Half a Person
June 9, 2010 1:27 PM   Subscribe

I am 37 years old. I am 5'4. I weigh 250 pounds. Should I get lap-band surgery?

Background: I have been on and off diets since I was 12. The only time I had significant results was when I lost 35 pounds on Weight Watchers 7 years ago. Since then, I've put on 75. I would like to lose around 100, though I'd be happy with 80 or so.

My problem stems from eating pretty much only meat, bread, and cheese. (I don't like most vegetables, and only some fruits.) I do not eat when I'm not hungry, so snacking isn't a potential sabotage route for me.

I have gone through all the preliminary steps for the surgery, and am waiting on approval from my insurance company, which I am likely to get. I have scheduled my surgery. Today, I met with the nutritionist and went through the food regimen for pre- and post-surgery. Now I am panicking. Will I ever be able to eat bread again? How can I enjoy life without diet soda? Should I try diet and exercise one more time? Or, having jumped through all the insurance hoops, should I go ahead?

Have you had bariatric surgery? How did you adjust? Was it hard? Were you successful? Or did you choose not to have surgery, and if so, what (if anything) did you do instead? If it worked, why did it work for you when previous diets didn't?

(I have read all the responses to this AskMe, this one, this one, and this one.
posted by cereselle to Health & Fitness (77 answers total) 18 users marked this as a favorite
Get your thyroid levels checked first. Make sure its not a thyroid problem.

Also dieting alone does not work. You will be surprised how only excersisng more will make you lose weight without changing your eating habbits.

Take the stairs at work. Take walks after eating lunch at work. Things like that .

My parents friend had the lapvband surgery hes lost 100 pounds so far. It makes it so you eat less. You still have infection risks and things like that.

I would seriously get your thyroid levels checked first and get more excersise.
posted by majortom1981 at 1:31 PM on June 9, 2010 [1 favorite]

Ps he enjoys everything he used to eat but you cant drink a lot of alcohol with the lap band. He also does get sick to his stomach a lot also.
posted by majortom1981 at 1:32 PM on June 9, 2010

You need a diet, in the sense that a diet is composed of certain things you eat and certain things you do not. Bariatric surgery will not stop you from eating those things. If you eat or drink things which aggravate the limits of your surgically-reduced stomach (whether it's too-fatty food or too much food or anything else), you will feel absolutely horrible, and that is the consequence. But YOU need to change the way you eat, and a life-altering surgery is a pretty steep price to pay to make you quit your bad habits.

I'm saying this as a strong proponent of Health At Every Size and a bigger person myself. Getting to a goal weight doesn't mean, "Hooray! I can eat cake in public without people giving me dirty looks for being fat!" It means that you still have to watch what you eat if you want to stay there. Lap band surgery is not permanent. If you have food issues (using it as comfort or staying away from certain foods, for example) and have lap band surgery, you may replace food with something else -- like alcohol, as happened with an acquaintance of mine. Again, the surgery can't cure the habits.

I mean, really. You're fat, I'm fat, we know this stuff. But it takes a serious change to really internalize it. I'm just not sure that bariatric surgery is the serious change that's right in this situation.
posted by Madamina at 1:37 PM on June 9, 2010 [2 favorites]

To me, if you re hesitating and not yet convinced, I would try the alternative. Or, don't do it just because you jumped through the insurance hoops.
posted by JohnnyGunn at 1:38 PM on June 9, 2010 [1 favorite]

Is there a reason you can't go back on to weight watchers, it sounds like it was working for you, unless I'm missing something?
posted by kylej at 1:41 PM on June 9, 2010

I have a family member and a friend who have done this. One of them enjoyed tremendous success over a long period of time, but struggles to eat well when he does eat -- and he's ended up in the hospital for malnutrition because he makes poor eating choices (so thin but not healthy.) The other enjoyed tremendous short-term success but then plateaued, for reasons TBD (suspecting poor eating habits and lack of exercise have combined to bring her as far as the band alone can take her.)

In short: unless you're eating properly and exercising regularly, the lap band can only help you so much. Ideally, you should start eating properly and exercising regularly right away to develop those habits so you can reap the pre-surgery health benefits (that will also increase the odds of a successful surgery and post-surgical recovery) and help you succeed in the long haul with the band.

Just remember: your new program to eat properly and exercise shouldn't be about the amount of food you eat, or whether or not you lose weight. Instead, you're focusing on making sure all the food you eat is healthy -- and when you have the band and your appetite is reduced, you'll still be eating healthy, but less food overall -- and your body is getting the exercise it needs -- and when the band reduces your food intake overall, you will lose weight.

Good luck, if you decide to go through with the band -- and hey, just for your healthy (forget about weight for now) start eating right and exercising. That always does good by a person.
posted by davejay at 1:41 PM on June 9, 2010

and yes this means no more soda and no more meat/cheese-heavy diets. if you can't make that commitment now, then you're going to have problems post-band. it isn't a panacea, it's just a tool that contributes to the whole effort.
posted by davejay at 1:43 PM on June 9, 2010 [3 favorites]

If you are asking others if you should do it, I would venture to say you're not yet ready.

I have a close friend who is about your size and was considering bariatric surgery. The reality of it is that it's a huge undertaking. I would exhaust all other options before considering surgery, especially because I really don't feel like this is a surgery-or-death situation.

A good nutritionist (you really need vegetables and fruit to maintain your health) and a trainer may change your life and your weight for the better.
posted by rachaelfaith at 1:45 PM on June 9, 2010

My father had this surgery last fall. While I'm 100% sure he's happy with the weight loss, there are a number of things (certain cheeses being the one he's saddest about) that he cannot digest at all. It is often unpredictable whether something will "go down" or not.
posted by roomthreeseventeen at 1:45 PM on June 9, 2010

Anecdata, so take this with a grain of salt, but I know four people who've gone through this surgery. Every one of them has gained a significant amount of the original weight loss back in the long term, and in two of the four cases have gained ~75% of the original weight back within five years. One got severe PTSD out of the surgery, and she's the slimmest of the four. None of them will ever get to behave like a "normal", slim person, ever, which I think is what most obese people want to do at some point.

The only way it actually works is if you keep up a restricted diet indefinitely afterward. If you're going to live on a restricted diet, you don't need to have surgery for that. If you can't live on a restricted diet without the surgery, your chances of doing so while on the surgery do not seem to be good. This is why I decided against it at the one point where I had the opportunity to look into it. I won't consider anything with that sort of failure rate, especially not when the risks of the surgery include serious bodily harm and even death.
posted by gracedissolved at 1:46 PM on June 9, 2010 [2 favorites]

I lost a hundred pounds a decade ago with low carb, and it works for me and continues to work when I need to manage my weight. I happen to think there are other benefits to reduced carbohydrates besides weight loss, but that's not really important here.

Bariatric surgery does work. My ex lost a hundred pounds with bariatric surgery. She's kept it off eight years later. She chose surgery because she couldn't stick with the diet. (That's not an indictment, just a fact -- not everyone can.)

Please know that the surgery basically works by making it painful and unpleasant to eat more than a quarter cup of food at a time. There's a lot of puking involved in getting used to this. Well, plus the whole surgery thing, feeling bizarre inside, and not knowing how your body will react for like four-six months.

Looking back on it all, both of us are happy with how we each did it. What's important is that you do something. Is surgery your something? If you've done your honest best with non-surgical interventions, then yes, you should.
posted by seanmpuckett at 1:47 PM on June 9, 2010

Bariatric surgery in general has a surprisingly low success rate (people do regain much of the weight they lose, quite commonly), and a high rate of complications (like malnutrition from not being able to absorb nutrients. A year or so ago a study was released that found that people who'd had bariatric surgery had a 27% chance of developing neurological problems in the 10 years after the surgery; it was one of the first studies to follow people for longer than 2 years). They're also a big money-maker for hospitals.

I believe from what I've read that the lap band has fewer of these complications than other options, but if you are otherwise healthy it seems like a drastic step. When I weighed 250 pounds, my blood pressure was fine, my blood sugar was fine, I was active and strong. I didn't have any medical conditions that could be exacerbated by my weight or possibly improved by losing weight. Since I believe there's little evidence that being fat in and of itself is a medical condition, I would not have chosen a lap band or other bariatric surgery at that point. It doesn't seem to me like doing something that drastic and risky is worth it just because I'm fat in the absence of health problems.
posted by not that girl at 1:48 PM on June 9, 2010 [3 favorites]

Response by poster: Majortom: I am hypothyroid, and have been on thyroid meds for quite some time. My thyroid levels are fine now. I don't drink alcohol regularly, but I enjoy a glass of wine or a margarita once every couple months or so.

Madamina, those are some very good points. I am also a proponent of HAES, and I'm doing this only because my belly is so big that I can't breathe when I tie my shoes. I am not healthy. :) I am fat, and I'm totally fine with the fat label. And yes, it's the life-altering aspect that's giving me pause. Lots of pause.

kylej: I have tried to go back onto WW, and have trailed off each time. The time that it worked was the year before my wedding, and I had a non-negotiable deadline to meet. Without an important deadline, I have a difficult time staying on the program.

davejay: good info, and you make good points. I need to hear that.
posted by cereselle at 1:56 PM on June 9, 2010

One of my best friends had the surgery. She does eat less and has lost quite a bit of weight but her complete refusal to do any of the other stuff like exercise or eat balanced meals means that she is now an unhealthy size 12 instead of an unhealthy size 18. And by "unhealthy" I mean on blood pressure and cholesterol drugs and pre-diabetic at your age.

If you have never been able to maintain a low volume, nutrient rich diet at all and are "panicking" at the thought of giving up bread this might not be the road for you. It is a major lifestyle overhaul to do it and be healthy in the long run.
posted by fshgrl at 1:56 PM on June 9, 2010

Can you just go back on Weight Watchers and plan to be on it for the rest of your life?

I don't know much about WW; so maybe that's not realistic. When I had to lose weight, I counted calories and kept a spreadsheet, because that's how I roll, and I still keep the spreadsheet and expect to for the rest of my life. I don't mind it and it takes no time, but if I don't have a system in place I will. not. stop. eating. Seriously, I'll eat my own arm.

So--whatever you do, it's 'for the rest of your life'. It kind of seems like the easier thing to do 'for the rest of your life' is find a system that works for you and just allow it to become a part of you, rather than having surgery and high level of maintenance and risks that accompany it.
posted by A Terrible Llama at 1:56 PM on June 9, 2010 [2 favorites]

It sounds like you are looking for an easy way out right now. You say you have tried and had little success, but you just eat meat and bread. Well, sometimes you need to suck things up and do stuff you don't like, like walking 30 minutes a day every day. Eating vegetables, cutting out carbs, changing your lifestyle.

I know it's not that easy. I know I'm simplifying things and making light of a serious situation, but it doesn't sound like you want to do it.

Go see an internist and have everything else checked. My wife just found out she has insulin resistance and when she started taking medication for it, she dropped weight quickly and easily. For the past year, she's been working her ass off and nothing worked. I'm not saying you have insulin resistance, but she wouldn't have known unless she had gone to really figure out what was wrong.

Good luck.
posted by TheBones at 1:58 PM on June 9, 2010 [1 favorite]

You're missing, kylej, that she lost 35 pounds on Weight Watchers and then gained it back plus 40 more pounds.

This: "dieting alone does not work" - is nonsense -- if you eat less than your body burns up it will certainly "work." I've been on plenty of diets and lost weight without being any kind of an exerciser.

I assume that you've had a thorough physical including thyroid check, cereselle?

What did the nutritionist say that scared you? this seems to be the major issue. Did she assure you that you can eat the foods you like, but in smaller quantities? Why can't you have diet soda? Can you tell us what she actually told you about how you have to eat?

If you have to eliminate any of the few foods you seem to like, it sounds as if this may not work for you. Would you be willing to expand your food repertoire at all?
posted by DMelanogaster at 2:00 PM on June 9, 2010

One of my coworkers got lap-band surgery. She looks amazing (I can't tell how much weight she lost, but it's significant) and she keeps losing.

However, she's also one of those folks who can't eat ANYTHING with high fat content. She can't eat bread, either. Like, she says she "keep it down", which sounds scary to me. She complained about it a lot at first, but now it seems like she's enjoying her new bod more than she enjoyed eating those foods.

It sounds like a hard decision for you. My mother has weight problems and struggles with it. It's painful. I wish you luck.
posted by Lizsterr at 2:00 PM on June 9, 2010

Should I try diet and exercise one more time?

As long as you see diet and exercise as temporary issues your weight problems will continue. You need to make permanent life changes.
posted by whiskeyspider at 2:01 PM on June 9, 2010 [10 favorites]

The only time I had significant results was when I lost 35 pounds on Weight Watchers 7 years ago.

Why did you stop?

Solve that problem first, before the surgery. You will need to be disciplined after the surgery, anyway, in the post-op recovery and life-long eating habits phases anyway (e.g. post-surgery, you will be at risk of "dumping syndrome").
posted by Cool Papa Bell at 2:06 PM on June 9, 2010

Response by poster: Another data point that I failed to put into the OP: I have a very hard time exercising because of this weight. I can't walk much further than a couple blocks without severe lower back and foot pain. So I do have that as a health issue. OTOH, my blood pressure and blood sugar are fine.
posted by cereselle at 2:07 PM on June 9, 2010

I have tried to go back onto WW, and have trailed off each time. The time that it worked was the year before my wedding, and I had a non-negotiable deadline to meet. Without an important deadline, I have a difficult time staying on the program.

So give yourself a non-negotiable deadline - lose however many pounds by the end of the year or you have to donate $100 to Sarah Palin.
posted by foodgeek at 2:08 PM on June 9, 2010 [3 favorites]

Another data point that I failed to put into the OP: I have a very hard time exercising because of this weight. I can't walk much further than a couple blocks without severe lower back and foot pain. So I do have that as a health issue.

It may or may not please you to know that exercise has not much to do with weight loss. There's a correlation between permanent weight loss and exercise, but exercise is trivial. It takes a three mile run to get rid of a McDonalds hamburger. If you add a soda and fries, you'll need to run ten miles.
posted by A Terrible Llama at 2:11 PM on June 9, 2010 [1 favorite]

I guess I should have summed that up as "don't worry about exercise right now."
posted by A Terrible Llama at 2:13 PM on June 9, 2010

Response by poster: More info: I stopped WW because I got down to a healthy weight and it felt unnatural and frightening. I am planning to see a therapist about that when I get to that point again. (Actually, I'm going to see a therapist ASAP because of the surgery issue.)

Whiskeyspider's statement pings something in me. It's not necessarily surgery I'm afraid of, it's a permanent life change. That could be surgery, it could be committing to eating 5 servings of fruit and vegetables my whole life, or whatever. I chose surgery because it's something I can't back out of. But now I'm seeing the downside to not being able to back out, and that's a much more restricted choice of foods (even more than I'd be restricted on a permanent diet change). That's valuable information to have.
posted by cereselle at 2:15 PM on June 9, 2010

Do you cook your own meals? I found that when I learned how to cook, I liked vegetables/fruits a lot more.
posted by roomthreeseventeen at 2:21 PM on June 9, 2010 [1 favorite]

You could always try to do the diet change before the surgery - test it out for a little while. Ask the nutritionist to give you a 7-day meal plan of what you would eat after the surgery, then stick to it. If it's unbearable, then give WW another shot and do as suggested - give yourself a deadline to lose X pounds (within reason, with guidance from a nutritionist) and give yourself unpleasant consequences if you don't do it (such as a donation to a cause you don't support).

Losing weight and keeping it off is a lifestyle change, whether you get surgery or not. If you don't have any other issues from being overweight such as high blood pressure or diabetes, then try losing weight with a lifestyle change (diet and exercise), especially if you're not sure about the surgery.

I have found that walking gets more comfortable for me the more I do it - so if you can only go 2 blocks now, just do 2-block walks until 2 blocks feels ok, then increase to 3. You can also try other types of exercise - a stationary bike, swimming, etc. if walking doesn't work for you.
posted by bedhead at 2:23 PM on June 9, 2010

The lapband thing seems extreme and unnecessary. Especially since you can grow a lot as a person doing this under your own power. Here are some thoughts:

- lean proteins fill you up pretty fast -- you could make lots of changes just switching the meat for chicken breast and egg whites, getting rid of the bread and cheese and replacing with fruit and veggies. Also, keeping a food journal and really knowing how many calories you're consuming.

- contra A Terribly Llama, exercising does make a difference in weight loss, in several ways
-- it suppresses appetite
-- it does burn calories
-- it helps preserve muscle mass, keeping your metabolism up (particularly resistance training)
-- it can produce an "afterburn" effect, increasing metabolism.

- Contra DMelanogaster, it's true that dieting alone doesn't work. It works to take pounds off, yes. But you eat up muscle as well as fat. This is bad, because it means it's much easier to put the weight back on afterward (because your metabolism will go down as well as because you'll be less physically able to do stuff).

You don't have to start out with intense exercise. I'd recommend swimming (no-impact), maybe elliptical machine (practically no impact). Just go for ten minutes to start. You can work up to more. Also, some simple resistance exercises -- just lifting five pound weights to start, and then, again, progressing to more. No matter how bad your physical condition is, you can do that.

I've dropped about 40 pounds in the last 5 months starting with the plan in Bill Phillips's Body for Life, and then moving up to more advanced stuff in Tom Venuto's Burn the Fat, Feed the Muscle, which I can't endorse highly enough.
posted by paultopia at 2:25 PM on June 9, 2010 [1 favorite]

to those who say that diet alone will not work.... that's just absolutely not true. i'm not saying that exercise isn't great, and healthy, and all those things, but you have to be aware that exercise (most kinds of it) are actually detrimental to weight loss despite being great for health. weight loss requires one to burn more calories than he consumes. exercise does burn calories (and building muscle in particular will raise metabolism/burn more calories in the long run), but it makes you hungrier! the hunger isn't proportional to the extra burned calories.

the easiest way to think about it is this: it takes 60 minutes to burn 300 calories, and 6 seconds to consume 300 calories.

some sources for the dubious:
why doesn't exercise lead to weight loss?
the scientist and the stairmaster
why exercise won't make you thin
myths about exercise

i'm not saying don't exercise! i'm just saying that going to the gym or "working out" is totally unnecessary (for weight loss, that is). just don't be sedentary. walking is pretty much the best exercise there is (both for weight loss and otherwise). you say you can't walk more than a few blocks without pain, but you could take it step by step (pun only kind of intended). work up to walking more and more the ways runners might train for a marathon.

in the meantime, DIET IS THE BEST WAY. it doesn't matter what you eat, just how much of it you eat. check out sparkpeople, maybe? you're just not
fat enough for such an extreme solution. as a data point, my sister is 37, 5'4", and weighs 280 pounds. she exercises loads and has no problems getting around. maybe you have a smaller frame or other health issues -- who knows? but my point is that you should be able to do this without surgery. start walking more. restrict your calories. voila.
posted by timory at 2:25 PM on June 9, 2010 [2 favorites]

meant to add: check out Stickk.
posted by timory at 2:31 PM on June 9, 2010

Response by poster: Dmelanogaster: The dietician said that I can't have anything carbonated, ever again. The gas expands the stomach pouch and makes you feel "like you're giong to die." I don't mind cutting back on the soda, but those sparkly bubbles are one of my favorite things. She also said that people who have the surgery aren't able to eat bread or rice, because it swells in the stomach pouch and makes them sick. As bread is one of my 3 food groups, that freaks me the hell out.

I don't think that I'm looking for an easy way out, but I am looking for something to make the weight-loss process easier. I'm not sure this is it.

Foodgeek, the Sarah Palin thing is actually a brilliant idea. To make it foolproof, I could give the money to my Republican parents and instruct them to donate it if I don't make it. Because they will.

Room threeseventeen, I know how to cook, but usually my husband cooks or we get takeout. I don't get home until nearly 8 pm.
posted by cereselle at 2:36 PM on June 9, 2010

Have you explored ways to (possibly) enjoy vegetables more? Different or unusual ones (bok choi was my gateway green--I wouldn't have eaten spinach at first but once I got on the wagon with bok choi I branched out), fresher/more in season, cooked differently (a lot of people overcook them)...
posted by needs more cowbell at 2:37 PM on June 9, 2010

I've never had weight trouble, so this is an odd place for me to weigh in, but (re. timory's comments) I think it's really dangerous to tell someone that it doesn't matter at all what they eat, only how much. That's like saying that one person can eat only candy and one person only fruit and (assuming all other things the same) they'll both be in the same condition. That makes absolutely no sense to me.

To the OP, your hesitance about the surgery should be some kind of red flag, which has clearly occurred to you already, since you're asking here. I'll nth the idea that what you need is a major lifestyle change (and that surgery might not be the right change in this case), even if that comes in small steps. I used to make resolutions every year, but like a lot of people I never kept them. This year I've started just forming a lot of good habits gradually, and it's working well for me—I'm talking about things as small as taking the stairs up from the train every day instead of the escalator to things as large as cutting out most meat, starch, and junk food from my diet. Once I started with the smaller changes, I felt more motivated and ready to tackle bigger ones. Yesterday I started my first week of the Couch to 5K running program, and I realized that despite how intimidated I've been by the idea of running for so many years, it wasn't as bad as I expected. Give yourself small goals, and when you reach them, you'll gain confidence. You can do it.
posted by divisjm at 2:43 PM on June 9, 2010

There is so much ridiculous misinformation out there about gastric surgery and it infuriates me that dieticians use this misinformation to scare patients into being "good" or successful.

Note: RNY gastric bypass in January 2009. Your experience may vary.

1. Drinking a soda can feel uncomfortable if I take a big drink or if it's warm. I generally avoid soda because I don't like it, not because "it makes me feel like I want to die".

2. Bread and rice do not cause any problems.

3. Sugar does not make me sick.

4. Fat does not make me sick.

5. The only thing that I cannot eat post-surgery that I could before surgery is peppers, bell or otherwise. As I was never a huge fan of peppers before, this is not a hardship.

I haven't thrown up since surgery. I do not have health problems as a result of surgery. I have not gained any weight back (and in fact, I am still sloooooooowly losing).

However, I wouldn't recommend WLS surgery for you right now. I think you need more than a dietician. You need some therapy. I have seen too many people fail this surgery because they didn't fix their brains before they fixed their stomachs. Figure out why you're fat. Figure out what food means to you. Do you eat because you're hungry? Sad? Bored? Is it your friend? There's a huge emotional upheaval after surgery for a lot of people because they have essentially lost their best friend and stalwart companion. The panic you're feeling because you've been told you can't ever eat bread again suggests to me that there's something deeper there.

It's just food.
posted by elsietheeel at 2:46 PM on June 9, 2010 [3 favorites]

More info: I stopped WW because I got down to a healthy weight and it felt unnatural and frightening.

So why can't or won't the same thing happen after the surgery?
posted by dilettante at 2:47 PM on June 9, 2010 [1 favorite]

Since you are on thyroid medication .Make sure you wait 2 hours after you take your pill before eating. I noticed this helps a lot. your doctor and the directions only say something like a half hour after taking the pill .

I am also thinking its your lack of vegtables. Fiber is a big help in losing weight

PS Excersise can be anything not just running. Doing things like taking the stairs instead of the elevator. Parking father away . taking walks during lunch all help .So dont tell him excersising wont work .

Also make sure your levels are ok .When was the last time you had them checked?
posted by majortom1981 at 2:48 PM on June 9, 2010

My problem stems from eating pretty much only meat, bread, and cheese. (I don't like most vegetables, and only some fruits.)

Children are picky eaters; adults should not be. Start eating more vegetables. After eating them for a while, you'll get used to them and you'll begin to like them. You need to eat like a responsible adult (I say this despite my awareness that many Americans don't do it). That means eating healthy food, whether or not it's your favourite.
posted by smorange at 2:48 PM on June 9, 2010

Also stop drinking soda. Repalce your soda intake with water. This means diet soda also.
posted by majortom1981 at 2:49 PM on June 9, 2010 [1 favorite]

Response by poster: timory: that stickK site is amazing. I am excited already!

At this point, what I think is that I'll try WW and exercise again for the next month, and see how it feels. I'll use the motivational techniques y'all have suggested, and if I feel good about it at the end of the month, I'll cancel the surgery (which isn't scheduled until July 20.)
posted by cereselle at 2:53 PM on June 9, 2010

Sent you a MeFi mail regarding my similar choice last year!
posted by theredpen at 2:53 PM on June 9, 2010

Would you consider trying hypnosis? There have been some stories recently that doing hypnosis to make yourself believe you have a lap band can be effective. Here is a link to a UK site. I mention this because I read those stories and decided to do hypnosis for an entirely different issue [fear of flying]. It totally worked.
posted by hazleweather at 2:57 PM on June 9, 2010 [1 favorite]

Sorry, can't figure out how to link. Apologies for the strange font above too [not very familiar with how to post]. The website is http://gmband.com. Cheers.
posted by hazleweather at 2:59 PM on June 9, 2010

If you don't want to/won't be able to give up bread, then don't get the surgery. Find another way to get the results you want. At least on a low-carb diet you don't have to forever get rid of bread!
posted by Sassyfras at 3:01 PM on June 9, 2010

Get your spouse to help you get on an exercise program to get your heart into shape. Join a group that walks together.

Gastric surgery? A friend had it, and I've watched her butter a piece of bread incredibly thoroughly to get it down. She initially lost, but has been really eating a lot, in small amounts, and has gained a lot back. To lose weight, you will have to give up things you like - soda and other things. But, the pleasure of having a healthier, more agile body with more stamina and energy is way nicer than diet soda and whatever else you may have to limit. Good luck, really. Trying again to use WW and other means is a good plan - you can change your mind if it doesn't work out.
posted by theora55 at 3:10 PM on June 9, 2010

Is there anything you can do about the fact that you come home at 8pm? The times in my life where I've had the worst eating habits were the times where my schedule was too packed to fit in cooking and sitting down and eating properly. If it's at all possible to change your schedule to come home a little earlier to help with the dinner planning and cooking, it might pay off. I know and sympathize with the feeling of being too tired to bother with real food; I have days where I come home late and look at the kale in my fridge and curse it because it requires time and effort to make it tasty, and I'm hungry NOW damnit and I don't want no stinking kale. You need to anticipate that feeling and work around it so that the kale seems like a slightly more appealing option. That's probably only a piece of the puzzle for you, but an important one.

Bariatric surgery will not give you extra hours in the day or the energy to cook, sadly.
posted by slow graffiti at 3:17 PM on June 9, 2010 [1 favorite]

>> My problem stems from eating pretty much only meat, bread, and cheese.

So only eat recipes from this book?


(Plus a full-spectrum b-vitamin supplement and maybe some krill oil.)

It's simple, high-calorie food. You won't go hungry. But the macronutrient ratios will make you lose weight.

If you only eat meat, bread, and cheese because you're busy, than this is a lifestyle issue. Surgery will not fix your lifestyle. Fixing your lifestyle so you have more time to cook and learning to cook more efficiently will fix your lifestyle.
posted by zeek321 at 3:20 PM on June 9, 2010

Ok, I'll put my $.02 cents here.

I had the bypass surgery on July 20th, 2009. So I'm getting close to my 1 year anniversary of the surgery. So far I have lost a total of 151 lbs. I started at 378. My energy level is very much higher, I can exercise a lot more, and feel like I'm finally contributing to my family duties more and more.

I was in the same boat as your are as far as exercise goes, I was only able to complete my day at work, and then come home sit in a chair, then go to bed, to try and get up and do it again the next day. I didn't have huge health problems, high cholestoral, high blood pressure, sleep apnea, was my main concerns. However, my family has a history of obesity and heart problems, so keeping on the way I was going was asking for trouble! That is why I went the option of bypass surgery. Now, I don't have to take cholestoral medicine, and from 2 blood pressure medications, down to 1 every other day. Sleep apnea has gone also. Gone from wearing size 58 pants to 38's, and 5X shirts down to XL now. Those are the positives I have gained from the weightloss surgery.

However, the surgery is not the end all of the journey, but the start of the journey. Yes you are right about carbonation, you are not supposed to have any. I was a diet coke drinker hardcore, usually a six pack a day, if not more. Had my last one July 19th, the day before my surgery. Honestly, with all the water that I have to consume, I don't have time for diet coke. As far as carbs are concerned (bread), I can eat a few bites of this but it does fill me up fast. The eating plan after surgery takes a while to get used to, mainly it is getting all the protein into your system on a daily basis. I need 70-80 grams of protein every day, so the first thing I eat on my meals is protein, if I have room then I eat vegetables, and then if I still have room carbs. However, you fill up so fast that you don't really want those carbs. I have had no sugars to speak of, because one, now that I have been this succesful, I don't want to go back there. Two, it could cause dumping, or getting sick because of the excess fat. Now that I'm almost a year out, I have been able to try different foods, but I try to stick to the original eating plan. I have been able to consume a little more food since I started, but it still seems like an awful little amount. This is adjustable to all people, depending on how the surgery goes.

I think the best way is to look at the surgery as a tool to help with your weight loss, not an end all be all. My surgeon and team that was assigned to me was very thourogh with the information and questions I had before making my decision. I was assigned a nutritionist for the first year, and a personal trainer during that time also. I have had friends that had the surgery, and then go on doing the same bad things that they did before, and gain all the weight back again. You need to use your tool to help you make the changes that you know you need to make.

My first three months after surgery were pure hell, I won't lie. I went back a month after my surgery and had my gall bladder removed, and had some other problems with dehydration and the like, but in retrospect, I would have the surgery done years ago, because of the way I feel now. You really have to go about the surgery with the right mindset, yes you are restricted to what you can eat, and drink, but when is the last time you went on a diet knowing you are going to keep all the weight off? This was a very hard decision for me, and I know you are considering all the bad things that can happen, and need to change. However, if you do decide to go for the surgery, make sure you have all the backing that you need from the DR. and clinic that the surgery comes from. You said yourself you did WW for a time, and then regained all the weight, the tool of the surgery will help you get the right mindset, but it is a COMPLETE lifestyle change. The best way I can describe the diet after surgery is like a modified atkins plan.

(Oh also, forgot to add, you have to take a lot of vitamins to help your body replace some of the nutrients you aren't getting from the food. This does take awhile to get used to, but it can be done.)
posted by snoelle at 3:28 PM on June 9, 2010 [2 favorites]

Also forgot to add, if you have any further questions, please me-mail me, I will try to get back to you as soon as possible, Good Luck!!
posted by snoelle at 3:28 PM on June 9, 2010

Timory, the very last link you posted gives good reason to disbelieve your claims. It quotes a bunch of scientists saying their claims were misrepresented when they were reported as saying exercise doesn't matter.
posted by paultopia at 3:39 PM on June 9, 2010

I posted this in another thread, but I'll summarize here, again. This is purely my experience, and is not presented as the norm, but as an example of what can go wrong. You already replied in thread, but I'll chime in anyway.

I had the surgery in 2008, and got a massive infection. I spent two weeks in the hospital, had the band removed, had a port put in for home antibiotics, a pouch in my abdomen to drain all the infected crap in my stomach, and nearly had to go on dialysis. I spent the first week in the hospital high as a kite, hallucinating from the pain meds, and the second week in abject misery, and came out of it all having lost 35 pounds, but only because I didn't eat for six weeks. I nearly had to drop out of my graduate program because of the time I missed, but managed to work it out.

If you decide to have the surgery:

Research, research and research some more. I know you said you already followed the steps, but unless you are in such dire condition that you are going to die soon from weight related causes, there is no hurry. I highly recommend obesityhelp.com, which has patient stories and testimonials. Please, please, don't get sucked in my the promise of easy weight loss. You can always reschedule your surgery for a time when you are more sure, and feel more ready.

I can't speak to the post-surgery lifestyle, because I only had mine for about two weeks before I had complications, but listen to your body. If you experience anything that seems out of the ordinary, contact your doctor, or get to an emergency room. Make sure your doctor has some reliable way to contact them with questions that involves more than calling the office and leaving a message.

If you decide not to have the surgery:

Your weight loss on WW proves that you are able to lose weight; as they say in AA, "the program works, when you work it." I have to remind myself that the progress or lack of progress is my own doing. This is contrary to what WW leaders will have you believe, and might not work for everyone, but it does for me. I need the accountability to realize that what I put in my mouth effects what I see on the scale, but I try not to beat myself up when it doesn't go the way I want. WW works for me, because I can eat the foods I like, as long as I do it within limits. Now, the thought of giving up sushi because I can't eat rice anymore seems crazy.

It's a cliche, but find an exercise you love doing, and do it. For me, that's roller derby. I weigh more than you, and I'm skating three or four times a week. I have to sit down more than everyone else, but I'm making slow progress.

Obviously my views on WLS are colored by my own experiences, and there are people who have been happy with their results. My belief is that it should be a last resort, taken as an option when death is imminent. It is far from the easy way out, but changing the anatomy doesn't change the mental state that helped get us to this point in the first place.

I've already written a dissertation, but if you have any other questions, feel free to send me a message.
posted by lemonwheel at 3:48 PM on June 9, 2010 [2 favorites]

My coworker got the surgery and she highly recommends the book Weight Loss Surgery for Dummies.
posted by whoaali at 4:10 PM on June 9, 2010

Paultopia, do you have any data to dispute this? Because I've been seeing the same studies as Timory.

It's not that exercise doesn't matter--everything matters, including whether or not to put a teaspoon of sugar in your coffee--it's how much it matters, and the fact that a lot of people don't understand the math because it tends to slide beneath the surface.

No one wants to hear to eat less. I run twenty miles a week, and I'm still incredibly careful about what I eat and truthfully would like to lose ten or twenty pounds as much as the next person. When you look at fitness magazines and so on, there's a lot of focus on how the right abdominal exercise will give you flat abs or a perfect ass but fail to put up front and center that if you don't stop drinking ginormous coffee drink frappewhatsits you will never, ever, lose weight.
posted by A Terrible Llama at 4:15 PM on June 9, 2010

If you haven't tried it, give the Atkins / low-carb a shot. It isn't for everyone, but I know of many who have lost substantial amounts of weight on it.

It's great because when you are feeling down (or when you first start) you can pig-out on traditionally unhealthy things like cheeseburgers (no buns!). Most people I know gorged on red meat, eggs, deli meats and cheese at first and then when their body adjusted they moved more into chicken and fishes.

Atkins and being in ketosis is not a great long-term diet (though low/moderate carbs can be more sustainable), but it is a great way to lose a bunch of weight quickly, if you take it seriously.
posted by jameslavelle3 at 4:15 PM on June 9, 2010

Just as a perspective -- I'm 28, 5'4 and two years ago I weighed 335lbs. I have lost a hundred pounds over the past two years without any surgery, just really hard work at the gym and weight watchers online. It honestly can be done. There are a lot of complications and risks that come with the surgery (I seriously considered it myself) and it isn't fool proof. You still have to make some incredibly hard lifestyle changes before and after the surgery and if you don't make real changes you can gain the weight back. I decided for my life and my body I was ready to make the changes to my lifestyle to lose the weight that didn't require surgery. I still have a ways to go, and there are times when I struggle with it, but it is possible to do without surgery.

If you want to talk about it or want more information, feel free to message me.
posted by gwenlister at 4:19 PM on June 9, 2010

i'm going to repeat this, because people seem to be misunderstanding.

exercise is good for you.
what you eat matters, not just how much.

HOWEVER. purely for weight loss purposes (not for health!), it really does NOT matter what you eat or if you exercise. if only matters how many calories in and how many calories out.

i'm not telling anybody to eat candy bars all day and take root on their sofas. this is just simple math.

i know a lot more goes into fitness and health than just this. really. i don't think i'm giving dangerous advice at all. all i want to tell the OP is that she doesn't have to give up the things she loves to eat in order to lose weight!
posted by timory at 4:21 PM on June 9, 2010

I think the problem is here is that you're contextualising your issue as a "fat" issue, or a weight issue. The issue here is that you're living a tremendously unhealthy lifestyle. If you have band surgery, you may or may not get skinny (plenty of people don't), but you will still be living a lifestyle that is deeply unhealthy. A lifestyle that may affect your mortality, and drastically affects your quality of life.

Whichever way you slice it, if you truly want to lose weight, you are looking at a lifestyle change, first and foremost. Surgery etc. will not act as a trump card here: to lose weight you must change the way you live now.

I think you should be seeing a counselor and nutritionist and work on eating a proper balanced diet with both of them. Also; bread, meat, and cheese alone do not cause weight gain (though I'm shocked you haven't keeled over from scurvy or rickets!), you are eating too much of these things.

Best of luck, whatever your decision is. Change can be very scary, but it can also be very liberating.
posted by smoke at 4:22 PM on June 9, 2010

My fiancee and I started Weight Watchers about a month ago and I'm kind of impressed with how their program motivates you to not just eat less but to eat better. The weekly meetings keep weight loss in the forefront of your mind, and the way they calculate points steers you toward healthier foods so you can eat more. Tracking everything you eat makes you very aware of portion sizes and that, yeah, you were eating way too much before.

Another motivator is that once you reach your goal weight, you can continue attending meetings free for the rest of your life (as long as you remain within a couple pounds of your goal) to help you maintain your habits.

They have changed the diet plan since you last tried it, by the way. You now get an allowance of points that you can use at any time during the week (some each day, all at once, or however else you like) in addition to the use-it-or-lose-it daily point allowance. And since you can eat anything you want, it is easy to combine WW with low-carb or anything, really. (My favorite, which I've recommended here more than once, is the Shangri-La Diet.)

It's too early to see whether it will be successful for us, but I think if it was successful for you before, it's probably worth another try.
posted by kindall at 4:40 PM on June 9, 2010

I am a little shorter and a little heavier than you and I would not have WLS. I am glad to hear you chose Lap-Band because at least it can be removed. A friend of mine had a RNY in 1998 (at 350 lbs) and she almost died because of a hernia that wrapped around her esophagus a few years later. It took a 14-hour surgery to repair and she was cut from collarbone to bellybutton and then all the way around the back, because they did a tummy tuck while they were at it. (They had already promised her that, and had no idea how bad the hernia was until they were already operating - the surgery was only supposed to take about 2 hours.) After all this she also had to be fed by gastric tube for 3 months via a backpack that was connected pretty much 24-7. Today she still vomits a lot, often gets bowel obstructions, has lost all her bottom teeth due to chronic malnutrition, and osteporosis already runs in her family and she's had both knees and a hip replaced (in her mid-40s) and has very brittle bones. She doesn't often feel hungry anymore and so will go half the day without eating and then wonder why she is dizzy and shaky. And she still has body issues... she is thin enough that her bones stick out in places and she still thinks she's fat and could stand to lose another 20 pounds.

Conversely, a different friend's mom had RNY and is doing fabulously. But I'm not willing to take that risk and turn out with all those horrible complications. I hope the best for you whatever you decide.
posted by IndigoRain at 4:49 PM on June 9, 2010

This is the story about my decision not to have the surgery. (sorry this is long). Nearly 2 years ago, my doctor scared the bejeezus out of me when he suggested I think about bariatric surgery (I was a size 24 and some 24s were a bit tight). I really, really did not want to admit to myself I needed it. But I had a problem in that I love to eat - cheese! wine! all sorts of non-diety foods! and I hated, like seriously hated so much, to exercise. I am clumsy and PE class left me scarred and sweating is so gross, etc etc.

But ya know, I knew the damn doctor was right. Asshole.
A friend (and fellow mefite) suggested trying a gym that was not a big box LA Fitness just-wants-your-monies kind of place.So I got myself to the YMCA and started easy - water aerobics (with flotation device), 5 or 10 minutes on the elliptical or treadmill, low weights on nautilus machines. I adjusted my eating a little - fewer desserts and snacks, smaller portions, made healthier choices but did nothing dramatic with the food.I enjoyed the Y because there were so many people there of different weights and ages and abilities I didn't feel conspicuous or (too) goofy.
I did this for 16 months. I got stronger and id more. It worked, but I got a little bored. The same friend got me an introductory membership at Crossfit for Christmas 2009. I DID NOT WANT. Those #%%#!*&s are crazy hardcore and they seem to like it. Weirdos.

I have been with Crossfit for 4 months and 29 days. I am a size 14 and I can clean and jerk I dunno, 70 or 90 pounds. I can row. I can swing a 25 pound kettlebell til my arms fall off. I can do many, many sit-ups. I am getting to where I can someday do a "real" pull-up. It's awesome. I am becoming a fit person. I can kick ass. And I still eat "real" food though I pay attention so I get good "fuel" for my workouts. I still have fajitas and a few margaritas on Friday nights. If I can do this, it is highly likely you can too - if you want to go this kind of route.

The best part: I saw my doctor last month and he says I am a different person. He's right.
So you, know, surgery may be right for you. My dad had lap band and he's decently happy. A friend had gastric bypass and she's happy (and a size 4). You may not like or have access to the Y or Crossfit. But I will tell you I would never in a zillion years trade my 200-pound deadlift or the scar on my knee from the first time I did 50 damn burpees for ANYTHING.

Good luck to you!
posted by pointystick at 5:01 PM on June 9, 2010 [11 favorites]

I'm seven years out from gastric bypass surgery. It's the best decision I've ever made. I lost 180 initially, I've put 50 back on with the birth of a second child and too many double stuff oreos but I would do it again in a FLASH! I've had some iron issues, had to have infusions but I can drink carbonation. Haven't read all the posts but if you reall feel no way out, do it. Best thing I EVER did besides my fertility treatments to get my babies. MeMail me if you need to.
posted by pearlybob at 5:23 PM on June 9, 2010

Calories in
calories expended
weight gain or weight loss

intake fewer calories
expend more
or both
surgery to force you into one choice is not the answer.

56 inch waist to 32 inch waist.
I now have the same size /clothing size I did when I was 20 years younger. Due to increasing calories expended and moderating calories taken in.

It's just simple metabolic math.
posted by BrooksCooper at 8:45 PM on June 9, 2010

Following up on the calories-in/calories-out, I wanted to share a strategy I've seen, and used successfully in the past:

Carry around an index card and write down absolutely everything you eat or drink. When you start doing this, measure your food so that your record is accurate. Most people will underestimate the quantity of food on a plate or in a bowl.

At the end of the day, tally up your calories.

Most people drastically underestimate how much they eat, and overestimate the amount of exercise they do in a day. The index card keeps you honest.

After a couple of weeks, you can start looking for ways to decrease the quantity of food you're consuming. Do that, and be honest with yourself about it, and you'll see the weight start of come off, no surgery required.
posted by burntflowers at 8:58 PM on June 9, 2010

This statement from you, cereselle, sets off all my alarm bells:

I stopped WW because I got down to a healthy weight and it felt unnatural and frightening.

I'm glad you're going to see a therapist about the surgery but I don't think you should put this part off til later. There's a disconnect in your brain, I think, because being at a healthy weight shouldn't feel unnatural and frightening. It should feel empowering and victorious.

I think you've realized that you thought the surgery was going to be your "quick and easy" fix, but you know now that it won't be. You need to stop thinking in terms of "diet" and really wrap your head around "lifestyle change." Yeah, it sucks. I used to be able to eat anything I wanted, whenever I wanted to eat it, and I didn't gain weight. Everyone said it would catch up with me someday but I laughed it off. It did catch up with me and I've struggled to get the weight back off. I started out thinking "everything in moderation" would be fine. It wasn't. I had to make a total lifestyle change and that was not easy for me. I was resentful for a long time until I started seeing results. I still get a little sad knowing I'll never, ever be able to go back to my devil-may-care days but I want a long, healthy life more than I want the stuff that's bad for me.

Until you get to that point, things aren't going to change for you, and surgery for sure isn't going to change you.
posted by cooker girl at 9:55 PM on June 9, 2010 [1 favorite]

I have to chime in on the "exercise doesn't help" theme. As a former professional athlete and outdoor professional I can assure you that is utter bollocks. The only time in my life I have ever gained weight are the times I'm stuck in the office for extended periods of time. I couldn't lose weight if you paid me to at those times and quickly develop a gut but it melts off when I return to constant levels of activity. I have 6 people on my crew, there isn't a gym membership between us and we are all in great shape. And eat plenty of normal food.

Some of us are not designed to be sedentary.45 minutes 4 times a week on an elliptical doesn't cut it, you could starve me and it wouldn't help (im a light eater so I mean that).
posted by fshgrl at 10:39 PM on June 9, 2010 [1 favorite]

I stopped WW because I got down to a healthy weight and it felt unnatural and frightening.

I read a book once by a guy who talked about his dieting experiences. He said that he came to the realisation that his weight was something comfortable to him, something he could hide behind. He felt naked and exposed without all the extra pounds on him. Something in him didn't actually *want* to be thin. This made it very difficult for him.
I don't know if you feel similarly but it might be a good starting point to think about, and for reframing your goals.

I am not overweight myself, but I was a very unhealthy eater. No breakfast, snacking instead of proper meals, very late dinners, few veggies, no fruit etc. One thing that changed the way I look at things was when a food expert told me: "the feeling of hunger is your body saying 'I need food, I am lacking nutrients. So you give it sugars and fats instead of what it asked for and it is temporarily happy, but then your blood sugar plummets all over again, and you are filled with this craving again. And you keep doing this, instead of giving it what it really needs."
I guess I just liked the idea of supplying my body with the stuff it needs, as often as I feel hungry, in small preplanned doses. It changed the way I thought about eating. (Which used to be "My body wants sweet stuff! Look how it's craving!")
He also said, "No one I know ever lost weight unless they started eating proper breakfasts." And that changed a lot for me.
posted by Omnomnom at 4:48 AM on June 10, 2010 [1 favorite]

I'll be a little blunt because...well, because it needs being said sometimes.

A large part of my job involves purchasing durable medical equipment for people who cannot afford it themselves. By and large, the waiting list for my program is upwards of 3 years. I buy everything from ramps to bathroom modifications to walkers and wheelchairs. In this state, obesity alone will not get you disability. However, obesity leads to a myriad of issues that will get you disability. In order to get disability, you can't work. Probably a full 2/3 of the people I work with daily have health issues related to obesity, although most of them became obese after losing their primary mobility to some other issue. Anyway...

At 37 and 250 you've got a choice to make. You're either going to go down the path where, in 7-10 years, you won't be walking any more. You won't be able to use a normal wheelchair, either, you'll need an extra-wide that won't realistically fit through most doors, and most places simply aren't accessible. Once you stop walking very much, you'll develop COPD or another respiratory issue. Once you develop that, you'll really barely move. Then really everything goes down hill. You get lymphadema, you get diabetes, and by and large medicare doesn't really care. At some point, you'll no longer be eligible for surgical alternatives because of the trauma it would exert on your body. At 37, you're at the point where your body is going to start to do things on its own, regardless of what you intend.

I'm 30 and overweight. I'm very active, I play on soccer leagues and hike and whatnot, I just dearly love to eat. I'm not trying to be mean to you---I'm saying that you need to look at yourself and decide where you're going to go---and probably involve some others in that decision. Over-eaters anonymous, therapy, something. Your size and behaviours are the result of a lifetime of making your own decisions and deciding what you like and what you love and what you really don't like. Up and changing those things---well, of course, that's difficult for any of us to comprehend--or to follow up with. Knowing what you need to do and doing it---two different things entirely.

Find some people with similar concerns and interests, share yourself with others, and step away from your shame if you have any. I would recommend that you try a serious program before you do surgery, if for no other reason than to get yourself into a rhythm and a discipline level where you know you can do your post-op routine w/o hesitation.

I have a friend who is also 30, and she's closer to 300lbs. She recently had a baby, and as a new years resolution she promised herself (and for her little one) that she'd do bootcamp, at least 4 days a week, for an entire year. She's not shedding weight like she thought she would, but her cardio is doing great and overall she's much healthier. As she's getting healthier, she WANTS to eat better, she's got incentive.

Anyway, I'm totally off the tracks now. My point is---make a decision. Be tough. No more wishy-washy.
posted by TomMelee at 5:26 AM on June 10, 2010 [4 favorites]


the reason this is the case for you is because you are a former professional athlete. you are in a completely different boat from most people. exercise at your normal level DOES help, and quite a bit, because you've reached the point where you have so much muscle and are so fit that your resting metabolism is much higher and you burn more calories naturally.

for the rest of us slobs, heavy exercise isn't going to help. maybe in the long run it will. (almost definitely in the long run it will.) but we have to reach that incredibly high level that you've attained. 45 minutes 4 times a week is quite a lot for those of us who aren't at all fit, and you say that's nowhere near enough for you. you're a light eater because exercise is your norm, it's not a shock to the system.

getting fit from fat takes diet first, then (heavy) exercise. you were fit to begin with! of course a drastic change to your active lifestyle makes you gain weight.
posted by timory at 6:25 AM on June 10, 2010

You are fat likely for emotional reasons that make you eat too much food. What you eat makes you very fat only if you eat way too much of it. Sure, surgery will provide a physical barrier to eating too much (at least for a while), but are you confident that you're emotionally where you need to be to keep from overeating again in the future? I'm not confident for you.

What benefit do you get out of being fat? There's something to your statement of how being thinner felt unnatural to you. In many cases (warning: psychobabble ahead!) I believe women are fat because for whatever reason they're putting up a physical barrier between them and the larger number of others who would find them attractive were they smaller. i.e., They stay fat to ward off attention. And this behavior usually has the side effect of weeding out the chaff who are "too shallow" to appreciate the winning personality and shining intellect of a fat girl.

I say this with affection and commiseration, as a former fellow fat girl. As many in this thread have said, if you want to weigh less, the changes you make will need to last quite literally all your life. It's a myth that there are people who've been fat for years, took one year out of their life to work out or have surgery, and then remained healthy/lighter/skinny after returning entirely to their former unhealthy eating habits. Those people don't exist. And you won't be the trailblazer.

But the results from the lifelong changes you know you have to make are so liberating! You're quite literally lighter! You take up less room on the bus, on a plane, at the movies, at a wedding. Your don't have to move conference seating further apart because it's too awkward to sit with your thighs touching a stranger for a couple of hours. You don't have that awful too-full-to-turn-over-in-bed feeling. You save money by eating less! You get to shop at a wider selection of clothing stores--and you don't have to settle for what merely fits (or zips up or doesn't strain at the buttons) because you'll be able to fit into lots of stuff. You can wear more flirty skirts because your thighs won't rub together. You get to be recognized for making a major accomplishment; you won't believe all the compliments you'll get. You will totally kick ass! You will probably get more years on this earth than if you stay fat! Who doesn't want to live longer?

There's not a day you won't have to pay attention to it. Like a diabetic who manages their condition with insulin, your new attitude toward food, exercise, and being generally healthier will move over time from drudgery to annoyance to "eh, it is what it is."

So if you're asking "Is being thinner it worth it?" The answer is a resounding FUCK YEAH. If you're asking "Am I ready to have surgery?" the only person who can answer is you. But I don't think you sound emotionally ready to make the changes required post-surgery. Like others in this thread, I recommend a therapist--and not one focused on the surgery. It sounds to me like you need someone to help you understand why you overeat at all.

Good luck!
posted by ImproviseOrDie at 7:28 AM on June 10, 2010 [9 favorites]

I wish you could favorite comments more than once. If I could, I'd favorite ImproviseOrDie's comment about fifty times.
posted by elsietheeel at 9:44 AM on June 10, 2010

Timory; that is simply not true. I get unfit and gain weight the exact same as anyone else if I'm sedentary. I lose it when I'm active. The only difference is the amount of activity (especially now that I'm old and broken). If any "slob" I know got as much exercise as I do, or my friends do, they'd rapidly get into shape. Fit people are not equipped with magic fat burning body parts or genetically superior or whatever you are trying to say.

I've gotten really out of shape and had to work hard to get fit again in my 30s. It sucked just like it would suck for anyone. It's doable but it takes a LOT more work than most people think so they get frustrated and quit.
posted by fshgrl at 11:12 AM on June 10, 2010 [1 favorite]

I want to pop back in to say my experience has been very similar to fshgirl's although I was never athletic in the least. I did the exercise first, then heavy exercise and had results (got smaller, lighter, stronger) and only then changed my eating. I think that is backwards from what many people do and many people may not want to it that way but it worked for me. I still have a long way to go and definitely changing both diet AND exercise is optimal but I have seen so many combinations of things work for people that I think the big thing is find what works for you.
also cereselle, feel free to memail me if you want more info about my experiences.
posted by pointystick at 12:47 PM on June 10, 2010

for what it's worth, taking numbers and blanket generalizations entirely out of the equation, exercise has never helped me, no matter how rigorous it was.

i lost 80 pounds and kept it off for the past 10 years through diet alone. (a very healthy diet of about 1500 calories per day, if you're curious). i am not sedentary -- i walk about 3 miles a day -- but i don't actually go to the gym or do anything to exercise on purpose. after losing the weight, i began to exercise very heavily, both cardio and strength, for about a year (at least three times per week for several hours, i'd say). i continued my diet on top of this. the exercise made me stronger, but i did not lose any weight while i was doing it and my appetite was through the roof. only when i stopped and went back my current "normal" level of exercise did the weight start dropping off again.

maybe i'm the anomaly here, but i'm certainly not the only one who thinks intense exercise is unnecessary for weight loss. if it helps you, that's fantastic -- i'm jealous! but it doesn't help me, and it doesn't help loads of folks.

i figure it is nice for the OP to hear that she can lose weight without as much effort as some people make it out to be. and, for clarity's sake, once more: diet is good. exercise is good. both together are doublegood. diet alone works for exercise. what you eat matters for your health. how many calories you eat matters for weight loss. many people above have shown the math, and it's correct. however, yes, different things work for different people. i hope we can all at least agree on that!
posted by timory at 2:52 PM on June 10, 2010

I think our ideas of what constitutes "heavy exercise" is quite different timory. On an "office" day I still walk or bike 2-3 hours per day. On weekend or field days its more like 8-10 hours of continuous activity be it working, hiking, yard work or whatever. I rebuilt half my house last year, probably 30 hours of manual labor per week on top of walking the dog, being in the field etc. Do that much physical activity and anyone will lose weight. It's hard not to waste away in fact, as you are often too tired to eat much.
posted by fshgrl at 5:54 PM on June 10, 2010

fhsgrl, that's definitely true. it's just not feasible for most people. that's damn impressive.
posted by timory at 7:14 PM on June 10, 2010

There's a disconnect in your brain, I think, because being at a healthy weight shouldn't feel unnatural and frightening. It should feel empowering and victorious.

Last summer I felt the victorious part, but I also had this unnerving feeling that I had taken someone else's body hostage. There was this feeling that wouldn't go away for a few months because my body had changed so much from its previous self. Ultimately, I figured my brain was just getting used to the new weight/new way of doing things, which is why I felt this odd disconnect with my body for awhile.

maybe i'm the anomaly here

I don't think so. My experiences with diet and exercise are similar to yours. I shed 11 inches from my waist over the course of a year and a half or so just by changing my diet. I didn't follow any of the oft recommended advice either; no scale, calorie counting, diet plan &c. Just watched what I ate, kept track with a measuring tape and, continued doing my errands on foot like I always have.
posted by squeak at 8:54 PM on June 10, 2010

TRimory you are not the anomaly. HeaVy exercise does not help one lose weight.
posted by zia at 11:18 PM on June 10, 2010

Cereselle: I've never been in your situation; my experience with weight loss was wanting to lose 20 or 30 pounds to be healthier. But I'm hoping this will be a valuable thing to hear anyway:

There's a really good chance you can get to a healthy weight and stay there without giving up any foods you love.

The thing that worked best for me was smaller portions.

That (for me) never meant starving myself. All it meant was paying attention to how much I really ate. (Like burntflowers's index card suggestion.)

I'm very short, and yet I've always been able to eat a lot. When I'd go out for Chinese, I'd eat the whole dish. Pizza - I'd go with a friend and eat half a pizza. Sandwiches for lunch at work? I'd eat the whole great big sandwich.

When I decided I wanted to lose weight, the first thing I did was figure out how many calories I was eating. (No, actually, that was the second thing I did. The first thing I did was to cut out practically all my protein in an effort to cut down on fat, and I felt absolutely terrible for two days.) I started measuring things. I measured my breakfast cereal. (Try it sometime. How many "servings", as listed on the side of the box, are you putting in your bowl? It's easy to get 3 servings in a bowl.) I looked up calorie counts for pizza. (Cron-o-meter can be great for this.)

I realized I was eating way more calories a day than I needed to.

So I started lowering that number. Just a single serving of cereal for breakfast instead of 3. Going out for pizza? I discovered I could have half as much and still feel fine. I didn't have that lovely "ooh, I'm soo pleasantly full!" feeling, but I wasn't hungry, either.

And that means leftovers! I love pizza. Now, every time I go out for pizza, I get to have it two days in a row! When I go out for Chinese, I eat half of what they bring me and take the rest home. It feels like I'm eating twice as much of my splurge foods!

And bit by bit, the weight came off and stayed off.

For me, it's been amazingly helpful to realize: I do have to change the way I eat, for the rest of my life; but I don't have to give up food I love, feel like I'm incredibly hungry all the time, or generally stop enjoying food.

For me, anyway, I enjoy food more now than I used to. Because really paying attention to what you're eating can be so much more enjoyable. I used to eat dinner in front of the TV. No more. Now, I pay attention to my meal. I pay attention to each bite - because I'm eating something I like, and I don't want to miss it.

(Okay, I read AskMeFi while I was eating lunch. That's not very mindful. Sigh.)

I'd encourage you to talk about this with your nutritionist and your doctor. Consider what it would mean to you to be able to keep eating the things you love (drinks with bubbles!) ... just more sensible amounts of them.

Good luck.
posted by kristi at 2:51 PM on June 11, 2010

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