(I sincerely hope this is the best board for this question, please let me know if it would be more appropriate elsewhere. I am really looking for support and opinions, not a diet plan so please bare with me as this has the potential to be LONG)
I have struggled with my weight as long as I can remember being alive. Many years of making the wrong choices and emotional eating got me to the point where I am currently a 350lb young woman approaching 30.
Over the last four years I have completely overhauled my lifestyle. I eat a very healthy balanced nutritionist and Dr. approved diet consistently and have tracked every bite for the last 18 months. I trained for and competed in several endurance events in the last year including a 1/2 at my current weight. I walk/run 4x a week for about 3-4 miles and go for 10-12 mile walks on Saturdays. I strength train twice a week and take a circut training class on Wednesday evenings. I feel better than I ever could have imagined and my body is capable of so much more than I ever thought it could be. I am perfectly happy with the way that I look and feel. I have reversed diabetes, lowered my blood pressure, and feel great! The scale however, has barely moved in spite of my best efforts.
I have had menstrual issues and crazy cycles caused by PCOS and the weight throughout this time. A couple of months ago my cycle came back with a serious vengence and despite multiple medication and bcp efforts lasted heavily for over 4 1/2 months and I am still having excessive breakthrough bleeding.
I visited a renowned gynecologist who after evaluating me asked me to come into her office. We talked about my life goals, me getting married and my future. She closed the door, sat next to me, looked me in my eyes and I will never forget what she said:
"Ms WhenTheGoingGetsTough I'm going to give it to you straight. Now that your body is in this pattern we can spend years trying different pharmaceutical solutions; but the fact of the matter is it is all in vain and the problem is your bmi and PCOS symptomns as a result. You are young and I don't want you to be like the patient I just saw who has been going through counteless fertility treatments that ultimately will never work. She was just like you when she came to see me 7 years ago. Now, she is almost 40 and she will never realize her dream of having a child."
"I am asking you to take control of your life. You are doing all of the right things through diet, exercise, and endocrinology that can be done and I think you are a perfect candidate for bariatric surgery. Sometimes our body gets so used to being a certain way that it takes a drastic metabolic shift for your nutrition and exercise efforts to pay off and reset your metabolism and endocrine system. In my professional opinion, I honestly believe if you do not do this you will never be a mother."
She then went on to give me success stories of similar women and gave me a referral to a bariatric surgeon. I have since done a ton of research and been evaluated and have been found to be an 'ideal' candidate for surgery and my insurance covers the bulk of the cost. I guess I have written all of this just to say, I know that I have done everything conventional medicine tells you to do to lose weight, live a healthy lifestyle, and take care of yourself and it stings that this could be the only way to have my efforts in the gym and in the kitchen pay off.
I simply cannot imagine my life without being a Mom and living a long healthy life to be there for my fiance, family, and friends. And I feel like if I don't go through with it, then at this point I am CHOOSING to be okay with that and I'm not.
I guess all of this is to simply ask my strong lovely bees who are actively TTC - if having this surgery was the only way to get to a healthy weight and ultimately become a mother would you do it and not look back?
I wouldn't. I've known several family members that have had it done. Two gained all the weight back, plus some. Two have done it within the past year and are miserable. You have to be very careful about what you eat and eat all the time to make sure you get the proper nutrition. You have to lose a massive amount of weight before they will do the surgery. There's so many follow-up appointments. Two of them experienced nausea and throwing up for months after th surgery. My grandmother has suffered ongoing extreme medical problems years after having her surgery.
If you go into it knowing that it is a lifestyle change, then maybe you can have a better experience. The problem is that your stomach stretches back out if you do not continue to portion control and you'll be back to your old ways (not specifically you, but you get what I mean). You sound like you have a handle on what it may take, but research it. It is not easy and if you don't follow all of the precautions, it is all for nothing.
ETA: I also know it wouldn't work for me. I have a love affair with food that isn't entirely emotional. I enjoy eating what I eat and would rather be a little chubby than to give it all up (don't get me wrong, I'm definitely more than a little chubby!). I'm also a terrible sick person and get super whiny, so my family wouldn't appreciate that.
I guess my question is - if you have truly been following the calorie restricted healthy diet prescribed by your doctor and you haven't lost weight...how does weight loss surgery help? Isn't that just restricting the amount of food which you take in, which in theory, you already are doing?
I would consider the surgery if that was the only way to a successful pregnancy, sure - but i'd also be concerned about the long term effects of weight rebound, which happens in so many people with the surgery. Would it impact your life span at all with regards to being there for your child well into late life?
@crayfish: I had a very similar question for the Dr and the way it was explained to me was that over calorie consumption is not my weight issue but it is my metabolism/endocrine system. WLS by nature is metabolic surgery and through the process my system would essentially be 'reset' allowing my body to respond to diet and exercise the way a normal person's body does.
@WhiteWedding: I appreciate you sharing, my hope is because I have already committed to a healthy lifestyle I won't have some of the same barriers. It is definitely something to keep in mind.
@WhenTheGoingGetsTough: First off, I know that when you have PCOS it is extremely difficult to lose weight. Like near impossible.
I am by no means an expert, but I don't think surgery is the only answer to helping you lose weight. Have you heard of metforin (sp)? I don't know much about it, but I do know that it helps those with PCOS lose weight and in turn regulate their cycles. Before you jump the gun and go for the surgery, I would recommend researching all your options.
I definitely don't think you should give up on your dreams of having your own children and family if that's what you want to do. Good luck!
I probably would. I'm also overweight and have PCOS, and am currently trying to lose weight to get ready to TTC next year. I'm down 35 lbs from June, but I'm still nowhere near a healthy weight. I'm hoping that I can get there on my own, but if not, I'd definitely consider WLS.
I have two relatives who had bariatric surgery. (Not sure if it was the lap band or something else... this was maybe 10 years ago.) One of them lost a lot of weight very fast, but put it all back on over the last five years. The other one got very thin, gained a bit of weight back but then stabilized at what I guess I'd call slightly chubby. I think the difference was that the second relative made lifestyle changes and was able to get at the root of her emotional eating issues better than the first relative. And since it sounds like you've got that part down, I don't know that WLS would run the same risk of rebound for you as it does for many folks who have it.
But research it carefully - there are a lot of risks and a lot of almost guaranteed discomfort after the surgery. You'll also have to be very careful about what you eat during pregnancy to make sure your baby gets enough nutrition - and I think they suggest delaying TTC until 18 months after your surgery. But then again, there are risks involved with carrying a baby while you're significantly overweight, too, like the heightened risk of gestational diabetes and much higher chance of having to deliver via c-section. So I guess it's just a question of weighing all the risks and making whatever you think is the best decision for yourself. I wish you lots of luck!
@MrsFarmer: Thanks so much for your reply! I am very familiar with Metformin because I tried to take it for several months more than once over the years (along with Glucophage and Januvia) and my body simply never tolerated it.
I have also seen many success stories of women who have PCOS having healthy pregnancies, but with a BMI of 58 I would be putting myself and my future baby in jeopardy and be extremely high risk. My endocrinologist, gynecologist, and primary think this is the best option for me but it's just scary and I was curious about what the consensus was.
@KatieBklyn: Congratulations on your weight loss I know every lb with PCOS can be a hard battle fought and you should be so proud of yourself. If I do decide to move forward it is because I feel like I have exhausted more traditional options and will work to make it an extension of the life long committment I have already made to myself. Keep up the good work and thank you for sharing with me.
My cousin had the same issues. They told her that she would NEVER be able to have a baby again and she had a cyst on her ovaries not too long ago that was removed. In the end the Dr told her she would not be able to have a baby again and prior to the cyst he said the only chance was weight loss surgery.
She had already committed to the surgery prior to hearing about the cyst as she already has one daughter and felt it would make her more healthy for her daughter as is. Needless to say less than a year ago she had the surgery and lost 100+ lbs already! OH and guess what?!?! We found out she is PREGANT again in August (and she had been trying for YEARS)!
@WhenTheGoingGetsTough: Hi there. I am not sure if you have looked into this but there has been a lot of success in the UK for people to have gastric band hypnotherapy. Essentially you would be hypnotized into thinking you had gastic band surgery. It might be worth a try before surgery. I know it sounds crazy but it really can work. My DH had it for an unrelated condition and it worked wonders.
I wish you the best of luck and hope your dreams of having a little one comes true.
I came across this awhile ago and thought you might find it useful:
http://www.marksdailyapple.com/i-will-never-go-back-to-the-broken-conventional-wisdom-of-my-past/#axzz2DdheD9SH
Not ttc, but if I were I would not have weight loss surgery, but that's probably because I think the conventional food pyramid is crap and doesn't work for everyone - I'd just change what I ate (and not in a switching from regular pasta to whole wheat pasta and cutting out fat kinda way).
Hope this helps, and good luck!
@WhenTheGoingGetsTough: I hope this doesn't come across as insensitive but would you consider adoption? I know some women who dream of having children and carrying the baby is a important part of that process and some women who just want children and adopting is not a problem. If you are uncertain about having the surgery, maybe the thing to consider is the alternative on how to have children (either through child birth or adoption) instead of changing your body.
I honestly thought about this long and hard before TTC. I have been diagnosed with PCOS for over 10 years and I knew the only way to get pregant was to loose weight. However, I limited my carb intake and have stuck to my diet since April and have lost 40lbs.
I understand you have done everything possible to loose the weight and I'm so sorry and sad for you that it's just not coming off. You are doing far more excersise than I could even imagine and I commend you for that, especially for not giving up after the scales haven't moved.
I say, yes, go for it! Of course, if it's what you want to do. Who are we to tell you weather you should or shouldn't get the surgery. We all go through different lengths to acheive our goals - reglardless of what they are. And for you, this surgery would hopefully bring you two - weight loss and bundle of joy!
Wishing you all the best! Please keep us updated on your decision. Good luck!
If I were you, I would get a second opinion from another doctor. If they are also supporting the idea of the surgery I would go for it. It sounds like you've tried everything else, so something so drastic might be the next step. Good luck to you!!!
I'm not currently TTC but I have had bariatric surgery. I had endometrial hyperplasia, which caused heavy cramping periods and my cycles were out of whack due to my BMI. My OBGYN told me that if I didn't get my weight under control that I would likely have a hard time conceiving and or keeping the pregnancy.
I could not imagine not being a mother, I went to the classes that Kaiser provided so I could get informed. I made my decision that this was the best choice for me as dieting and exercising only got me so far. The process of reaching the 10% weightloss required for Kaiser was a year long process for me as I was on medications with a side effect that make you hungry all the time, which was keeping my hyperplasia in check.
In January of 2012 I had vertical sleeve gastrectomy or VSG, I told myself I'm young and I don't want to live with the issues that come along with RNY/gastric bypass for me for the rest of my life. and the band just seemed to high maintenance, VSG was my option over the LAP Band as well. All I can say is that I would do this surgery a million times over, my cycles are regular, my periods are lighter, cramping is almost nill and I feel good about myself, I take estrogen fee NORA-B as my BC and it's working great, I have more energy. Just know that surgery is not a fix-all, it's a tool and you must be committed to a life change, you should probably go to a counselor for your emotional eatting issues as a transfer addiction is a reality in the bariatric world.
My best rescource and inspiration was the VSG forum on www.Obesityhelp.com, you can ask anything and the vets will answer. I also reccomend watching Youtube videos of people documeting their journies, but make sure to watch each type of surgery i.e. VSG, RNY, LAP Band and even the duodenal switch.
If you decide to have children after bariatric surgery just know that there is no real risk to the baby as far as not consuming enough calories, you really only need to take in about 300 extra calories that what your bariatric surgeon set for you which will typically be 1000 to 1200 calories a day during maintenance. I've seen lots of pregnancies and babies born to people on the forums who've had a similar fight as you and I.
I wish you luck with any decision you make.
@plchansen: Thank you so much for sharing your story, would you be open to talking to me a little more about your experience via PM? I am so glad you're doing well!
Thanks so much for all of the advice everyone, I certainly have a lot to think about. I currently eat what I can best describe like a hybrid between Paleo and the GI diet and I feel incredible! I would recommend it for everyone (besides the fact that I haven't achieved the weight loss I need to be truly healthy) and through that and the exercise I am no longer a diabetic, lowered my blood pressure, and really have managed a lot of the unsightly stuff that comes along with PCOS sometimes.
@WhenTheGoingGetsTough: I would be happy to, just PM me and I'll answer anything I can.
I certainly hope I don't step on any toes here, because I know people who have had weight loss surgeries and they're now living awesome lives and I'm truly happy for them, but the though of someone spending all that money on weight loss surgery just to conceive instead of using that money to adopt a sweet child that needs a loving family makes me really sad. There are so many kids who need familes that love them--and if you're one of those who wants that 'baby' experience, there are thousands of teens who are pregnant and looking for adoptive families. If you have enough money for a surgery like gastric bypass, you need to really evaluate and see if that's the best way to use that money. And just because you have the surgery doesn't mean you're not going to have food cravings. Weight loss surgery requires a lot of dedication--you have to plan special meals around a certain diet. Why not just do that anway and not risk your life with this dangerous surgery.
No, I would not do it. Eat healthy, walk a lot, and consider adoption.
I consider weight loss surgery a 'worst case scenario' option. There are so many other paths you can try before going down the path of surgery. Get a second (and third) opinion.
@Wed2Attn: I have thought a lot about that as well, and I can definitely see it from that perspective. Not being able to have children was certainly the catalyst for exploring this option, but will not be the only determining factor if I decide to move forward.
In spite of the great strides I have made in taking great care of myself, the bottom line is my total life expectancy is certainly reduced by continuing to be this heavy. It would be irresponsible of me to give a deserving child a home only not to be around for them as long as I could be - whether that be through having my own, adoption, or fostering. It would be equally irresponsible of me given my health to get pregnant in this body if I could :(
I would not; I say this as someone who was told I would never have a child without medical intervention, and decided to accept that and live my life without children. (Then I got pregnant! Surprise!) I think that for a doctor to offer you this kind of hope -- that you will never have a child without WLS, and that with it you will -- is irresponsible, to be honest. I'm sure she's being honest but that doesn't mean she's right. WLS scares the sh*t out of me. I am grateful that I know a few people who've had it and are still relatively healthy after losing some (but not nearly as much as they were told they would) weight. I would strongly urge you to get a second (and probably third) opinion.
@Budgeting in Seattle: This. Exactly what I was thinking - adoption. There are so many children that would love to call you mom!!! Please think carefully over all of your options!
@FauxBoho: I'm sorry, I couldn't help but LOL at your username given this thread! ;) I have sought out opinions from a gynecologist, primary, endocrionologist, and the bariatrician (though let's not count his opinion 'cause who doesn't want more business, right?). In so many words I'm living the 'worst case scenario' in spite of an active lifestyle and have some really tough decisions to make.
I wouldn't if it were one doc who stood to make some serious cash who suggested it to me. But it sounds like you have had multiple doctors (some of whom have only your health not fiancial gain at heart) say this is a viable and good option for you. It isn't that you aren't doing everything you can to be healthy on your own, it is that your body doesn't want to work with you. I think if your doctors who know your personal health and your own research find this to be a good option for you to make you healthier and allow you a safer opprutunity to conceive, then that is a good thing. Don't let someone else guilt you into thinking it isn't okay for you to want this surgery to have your own biological children. Different things are important to different people and if one of your major life goals is to conceive and carry your own biological children and this gives you that option in addition to giving you a healthier life over all, personally, I would 100% do it.
@WhenTheGoingGetsTough: I am kinda surprised by all the 'don't do it' responses on here. I think I would do it.
I think that you have learned how to not eat emotionally anymore so there's less danger of rebounding. You've tried other drugs. You've tried the lifestyle change thing and stuck with it. It sounds like you are at the final option stage.
I would still get a second opinion and do a LOT of research on the surgery/effects, but if you think you can accept the risks, and the negatives outweigh the positives, you should do it.
I had an unrelated, less risky surgery (boob reduction) and I wish I had it done sooner, so I am definitely a pro-surgery person. You definitely shouldn't take it lightly (which you're not), and only do it for YOU, but this isn't even a vanity thing.
I would seriously consider going through with it if I were you!
@WhenTheGoingGetsTough: lol yes, sometimes I forget about my username :)
I have been on a path to understanding my health and fitness for about 5 years. I have lost a bit of weight over that time but it has taken many failures to get where I am now. I am only here through fully understanding how my body works and what is best for me. It's been long and hard road and to be honest, if I had been handed a pill or given the option to operate I may have take it but by doing that I woudnt have understood why I was unhealthy and how to fix it. That is why I say operating is 'worst case scenario'
Tough love here. No, I would not get weight loss surgery. It doesn't change your metabolism, it restricts your food intake. There are complications and personally I don't think surgery should be an answer to weight loss ever. Have you been to therapy and a nutritionist? I know you think you're doing everything right but *maybe* you're not. I think there are ways for you to lose weight that don't include surgery and the surgery is not easy or fun or a quick fix.
I would definitely do the surgery. Especially since you've done everything in your power to lose the weight on your own. As long as you maintain the new lifestyle you've chosen for yourself, you'll never gain the weight back.
My mom had the lapband surgery. She lost a lot of weight, but never made those hard lifestyle changes. She has since gained some of the weight back and remains overweight. She's still considerably smaller than before the surgery, even though she's not at her ideal healthy weight.
What do you have to lose by doing the surgery? It sounds to me like the worst case scenario is nothing happens. The status quo stays the status quo. Talk to the Doctor. Is that even likely? Sounds to me like you have everything to gain. I wish you all the best!
@RunnerBride13: "I know you think you're doing everything right but obviously you're not." I'm sorry, are you a Doctor? What a ridiculous thing to say. I don't know anyone who has drastically changed their diet and exercise routine the way she has.
Listen to your Doctor. Get a second opinion even. If they recommend it and it's something you want, then do it.
If I wanted a baby, and all these doctors told me I needed surgery in order to have one, I would schedule that surgery for tomorrow.
Having had WLS, I had to make a lot of decisions about why this is my best option and think long and hard about what my realistic espectations were.
People can be anti WLS for the simple fact that they think the person who is overweight is just lazy or eats too much. They may think that the person needs to exercise more and eat healthier. Sometimes that's just not the case. Sometimes medical intervention is the best way to counteract that persons co-morbidities. It sounds to me like you've got a good handle on your diet and you are reasonably active. Sounds like you've tried just about every diet under the sun, but at the end of the day it's your metabolism and PCOS preventing any dramatic weightloss.
Find a WLS support group nearby and drop in. See what issues and struggles they've had. See what victories they had as well. Your best bet is to get yourself informed. I did a ton of research before I made my decision for surgery and I learned so many things on the obesity.com forums, stuff your Dr. wont even tell you will happen. I can tell you the almost every post WLS patient will tell you they would have the surgery a million times over and that they wish they had done it sooner.
I agree with the adoption route if you're having trouble getting pregnant. (Have you already started trying to concieve or are you exploring all of your options first?) Even as a woman who should be able to concieve naturally, my fiance and I are looking at adoption simply because it is the best gift you can give a child who otherwise has no family and no home. There are several adopted children in my family and from personal experience it is no different than raising a birth child, there is still so much love. I understand you're worried about life expectancy but anyone could get hit by a bus no matter how healthy they are. If you want to be a mother, you should raise a child. With your healthy lifestyle currently, who knows if you will have problems later or not? Not every doctor is right.
@RunnerBride13: Certainly, it is unlikely that someone my size got here by 'doing everything right' and I have acknowledged that. But it is equally unlikely that someone that has sought the assistance of a team of specialists + a personal trainer and a nutritionist and put in the work would not see the physical change that should be happening now. Unfortunately, I have a lot of medical factors at play that I did not go into here.
If you are going to be in medicine, surely you know you couldn't possibly see the whole picture in an internet post and I would hope you would provide more constructive, compassionate advice to those under your care.
I don't have an answer to your question but I just wanted to stop in to commend you for the lifestyle changes you've made. I can't even imagine the challenges you have faced with your weight, and the lifestyle changes you made are difficult for anyone, and I really respect what you've accomplished.
@WhenTheGoingGetsTough: I edited "obviously" to "maybe," I realize that the wording wasn't as nice as it could have been.
There are negative affects that surgery can have...try seeing a dietician instead they have a lot more knowledge in diet an nutrition than a doctor or nutritionist. They specialize in that much like a cardiologist specializes in the heart. Tuan nutritionists don't go to school nearly as long as a dietician does.
I have no advice but I commend you on turning your life around! I know how difficult it is.
I commend you for changing your lifestyle, and im sorry your not seeing the scale go down. i know it can be really frustrating when your trying so hard. when i first read your story i thought of course and then as i thought about the many people in my life who have had this surgery i thought no way!
this summer my friend had this surgery and they told her there were hardly no risks. she ate just like they told her to and everything, unfortunately she ended up in the hospital twice for long stays and has now been put into a nursing home! They have continued to monitor her diet and everything and she is still in there months later!
My father inlaw also got told he was an ideal candidate for this surgery the first time he went in there. The only thing is after he spoke with another doctor they told him he couldnt have the surgery it would be to high risk and hes really only 225-250 lbs. But i think they tell almost everyone theyre an ideal candidate if their insurance will help cover it. could be wrong but i do think they recommend it way to often
My aunt also had this surgery and has had many many health issues since including her kidneys which they wanted her to go on dialysis. She can still only manage to eat only a few bites of a sandwhich and it still goes right through her.
I have had 3 friends that had it but were on such a restricted diet afterwards that they wished they never would of done it. They gained back some of the weight but whenever they ate they still were very restricted what they could eat and things always went right through them so they would be running to the bathroom.
I know these scenerios probably dont happen to everyone, but i think when you go to have a surgery they dont always inform you of the bad things that can happen and even in that class they have you go to to inform you on the surgery, its made to persuade you to get the surgery. To me there is just way to much at risk! I know you said you were eating a a balanced diet but did you nutritionist ever recommend trying a gluten free diet? I think i will be switching to something like that in the new year. I have a client who was able to drop 30 lbs in just a few months switching to that because she had a gluten allergy that was making it hard for her to drop weight. I know you probably feel like its a never ending battle with the scale but I wouldnt take the surgery option yet. I would try a little longer and also visit a university hospital if you have any around where they always do a really good look into whats going on with you and can recommend something different. That's what Im doing now for other issues and they are soo helpful! Sorry for being long winded.
Hope things turn out well for you and that you get a little bundle of joy soon!
have the surgery! It will provide more benefits than you'll ever know. I had RNY gastric bypass over 6 years ago (insurance covered it) lost 130lbs and yes, at first you are very restricted with what you can consume (you're supposed to be) but the weight loss was dramatic not to mention I did away with all seven medications I was taking previously AND I no longer had to contend with diabetes, high blood pressure and high cholesterol. Within a week post surgery I was off all meds. It really saved my life. I have not had any children since having the surgery, but after our wedding we plan to TTC immediately and I feel I am in the best shape I've ever been in to have a healthy pregnancy. I eat normally, I just eat healthy and exercise and have been able to maintain a healthy BMI. It's worth it for many reason. It is a personal choice but I am a success story and I wouldn't think twice about doing it again.
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