Weight Loss Surgery - Pre-op weight loss

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03-30-2013, 02:50 AM
Obviously, I'm not getting bariatric surgery because I'm fantastic at losing weight on my own. However, today I learned that I'm actually supposed to be losing weight pre op (only two months left out of six and I'm being told now?!) and they will not do the surgery if I can't manage to do so. Last month was absolutely horrible for me as I went through an all or nothing phase and actually went up a couple pounds. I've already addressed this with my dietitian, but I'm kind of starting to freak out. I know that I can still get to at least 285 realistically (even if it is optimistic), because it will average about 2lbs a week, but having sat between 295 - 300 for so long, it almost feels impossible.

That being said, I know I need to get that out of my head if I'm going to do this - it's NOT impossible, just kind of scary. But I'm done standing in my own way (I'm looking at you, Easter candy.) I know I can do it, and I'm ready to do whatever it takes to do what I need to do. My next appointment isn't until April 25th - that gives me 26 days to give it all I've got to show that I'm making progress in the right direction, and then one month after that until I meet with the surgeon. I know it's never a good thing to expect certain numbers as our bodies don't always agree with us, I'm just using the 2lbs a week as a frame of reference/to keep the over all goal realistic.

Now I'll be the first to admit I definitely haven't been 'trying' to lose at all over the past few months (obviously), because I've been more focused on understanding the emotional/psychological side to this process. Well, I'd like to think I've got a pretty good handle on that now and I'm ready to start trying!

LONG STORY SHORT: It's my understanding that most if not all bariatric patients are required to lose x amount of pounds pre surgery. What did you do/what are you doing to get the weight off in time?

03-30-2013, 05:42 AM
This might be awful advice... but if you aren't where u need to be for surgery wOuld u consider self pay? I spoke with my surgeon in Thursday and he didn't mention anything about losing weight ahead of time . I know it sounds like a lot of money but think of it as if it were equiv to car payment u would have for 5yrs.

Ummm. But when i was doing quick weight lo ss they said to stuff urself with as much protein u can for like a week. No carbs!! Just meat and salad. U can have a half orange morning and night. I lost 7lbs that week and that's with me cheating.

Maybe that can work for u to get the ball rolling to 285!

03-30-2013, 10:13 AM
I had to lose 40lbs before I could even see the surgeon. It took me a year to do so, and not the six months they had anticipated it would take. I was even following the Medifast program that I had used successfully in the past to lose weight. So, I understand the frustration you are experiencing.

Medifast, Optifast, or IP could be methods you could use to lose the weight. They are not cheap, but could help you meet the weight-loss goals faster.

03-30-2013, 10:21 AM
Surgeons have lots of reasons to require weight loss before surgery: proving your motivation, that you can follow directions, shrinking the liver, and so on. Others simply don't want you to GAIN.

My surgeon didn't require patients to LOSE weight, but anyone who weighed 500 pounds or more HAD TO lose some weight because the load limit on the OR table was 500 pounds. He did require, however, that you didn't gain anything.

Now, as Zeitgeist said, it really doesn't matter how you do it. if you fast, do a liquid diet, whatever, go for it. YES we all know they're not healthy over the long term, but since it's about qualifying for surgery, it really doesn't matter HOW the weight is lost, does it?

gotta pat you on the back, too, for paying such close attention to the emotional aspects of eating. now's your chance to put those lessons to the test. you can do this!

03-30-2013, 10:25 AM
I didn't have surgery but I lost a lot of weight in 2 months (42lbs) by seeing a nutritionist and getting on a medically supervised diet.

If you are going to do it on your own, I would cut out any soda or fruit juice due to the calories and drink a lot of water/crystal light, coffee or tea (both black). For food, I would eat mostly chicken and pork with red meat maybe once a week. Make sure you weigh your portions, it's so easy to go over on portion size! And then for sides and snacks, fruit and veggies of course.

I know it seems like a lot to change all of a sudden esp. since you said you haven't actively been trying for these 4 months you were waiting already. But you are on a mission to get a few pounds off so I'd do all I could to get it off quickly and safely. (Don't starve yourself or eat very low calorie, it's not going to work I promise you.)

My doctor wanted me to have weight loss surgery and I was too scared to. So I asked if I could try the medically supervised first and see how I did with that. Almost 125lbs later, I'd never qualify for the surgery and I'm so happy!

Good luck with everything, I hope you get everything you want and more. :)

03-30-2013, 12:10 PM
Before surgery, I had great progress with Ideal Protein. It's an excellent way to drop 30 pounds in a month or two, but for me, it was unsustainable, and as soon as I stopped eating packets of food, the weight came back. I'd recommend it to anyone, still, in hopes that they can experience such a great program. I learned a lot which I will use in my time post-surgery. I understand nutrition now, which I think will be great in the coming months.

03-30-2013, 01:03 PM
I had the opposite problem. I went in at just 4lbs above the "bar" of what my insurance would pay for. So I spent the entire 6 months being told NOT to lose weight. I swear it drove me to tears a few times because I was educating myself and preparing so well that I WANTED to get on it and LOSE!!

Then the last 2 months of my 6 I gained from 235 to 250. THAT sucked. But, sigh.... at least it got me approved and I was back down to 227 this morning. :-) Do what you have to do to get there and get it done!!

It stinks to have insurance regulating what you can and can't do. I didn't feel like I was in control of my process until after surgery (last Monday) but I already feel so much better having it back in my own hands to handle!!

03-30-2013, 02:42 PM
I work in an OR and am on a team who performs bariatric surgeries. Our surgeons typically will put their patients on medifast and/or optifast before surgery and their patients do lose a significant amount of weight doing this. As stated above, they are looking for committed patients because the complications of these surgeries are not to be taken lightly. Losing even 20 lbs will cut down on the amount of fat found around the liver (that has to be retracted during the procedure, or you risk injury). Sometimes it's even the Anesthesia team who requires a bit of weight loss to decrease the risk of a difficult intubation/extubation and strain on the heart.

Did you have to sign a contract with your surgeon? Most surgeons I've worked with (maybe even all) have had their patients sign a commitment/weight loss contract. Also make sure your insurance company has authorized payment ASAP, I can't tell you how many times we have cancellations the DAY BEFORE surgery because the authorization hasn't gone through...and I don't know about you, but I would be infuriated if that happened to me, especially after being NPO and working to mentally prepare yourself.

What procedure are you having?

03-30-2013, 04:01 PM
First of all, thank you everyone for being so supportive and non judgmental! I was kind of worried I'd get a slew of comments about how I should have been trying harder the past four months/that's an unrealistic goal to set for myself, etc etc. Guess that was just the voice in my head! You're all such an amazing help. On to individual replies...

2Chi - I wish! Unfortunately that's so not an option for me right now, so I'm just gonna have to do everything I can to get where I need to be! I'm definitely going to make sure everything I eat revolves around protein as the main source, since that's what they want me to be doing anyway, it's productive on two sides yay. Thank you!

Jen - I can't imagine being expected to lose 40lbs, how intimidating! I'll look into them for sure, thank you!

Jiffypop - Yeah, they touched on the liver thing yesterday too which got me a little worried. I don't want to put myself at risk just because I couldn't buckle down and do what I need to do. I'm glad you agree! I'm not going to starve myself or anything, but I know quick weight loss takes a little more than traditional diet/exercise for me, and I think that's okay for short term since like you said, it's about qualifying for surgery! I really put a lot of thought and effort into working on the emotional side because I wanted to make sure there would be no reason I didn't know about that would make me not lose or even gain it all back in the end. I wanted to be fully prepared for that. Thank you!

elvislover324 - Lucky for me, the only two things in the world I can never get sick of is water and chicken (Okay well no, you could add chocolate to that list but let's pretend chocolate doesn't exist for a while lol) so I like your advice! haha. It's really a good tip for me to weigh portions, because I have a major tendency to let my eyes decide how much is enough, and of course, that's always way too much. I really need to work on incorporating more fruits and veggies though, because I'm very picky but I know some stuff is an acquired taste so you just have to keep eating it. Easier said than done, obviously! Congrats on the loss sans surgery, that's amazing! Good for you and thank you :)

Jolie - Yeah, I was going to try IP before I even started the surgery route, but like you said, I know it would be unsustainable for me because I'd have likely went back to my old eating habits once I was off the plan. Since this is only two months though, I'm gonna check it out. Thank you!

MadCowOnTheMend - Omg I'd love to have that problem, even if it drove me crazy! haha. I know what you mean, I can't wait until there's no more insurance hoops to jump through. Congrats on your success so far, I'm excited to your progress! Gives me hope :) Thanks for your encouragement!

sunshine79 - I have signed a contract that said I would work with the dietitian to learn healthy habits and prepare myself for life after surgery etc, but it didn't say I needed to lose weight post op. Obviously I do though! I'm hoping they'll have me do the liquid diet before surgery like many others I've seen have because I want it to go as well as possible, but if they don't, I think I'll do it myself. They don't submit to the insurance company until you're done with the six month program unfortunately, but I do know they won't schedule a surgery date until they know if you're covered or not. I'm hoping to have the lap band, but I'm warming up to the sleeve if that's what my surgeon thinks is best for me :)

03-30-2013, 04:20 PM
Have you considered mimicking the pre-op diet? Drink protein shakes to get 60-80g of protein a day. Then have 2 small meals. The protein will make you feel full. And, for me, drinking chocolate protein made it worth it. :-P

03-30-2013, 04:47 PM
That's kind of what I was thinking! My dad bought me one of those big containers of protein powder (chocolate, imagine that haha) last week and I asked my dietitian if it was okay to substitute it for meals sometimes and she said yes, but didn't suggest making a habit of it because if I do that after surgery (assuming I get the band) it will just slip right through and won't make me feel full. However, if I did use it, it would be just pre op. Well, and during the healing process after, but you know.

I think for now I'll just try to get in as much protein as possible, cut out 100% of unnecessary foods (kind of a eat to live not live to eat mentality) and continue drinking buckets and buckets of water and see where that takes me! If I haven't made enough progress by my next appt, I'll ask for my dietitian's advice, because I'll have another month after that to do whatever I gotta do!

Thank you all so much!

03-30-2013, 08:27 PM
Sounds like a great plan. :-) You can do this!!!

03-30-2013, 08:33 PM
oh one more point. as you do your fast/quick weight loss/whatever route you go - DON'T FORGET TO TAKE YOUR VITAMINS!!! the LAST thing you need is to be anemic or something going into the surgery!

OK. another one more point. :hug: even if we were the type of folks who wagged fingers in your face about what we thought you should have been doing over the past couple of months [and WE'RE NOT like that], what would be the point? you have to deal with TODAY and forward, not yesterday. And that's actually a major point to keep in mind. Today's the day you can change the way you deal with food. If yesterday's attempt didn't work the way you'd hoped, you get another chance to change it TODAY.

So, the point of all this is LOOK TO THE FUTURE, not to your past. Except, of course, to look at what worked and what didn't work so you can choose what served you well and what you need to leave behind.

03-30-2013, 09:04 PM
Definitely! I've put them in one of those weekly pill sorters so I never skip it cause I can't remember if I took it or anything like that. Such a shame that they have to taste so gross though haha. That's also something I had to really hash out with the dietitian/psychiatrist over the last visit. I have a tendency to go at it with an all or nothing attitude (well I ate one cookie and blew it, might as well eat whatever I want for the rest of the day!). I'm learning to accept failures as a lesson in what not to do next time, get back up and move on! I really needed that reminder though - read that right before I went to make cupcakes with my sister for Easter, yesterday I would have 'tasted' the frosting a billion times, today I decided I don't need, or WANT, to and I just kept wiping my hands off instead. Small victories!

I'm eternally grateful for the support & attitude of everyone here <3

03-31-2013, 12:31 AM
good for you!!!! i've come to view this as a matter of balance and mindful eating. Now, remember, I'm telling you this as someone who had surgery more than 10 years ago. this attitude change didn't happen overnight - it took months, maybe even years. but you've taken a HUGE step today - and tomorrow for Easter, you'll be mindful of what you put in your mouth. you'll enjoy - really enjoy - what you eat, and when you've had enough, you'll stop. you might save a little room for dessert, but just a little bit. and that'll be fine.