Weight Loss Surgery - Looking for some advice




View Full Version : Looking for some advice


Madiao
08-02-2013, 10:26 PM
Sorry in advance for the long post!

I'm not really where to start with this so I'm just going to jump right in there. I'm 21 years old and I weigh roughly 95kgs, which is about 210lbs or 15 stone. I have a BMI of roughly 34-35.

I've been struggling with my weight for many years and just watching in go up and up and up in the last 5 years and no matter what I did, nothing would stop it increasing or push it back down. I was a really thin child though, before puberty. Although, my whole family is overweight, even the majority of my extended family is quite overweight.

Recently I have been doing research about weight loss and what could be hindering it, and I found a lot of information about how sleep and being overweight are related. Around the time my weight started to increase a lot, my sleep was also getting dramatically worse, I was having lots of trouble getting to sleep and staying asleep. I complained to my parents and doctors but no one really took me seriously, so I just learned to live with it. But in the last few years it has just become too much and I find myself so exhausted all the time I don't want to do anything, I try to exercise as much as I can, usually about 40 minutes 5 days a week, but it just doesn't seem to be enough to make the weight come off and stay off. The lack of sleep also gives me insane cravings for sugary foods or carbs around 4-5 o'clock in the afternoon because my body needs the energy and I just feel hungry all the time because my hormones are all out of whack and nothing I do makes the hunger go away.

I've been to see a sleep doctor who told me to have a sleep study done. It came back negative for sleep apnoea, which is awesome, but it said that I have a really high arousal index, which I found out through my own research can be caused through high blood sugar and a lower threshold for excitement in certain neurons in the brain, which can be caused from being overweight. So it's as if the two issues are just feeding each other. And to make things worse it's also causing unbearable headaches and irritability and general weakness which just make everyday life so hard. The doctor did give me medication to take to fix my sleep but it doesn't work. He also didn't have many other options to try that I haven't already tried before.

I guess I'm just at a point where I have tried so hard to fix this for so many years but the weight just kept piling on, I don't know what else to do, I just want to break the cycle!! So I have been considering having something surgically done to make weight loss easier for me. I know that surgery isn't a quick fix, and isn't going to make the weight just fall off without effort. I've done a lot of research about the potential risks and complications with the different surgeries and how much work it will take to re-educate my brain about portion size and what to eat, and I am prepared to put in the work. I just want it to be a tool to help break this vicious cycle that is making my life impossible!

I'm sort of scared to ask my doctor about the surgery though in case he says that I haven't tried hard enough to lose the weight by myself or that I'm not fat enough!

Has any one else had any issues with doctors and telling them surgery isn't a good option? Or had issues with sleep and weight before? Please help :)


jiffypop
08-03-2013, 04:53 PM
wow. your post brings up a lot of questions. and believe me, i wish i had some answers. My first question: did your doc tell you if you were desaturating? that's a really REALLY important thing to know. the only thing that the arousal index tells us is that you become almost awake a lot. and there are MANY more reasons for it than you've listed.

Also, what medication did your doc give you? and why did he give it to you?

IN GENERAL, IN THE US [and i'm figuring you're NOT in the US because you wrote apnoea :) ], insurance covers WLS only for people whose BMI is over 40. They'll cover it for people who have a lower BMI if they have something else going on - like sleep apnea. and you don't. I have no idea if your current sleep disorder is related to your weight, and i'm not sure your doc does, either. and it could be a 'which came first' issue.

another issue is that most people lose weight FIRST by changing their eating habits and then secondarily by exercise. Some dieticians have told me that exercise helps cover mistakes, helps keep the weight off, and improves general health. BUT alone, it's not a good weight loss method. [although something can be said for the fact that if you're exercising, you're sure not eating at the same time!]

My heart goes out to you. before surgery, i was bedridden, very desaturated, with severe sleep apnea. i feel your pain. they would NOT let me have surgery until all that was fixed.

you also say that your hormones are out of whack. that could also be a factor in weight gain and trouble losing.

it sounds to me like more time spent with a doctor who will listen to you and take you seriously is in order.

Suzanne 3FC
08-04-2013, 08:29 AM
Or had issues with sleep and weight before? Please help :)

It sounds like you are going through a tough time right now :hug: I never experienced problems with weight and sleep, but I do recall noticing how the type of food I ate affected my ability to sleep well. It can also affect how you feel during and after exercise, which seems to be another obstacle for you.

Would you mind sharing a typical day's worth of food with us?


Madiao
08-06-2013, 07:58 AM
Hi guys,

thanks for the support! My doc said I wasn't desaturating. He has given me many different types of sleeping tablets, circadian rhythm tablets, antidepressants, epileptic medication and muscle relaxers but nothing seems to be able to keep me asleep. Some of the tablets did wonders for putting me to sleep really fast though. I have seen a sleep doctor and a dietician and regular doctors in the past. I asked the sleep doctor a few times about my weight and how sleep can affect it or it can affect sleep and all he says is that if I sleep better I will have more energy so might be able to lose weight. When I ask the dietician how diet and weight affect my sleep, she changes the subject. When I ask my regular doctor he just refers me to see the above mentioned "specialists" in the areas.

I'm in Aus and the places I have researched say you need a BMI over 35 which is why I started to consider it.

My regular daily diet usually consists of high fibre cereal or a fruit smoothie for breakfast, sometimes toast if we're out of milk. Lunch is usually left overs of dinner or a sandwich or occasionally a low fat canned soup. Dinner changes but regulars include stirfry chicken and veggies, chicken wraps, some kind of roast meat and veggies, home made hamburgers, fish and salad. Usually don't have dessert, if I do it's usually yogurt. Sometimes we have something sweet like apple pie and ice cream, but not very often.

For snacks I usually have some fresh fruit, or after work some cheese or tuna or milo.

Over the last 18 months I have dramatically cut out pasta, bread and rice. We only have pasta once every 3 or 4 weeks, same with rice. Bread is more like a few times a week. And portion sizes are in line with what the dietician told me I should be eating, which is around 1500-1600 calories a day.

I really don't understand what I'm doing wrong! I'm doing my best to keep portions sizes down but I constantly feel hungry and have the worst sugar cravings. For the most part I ignore the sugar cravings.

I just feel like I have tried so hard over the last few years to get this under control but I cant :( is there something I am doing wrong?

giselley
08-14-2013, 12:05 PM
1,500 to 1,600 calories. Are you a female or a male, how tall, ect.,

I think 1,500 calories are enough to keep your heart and lungs going, but is it actually giving you sufficient energy to "work" and do any physical activity? If now, I could see why you would have sugar cravings. You are starving.

One thing that has always confused me is whether you calculate your calorie needs from where you are (overweight) or for your idea weight (what you would need if you weighed your perfect weight). For me, I need about 2,500 calories if I wanted to remain overweight, and I would need 2000 calories if I wanted a smaller body. If I eat 2,500 calories, I will stay fat. If I eat 2000 calories, I will lose weight and go down to where I need to be.

1,500 calories does not sound like much more than a young child would need, or maybe a 98 pound woman.

Maybe this is the cause of your hunger?

MauiKai
08-14-2013, 02:08 PM
I think 1500 calories is a fine amount for an average woman in most cases? I mean, not if you're running a marathon or something, but for an "average" day.

Lolo70
08-14-2013, 04:44 PM
If you have not already done so, it might be time to see an endocrinologist. Have you tested adrenal hormones, thyroids (the whole panel) and sex hormones (estrogen/progesterone, testosterone)? In particular, cortisol should be monitored over a 24 hr period. I am not sure whether you take the pill, otherwise a very low dose estrogen may be helpful. Particularly if your sleep patterns vary with your cycle.

Have you tried to take melatonin (this may be your circadian rhythm tablets)? Usually sleep requires the production of melatonin and decreases in the levels of serotonin in the brain (it is actually a bit more complicated). Serotonin production in the brain requires uptake of the amino acid tryptophan. Since you seem to eat meat mainly in the evening, you may get your tryptophan up. Cheese and some fruit are also high in tryptophan. In the morning, melatonin goes down again and serotonin up. So, maybe eat trp-rich foods in the morning. A long shot, but nevertheless.

You may also be on the right track experimenting with carbs. Maybe try to see what the effects of a ketogenic diet (50g carbs/day) are versus a high carb diet. Your epilepsy drugs may have gone in the direction of ketogenic diet. Low carb dieting will adjust your insulin and leptin levels. If doing a ketogenic diet, make sure your thyroids are fine.

Otherwise investigate magnesium levels, L-carnitine, omega-3 (fish!) etc. to see whether you have some deficiency.

I have found that lack of sleep/disrupted circadian rhythm induces low-level chronic inflammation, which leads to weight gain. You eventually get into a vicious cycle where one feeds the other. Your brain will have altered metabolism when sleep patterns are disrupted long-term. Also, many hormones, including active T3 thyroid hormone, follow a circadian rhythm. So does leptin.

Circadian rhythm:
http://www.ncbi.nlm.nih.gov/pubmed/21127246

There is definitely a link between glucose (carbs) and sleep via small peptides called orexins. Sleep/wakefulness comes in because narcoleptics seem to have orexin-deficiency. Narcolepsy has also been linked to obesity, probably also due to orexin.

http://consumer.healthday.com/cognitive-and-neurological-health-information-26/brain-health-news-80/research-reveals-blood-sugar-s-effect-on-wakefulness-533012.html

http://www.ncbi.nlm.nih.gov/pubmed/23791983