The Ups and Downs of Weight Loss Surgery

A big part of my current story is that I recently had gastric bypass weight loss surgery.  I have struggled with my weight since I was in medical school.  Medical training means long hours, little time for yourself, and lots of hospital food.  I started putting on weight as a resident and really never stopped.  The weight gain was slow enough for me to try and ignore it along the way, but deep down I always knew what I looked like.  Each time I struggled with my depression, my weight would go up even more.  I was diagnosed with binge-eating disorder at one point as well.

I started looking in to weight loss surgery last year as I was slowly creeping up on the 300 pound mark.  There were two women in my practice who had both gone through slightly different procedures, and both were able to lose a significant amount of weight.  One has lost over 130 pounds and kept it off for over 10 years.  So, I made my first appointment with a bariatric surgeon.

Making the Decision

There was no question that I qualified for the surgery as my BMI had been in the morbidly obese range for some time.  To get full insurance coverage, you also have to show that you have tried a medical weight loss program for at least 6 months and “failed” it. It can be any Weight Watchers type program or you can meet with the surgical team’s dietitian for 6 months.  You’d think losing some weight before surgery would be a good thing, but not if you actually want to have the surgery.  Insurance.  Sigh.

It actually took me some time to decide if I really wanted to go through with the surgery or not.  When they describe the process of cutting away 90% of your stomach, it’s jarring, even for a doctor.  During my 6 month “diet” I did try to exercise more and even hired a personal trainer.  But I’ve always been terrible at dieting and I just kept gaining weight.  The girls in my office were very positive about their surgeries and this lessened the fear for me.  The doctor recommended that I undergo a gastric bypass procedure, the most “extreme” of the surgical options.  This was largely based on how much weight I needed to lose.

The leadup to the surgery required several medical tests, including bloodwork, a chest x-ray, and EKG. I also needed an upper endoscopy (scope down my esophagus) to look at my stomach. Finally, you need a full psychiatric evaluation.  I think it’s good to have these tasks to complete, as it makes you think about what you are embarking on each step of the way.  I was able to complete the necessary pre-surgical evaluations while in the 6 month diet process.  This meant that by the end of the 6 months I was essentially ready for the surgery.

gastric bypass

The actual day of surgery is a little bit of a blur, thanks to anesthesia.  They encourage you to start drinking clear liquids the same day, which basically means sipping on broth and juice.  You learn to keep track of how many ounces you can drink at one time.  The maximum recommended is only 4 ounces, which is about the size of your new stomach, or “pouch”.  I spent two nights in the hospital which meant that my pain was well managed by the time I went home.  I didn’t even need any help at home when I returned the second day after surgery.

The next 4 weeks of your life are consumed by following the strict diet they have set up for you.  You slowly go from drinking only clear liquids, to drinking full liquids, to purees and finally soft foods.  Even when I could only drink, I didn’t really feel hungry which was weird to me.  Before I could eat real food, I found that I was tired a lot, likely just from the lack of calories.  Once nice thing for me is that I was able to take 4 weeks off from work, so I didn’t have to worry about the diet at work.  

losing the weight

The weight didn’t seem to come off as quickly as I was expecting it to.  My girls from work kept telling me that the weight would “just melt away”, but that has not been my experience.  It’s been more of a slow and steady process for me.  I should know better than to compare myself to others, but I guess this is a lesson I have to learn over and over.  The slower weight loss definitely had me feeling down on myself at times.  I am thankful that I was in a good place mentally when I started this journey because it definitely can be triggering to your anxiety and depression at times.

It has now been 3 months since I had surgery, and I am down 50 pounds.  I am torn between thinking of this as an accomplishment, and realizing how far I still have to go.  Overall, I need to lose half my bodyweight, so I’m only about a third of the way there.  Even now, I still don’t feel hunger like I used to.  If I don’t pay attention to the clock, sometimes I will forget to eat and not even realize it until I just don’t feel good.  I can still only eat limited amounts at one time, a lesson I have learned the hard way by vomiting way more than I would prefer.

The good news is that my desire to binge eat has gone way down and I don’t have many “cravings” nowadays.  I’m still not supposed to drink any alcohol, which can be tough during COVID.  I take lots of vitamins and will do this for the rest of my life.  But almost all of my blood work has normalized, including my diabetes and high cholesterol.  That’s always a reason to celebrate.

Overall, I think bariatric surgery was a good path for me.  It has already improved my health and hopefully the weight loss will continue over time.  Have any of you considered weight loss surgery?  Or have you gone through it yourself?  I’m interested to hear your stories and answer any questions you may have about mine in the comments below.