Decisions....Decisions....RNY, Sleeve or something else
 

I'm nervous. I'm scared. I'm praying that I can stick with whatever method I choose to lose weight.

My doctor recently told me that in addition to my current health problems likely getting worse T2D, HBP, Sleep Apnea, High cholesterol, etc., my current limited mobility due to back pain will also likely get worse if I don't lose a significant amount of weight soon. She recommended Opti-Fast over bariatric surgery, though I am considering and researching both.

I went to an introductory class about weight loss surgery, which was ok. I think I learned one or two things, but mostly it covered things I heard about from friends, my niece who is a dietician in Southern Cal and works with bariatric patients, and info I found online. Anyway, the class is required as a first step for anyone considering weight loss surgery. The next step is get a referral for surgery from my primary physician and then to take the surgery overview class which is conducted by a dietician and goes into more details, then to meet with the surgeon, and all that stuff. I'm going to wait to ask my doc for a referral until next week after I complete the intro class tomorrow for the "Medical Weight Management Program" (Opti-Fast).

My bf really wants me to try Opti-Fast first as he doesn't think it's smart to have surgery to resize, reroute and remove my internal organs without first trying to lose weight by any means (meaning Opti-Fast or any other means) while keeping my body in-tact. I understand his concern. I also know that he has not been with me through my weight loss struggles and increasing pain these past 10 years since I hurt my back. It's a lot to think about. I didn't fall asleep until nearly midnight last night because I was thinking about this.
I understand my bf's concern is because he loves me, and I appreciate his concern. My sister, who did Opti-Fast successfully and kept nearly 100 lbs off for 3 years (and then gained some of it back), said she'd recommend having surgery over Opti-Fast. Her daughter (my niece) had gastric bypass (RNY) and it saved her life. My niece is 5'2" (same as me) and was around 300 lbs. I don't know how much my niece lost, but she looks and feels great, and is having a very healthy pregnancy (she's due in a couple weeks). Another difference between Opti-Fast and surgery is that my insurance covers surgery (out of pocket would be around $100, maybe slightly more). My insurance doesn't cover Opti-Fast (out of pocket would be around $4,000 or more). My bf thinks it doesn't make sense to have organs resized, rerouted and removed to save money. I understand his concern. I am giving this careful and serious consideration...there is so much to think about and research.

My back specialist is recommending I start with Opti-Fast because for my insurance/medical group patients who want bariatric surgery are required to lose 10% of their body weight prior to surgery.

I just want to make the right decision for me, and to have the strength and determination to stick with it.

It sounds like you have a lot of choices to consider and some major considerations.

Can you try both? Begin Opti-Fast (which would help you lose the required"\ 10% before surgery) and use that as a guide. You might discover that you're really happy on that program and think it is the best method for your weight loss.

But it also might show that surgery is the answer for you, as you need a bigger tool to help get the weight off. From there, at least you can make the choice between the RYN, the sleeve or whatever. At that point, you can look over options with your surgeon and make the best choice for yourself.

If this is really forward or too personal, feel free to ignore. But I notice you're from the Bay Area and that you're process seems similar to mine... do you have Kaiser for your insurance? I do, and was going to say, if you decide to go with surgery and have Kaiser, please feel free to PM me if you need any advice navigating their system.

My sister from the SF Bay Area has Kaiser, and they paid for her Optifast
Program last year. She regained some of the weight, and wants to go back on the program, but they are making it really difficult for her to rejoin the program because she travels for her work, and would have to miss some of the meetings. She tried to explain to them that she is wage earner in her family, and has to miss some meetings whether she wants to or not. They were inflexible. Anyway, she liked the ease of the optifast shakes and meals, but had a hard time transitioning back to regular food without regaining.

Good luck with your choice.

hi diyana - yes, you have some very serious thinking to do, and it'll be really important to talk with your doc, the surgeon, and both optifast and surgical patients.

I gotta drop this idea in your head, though. The REAL question is: what's the best way for you to lose the weight AND KEEP IT OFF?

that's a question that only you can answer... I ended up with the surgery because it gave me the best chance of losing it and keeping it off, as long as i followed the rules.

and that's the important part. No matter how you lose the weight, you'll always have to follow certain rules - i don't know of a single person who maintains their weight without this step.

keep asking questions...

Thanks so much ladies. I can't tell you how much I appreciate your insight.

Ducky, yes, I live in the South Bay (San Jose area), and I have Kaiser insurance.

I've made my decision. And Ducky, what I've decided is essentially what you mentioned (and other people have suggested too...even my doctor).

Tomorrow, I'm going to ask my doctor for a referral for bariatric surgery. Once she submits the referral, I'll have a surgery orientation with the dietician and possibly others from the bariatric program staff. At that orientation, my weight will be taken...the starting weight...of which I have to lose 10% before I can have surgery. To lose that 10%, I have signed up for the Medical Weight Management Program (Opti-Fast). Once I've lost the initial 10%, which will take roughly a month, I'll decide whether to do the surgery or continue with the Opti-Fast. One of the doctors of the Opti-Fast program says that bariatric surgery patients frequently use the Opti-Fast to lose the 10% and then some of them end up cancelling their surgery. I figure by 3-4 weeks into the Opti-Fast, I'll know whether I can do another 3 months of Opti-Fast, or if surgery would be the best option.

I've sought out opinions of lots of people and done some soul searching. Yes, it would be preferable to lose weight without having any internal organs altered. The question that I keep asking myself is...will I be able to keep my food healthy and portions small if I don't surgically alter my stomach? And honestly, I don't know.

What I do know is that however I lose the weight, is going to require discipline. Discipline and commitment that I'll need for the rest of my life.

Good luck, Diyana. I struggled for years on various diets-the last was Ideal Protein which cost me around $6,000.00 to lose 50 pounds that I re-gained in 2 years.
It's really not about what gets the weight off-all diets will work if you follow them. It's about maintaining and keeping it off. I finally got sleeved on May 26th and see how this is going to be a permanent tool for me (portion control). I am changing my eating habits now for lifetime and do not regret this. I was sick of the losing/re-gaining cycle.

All the best to you with whatever you decide!

Kaiser, as I understand, doesn't have a solid 10% policy, although they give you that as a guideline. Your surgeon will tell you your official number.

My mom was in the 240s, and had to lose like 12 lbs.
My friend was at 290, and needed to lose 27lbs.
I was at 285 and was told to lose 20.
We all had different surgeons and different centers, so things change. Just don't be upset/surprised if that number isn't what you think it is.

Thanks, Ducky, WorldTraveler, and everyone! I can't even begin to tell you how very much I appreciate all your insight.

Hugs,