No to weight loss surgery

[Wendells_]

I applied for a referral for weight loss surgery but have been told as my BMI is only 31 I won't be considered (has to be 40). I have battled with my weight since I was 21 (am now 59) but only diagnosed Type 2 13 years ago after completing 6 months of chemotherapy. Since then my medication has risen in terms of amount and type. I inject Humulin daily (16 units), take slow-release Metformin twice a day (1g), and take Glimepiride. I have developed liver cirrhosis, but don't drink and my cholesterol has just risen and so have been prescribed a different statin to what I was taking. I have been to Slimming World since November 2019 and lost 1 stone only (this is my 5th attempt in 10 years) and I exercise 7 days a week, either a 1-hour walk & kettlebell or cross-trainer and exercise bike. I have put on 8 pounds in lockdown and I am now upset that nothing else can be done. I will just wait for the next doctor to tell me I am obese (13st 10) and to lose weight. Sorry, a bit of a rant as I am feeling sad but has anyone else had this experience?

 

[xfieldok]

Welcome to the forum. Do you know what your hba1c was, and do you test using a meter, you should have one if you are on insulin.

What are you eating in a typical day?

Most of us follow a low carb way of eating. Have a look at the link in my signature.

When I was first diagnosed I went keto less than 20g carbs per day. My main objective was to get my numbers down. Weight loss was a byproduct.

Lots of info on dietdoctor.com.

Slimming world, WW are in no way qualified to advise T2S on diet.

 

[Pipp]

Hello @Wendells_ and welcome from me, too.
Losing weight is so difficult. I know from personal experience. It is also demoralising when health care professionals keep referring to weight, and often blaming all ills on the fact that you are too heavy.

Something that leaps out from your post is that you have attempted it 5 times in 10 years. So something is not working right for you. A change in method is called for. Although you are so disappointed at being refused weight loss surgery, don’t get too hung up on that or be tempted to gain the weight just to qualify. (You weren’t thinking of that, were you?) A BMI of 31 is only just into the obese range, and a small reduction into ‘just overweight’ can be a good morale boost. You can do it.

Perversely, it was the suggestion of weight loss surgery that led me to find other ways of regaining control of my health. It can be done.

As you are new to posting, Although looks as if you have been a member for some time, if you haven’t already done so, have a read around the forums and particularly the new member info, even though you are not newly diagnosed it can help to go back to basics.
https://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.17088/

As already mentioned, by @xfieldok , low carb way of eating gives good results for many, both in control of blood glucose and weight loss. I found this useful
https://www.diabetes.co.uk/forum/threads/a-new-low-carb-guide-for-beginners.68695/

Keep reading, and keep posting.

Edit: Medication monitoring advisable if reducing carbs, and indeed for any change in diet.

 

[EllieM]

Slimming World tend to adopt a high carb low fat way of eating, on the principal that 1g of carbs has less calories than 1g of fat. T2s have a genetic disposition to process carbs badly, and to both gain weight and have too high blood sugars if they eat more carbs than their bodies can tolerate....

A typical T2 's body will produce more and more insulin to try and process excess carbs, but once the body's insulin production is maxed out, their blood sugar rises, and the extra weight goes on. The weight gain increases insulin resistance and you are set into a vicious circle of increasing blood sugars and weight.

I am not promising that your weight will reduce and you will come off insulin if you drastically reduce the amount of carbs in your diet, (it depends on whether your insulin producing cells have been damaged by 12 years of over production) but I would suggest that it is a strong possibility and you really have nothing to lose. And you are still on relatively little insulin for a T2 so you should still be producing plenty (Disclaimer: I am not a doctor).

Only proviso: be careful about reducing carbs on your current medication, as you will probably need to reduce it drastically so as to avoid hypos.

Good luck.

 

[Pipp]

Slimming World tend to adopt a high carb low fat way of eating, on the principal that 1g of carbs has less calories than 1g of fat. T2s have a genetic disposition to process carbs badly, and to both gain weight and have too high blood sugars if they eat more carbs than their bodies can tolerate....

A typical T2 's body will produce more and more insulin to try and process excess carbs, but once the body's insulin production is maxed out, their blood sugar rises, and the extra weight goes on. The weight gain increases insulin resistance and you are set into a vicious circle of increasing blood sugars and weight.

I am not promising that your weight will reduce and you will come off insulin if you drastically reduce the amount of carbs in your diet, (it depends on whether your insulin producing cells have been damaged by 12 years of over production) but I would suggest that it is a strong possibility and you really have nothing to lose. And you are still on relatively little insulin for a T2 so you should still be producing plenty (Disclaimer: I am not a doctor).

Only proviso: be careful about reducing carbs on your current medication, as you will probably need to reduce it drastically so as to avoid hypos.

Good luck.

Thank you, @EllieM . I ought to have realised caution necessary when reducing carbs if on insulin meds.

 

[ziggy_w]

I applied for a referral for weight loss surgery but have been told as my BMI is only 31 I won't be considered (has to be 40). I have battled with my weight since I was 21 (am now 59) but only diagnosed Type 2 13 years ago after completing 6 months of chemotherapy. Since then my medication has risen in terms of amount and type. I inject Humulin daily (16 units), take slow-release Metformin twice a day (1g), and take Glimepiride. I have developed liver cirrhosis, but don't drink and my cholesterol has just risen and so have been prescribed a different statin to what I was taking. I have been to Slimming World since November 2019 and lost 1 stone only (this is my 5th attempt in 10 years) and I exercise 7 days a week, either a 1-hour walk & kettlebell or cross-trainer and exercise bike. I have put on 8 pounds in lockdown and I am now upset that nothing else can be done. I will just wait for the next doctor to tell me I am obese (13st 10) and to lose weight. Sorry, a bit of a rant as I am feeling sad but has anyone else had this experience?

Hi @Wendells_,

Welcome to the forum. It is really frustrating when you have to work so hard to lose any weight at all and when it then comes back so easily.

I agree with the other posters -- it might be worthwhile trying to lower your carbs. For us T2s, who are insulin resistant, low carb often works where low-fat doesn't. In addition, it might also help a bit with your liver as well as your blood sugars. As low carb is usually very effective in lowering blood sugars and you are on quite a bit of medication, you should probably work with your GP to do so safely.

Btw, for most us food is 90 percent of the equation and exercise only 10 percent.

 

[LaoDan]

I applied for a referral for weight loss surgery but have been told as my BMI is only 31 I won't be considered (has to be 40). I have battled with my weight since I was 21 (am now 59) but only diagnosed Type 2 13 years ago after completing 6 months of chemotherapy. Since then my medication has risen in terms of amount and type. I inject Humulin daily (16 units), take slow-release Metformin twice a day (1g), and take Glimepiride. I have developed liver cirrhosis, but don't drink and my cholesterol has just risen and so have been prescribed a different statin to what I was taking. I have been to Slimming World since November 2019 and lost 1 stone only (this is my 5th attempt in 10 years) and I exercise 7 days a week, either a 1-hour walk & kettlebell or cross-trainer and exercise bike. I have put on 8 pounds in lockdown and I am now upset that nothing else can be done. I will just wait for the next doctor to tell me I am obese (13st 10) and to lose weight. Sorry, a bit of a rant as I am feeling sad but has anyone else had this experience?

My BMI was 41, now I’m around 30. What’s working for me is low carb, 10-15% calorie deficit and exercise. Its probably mostly the keto-ish diet. Hope you find your path!

 

[bulkbiker]

I applied for a referral for weight loss surgery but have been told as my BMI is only 31 I won't be considered (has to be 40). I have battled with my weight since I was 21 (am now 59) but only diagnosed Type 2 13 years ago after completing 6 months of chemotherapy. Since then my medication has risen in terms of amount and type. I inject Humulin daily (16 units), take slow-release Metformin twice a day (1g), and take Glimepiride. I have developed liver cirrhosis, but don't drink and my cholesterol has just risen and so have been prescribed a different statin to what I was taking. I have been to Slimming World since November 2019 and lost 1 stone only (this is my 5th attempt in 10 years) and I exercise 7 days a week, either a 1-hour walk & kettlebell or cross-trainer and exercise bike. I have put on 8 pounds in lockdown and I am now upset that nothing else can be done. I will just wait for the next doctor to tell me I am obese (13st 10) and to lose weight. Sorry, a bit of a rant as I am feeling sad but has anyone else had this experience?

Hi and welcome

You might find this helpful?

https://twitter.com/DrPaulMason/status/1288726931953704961

 

[Daibell]

Hi. I would be very wary of SW or WW as they tend to allow too many carbs and talk about calories which are irrelevant. You need to think Carbs and set yourself a daily limit. I would go for 150gm/day initially and try to go below 100gm/day if you can. Have enough proteins and fats to keep you feeling full. It's mainly the carbs that cause weight gain and not the fats which is why monitoring calories measures the wrong thing for weight loss (despite the NHS etc saying otherwise). You will need to measure your BS fairly often as you reduce the carbs in case the insulin also needs to be reduced. As others have asked let us know your typical diet and HBA1C.

 

[bulkbiker]

Hi @Wendells_

Not sure if you are a tweeter but if you are this lady is well worth a follow.

https://twitter.com/AmyDee1001/status/1288841169976393728

 

[VashtiB]

Hello and welcome,

I'm only a little younger than you but a higher BMI however I've lost over 30 kg in about a year by only dramatically lowering my carbs and not counting calories at all.

Having said that you should gradually reduce as you are on blood sugar reducing medication. Don't lose hope- I also found that the medical profession really don't understand obesity and diabetes. It was only when my very slim husband would confirm that I was not actually eating that much that the doctor would even consider believing what I said. They really don't believe that people who are overweight can count calories without cheating and may do a lot of exercise. It is very disheartening.

People here have had some success- but be careful not to hypo make sure you test frequently.

Good luck, welcome and let us know how we can help.

 

[TeddyTottie]

Just to echo what everyone is saying - low carb (with all proper precautions for your medication) is a complete revelation. I have lost over 24kg since last December without counting any calories. Low carb enables the body’s natural fat storage and release mechanisms to re-establish themselves and start to work as they should, not being blocked by excessive insulin.

The extra fat and protein is yummy and very satisfying. I wouldn’t say I am never hungry because I do get hungry, but it’s a much more natural, less urgent and good kind of hunger, not that OMG-feed-me-carbs-NOW kind of craving. If I choose to ignore it, it goes away as my body uses stored fat to meet its needs.

Intermittent fasting is also very helpful, ie. reducing the time you spend each day eating. I find a couple of days in the week where I only eat my evening meal very useful and really, no kind of hardship to undertake. Some people like 24, 48 hr fasts, or even longer. I haven’t tried that (yet). I know, it sounds impossible now but your body, and your relationship with food, will change and the previously-unimaginable becomes easy. Again, check how this sits with your medication.

Unlike Daibell, after my T2 diagnosis I went extreme low carb straight away - this allows your body to make the switch to fat as a primary source of fuel quite quickly. Higher amounts of carbs can leave you in a state where your body is still relying on glucose for fuel but you are not supplying enough for its needs - hence, ‘keto flu’. But we are all different, it’s all about what works for you.

Good luck - you can do this, and it can happen quite quickly. Make a start and it will soon get easier and you will be so impressed with yourself!

 

[ickihun]

I applied for a referral for weight loss surgery but have been told as my BMI is only 31 I won't be considered (has to be 40). I have battled with my weight since I was 21 (am now 59) but only diagnosed Type 2 13 years ago after completing 6 months of chemotherapy. Since then my medication has risen in terms of amount and type. I inject Humulin daily (16 units), take slow-release Metformin twice a day (1g), and take Glimepiride. I have developed liver cirrhosis, but don't drink and my cholesterol has just risen and so have been prescribed a different statin to what I was taking. I have been to Slimming World since November 2019 and lost 1 stone only (this is my 5th attempt in 10 years) and I exercise 7 days a week, either a 1-hour walk & kettlebell or cross-trainer and exercise bike. I have put on 8 pounds in lockdown and I am now upset that nothing else can be done. I will just wait for the next doctor to tell me I am obese (13st 10) and to lose weight. Sorry, a bit of a rant as I am feeling sad but has anyone else had this experience?

I've had weight loss surgery and I'm still 15st 4lbs. Mind u I still hv some work to do to try and manipulate my liver health with metformin and go heavy on my need for low fat and low carb which in turn is low calorie.
I have been morbibly obese most of my adult and teen life. I'm now 49yrs old.
My surgery and others don't leave anyone without some mild or moderate side affect. A old few major complications. I'm lucky and I hv gained more than any negativity from my Roux-en-y operation a year ago. I couldn't be happier with my weight loss. My skin has coped enormously well, so far.
I would say most of the positive effect on my appetite and insulin need has concluded that metformin only help stabilise my bgs rather than 'cure' any of my diabetes. I'm still producing some of my own insulin but I think due to injecting off and on the rocky 14yrs of pregnancies etc has really helped.
Not everyone needs a medical operation to help solve their rocky diabetes and obesity.
The forum has various recommendations of which I would seriously try first. It's the very best way to understand YOUR body.
Maybe one day the threshold for some procedures may be lowered once more evidence becomes more obvious. So therefore more positive for everyone.
Please feel free to PM me as I must go rescue some lego. Ha ha

 

[Wendells_]

Thank you for your reply and good luck with your journey.

 

[Wendells_]

Thank you everyone for your replies and support. My Hba1c was 53mmol in June which had been a drop from 68 last year. I have now started a low carb diet and have lost 3lbs this week and my bloods are pretty stable when I test each meal. I will update this when I can. Once again thanks for making me realise my mistake in using SW instead of low carb.