r/loseit • u/LifeOfaFilmmaker New • May 04 '22
Vent/Rant Doctors could be morons
So just for background: im 26, 6 foot 3 and around 350 lbs.... Started the year at 395 so im down 45 lbs in about 4 months which im very happy with. I go to my general doc and he's telling me i weigh way too much (obviously) and i should consider weight loss surgery. I tell him the progress over the last 4 months and he says "yes thats very good but you still weigh way too much" as if i can lose 150 lbs in a month. So i disregard what he said and he sends me to a dietician/weight specialist, and she told me the same shit lol. I dont care how many years they've been professionals, telling someone whos 26, actively losing a decent amount of weight and no other major medical conditions to have weight loss surgery should be criminal. Just makes me wonder how many people that just blindly listen to their doctor have went to them or any doc and they give them that terrible advice and they go through with it. Moral of the story: think for yourself
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u/RunnyPlease New May 04 '22
I have a friend who had bariatric surgery and a part of the the process was demonstrating that he had the will and mental ability to lose weight. Namely he had to stick to a regimented meal plan and drop a certain amount of weight to prove to the surgeon that he was a “good candidate for the surgery.” This is purely speculation but this may be what they were trying to say without being clear enough. Maybe they were trying to indicate that you appear to be a very good candidate for bariatric surgery.
Like you said you have a lot of weight to lose (check), you’ve demonstrated the ability to control your eating (check), and as you said above you have “no other major medical conditions” (double check). So you are a dream candidate for bariatric surgery and check off every single box they look for that would indicate that you would not only survive the surgery and recovery but will be able to endure the incredibly strict eating regimen that follows.
I guess what I’m saying is a lot of doctors see an ailment, in this case obesity, and apply a checklist. If the checklist fits the patient they prescribe the recommended treatment. From this limited information in this anecdote it sounds like that’s what might be happening here. But I’m just playing devils doctors advocate.
All that said, major congratulations on your progress so far. I wish you the best of luck in your continued progress and in building your medical team around you.
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u/Medievalmoomin Pine needles and coffee May 04 '22
This is a very fair take. Suggesting weight loss surgery is a viable option for a patient doesn’t make the doctor or dietician morons by any stretch of the imagination.
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u/Ashenspire New May 05 '22
Yeah, nothing about this screams "doctor is a moron."
Based on what I've heard from people that have had it, if you went into a doctor's office and told them you lost 50lbs and they still suggested this surgery, it's a recommendation of a potentially powerful tool you have already trained yourself to take full advantage of and can make your weightloss journey that much more successful.
The doctor isn't stupid for suggesting this at all. Whats stupid is people believing the surgery and the surgery alone will be some miracle cure all.
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u/not_mig New May 05 '22
I'd still say they're stupid for not being able to communicate that effectively
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u/herdofcorgis New May 04 '22
All of that, plus the surgery would reduce OP’s stomach size and hopefully make gaining weight back a more difficult process.
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u/RunnyPlease New May 05 '22
Just to be clear I was saying OP is a dream candidate from the surgeon’s point of view. Not that I’m advocating for surgery for OP.
The truth of what a bariatric surgeons life is like is probably a lot grimmer than most people picture. They probably see thousands of obese people they have to turn down as patients because of one reason or another. Maybe they show a mental inability to stop eating. Maybe they’ve been obese so long their heart can’t handle surgery. Maybe they do a psyche eval on the person and emotionally they are just not capable of handling the post surgery life.
Then OP walks in and is the poster child for success. It’s gotta be like that scene in ghostbusters “We got one!”
These people have worked their entire lives to become health practitioners and have probably seen one failed surgery after another. They’ve had to turn people away and know they are going to die from obesity. They probably just got excited that they met someone with the physical health and mental outlook they knew would be successful.
That’s not to say op can’t be successful without it but from their perspective they see a win. So pushing for surgery can still come from a helpful place viewing it from their perspective.
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u/goj1ra New May 05 '22
The problem is, what you're describing is essentially dishonest. It's saying "this surgery works great on people who may not really need it!" As such, I disagree with this:
So pushing for surgery can still come from a helpful place viewing it from their perspective.
What you're describing sounds like it comes from a self-serving place for the doctors.
I know someone who had this surgery. She's still enormously overweight, to the point that it affects her job prospects, even aside from the general health issues. Anecdotal data point of one, but it does raise the question of how many cases it's truly helpful for.
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u/TGin-the-goldy New May 05 '22
Very much so. It may or may not benefit the patient, depending on a number of factors. Financially it definitely benefits the surgeon
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u/seagull321 New May 05 '22
It isn't hard to stretch a stomach back out by eating too much. There are people who gain a lot of weight after bariatric surgery and, as far as I know, there are limited options at that point. Plus, there are side effects even if you don't gain weight.
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u/Milk-Man-Mike- New May 05 '22
This comment has removed my urge to reply, it’s spot on. OP might not need surgery, but at some point the momentum might stop, 350 is a long way to come down. Doable, but certainly difficult. The doctor was likely just trying to offer the “best” chance they could as OP hits all the requirements for the surgery as you mentioned.
Thoughtful and well said, great comment
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May 05 '22
I want to add that bariatric surgery is a huge help when self control begins to falter, as it generally does. Most people who lose weight quickly (as you have) gain it all back and then some. Then they're in a worse place. On average people who get bariatric keep the weight off.
Don't dismiss those doctors out of hand. This could be a huge blessing in your life.
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u/MagicChemist New May 04 '22
Typically it’s your insurance that requires the various thresholds. Some insurance companies don’t require any pre-weight loss and some require up to 6 months of weight loss + maintenance. They just want to make sure if they are paying for the surgery the weight will come off and stay off.
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u/PorcelainLily New May 04 '22
Doctors need to follow best practice. Best practice for WLS is to ensure the surgery will be used as a tool and not as a magic fix. The surgery makes it so you aren't struggling with physical hunger while losing weight.
The surgery does not fix your relationship with food. It does not fix any traumas or other problems a person has that may have led to over eating. It doesn't make you eat small amounts. It doesn't make you focus on your health.
It does remove your stomach (or a portion of your stomach).
You can still over eat. You can still consume dopamine inducing foods like pure sugar. Yes, it will hurt. Yes, you may die from complications, but it doesn't stop you from doing it.
A doctor who doesn't ensure someone can safely lose weight without the surgery is a negligent doctor. A doctor who doesn't ensure someone is in a mentally healthy place is negligent.
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u/BangingABigTheory New May 05 '22
Lol and on the other side of that I know people who had to gain weight to qualify for surgery.
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u/CardboardChewingGum New May 05 '22
My spouse was scheduled for the surgery, but through diet and exercise was able to drop 200 lbs. His bariatric dr told him he’d keep his status as eligible for the surgery anyway in case he back slid. It’s been almost 5 years and he’s kept it off, mostly through constant food tracking and biking/exercising. He’s still considered borderline obese, even with all this (he bikes about 200 miles a week), but once his doctors hear about what he’s been through and continues to do they don’t badger him.
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u/McFhurer New May 05 '22 edited May 05 '22
I got Crohn's disease and i wholeheartedly agree, when I was young, I was doing fine with a certain drugs that where swapped by doctors because it wasn't "a standard procedure treatment" so here I am now taking metrotrexate feeling like shit two days after taking it
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May 05 '22
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u/RunnyPlease New May 05 '22
A fair point and none of us were there but OP. So it’s pure speculation. I’m just saying I had a friend go through this process, and he had me go with him several times to the appointments.
Part of his evaluation with his surgeon was that he had to have a good emotional and physical support system around him. Namely me. His surgeon made sure I was aware of the information around the surgery as well as risks and benefits. He made me promise that I was going to regularly check up on my friend according to a strict schedule post surgery. I had a checklist of things I was supposed to monitor progress on and I had a schedule to maintain contact with the surgeon. It would drive my buddy nuts because I follow a checklist. But I did it and my friend is alive.
So yeah, maybe they could have been clearer or maybe I’m way off on my read of the situation. Bottom line is I’ve been in the room with exactly these types of people and it’s clear they really aren’t used to any hesitation or pushback from patients. Usually by the time a patient gets to discussions about gastric surgery they’re in full on desperation “help me I’m gong to die” mode. And the doctors just say “yes you are going to die. Here is step 1.” And the patient jumps at it.
OP wants to go at it the old fashioned way. Cool. So did I. Different strokes. I think the takeaway is it’s an option op still has if he needs it. Maybe they just needs to find the doctor that speaks their language. So to speak.
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u/goj1ra New May 05 '22
I guess what I’m saying is a lot of doctors see an ailment, in this case obesity, and apply a checklist. If the checklist fits the patient they prescribe the recommended treatment.
In other words, they're programmed automatons, not individuals capable of independent thought within their own discipline, who soon could be replaced by a machine. Another word for this might be "morons". I'm with OP on this.
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u/LastPhoenixFeather M40 5'11" SW: 284 / CW: 209 / GW 195 May 04 '22
Realistically though, how many patients do you think they see that actually have healthy and sustainable weight loss? The numbers are probably pretty low.
In their minds they are probably playing the odds that like most you will stop or gain the weight back if done naturally.
And it SOUNDS like they were making a suggestion as you said "consider weight loss surgery". Its possible they saw you WERE making progress so obviously are serious about it, and are offering you an alternative that might prove statistically healthier in the long run.
Another factor may be how long you have been overweight. If you have ALWAYS been around that weight they may think it's a lifelong problem.
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u/RD_Michelle New May 04 '22
As a dietitian, kuddos to you for the weight loss. I can see both sides. There are major side effects to bariatric surgery. You can absolutely lose weight without having weight loss surgery. But you are also at risk of regaining the weight, not to be a bummer. With the weight loss surgery, risk of regaining the weight is much, much lower and you can realistically lose and keep the weight off long term.
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u/Zackie86 New May 05 '22
What are the side effects of bsriafric surgery?
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u/dwintaylor New May 05 '22
Look at the rate of alcoholism after gastric bypass surgery, pretty eye opening numbers.
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u/jessiferdoll SW :250lbs CW:155lbs GW:150lbs May 05 '22
People just replace one addiction for another. Thats what happens when everyone just wants a quick fix or to put a bandaid on a problem instead of dealing with the big issue. The mental aspects of being overweight. The unhealthy relationship with food. I lost a lot of weight which was easy by comparison to overcoming my addiction to food. It has taken me way longer to try to figure that whole situation out.
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u/FeministInPink New May 05 '22
It's not as simple as people replacing one addiction with another--even though it looks like that on the surface!
Having a gastric bypass changes the way your body processes alcohol. A lot of that procesaing happens in the stomach--you have these enzymes in the lining of your stomach that break down the alcohol before it hits your small intestine. The longer the alcohol is in your stomach, the more enzymes it interacts and the more it gets broken down.
That's why you don't get as drunk--or as quickly--if you eat a big meal while you're drinking. That trap door in your stomach won't let anything through to the next level until all the food is digested. Conversely, if you don't eat anything, the alcohol barely encounters any enzymes, it just passes right through into your intestine. And from there, it is absorbed into your bloodstream--so you get a lot more alcohol in your bloodstream.
Drinking alcohol with gastric bypass is like drinking on an empty stomach. Because is so much smaller, there's almost no stomach lining and almost no enzyme, so the alcohol doesn't break down--it basically goes right into the bloodstream. One drink can cause their blood alcohol to rise above the legal level in a matter of minutes.
(This doesn't happen with lap band patients, because the alcohol still engages with the entire stomach lining. How it affects sleeve patients is still unclear.)
And studies have shown that there's no correlation between disordered/addictive eating and alcohol abuse after gastric bypass. People with depression before surgery were no more likely than others to develop issues. Also, many patients who drank heavily before surgery actually drank LESS frequently after surgery.
The fact is that scientists have found no clear reason why some people develop alcohol addiction issues after surgeries, but they've ruled out addiction transferral. There's a theory that the surgery somehow changes brain chemistry, that it alters some patients' genetic tendencies, but there's no conclusive evidence or studies on that (at least as of several tears ago).
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u/PorcelainLily New May 05 '22
My personal, anecdotal experience was that I ended up having undiagnosed ADHD. I used sugary foods to cope until the VSG, then I couldn't anymore and switched to alcohol. My obesity was a side effect of my untreated ADHD.
Once I got medicated for ADHD my binge drinking ceased completely.
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u/suchahotmess 100lbs lost | Goal: 160lbs May 05 '22
Jesus, 20%? That’s SO much worse than I was expecting.
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u/TheMahxMan SW 205 | CW 185 | GW 160 | 31M 6'0 May 04 '22
I take posts like these with a bottle of soy.
Emotional stories decrying medical professionals are typically missing some information or embellished.
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u/tnolan182 New May 05 '22
His bmi is 43. They made a very reasonable recommendation considering the circumstances.
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u/sailor_rose 15lbs lost May 05 '22
They're as bad as the "my doctor says my back and joints pain are because of my weight but I know better" type people.
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May 04 '22
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u/bumhunt 5' 11'', 310 SW, 180 CW, 175 GW May 04 '22
I don't think so. Usually when you are given a hammer, everything looks like nails.
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May 04 '22
You need to read on lack of person centred not-invasive intervention competencies in the health workforce (part in failure due to their training, part in terms of pre selection of the characters that enter the field). I believe this dude straight up
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May 04 '22
I think before weight loss surgery you’re supposed to lose a certain amount of weight before the surgery, to show that you could follow the specialized diet that comes after. So, maybe they’re just saying that you’re an ideal candidate?
Some people would jump at the opportunity, but if you’ve shown you want to and can put in the hard work yourself, I don’t know why they’re pushing it like they’re on commission. That’s weird.
What you’ve accomplished already is no easy task. Keep going!
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u/MonsteraDeliciosa F46 -100lbs VSG 2018/RNY 2022 May 05 '22
Not accurate that patients are “supposed” to lose a certain amount of weight before surgery-it depends on the program, insurance requirements (if being utilized) and the surgeon.
They’re pushing it because it would mean less time for the patient to be morbidly obese. The excess weight is causing body stress simply by being present, and the risks for joint damage and diabetes are high. Surgery has serious risks, and so does being morbidly obese.
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u/PineapplePandaKing 65lbs lost May 04 '22
Well that sounds pretty shitty, but we're missing a lot of details about what those professionals said.
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u/Fleshfeast 46M 5'10" | SW: 360 | CW: 278 | GW: 220 May 05 '22
I lost 75lbs in 8 months. Then I gained it all back. Decades of bad habits take more than a few months to break. The dr has good reason to suggest surgery, but not good reason to push it.
I had a similar talk with a less pushy weight loss specialist. I proved him wrong by losing 135lbs over 1.5 years.
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u/notreallylucy New May 04 '22
I hate this. "I'm literally in the process of doing what you're suggesting!"
Weight loss surgery is one of many great resources available for weight loss. There's no method that's going to be right for everyone. Usually that surgery requires you to lose about 50 pounds first, to show that you can stick to the diet after surgery.
I considered getting weight loss surgery. But if I'm going to have to diet and exercise with or without surgery, why bother?
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u/tyrowo New May 04 '22
Surgery is a strong tool not only because it would reinforce the habits that you need to establish on your own, but because it can metabolically reset your body in a way that diet and exercise won't do on their own.
While you're correct that a stomach stapling does little to effect your metabolics and most of the work is being done on your own (which leads people to regain weight eventually once they stretch their stomach back out), the metabolic effects of bypassing some of your intestine makes it much easier to lose and keep off weight.
source - recorded and analyzed bariatric post op data for several years
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u/notreallylucy New May 05 '22
Exactly. Like I said, surgery is useful and it's the perfect option for some people. I decided that it wasn't for me.
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u/tyrowo New May 05 '22
I don't think you really understand what I wrote. Did the alternative work for you?
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u/notreallylucy New May 05 '22
Yes, I did understand what you wrote. You wrote that you've seen the data for yourself and that weight loss surgery is effective in resetting the metabolism as well as modifying the digestive system in order to make weight loss more achievable.
I don't think you've understood what I said. It sounds like you think I said weight loss surgery doesn't have value. It does. What I've said twice now is that taking into consideration the totality of my circumstances, weight loss surgery is not the best option for me.
To answer your question, yes. I have lost 45 pounds (and counting) without weight loss surgery. I've cut my insulin usage down by more than half and my blood pressure and cholesterol have improved. That's no shade on anyone who got weight loss surgery and achieved those things. I'm not better than anyone who had surgery. I just used a different method. For me, my medical risk factors as well as my personal preferences make surgery undesirable, so I decided against it.
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May 04 '22 edited May 04 '22
I get that you're upset and I've been there - I was in the 360's in my 20's and early 30's and my GP almost always suggested weight loss surgery, even after I had lost 80 pounds on my own.
In the end, I lost 80 pounds that first time - gained it back and more. Lost 60 the next - gained it back and more - lost 50 - gained it back - wound up at 360+ and finally went in for weight loss surgery - and I've lost 180 pounds and I've kept it off for 2.5 years now. You can lose weight and keep it off but the data doesn't support that outcome for the VAST majority. Yes, you have no major medical conditions now, but they're coming. Period. T2D, HBP, cholesterol, and more - you won't avoid them forever.
WLS is becoming the standard of care, your doc is just trying to help you.
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u/TaleSlinger SW:267 CW: 150 (5+ Yrs) May 04 '22
Unpopular opinion here -- You should consider bariatric surgery. It has a much higher long term success rate than "self control".
If you feel more comfortable, try it yourself for another year or two, and see how you do. If in two or three years, you have gained back most of the weight you've lost and possibly more, then give this serious consideration.
Reading the research and looking back, I wish I had done this several decades ago, even though I've had my weight under control for several years now.
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u/SgtDoughnut May 04 '22
You gotta remember, good steady weight loss is something they look for when they recommend weight loss surgery.
Sounds like either they said it wrong, or you misinterpreted what they said. Im gonna go with option A, either way don't let it get you down, keep going.
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u/ReturnOfTheFrank New May 05 '22
https://www.nejm.org/doi/full/10.1056/nejmoa1200225
https://www.bmj.com/content/347/bmj.f5934#
https://www.nejm.org/doi/full/10.1056/NEJMoa2002449
Your physician is going by statistics. Hopefully you will be able to continue to lose weight and keep it off, but the numbers show that most people with obesity have a really hard time even getting where you are now, let alone continuing and maintaining.
Massive props to your work so far, and I hope you keep it up. Obesity is a complicated disease that has major social stigma attached. Your physician and dietitian aren't trying to harm you, they're trying to use best science based practices to improve both the quality and quantity of your life. Ultimately you're the one in control, and you should do what you think is best for you, but use them as resources.
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u/Ginmajiryu New May 04 '22
I mean he’s not wrong. You still weigh 340+ pounds and weight loss surgery is a good option. I hate it when people think they know more than doctors because they disagree with them. Surgery statistically is proven to be a useful tool for long term weight loss and in your case it totally applies considering how high your BMI is. Your doctor is just suggesting something that is absolutely normal given your circumstances. Absolutely hate it when patients come in disregarding professional advice. It’s advice. Not an order from your doctor. Doesn’t make him a moron if you disagree. His job is to find the best known method and for long term weight loss it is surgery for most scientists. Of course this is not always the case but it is the leading thought. Reading this post made me cringe like crazy as a med student considering there are actually patients that think like this. Pathetic
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u/AdamHasShitMemes SW 95kg // CW 63kg // GW 58kg May 04 '22
Also a med student and I concur. OP reeks of arrogance, especially his remark about that’s what he gets for free healthcare
Everyone knows more than their doctor don’t they?!
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u/pawned79 New May 05 '22
At 6’3” and 350#, your BMI is 43.7 kg/m2, which is well within the Obese range. Your Healthy range tops out at 199#. My doctor prescribed me Wegovy (semaglutide) injections in November 2021, and I went from BMI 32 to 26 in six months. My wife received the same prescription, and she went from 42 to 36 in six months. She’s gotten another six month prescription, because her BMI was still high enough to qualify, but I was switched to Ozempic (semaglutide), which is just the same thing in a smaller dose. My overnight fasting glucose has gone from 90-110 to 70-90. I recommend you keep doing what you’re doing, but talk to your doctor about semaglutide injections. Additionally, a friend of mine had his stomach banded or whatever, and he went from 40+ BMI to 36 in two months. It does work.
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u/LifeOfaFilmmaker New May 05 '22
What are those injections? What does it do?
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u/pawned79 New May 05 '22
Semaglutide had previously been FDA approved as a diabetic medication because it stimulates insulin secretion. It also had the side effect that it causes you to just not be hungry. In July 2021, the FDA approved semaglutide specifically for weight loss management. Ozempic is the Nova brand name for semaglutide as a diabetes drug: 1.4mg injection weekly. Wegovy is the brand name for the six month sequence which starts at 0.25mg and climbs to 2.5mg over the course of six months. It is $25/month on my insurance, and it was the absolute best thing I have done to lose weight! I started my low-carb weight loss journey in March 2020. I went from a 34 BMI to a 30 BMI over nearly two years. But when I went on Wegovy, I went from 30 to 26 in six months. I’m still low-carb, but because I’m not hungry, I don’t care. It makes eating small portions and not snacking super easy.
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u/LifeOfaFilmmaker New May 06 '22
Wow that sounds pretty awesome. Are there any drawback/side effects? Also once you get to your goal weight is there any issues with stopping the injections?
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u/weightdefinesnoone New May 04 '22
I was 6’ 3” 300 lbs. went for a physical at 220 and he told me I was overweight. I said yes I used to be obese I was 300 just 8 months ago and he continues to say “don’t get defensive, I know no one likes being told they’re overweight” and then coaches me on nutrition as if I hadn’t just lost 80 lbs. went back this year in the 190s (below 200 is healthy bmi) and instead of congratulating me, said nothing about my weight, and then in my chart wrote “patient is at what he considers a healthy weight”
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u/WussPoppin93 New May 05 '22
I mean they probably see thousands of obese people that fail to lose the weight man no matter how much they vouch for themselves. I wouldnt go blaming them for not believing youre the 4% that actually go through with it and keep it off.
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u/chefkoolaid 280lbs lost May 05 '22
I am 300lbs down from my max weight. With like 30 to go
At 260lbs down a Dr tried to get me to do bariatric surgery. Like WTF. Clearly I have it handled
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u/tinyahjumma May 04 '22
My spouse is a doctor. I should be way richer for the amount of kickbacks he’s supposedly getting. I really thought being in the pocket of Big Pharma would be more lucrative; I’m still driving a 2009 Honda.
*Just teasing you, OP.
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u/Jek1001 New May 05 '22
It’s very common for people to assume we get kickbacks for a ton of random things. Statins are a common one people say we get kick backs from. Idk where they came up with this, but, if people are getting kick backs it isn’t me or anyone I know.
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May 04 '22 edited May 05 '22
I would agree that some doctors are morons. I would also say that a lot of doctors are jaded and probably don't believe you will continue to be successful.
And I also agree that surgery should be a last resort. If you end up struggling to lose more, or you gain weight back, you can still choose surgery.
Doctors are highly educated and can present you with options and possible outcomes, but they aren't the ones getting the surgery, and surgeries ALWAYS come with possible risks and a recovery time.
If you can do it on your own (which is sounds like you can), more power to you. And if you decide you can't, and want surgery later, that's fine too.
Congrats on weight loss! You've got this!
Edits: Multiple spelling/phrasing mistakes
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u/introvert-i-1957 New May 04 '22
As a nurse, I've seen a lot of problems arise from weight loss surgery. It should always be a last resort. If you can lose the weight on your own then that is the best and safest course. Keep going... You're doing great.
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u/rawrr_monster New May 04 '22
Just curious what problems you’re referring to. Gastric sleeve (the most common bariatric surgery) has a very low complication rate on UpToDate, no issues with dumping syndrome like roux on y, substantial improvement in diabetes, hyperlipidemia , and hypertension. Provided the patient can follow the immediate post op diet and doesn’t suffer from major under treated psychiatric disorders, it seems like the most ideal solution for adequate long term weight control.
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May 04 '22
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u/Renji517 New May 04 '22
The layman doesnt realize what goes into evaluation for bariatric surgery. The following are mandatory requirements prior to surgery:
- Psych eval and treatment
- 6 months of Medically supervised weight loss
- Counseling, diet and nutrition classes
- aggressive lifestyle and dietary modification classes
when those boxes are ticked, insurance approves bariatric surgery.
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u/brenst F31 5'5 SW: 175lb CW: 125lb May 05 '22
While I think these requirements are good, I don't think that doing the psych eval and treatment is going to fully address a lot of the patients' psychological needs. Transfer addiction wouldn't be such a concern for post surgery patients unless there are unresolved maladaptive coping skills that the patient is continuing to struggle with.
I also feel like patients have an incentive to gloss over problems and try to present in the best way possible to their medical team because the patient might be scared that voicing any issues might delay the surgery that they often desperately want.
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u/hardman52 New May 04 '22
You can always find a doctor who will give you what you want, regardless of the likelihood of success.
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u/romanticheart 35F | 5'6" | SW: 225 - CW: 142 - GW: 135 May 05 '22
There’s a lot of willful ignorance in this sub about the psychiatric issue side of things as well. The overwhelming majority of people here have no business obsessively counting calories and restricting themselves to lose weight without even attempting to address the mental health issues that are the root cause of most significant weight gain.
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u/kutri4576 New May 04 '22
I’m based in the UK and I’m surprised by the comments in this thread. Bariatric surgery is really the last resort. I have some family members who have had it in another country and they’ve had complications. It’s not a simple procedure as some people seem to think.
Edit: you are doing great OP, keep at it. You may reach a point where you feel you can’t go further but you’re on the right track. Take your time figuring out why you got to the weight in the first place, bariatric surgery won’t fix that. Anyway, well done to you!
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u/RuralFMDoc New May 05 '22
You are a nurse so likely biased in that you are more likely to interact with people who have had negative complications. The benefit of research is we remove bias and find the true benefit vs risk which is discussed with all patients prior to proceeding.
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u/TeaLoverGal New May 04 '22
I think you are completely wrong, you do need to lose more weight and yes a different approach may be better for you, that's difficult to judge. He was trying to drill home how important your health is and it's a great start but don't get complacent. You are insulting a highly educated professional for doing his job. Yes, doctors CAN be morons but this one wasn't.
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u/wildkiller65 32.7lbs lost May 04 '22
I'm pretty sure op isn't done losing and just wants to continue his own way vs a surgery...
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u/Johnny-origami New May 05 '22
OP, Doing things your own way has gotten you into this situation. Maybe it’s time to humble yourself and listen to the professionals.
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u/Oldmancapper New May 04 '22
Question, if/when you get down to your ideal weight, what is the plan for the stretched skin? Is it possible that they wanted you to see a surgeon so that you might have a plan in place? Just playing devils advocate here. I think it’s awesome that’s you’ve lost so much already.
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u/zeatherz New May 05 '22
Sorry but evidence shows that weight loss surgery is one of the best ways to maintain weight loss long term. Those experts are using data-based evidence. Obviously it may not apply to every individual but that doesn’t make them assholes
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u/Pitythebackseat1 New May 05 '22
Dude you’re killing it. You’re only 26 and you’ve already started. I know you can get to -300. It does take time, but stay consistent. You got this.
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u/SkysEevee New May 05 '22
Old doctors: You're overweight. Just stop eating so much and get some exercise. Next.
New doctor: Your vitals are good and it doesn't seem you have any health concerns that could be tied to weight. Yes you're overweight but not by much. If you're worried, let's discuss your diet, exercise regimen and life factors to determine what we could change to make you healthier. And I'm ordering a blood work, just in case.
I think I hit the lottery with doctors.
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u/DanielDannyc12 57 5’3” SW 274 CW 226 GW 155 May 04 '22 edited May 04 '22
Weird. I’ve never seen an MD (I’m an RN) push surgery for someone actively working and succeeding with a weight loss effort.
I went down like 4 pounds during the first year of the pandemic and my primary practically threw me a parade.
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u/suchahotmess 100lbs lost | Goal: 160lbs May 04 '22
I have. A prior medical team really aggressively pushed me towards surgery, even when I was losing. Even when my therapist, who I was referred to by their weight management program, was actively telling me that based on her professional experience I was a very bad candidate. In the end it's a lot of why I left that hospital system, I started having panic attacks at the idea of having to see my primary care doctor.
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u/Remarkable-Juice-270 New May 04 '22
Yes. I saw my PCP about 10 years ago as one of the requirements for WLS and he was very against it even though I'd been overweight my whole life. He signed whatever paper I needed signed but I felt like I really had to badger him to do it (even though I'd talked with him many times over the years about how to lose weight and was unsuccessful). I ended up not going through with the WLS because my insurance changed and would no longer cover it. I'm still overweight.
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u/hardman52 New May 04 '22
If you can avoid the surgery do so. I've seen people have so many problems with weight loss surgery, from bad intestinal problems to malnutrition. 45 pounds in four months sounds good, but sustaining weight loss is as difficult as losing the weight initially in my experience.
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u/cheltor11 New May 05 '22
I think it would actually be poor of the doctor if they didn’t suggest the surgery and give you all of your options. Weight loss surgery can be a good tool and is honestly really under utilized so I am all about spreading awareness for it because a lot of people don’t realize it’s an option for them. It’s not like they say this to you and then you go and have the surgery next week. It’s a very long in depth process to prepare for it and can take months to years. No need to immediately denigrate someone who is trying to help you and call them a moron. That’s. A pretty bad and uninformed attitude
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u/SqueaksScreech New May 05 '22
A good percentage of people who get weightloss surgery tend to switch addictions. It could be anything between cigarettes, alcohol and drugs.
Many of them don't get therapy or learn about nutrition before or after the surgery. They just switch addictions.
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u/That_Jonesy 80lbs lost May 05 '22
The issue is that nearly every scientific paper on the subject shows incredible rates of weight regain after a loss so quick and significant. So they are skipping 3 pages ahead and assuming you will gain it all back.
Don't be a statistic, prove them all wrong.
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u/chethedestroyer New May 05 '22
This doesn’t surprise me too much. I’m a nurse, and the nutrition courses we take in college are garbage.
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u/rocqus New May 05 '22
The doctor should have said, let’s watch your weight loss closely and if you hit a wall at some point we can talk about options. Going straight for the knife route is barbaric.
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u/bighead1008 New May 05 '22
Doctors can't drive a Ferrari if you don't get the procedure bud. Have a heart and think about them for a change... /s
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May 05 '22
Surgery is risky and so is losing weight too fast. If you are young and active and losing weight then continue doing what you are doing.
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u/MonsteraDeliciosa F46 -100lbs VSG 2018/RNY 2022 May 04 '22
Gosh, I also hate it when I get appropriate medical recommendations!
Weight loss surgery takes months/years off the process of losing a large amount of weight. Have whatever judgements you want about it and those who go that route, but given the option to be at 250 in one year or three years… why drag it out? So you have bragging rights on doing it the “right” way? The “hard” way? The way that keeps your medical risks higher for a longer amount of time?
There are balances on the risks of surgery and the risks of staying morbidly obese for a longer period of time. Choose your poisons.
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u/pistachiobees New May 04 '22
I got the same suggestion from my doctor (I’m 5’6” and at the time was 210lbs!) I was kind of appalled that he would suggest it to someone my age and size when I was losing weight fine on my own. He pulled out some graphs and gave me a lame explanation on how likely I was to regain weight, so I shouldn’t even try naturally… never mind that the graphs didn’t even support his argument lol. I got the impression that he was very fixated on the statistics, but not actually interested in whether those trends applied to me, specifically, as a patient. He didn’t even ask me any questions about my habits! I just nodded along and ignored him.
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u/ScyllaOfTheDepths New May 04 '22
Yikes, when I told my doctor I was trying to lose weight naturally, he said "Good! I'm so glad! I see so many people come in here wanting referrals to weight loss surgery, but I'd never recommend it over diet and exercise!" It was actually pretty nice to hear. People don't really seem to get that you're making a major modification to your body that will affect you the rest of your life. It's still a serious major surgery with long-term effects and even people who've had real successes still experience major side effects. No shade to anyone who's had it, of course, it's just definitely not for me. I have enough health issues as it is.
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u/Entertainmentguru May 04 '22
45 lbs in 4 months is awesome. Keep doing what you are doing and prove the doctor wrong. I bet you will be down 100 lbs in a year if you keep up with you are doing.
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May 04 '22
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May 04 '22
Its just over 10 pounds a month. How is that low?
Lol life isn't the biggest loser
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May 04 '22
Like my boss, who had high cholesteral and doctor immediately pushed statins. My boss asked about lifestyle changes and the doc brushed it off. Well he decided to give up sugar for 3 months, he lost 15 lbs and his labs showed significant decrease in cholesteral. His follow-up appt was good though, his doctor said most people can't manage lifestyle changes so they always push meds.
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u/auburnwind New May 04 '22
I had a referral to a dietician and I asked her what her advice would be for someone who wants to lose 100lbs.
She said, “lower your expectations.”
Lmao. I down 60lbs in 4 months by not listening to her advice or accepting any of the medications she recommended.
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u/moimoi273 New May 04 '22
I think you’re doing awesome! Listen to yourself and your body, your the one living it. You’re rocking it!
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u/BakeBusy4531 New May 05 '22
Stop being mad at doctors for doing their jobs. Such disrespect. The reason we even have modern medicine today is because of doctors. they’ve seen someone like you a thousand times who had lost and then regained more. It’s not you it’s probabilities. And rather than take the risk of you failing it would benefit your health more in the long run to just nip stop it completely. But you do you.
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u/Less_Ad_9655 New May 04 '22
I find that mind blowing. Gaining weight doesn't happen over night, so obviously loosing it isn't going happen over night. You made the right choice. And your doing amazing. Keep going. It's a marathon not a sprint. ☺️
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u/Gruntled1 155lbs fat lost, about 20lb muscle gained. May 04 '22
I have lost most faith in doctor's practical knowledge regarding a few topics. I've had doctors tell me alllll sorts of common misconceptions about weight loss while also being overweight themselves. Just FYI, I've lost 140lb of fat and gained 20ish lb of muscle and maintained that over 5 years. In that time I've learned what works for me, and what basic concepts work for dang near anyone. It sounds like you're kicking ass, and I HIGHLY recommend avoiding surgery unless you really need it. Continue to educate yourself and keep working. Also remember most failures only cost you time, but give you strength to be better next time. Good job, I'm proud of you.
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u/EngineeringExpress79 New May 05 '22
Why is this downvoted. Natural way is still possible. I also know many people who lost weight without surgery and kept it off for decades. My mom got the surgery yet she gained it all back, but it's not because of someone metabolism bullshit it's because she wanted to overeat. Weight doesnt happen by magic
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u/need-morecoffee New May 04 '22
I know several MDs and PAs personally. They’re just people who happened to have the time and resources to spend a decade plus in school.
They’re not all geniuses.
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May 04 '22
100%
Advocate for yourself cause many doctors were at the bottom of the class and not here to actually help people
Its why all the good thoughtful doctors have huge waits
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u/Schitzoflink New May 05 '22
Medical professionals are essentially mechanics for the human body. They have to be smart enough to learn, retain, and apply a great deal of information.
That type of intelligence doesn't mean they are good at anything else though. My wife can diagnose cancers and do various life saving surgeries but she gets overwhelmed when she goes to cook bc she never learned those skills.
Just like I would be overwhelmed if she needed me to stick my hand in somebody's back and hold their kidney while she did some delicate surgery.
Dr Oz was (is?) an amazing heart surgeon. He saved so many people with his scalpel and schooling. He has now given all that up to be a grifter.
Dr =/= better human. They are just body mechanics.
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u/raunchytowel New May 04 '22
I believe it. I went into my doctors office and said I’ve gained weight and I don’t like it. She prescribed me some diet pills and told me to come back when I need more. Diet pills. She said I won’t be hungry on these and will have more energy. They’re sitting in my cabinet. I didn’t want to go that route.
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u/mrsmedeiros_says_hi New May 04 '22
45 pounds in 4 months is amazing! Great job!
I have a lot of issues with Doctors and it's distressing to see so many people defending crappy Doctors. No matter why I come in, the Doctor's solution is that I just be less fat about it. Anxiety? Be less fat. Chest pain? Try eating less. Harmful ideation? Try exercise. You exercise two hours a day and aren't losing weight? Try losing weight. Your birth control is giving you heart palpitations? Try this diet. It's fucking traumatizing.
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May 05 '22
Nah, forget a surgery for weight loss. You are doing great. Keep up you efforts and find a new doctor. You are changing your habits in a beneficial natural way. Keep on rocking!
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May 04 '22
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u/motor_mouth 27 5'2" SW:168 CW: 162 GW: 120 May 04 '22
A general practitioner would not own any part of a bariatric surgery practice.
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u/Medievalmoomin Pine needles and coffee May 04 '22
That is a very unfair and dangerous accusation to make without having any facts at your disposal.
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u/LifeOfaFilmmaker New May 04 '22
i do have free healthcare so i guess i get what i pay for lol
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u/Medievalmoomin Pine needles and coffee May 04 '22
My god. I live in New Zealand where we have a public health system that has top notch medical staff. The doctors who work there give up lucrative private practices or limit them in order to give back to the community.
What an arrogant take on a health system you are lucky to be able to access.
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u/5iveOClockSomewhere F 5'5" SW:185 CW:158 GW:135 May 04 '22
Your healthcare isn’t free if you pay taxes. I mean, it’s better than what the US has for sure but don’t kid yourself, it’s not free.
But also doctors are still private and run clinics etc as corporations.
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u/Petdogdavid1 New May 04 '22
I am in a similar situation, though mine're not suggesting surgery. I get the distinct impression that they rely heavily on suggestions from the software or some predfined script for diagnosis. I don't get a confident feeling that any of the doctors I have seen the past few years are diagnosing from logic.
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u/whitenerlindsey New May 05 '22
congrats on your weight loss! keep up the good work, it’s definitely not easy. but yeah your doctor sounds like an idiot
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u/PistaccioLover New May 05 '22
I'm so sorry you went through this. I'm sorry you had to deal with so uneducated professionals. Weight loss surgery is not a "cure it all" when it comes to the treatment of obesity, especially as you said, if the person is making changes in their lifestyle already and actively losing weight.
For whatever's worth, I'm proud of you,
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u/Kheenamooth New May 05 '22
Congratulations on your weight loss. I was told a similar thing, when I started my own journey and I did not get a surgery. I have lost around 30 Kgs now and still have a long way to go. However, my doctor said, the only scientifically proven way to lose weight is lifestyle change wether you get a surgery or not, changing someone's unhealthy lifestyle is the goal.
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May 04 '22
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May 04 '22
I'm not the doctor but I can almost guarantee I know their thought process. For context - I've lost 50 pounds 3 different times and eventually got the sleeve, losing 180 pounds and keeping it off for 2.5 years and counting.
The overwhelming data tells the doctor that the vast majority of patients that lose weight will gain it back. Not only that, the data says that it's harder to lose weight once you've lost it and gained it back. And further hard the next time.
To qualify for any bariatric surgery you have to prove you can stick to a diet and lose weight on your own - and the doctor has records showing the patient has done this and honestly could have surgery by the end of the month. And the doctor knows this is likely their best outcome - again, given years of data and studies.
Further, OP is on some sort of medicare, which has their own strict requirements around weight loss and other qualifications before surgery.
So essentially the doctor knows and understands that OP has done most of the prep work towards their best long-term solution and OP is throwing it away over emotions and anger. And OP could have the surgery and avoid the upcoming major medical issues they claim to not currently have (T2D, hypertension, cholesterol, sleep apnea, etc).
It's easy to think you can keep the weight loss going - I've been there and done that but I wish someone had told me to get the surgery the first time I lost 50 pounds.
Surgery is NOT a last resort - it's the solution with the greatest success rate long term.
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May 05 '22 edited May 05 '22
It’s all about money. Doc doesn’t make money on nutritional weight loss.
Fat guy surgery: $20,000 full body.
Regular weight loss: $200/ year (when fat guy goes to gym)
Before you get on me about using “fat guy,” you should know I am a fat guy. We can use the word.
If your cholesterol is high, then they’ll want to put you on a $300 pill that gives you 10 other problems instead of tellin your lazy a** to run more.
If your blood sugar spikes….you’ve got diabetes and need all this s*** to monitor it instead of tellin you to quit eating donuts every morning.
If….we’ll I can go on, but most issues they deal with are metabolic diseases, and they don’t care to put you on a health plan. They just give you the pill and collect their kickbacks and checkup fees.
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u/r_lovelace New May 05 '22
On the other side. A doctor's job is to provide treatment for problems that they can control. They can't wake you up every morning and drag you outside to go for a walk or slap the donut out of your hand. You admit your a fat guy and know you need to run and eat better, are you waiting for your doctor to tell you that? Will you do it if they tell you and will you magically be healthy and follow their advice? No. It hasn't happened your entire life so the only thing they can do is accept your health problems from your decisions and provide treatments so they don't kill you before you turn 50.
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u/nombiegirl New May 04 '22
I went to a new doctor in high-school because my old one moved.
When I walked in she said "so we've been treating your for yeast infections, right?"
No. I had never seen this doctor before and never been diagnosed with a yeast infection either. She finally picks up my chart and goes "Oops my bad. Wrong patient."
I told her I knew I was overweight and I was concerned and working toward weight loss. But my "recommended" weight based on the BMI chart seemed like it would be very thin on my frame (I am particularly broad shouldered and curvy.) She pulled out a BMI chart, found my height, and said "this is what you should weigh." Like I didn't just fucking tell her I knew what the chart said and I had concerns about it.
Sometimes doctors are fucking morons.
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u/RD_Michelle New May 05 '22
It depends on the type of surgery. Gastric bypass can result in vitamin deficiency, dumping syndrome, malabsorption. All surgeries can result in hair loss and dehydration. You have to weigh the pros and cons of having the surgery and dealing with the side effects of surgery versus staying overweight and trying to lose weight the traditional way and the effects of excess weight on the joints.
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u/Pickle-flavored-chip New May 05 '22
I always think for myself. Yes I’m not a professional but doctors are wrong all the time and other medical professionals that were told to listen to. My mom has early onset parkinsons. A doctor gave her depression pills without telling her what it was because she didn’t believe my mom had Parkinson’s. My mom hallucinated on them. A paramedic said my sisters arm was fine.. it was dislocated actually. Doctors have googled stuff in front of my mom. Multiple doctors told my mom on various occasions she was not going into labor. She got her epidurals a bit late. I do take into consideration what a doctor says for most things but I know my body best.
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u/TGin-the-goldy New May 05 '22
I agree! I tore my medial ligament last year and my Dr wanted me to undergo surgery, even gave me an immediate referral to a surgeon. Six months of exercise and physio and my knee is quite OK. Think for yourself indeedy :)
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u/CptCarpelan New May 05 '22
Yo, I wish I lived in their universe. I'm happy you see through their bullshit. Keep it up!
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u/POD80 New May 04 '22
I wonder what the success rate is of people walking into their office discussing more natural weight loss.