not: do any of those who know about the surgery/knew you from before seem to feel like you've "cheated" a bit?

Or is it just the physical difference that seems to change their attitude?

Galbin · 01-06-2021 5:05pm

Deleted User wrote: »

For me personally, and this is where I'd like to put a question towards the AMA guest, I would characterise myself as having a sugar addiction of sorts, coupled with an ability to never feel full.

I can sit down to a massive takeaway, and although it may start to be uncomfortable, I will manage to eat it all, or of i do have to stop, within 15 minutes, I'll be back eating the remainder again.

I'd often have been in restaurants with people, and we'd order similar/same things, and everyone else would be busted after the dinner, some not finishing, whereas I'd be thinking "will i look bad if i get two desserts.. pretending i want to just see what they're like".

I've an insatiable appetite.

Hope the mods don't mind me putting this here, but your symptoms sound like classic insulin resistance. I have PCOS and when I first developed it I went from having a normal appetite to only being full if I was stuffed. In response, I developed an eating disorder and would starve all day so that when I would eat I could eat enough to feel full. Once I was finally diagnosed and put on metformin (which treats insulin resistance) the desperate hunger went away.

They used to think that weight gain caused insulin resistance/diabetes and so diabetes/IR was a person's fault. Now though more and more research is supporting my n=1 experience that inulin resistance happens first and then weight gain (followed by diabetes in the genetically susceptible). Unfortunately, for some reason, it's hard to get a fasting insulin test done here so I went through a UK lab.

gormdubhgorm · 07-06-2021 1:57pm

The OP can correct me if I am wrong. But from reading the OP's posts there seems be a bit of confliction going on.

The OP admitted that they used to view obese people as purely lazy without taking into account their mental and physiological aspects. Which prevent some obese people from going the natural route to lose weight. As most people do let's be honest.

Also the OP seemed to have gone this surgery route for health reasons, to look better, and feel better about themselves.

Yet on the other hand the OP seems surprised that people treat them differently.
Surely it is because people see a person:

1) Making an effort and a successful one
2) Looks healthier and seems happier etc.

Yet the OP seems very irked by the fact that people now say 'you are looking well' and the OP's response is always 'I always looked well.' It seems like a bit of mental trick on behalf of the OP?

Surely this is,

1) A delusion on behalf of the OP that they always looked well - still a mental conflict there?

And

2) The 'you are looking well' comment from others is merely a nice way of saying 'you are looking much better than you were before' ? And people are pleased for the OP etc.

--

So I suppose my questions are:

Since the surgery does the OP feel better and happier in themselves? Both from a mental and physical viewpoint.

And is the OP merely annoyed about 'you are looking well' comments. As it is a reminder of how the OP was, and how the OP was viewed?

volchitsa · 13-06-2021 9:27am

gormdubhgorm wrote: »

The OP can correct me if I am wrong. But from reading the OP's posts there seems be a bit of confliction going on.

The OP admitted that they used to view obese people as purely lazy without taking into account their mental and physiological aspects. Which prevent some obese people from going the natural route to lose weight. As most people do let's be honest.

Also the OP seemed to have gone this surgery route for health reasons, to look better, and feel better about themselves.

Yet on the other hand the OP seems surprised that people treat them differently.
Surely it is because people see a person:

1) Making an effort and a successful one
2) Looks healthier and seems happier etc.

Yet the OP seems very irked by the fact that people now say 'you are looking well' and the OP's response is always 'I always looked well.' It seems like a bit of mental trick on behalf of the OP?

Surely this is,

1) A delusion on behalf of the OP that they always looked well - still a mental conflict there?

And

2) The 'you are looking well' comment from others is merely a nice way of saying 'you are looking much better than you were before' ? And people are pleased for the OP etc.

--

So I suppose my questions are:

Since the surgery does the OP feel better and happier in themselves? Both from a mental and physical viewpoint.

And is the OP merely annoyed about 'you are looking well' comments. As it is a reminder of how the OP was, and how the OP was viewed?

The OP hasn't come back, so I'm going to give my reaction to this, as it's related to my own question.

I don't think he/she was complaining about people saying "you're looking well": it was more about being treated differently. As you said yourself.

IMO the question is whether it's ok to judge people negatively for being overweight, and seeing that as proof that they're "purely lazy". Would you judge someone negatively if their car wasn't cleaned regularly and if so, does it matter whether they clean it themselves or get it valeted? Or if their garden is a bit unkempt - and again, does it make a difference if your garden is lovely because someone else cuts your grass or if you need to do it yourself before people can think well of you for it?

There just seems to be a lot more personal judgment of people for their physical appearance than any other part of their lives, and also a feeling that it's fine to keep your belongings looking lovely by having someone else do the hard work of looking after them for you, but if you don't manage to keep your body perfect through your own efforts, they're a bad person. (I'm kind of guilty of this myself, though I try not to, but then as you say, the OP had the same reaction themselves. It's almost the norm.)

That's why I wondered whether people who knew the OP from before (work colleagues but also friends and family) and who know about the surgery, treat them differently to people who only see the "new" person in front of them, and don't know the back story.

I've had weightloss surgery, AMA · 17-06-2021 11:29pm

volchitsa wrote: »

When you say people treat you differently now compared to before, do you think there's a difference depending in whether they know you've had bariatric surgery or not: do any of those who know about the surgery/knew you from before seem to feel like you've "cheated" a bit?

Or is it just the physical difference that seems to change their attitude?

Yes, a few people have mentioned that it feels like cheating. I understand that reaction because I used to feel that way. I usually deal with those remarks head on and chat through it with them. People are curious as it's often the first time they have spoken to someone who has had it and people respond positively when things are explained in more detail. Even people with weight problems have a lot of misconceptions and stigma about it, so we are all learning.

volchitsa · 17-06-2021 11:48pm

And do you think it’s important to talk about it or is it no longer a big thing in your life?

Like, could you forget you’ve had it done or do you remember every time you sit down to eat?

I've had weightloss surgery, AMA · 18-06-2021 12:09am

gormdubhgorm wrote: »

The OP can correct me if I am wrong. But from reading the OP's posts there seems be a bit of confliction going on.

The OP admitted that they used to view obese people as purely lazy without taking into account their mental and physiological aspects. Which prevent some obese people from going the natural route to lose weight. As most people do let's be honest.

Also the OP seemed to have gone this surgery route for health reasons, to look better, and feel better about themselves.

Yet on the other hand the OP seems surprised that people treat them differently.
Surely it is because people see a person:

1) Making an effort and a successful one
2) Looks healthier and seems happier etc.

Yet the OP seems very irked by the fact that people now say 'you are looking well' and the OP's response is always 'I always looked well.' It seems like a bit of mental trick on behalf of the OP?

Surely this is,

1) A delusion on behalf of the OP that they always looked well - still a mental conflict there?

And

2) The 'you are looking well' comment from others is merely a nice way of saying 'you are looking much better than you were before' ? And people are pleased for the OP etc.

--

So I suppose my questions are:

Since the surgery does the OP feel better and happier in themselves? Both from a mental and physical viewpoint.

And is the OP merely annoyed about 'you are looking well' comments. As it is a reminder of how the OP was, and how the OP was viewed?

I'm not surprised that people treat me differently as I was expecting some changes, but I am surprised at the ways they treat me differently and the degree to which it changed my interactions. Things like how people stand closer to me, make more physical contact with me, smile at me more, etc. That goes for both people I knew before and new people I have met since. I don't blame people for doing it, it just feels odd.

I think you're right that some people feel that I'm making a bigger effort and they approve of that so they treat me better. One colleague did say that to me.

To answer your questions, yes I feel much better, much happier, and much healthier, both mentally and physically. My sex life has also improved, which is an important thing that I forgot to mention earlier. Weight can have a big impact on our relationships and we shouldn't be afraid to discuss that.

When people give me a compliment, I accept it and thank them, I certainly don't say anything cheeky or rude. I might think "I always looked well" in my head but that's because it's true, I always did think I looked well, I just look and feel even better now. If I hadn't been suitable for bariatric surgery I would have had to accept potentially being overweight/obese long term and part of that is having a positive self image. I look back at wedding photos and I think we both look fantastic and very happy, even in my XXXL clothes.

I don't feel irked by people's awkward comments, more surprised and amused. People do not spend their days thinking about me or my weight loss, so sometimes they make remarks off the cuff. I'm sure I do that as well about other things, we are all human, so I don't give people grief for it. It's just odd to experience such a difference based on the amount of adipose cells I happen to have under my skin.

All of these conversations were in the first few months after the surgery when people were seeing my major weight loss. For the past few years I have just been getting on with life. I can't even remember the last time I thought about these things, they are only in my head now because of the AMA.

I've had weightloss surgery, AMA · 18-06-2021 12:16am

volchitsa wrote: »

And do you think it’s important to talk about it or is it no longer a big thing in your life?

Like, could you forget you’ve had it done or do you remember every time you sit down to eat?

I talked about it a fair bit at the beginning as it was coming up naturally and people were curious. I don't think about it when I eat except on the rare occasion that I try a new food and I'm not sure how much I will be able to manage.

farmerval · 20-06-2021 9:08pm

On a slightly different to the surgery, does the OP think that the general HSE/ Medical profession's advice or strategy is fit for purpose.
Is our advice in the food pyramid etc correct for the modern world.
In my opinion some of the issues we have are around the types of food we eat and the constant grazing /eating habits of modern society.
Yet I feel that the responses are somehow formulated by people that believe that we are still eating three square meals per day, as our parents would have done.

Walk into any small shop or filling station and most/all of the shop is given over to coffee and snacks/sweets. Stop at a motorway filling station and you have probably 3 or 4 choices of fast food.

I believe we have moved to a vast proportion of processed calorie dense but nutritionally poor food. I don't believe that the response from health authorities reflects the realities of modern society.

It would be interesting to get the OP's opinion having been through the system from both sides.

Galbin · 20-06-2021 10:25pm

I've had weightloss surgery, AMA wrote: »

I'm not surprised that people treat me differently as I was expecting some changes, but I am surprised at the ways they treat me differently and the degree to which it changed my interactions. Things like how people stand closer to me, make more physical contact with me, smile at me more, etc. That goes for both people I knew before and new people I have met since. I don't blame people for doing it, it just feels odd.

I think you're right that some people feel that I'm making a bigger effort and they approve of that so they treat me better. One colleague did say that to me.

Prejudice against obese people really is the last socially acceptable stigma. It's so sad. I hope such people are not your loved ones. Given that things like atypical anorexia exist, your colleague sure is assuming a lot. Both fat and thin people can eat really well or really badly.

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

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