Surgery? Yes or No

As someone who has had gastric bypass surgery, I can say that it was the right decision for me. I am 44 years old with type I diabetes and had multiple health issues that were on a downward spiral prior to the surgery. My kidney function was declining fast, my blood pressure was outrageously high, I was using a CPAP at night and I couldn't walk out my front door to my mailbox. I started using MFP several months before my surgery and was making slow progress. I went thru 3 denials before my surgery was approved and I had made my mind up to do it myself. When I got the approval, what made up my mind for me was that I had another intestinal issue that also needed repairing and we could "kill two birds with one stone." I had my surgery on 9/27/12.
Surgery is NOT the easy way out and is NOT the option for everyone. If you are able to lose the weight w/o it, I would not alter your body thru such a drastic procedure. Understanding that you are sedentary, the low calorie supervised diet may be what works for you and eventually with weight loss, you may be more successful with joint replacements--the excess weight could hinder the success of such a surgery.
I do understand the dilemma--I ate about 500-700 calories a day for a few months and am up to 1100 presently. I know many who have had the sleeve, band, and roux en y and at maintenance, they eventually eat a fairly normal diet. If you are interested in learning more, there are several groups here on MFP with members who are very helpful and have a lot of experience.
Surgery was the right choice for me, but it is not for everyone. Research is the key. And listen to your heart. Only you know what is right for you.

Maybe I'm too cheap to pay for the surgery but it seems you are well on the path to losing 40-50 pounds by the end of this year. Is the money that you will spend on the surgery worth the possible additional 20 pounds that you will lose by the beginning of next year? Plus I'm personally nervous with any surgical procedure - there are risks.

You seem to be doing really well with your current program.

First, congratulations on what you have accomplished already. I can certainly understand the dilemma and your caution. And I would also urge you to take everything here (even from me, maybe especially from me???). We're anonymous voices on the net, so consider that first.

8 pounds a month, or 2 pounds a week, is not excessive. If that is what you are losing, you have been operating at a deficit of about 1,000 calories/day. As you lose weight, your calorie requirement will come down, so without an increase in exercise, your weight loss may slow a bit, but not too drastic. I just ran some sample BMR calculator numbers and a loss of 50 pounds would result in a loss of about 200 calories/day so at 250 pounds you will burn 200 calories less per day than you would at 300 pounds. Still that is less than 1/2 pound a week.

I can understand the desire for the joint replacement as someone with 2 artificial hips and 1 new artificial knee (I have congenital OA not RA). But you seem to be having serious concerns about the bariatric surgery. So a few thoughts.

1. Have you had a psych consult. I know most bariatric surgeons insist on one. The pros and cons should be fully discussed in this setting I would think.

2. Have you had a second opinion of a different bariatric surgeon in a different surgery group?

3. Is it the bariatric surgeon who is telling you that you can't keep losing like that unless you cut to 800 calories or is that another doctor? As a general rule, doctors, don't know a whole lot about nutrition and diet. For those questions, I really think you should consult with an R.D. (a registered dietician). They are the experts the doctors consult. The people that every new diabetic patient should see.

4. Have you talked with your orthopedic surgeon about joint replacement and have they given you a weight goal before they would recommend doing joint replacement.

5. I know it can be extremely painful for someone with RA to exercise, but have you consulted with a Physical Therapist. I am a big believer in what a PT can do and they may be able to design some exercises you can do that will at least allow you to get some modest level of exercise without too much pain and wear and tear on you.

I think in the end it comes down to you -- what you are comfortable with, the timetable you want to have it done. Joint replacement is no miracle cure, no quick fix. Depending on the joint being replaced it can be a hard recovery. I had my new knee done September 24 and I still consider myself in recovery mode and will for another 3 months. Hips are faster. But you have to be comfortable with the decision. You have to be at peace with your decision. This can't be the surgeon's decision. What do you want, what type of life do you want, short-term, medium-term, long-term? I think you certainly have more questions to ask and more things to ponder before you make a final decision.

But like i said, I along with everyone else here is a voice in the wilderness, so take that for what it is worth as well.

Good luck and send me a message if I can be of further help.

I tend to agree with iggyboo above. I am a fan of western medicine actually, but you are doing it on your own. Also, there is always some way to be more active. Try consulting a personal trainer (many come to your home) and see if you can't do light weights, leg or arm lifts, shoulder rolls, etc. There is not a single health condition that does not benefit from more movement.
Best wishes!

I cannot comment on the surgery as I never had it. But I did lose 182 pounds, i started at 38 pounds and lost my weight from pretty much the same calorie range consistently (1800 calories). Why dont you stick at your calorie range (or maybe a fraction higher) till/if the losses stop and then reassess if you are not eager for the surgery?

Bookie...You know my story. I have degenerative arthritis and need double knee replacement surgery. I was offered gastric surgery and said NO THANK YOU.

You and I joined MFP about same time, and we have been losing about the same amount of weight per month. I am already eating 1,000 calories per day and still losing weight without starving. I also am sedentary much of the day, but that does not mean that you can't do some kind of exercise. I weight 216.6 pounds this morning. I don't believe that I need to permanently change my stomach to continue losing weight. I haven't stopped losing weight so far.

Are you just tired of being on 'a diet'? Do you think that it is going to be easier, when your stomach is a sleeve? No, Sis. You will have problems. That sleeve surgery does not mean an easy ride or more food. It means less food and more restrictions than ever.

4 female members of Ed's family and one church friend had some kind of gastric surgery. One nearly died during the surgery and ended up in a coma. The surgery never was finiished, and she continues to have problems which the surgeons can't undo. Only one of those women kept off the weight they lost. The others gained back most if not all of that weight, and all of them have some kind of health issues related to that surgery.

Get another opinion. Your doctor may not be qualified to discuss the real issues that you will face.

You still have another option. Keep doing what you are doing. Tough it out. If I can do it, so can you, Sis.

Hi there, my friend!

"My beginning weight was 339 and I'd lost 12 pounds when I joined MFP in Feb. 2013.
The program gave me a calorie regimen of 1470s based on my height, weight, and level of activity."

So you started MFP at 327 pounds, and were given a goal of 1470? That would suggest that you're very short and put in that you wanted to lose 2 pounds a week, is that right? Otherwise, MFP would never have given you such a low calorie goal.

I say that because I'm 5'4", also very sedentary, started last week at 270, plugged in 1 pound a week, and my calories came back as 1720.

That really isn't relevant to what you were asking-- I was just curious. Sticking to such a low daily calorie level seems very challenging, but clearly you're making it work and it's working for you. Congratulations on that impressive weight reduction.

I don't think MFP will let you go below 1200, from what I understand, at least not in its recommendations.

Anyway-- I understand the desire to get the weight off as fast as possible, especially with the health concerns. But from what you say, the surgery will not provide that much potential benefit, especially when compared to the risks.

When I had a gallbladder surgery, the surgeon was also really pushing me to get the weight loss surgery. I found that really odd that a surgeon would be pushing for a surgery when it seemed like he would be encouraging me to do all I could to lose weight without surgery. Likewise, all the ads I see for weight loss surgery concern me as well. Not that the surgery hasn't helped large numbers of people-- it's just the commercial, business-like aspect of it that doesn't sit right with me, and causes me to wonder how many doctors are pushing the surgery for financial gain. I'm especially inclined to wonder since you're clearly having such good success without surgery.

Personally, I think surgery should be reserved for those who are absolutely convinced that they can't get the weight off any other way-- and even then I have my doubts, because most of those individuals are required to lose a percentage of their weight before the surgery, just to prove their willingness to comply.

I really don't mean to be making judgments, because I know there are a lot of people who feel that weight loss surgery saved their lives. I just have concerns about any kind of surgery and would urge you to be very sure that surgery is what you feel you need.

Why not just keep going till the end of this year and see how you do on your own, staying around 1200? Like Kazsjourney said, you can reassess if your weight loss stops.

It's a tough decision. I have lost 53 pounds but I decided to have gastric sleeve surgery. Some people have asked me why I made this choice when I am successful with losing weight. I actually have over 200 lbs total to lose. I know some people have lost this much on their own, but I have several reasons why I think surgery is a good choice for me. I see it as a tool that will help me facilitate my weight loss. The task at hand is overwhelming to me and I feel surgery will help me. I don't see it as a miracle cure. I will have to continue to do everything I do now. I will continue to use MFP and all of the things I learned during this process, and I will have to continue exercising. I know some people have regain, but I have to wonder if they made the same changes I have made before their surgery. Starting your weight loss journey before surgery is said to help you be more successful. Also, I consulted with my physician and more than one surgeon. I have also taken the extra step to have therapy to sort out the issues in my life that molded the behavior that led to me being obese. My opinion is that no matter how you decide to lose weight, you need to get your head straight before you can get your body right. Honestly I used to be totally anti-surgery, but I think if it's part of a larger overall plan, it can work.