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15-05-2021, 13:20   #31
I've had weightloss surgery, AMA
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As someone who's also had bariatric surgery do you find it now impedes further weight loss as you are so used to eating lower calories
No, I haven't had any problems like that. I aim for 1,500-1,800 calories and that keeps me steady.

Exercise is the key. Now that I am lighter I can do way more, so I would walk 10-12k every day, do weights 2x per week, and before covid would swim and do classes.
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15-05-2021, 13:29   #32
I've had weightloss surgery, AMA
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What did you mind most about being overweight, before?

Was it appearance, fatigue, self-image, health issues, Potential health issues, breathlessness, sex-appeal, -- or whatever, or something else??
Yes, all of the above were in the mix.

Funnily enough, I always thought I looked nice in photos and my friends and family always were positive about my appearance. Looking at old photos now I am amazed, I was so big. I was unhappy with my mobility and it was affecting normal activities.

One of the things that started me thinking about it was being in a theme park and barely being able to squeeze into the rollercoaster. I was so sad that I might not be able to bring the kids on days out because of my weight.

At work I was advising patients who were lighter than me that they urgently needed to lose weight so prevent diabetes, etc. One day a young patient asked me why I hadn't taken my own advice. I had no answer and I realised it was ridiculous.

Then my GP just said it to me one day when I was in for something minor. He said you are young, you are successful, but you are shockingly overweight and you will regret it if you don't act now. That jolted me, I knew I was neglecting my health.

The thing my obesity team drilled into me was that losing weight would not make me happy, they really emphasised that from the beginning. But what I found was that it removed a very big barrier to happiness so I can use my energy to look after other things and I don't have to stress about my weight and appearance. It was a sort of a reset and a 2nd chance at life.
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15-05-2021, 15:16   #33
DaCor
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How hard was it to convince your GP that you needed this?

Do you have to be above a certain BMI to be allowed to have this surgery?

Can you go off your own bat and just make the required appointments (psych, dietician etc) and do it all without a referral?

Asking because I've been pushing for a referral for 4 years from my GP, done the dietician etc but still nothing
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15-05-2021, 16:53   #34
cloudatlas
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It's strange to see something that is a compulsion being described as a disease.
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15-05-2021, 18:35   #35
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It's strange to see something that is a compulsion being described as a disease.
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!)
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15-05-2021, 23:51   #36
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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.
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16-05-2021, 14:31   #37
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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?

Last edited by greenbicycle; 16-05-2021 at 14:38.
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16-05-2021, 14:48   #38
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Yes, all of the above were in the mix.

At work I was advising patients who were lighter than me that they urgently needed to lose weight so prevent diabetes, etc. One day a young patient asked me why I hadn't taken my own advice. I had no answer and I realised it was ridiculous.

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.
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16-05-2021, 15:14   #39
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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.
Not really, think of it this way, a dentist with a mouthful of rotten teeth telling you dental care is important would be worthy of a challenge too
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16-05-2021, 15:49   #40
air
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coupled with an ability to never feel full.
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I can sit down to a massive takeaway, and although it may start to be uncomfortable,
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I've an insatiable appetite.
Not wishing to go off topic and you've made a valuable contribution here, but just thought I'd point out the contradiction in the above statements.

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 hope that if you haven't perhaps realised this before, then doing so might help you decide which direction you need to take to start dealing with the root cause.

With regard to obesity as a disease, I believe it's now understood that being obese long term does permanent damage to the endocrine and other systems. This may explain why medical intervention is required to recover from it beyond a certain point in many cases.

Best of luck to you both and thanks to the OP for the insights.
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16-05-2021, 17:37   #41
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Clearly when you eat to the point that it's "uncomfortable" you're full, your body knows it and you know it.

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.

Last edited by KKV; 16-05-2021 at 17:41.
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16-05-2021, 18:16   #42
air
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In theory you'd assume that a smaller body would require less energy to keep it ticking over
Thanks for the insight, very interesting.
I may have been premature with my speculation regarding your satiety issues so, for me personally if I'm at the stage of feeling uncomfortable, that's definitely also "100% full".
I can't imagine an irresistible compulsion to eat more at that point.

With regard to the quote above, we do in fact we expend a lot of energy keeping ourselves warm.
Maintaining 20st of human at 37C in a 20C room is an ongoing battle.
In this regard the 20st you actually requires less energy to keep warm than 14st you, muscle mass etc all being equal.

Your surface area to volume ratio is reduced and you are better insulated by subcutaneous fat.
You will also feel colder at the same air temperature due to the subcutaneous fat between your blood filled muscles and your skin (temperature is predominantly sensed by the skin), so you're more likely to wear more clothes, reducing thermal burn yet further.

So an overweight person has physics to battle on top of everything else.

You can use these facts to your advantage too though.
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16-05-2021, 22:13   #43
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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.
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17-05-2021, 00:06   #44
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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?
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17-05-2021, 11:16   #45
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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.
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".
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