I've just had what I call an environmental gain (when I gain weight around a short term stressful event) so I'm hovering at around 245, BUT when I restrict calories and get more active I drop weight pretty quickly and my "normal weight" I sit at around 225 and I'm 5'6 so I have a BMI that barely qualifies me for surgery but for my co-morbidity of obstructive sleep apnea.

I'm considering surgery- and by considering I mean, I've been in therapy for three years, had a consult with a surgeon and I'm on a fast track to approval with a bariatric nutritionist.

There are alot of reasons I think I want to get surgery- I'm not currently diabetic, but I'm a decimal point away, I want to leave my current job and go to grad school to pursue a different career and I'm honestly scared that In this market I'll have a harder time finding a job fat, I think losing weight will really improve my life and while I CAN lose weight with diet and excersise alone. It requires an amount of mental energy that I find really taxing and its a real struggle-not physiologically, my body responds really well- but mentally. Its really really rough and I don't think the cycle of lose/and regain are good for me.

What I really want from surgery is to make the process of losing and maintaining weight loss not such a constant mental expenditure. I realize I'll always have to be thoughtful about it but will I always be obsessed? I don't know that surgery will change that...but sometimes I feel like if it were just a *little* easier I could feel like I was losing weight AND having a life as opposed to holding on to the weight loss by my nails and then losing my grip whenever life gets overwhelming.

BUT in spite of all this, I'm young (26) and I'm physically active, I feel like I look healthy, I feel like I'm a high energy person and one of my biggest fears of surgery is that I'm risking that and because I'm not so dangerously obese (yet) I feel like I still have time to try without surgery. The other wrinkle in this is that I'm interested in the sleeve vs the band (the foreign object in my body makes me uncomfortable and I don't like the risk of complication with the band when I may be going on a students health insurance plan a year or so post op) so I'm afraid any weight loss will be very fast.

I'm interested in the experiences of those who were relatively light when they had surgery, especially if they had the sleeve. Any regrets? Did you ask your surgeon to remove less of your stomach than someone who had alot more to lose? Did you feel your loss was fast?

I'm so confused...

I haven't had surgery... but I started my journey at a BMI close to 40. I had a consult and met with a counselor for the required 6 months before scheduling surgery.

In the end, I decided not to go through with it. I'd lost a fair amount of weight during my time in counseling and realized a few things.

Surgery doesn't remove food obsession from your life. It might actually make it worse. You're changing how your body functions. You'll have to be MORE aware of how you're eating, to be successful without being unhealthy. I didn't want to have to worry about nutrient deficiencies ETC. It all scared the heck out of me!

You're so young!!!! Give it a try for a few months first. I bet you can make some big changes in that time and see that you can do this!

I had my weight loss surgery when I was 26. If you're the type to obsess about food, calories, weight, etc., I think that's a personality type, and physical surgery won't change that.

You seem to think fast weight loss is a bad thing - why is that?

With the sleeve, you don't want less of your stomach removed because the part removed is the stretchy part; making the sleeve a certain small size is so that stretchiest part of the stomach is gone. If the stretchier part is left for a larger sleeve, then you have an increased risk of your stomach stretching out over time, which would very likely have a negative impact on your long-term success.

The sleeve is most successful for "lightweights" starting with a BMI of 35-45. I know quite a few sleeve patients and don't know ANY who lost too much weight. I even know some people who had a full DS with a starting BMI of only 35, and even they did not lose too much weight.

The thing that stands out in your post is how you mentally struggle with eating healthier and restricting calories. However, with any weight loss surgery, it is a very mental struggle. A lot of people find it very mentally taxing after the surgery since they HAVE to eat better since their stomachs literally can not take eating mass amounts of foods. If I were you, I'd look at reports of the mental struggles people face after the surgeries since that seems to be the biggest issue for you.

Weight loss is a mental game as much as it is physical. You can treat the physical body in any way to get the weight off, but neglecting to treat the mind just sets one up for failure.

That's one of the problems with our society and weight loss in general; we forget about the mind.

I'm just a bit younger than you and lost the majority of my weight recently. I didn't have surgery but I would have qualified for it at my starting BMI. All the way down it was a GIANT mental game that didn't always have to do with the fact that I was restricting calories. Weight loss messes up your sense of self and perception and I tell people that some of the most jarring experiences I've had are the instances where I couldn't recognize myself in pictures or even in the mirror.

You can literally feel like a stranger in your own body. Unless you're truly ready mentally for much more than just restricting calories, you shouldn't just get the surgery and hope that it will solve everything.

SO well said!! I totally agree.

For those of you who are posting but who haven't had surgery and aren't considering it, please read this thread:

http://www.3fatchicks.com/forum/weig...ead-first.html

In my case I opted for surgery because I never felt full. I was going to the gym 2-3 hours a day 7 days a week at one point and never lost a ton of weight. At the most I was able to get down to 240lbs, but couldn't get below that because a large part was my eating. I was always hungry and never full.

I decided on the lapband for myself because I wasn't sure about completely rearranging my insides when restriction was my issue. So far the restriction has worked really well for me and I eat significantly less than I did before and finally am feeling what full really is (instead of the over-stuffed thanksgiving belly all the time).

I am going to be 28 this year and I finally was in a financial space to opt for this surgery after many years of considering it and trying to lose weight with diet and exercise. Having dieticians telling me to measure my portions, having personal trainers telling me I worked out too hard and too much. So, this was what worked in my INDIVIDUAL situation.

All in all take the advice of everyone on here as what suited them, everyone's situation and lifestyle will be different going into their decision. This is what worked in my case so far, and I'm just a couple weeks into my surgery so I'm relatively new. However, in the end it's really up to you.

I really appreciate your replies folks. They've given me alot to think about. I'd still really love to hear from folks who have personal experience having the surgery as a "lightweight" if they happen to stumble on this thread but its been interesting to hear from "could've beens"

I don't think I've neglected my minds role in this. I've been seeing a therapist for three years largely about this issue and while I dont think I'm cured by any means I really feel like I have a handle on things. That being said I struggle with the lose gain cycle. Unless I'm super hyper vigilant preventing a regain after hitting a certain low point (lets call it 215 for me) is really really difficult. Before I had even said much about myself at the consult, the surgeon explained this phenomenon to me of "set points" and homeostasis as it relates to obesity- and I cried- it made SO much sense to me why losing always felt like I was merrily chugging along until a certain point...and then BAM im holding on to any loss my sheer force of will.

Jillybean, you asked a really good question. I didnt realize it but I do think of fast weight. loss as bad unless there is a medical reason to drop weight really fast and that's not true for me yet. I think that's the great tension for me in this decision. It'd be a quality of life thing for me to a great extent. It's not a health emegency or something that will help resolve infertillity. If that were true for me, it'd be easier to make this decisionI feel relatively healthy. I really like my life. There's no question in my mind that being a healthy weight will improve my quality of life and that WLS would be a really vital tool for me to to acheive that but I'm struggling with the decision to risk good for better.

I have alot of the same concerns that Val expressed...and its funny I recognize Val from the weight training boards...I have some specific concerns about that. I fought hard for alot of my muscle mass (some of it was the gift of obesity) but the idea of losing the muscle Ive built or not being able to fuel some of the heavy lifting I'm doing also makes me uncomfortable. BUT if I wait until there is a medical emergency I'm losing this opportunity to have the surgery where my youth and relative health will promote a better outcome.

I was at my highest 270 lbs and 246 on my surgery day, I had a sleeve. I don't know if that is sort of what you are looking for or not. When I was your age I was under 200 and if I knew then what I know now I would have done anything including surgery to keep the weight off. It came to the point where I realized I was never going to lose weight without surgery.

I was no where near being a lightweight when I had surgery; quite the opposite. However, I'm a bit envious of those who do have the surgery at lower BMIs and make it to goal in 6-8 months. I wish I had considered this path years ago, before my weight became so out of control. My surgeon's office just told me this week that I will probably never be a normal BMI and I need to accept that I will most likely always be in the overweight, if not obese category.

I did this for health and my health/energy/life is so greatly improved, that I know logically that I shouldn't care. And, for the most part, I don't. It would be nice to see a single digit on my clothing, though.

I was perfectly healthy fat person, too. Until I was diagnosed with type 2 diabetes at age 25. You never know when everything can change. I had NO symptoms of the diabetes; it was only bloodwork that led to my diagnosis. I had my WLS just under a year after that diagnosis. I can't say I wish I'd had the surgery sooner because I know why I didn't (even though I've been overweight since about age 4 and over 200 pounds upon entering high school), but, as they say, if I knew then what I know now...

As for muscle mass, most of us HAVE to lose some lean body mass. For example, when I once had my body mass tested, I had about 200 pounds of lean body mass. Well, since it's impossible to be 0% body fat and also impossible to ever weigh less than 200 pounds without losing some of that lean mass, some of it had to go. But as long as you focus on consuming protein and exercising, there's no reason you can't lose weight quickly while still maintaining much of the muscle you've worked for. Especially if you keep your carbs low enough to go into ketosis, where your body would focus more on burning fat for energy (true both with or without WLS).

I had the sleeve when my BMI was just about 32, and it was absolutely, without question, the best decision I ever made. I was 51 when I had the surgery and my only regret is that it wasn't available when I was 26. I feel a million times more normal now than I ever did when I spent virtually every waking moment obsession about my weight and fighting hunger pangs.

It took me a full year to lose my weight and I did and do a lot of exercise. Those of us with lower BMI's don't lose nearly as fast as our larger brothers and sisters.

I say "go for it!" I feel like my obesity is an incurable disease but the sleeve gave me a fighting chance to get it into remission and keep it there. It has leveled the playing field so I could develop a whole new healthy lifestyle.

I have not had surgery but I can tell you that it has crossed my mind. Crossed my mind quite a bit, actually. My main thing is fear of surgery. I am giving myself 2 years to lose the weight on my own-past that surgery is on the table. Have you been trying to lose the weight for the 3 years that you've been in counseling? Maybe set a timeline for yourself. I identify with your struggles of constantly thinking about food, it is disabling at times for me. *hugs* good luck with whatever decision you make!

Thanks, Jiffypop!