The Process Of Bariatric Surgery On The Nhs

[Jemz]

Yes I have finally done it, after 10 years of being morbidly obese and struggling to lose weight ...... I've been referred to Specialist Weight Loss services with view to having surgery.
Today I had my first appointment with a dietician. It's a 12 to 24 month commitment with monthly appointments before surgery.
Am hoping I can lose weight in that time and avoid surgery but .......
the advice:-
- 3 meals a day, no skipping or fasting
- small amount of starchy carbs with every meal
- eat low fat everything

Not sure this will work as I've spent 30 years on that game!

She told me that high fat meals will give a false blood glucose reading because they take longer to digest and my blood glucose will continue to go up hours after the meal. Is she right?

Any comments gratefully received

 

[NicoleC1971]

I think not! If you were eating pizza this would be true but if you are eating low carb and high fat then why should your bg rise?
I assume this part of the process is the hoop you need to jump through to get to surgery but it doesn't mean you have to do what she says!
I also assume that you are at this stage having tried low carb already? Fasting or low carb are valid alternatives to the 'Eatwell Plate' which you cleearly have no faith in! Bariatric surgery will also cure you but has obvious drawbacks.

 

[Pipp]

I was told bariatric surgery was my only option way back in 2010. I didn't want surgery, and instead found the work of Professor Roy Taylor and followed that route instead.
Not trying to suggest any one method favours another. We each have to find our own best way. I avoided surgery. Managed a loss of 49kg without it. Admittedly regained almost half of that when follow on was the low fat carb with every meal recommended. Have since maintained using low carbing method. Would this low carbing been the best for me? Possibly, but I was working with the information I had at the time.
Before making any decision @Jemz I would seek out as much info from reliable sources on your choice of weight loss method. After all, if you have been following the low fat carbs with every meal method for 30 years without success, then why would it be succesful for you in your pre-surgery phase.
Whatever your choice, I wish you well, and hope you will engage with the members of forums here to share experience and knowledge.

 

[Rachox]

Maybe @ickihun could help here, she’s further through the process.
My own experience was at my first appt with the GP on diagnosis he suggested bariatric surgery, I was still in shock at being told my diagnosis so said an emphatic “no!” I went on to eat low carb and still do, and I’ve lost 6 stone, too light to qualify anymore.
You’ve obviously thought about your decision and wish you well.

 

[lucylocket61]

She told me that high fat meals will give a false blood glucose reading because they take longer to digest and my blood glucose will continue to go up hours after the meal.

just to say that she is wrong. The fats in your diet will not raise your blood glucose levels. hey may slow down your carb absorption, so your post meal reading could be lower by a bit, depending on how much you have eat and what you ate.

 

[rosco 2]

This is not an area of expertise for me. However I wonder what help anyone might get if you achieve huge weight loss but have acres of skin folds left which will clearly impact upon body image. Might be worth considering and, indeed asking.

 

[Mbaker]

With what is known about the 3 macronutrients, I believe only persons with RH have a differing response from the norm, so rubbish is being trotted out to you. I might adjust high fat to healthy fat as foods such as avocado, perhaps some yogurt or cheeses as condiments are not exactly your protein swimming in liquid fat. I would also change 3 meals to working up to a 2 on a 16 / 8 or 16 / 6.

Why would a small amount of starchy carbs be recommended when a satisfying amount of non starchy carbs could replace them and you still be quids in from a weight loss perspective.

12 to 24 months provides you with enough time to gain expert knowledge of the pros and cons of the procedure. If I remember correctly a con is that tablets may be required to ensure your immune system remains capable after the surgery, due to the smaller food intake capability and that surgery is effectively being undertaken when the issue is not technically medical, just an excess of energy within the body; on the other hand with likely full Pre-diabetes remission and the benefits of weight loss such as lower blood pressure if you have this, there are quite a few pros.

At the same time you may find during this period an approach which systematically lowers your weight without the surgery, the best of luck.

 

[Jemz]

Thank you all for your comments. Much appreciated.
Will certainly use the forum to follow the evidence rather than blindly follow the dietician's advice .... I'll be choosing which hoops I am prepared to jump through!
I have tried low carbing both maintenance and vlcd with weight loss but not for any length of time
Maybe the next 12 to 24 months is my time to consistently eat low carb and see where I end up

 

[ickihun]

Yes I have finally done it, after 10 years of being morbidly obese and struggling to lose weight ...... I've been referred to Specialist Weight Loss services with view to having surgery.
Today I had my first appointment with a dietician. It's a 12 to 24 month commitment with monthly appointments before surgery.
Am hoping I can lose weight in that time and avoid surgery but .......
the advice:-
- 3 meals a day, no skipping or fasting
- small amount of starchy carbs with every meal
- eat low fat everything

Not sure this will work as I've spent 30 years on that game!

She told me that high fat meals will give a false blood glucose reading because they take longer to digest and my blood glucose will continue to go up hours after the meal. Is she right?

Any comments gratefully received

Hi.
Yes fat slows your digestion. Yes it affects insulin therapy, from experience.
I lost my target weight loss and more by reducing my carbs. No snacks. Water more and low/medium fat. Protein more than I was eating at my education classes. My educational classes was info against how I was losing weight. I was having 7portions of protein, per day. 2 portions of carbs and 1-2 portions of oils (nuts and mackerel mainly). I enjoy loads of eggs, mackerel and almond flour helps me make cakes, biscuits etc.
Don't be afraid to lose weight then tell dietician how you are doing it. They need all the help they can get.
High fat never helps me lose weight. I'm rather immobile but still lost 3st. Some before my first weigh-in for wls programme.
Low fat doesn't stall my weight loss. High fat does.
You must supplement thou as my restricted diet left me insuffient in most things due to my loss of appetite.
It works thou. It will get you the op.

Ive just reread what the liquid /liver shrinking diet is and it's low carb. Or mine will be. Milk may be my only concern for too many carbs if too much milk.
Low carb diet is excellent for reducing fatty liver. A fatty liver stops weight loss. Irrespective of diabetes or obesity.
Resolve your fatty liver and you will start to lose weight. May only be 0.5lb loss a week but week after week, it all adds up. My underactive thyroid hates weight loss. It fights it all the way.
You will lose the weight, and more. Some don't need the op once their body starts behaving itself.
Unfortunately I had to stop metformin due to ibs and stomach infect so readded 2st. Wls are aware and I'm still trying to tolerate metformin for that 2st loss I still prefer.
I does affect weight loss confidence. Are you on metformin @Jemz and how long have you been tolerating it?

Bariatric surgery isn't something separate to weight loss. Weight loss is the whole picture and surgery is an aid. One of a few aids in reducing weight.

 

[ally1]

I had thought about having surgery but am not sure.
My gp agrees with me, as I Don, t have any will power as I swing so much re food. We both agree because with my bipolar, my moods affect me differently re eating
I wish you well

 

[rosco 2]

Good morning. Are you able to do any exercise such as walking? This is my strategy plus the very low carb. I lost weight - so far 5kg in 3 weeks - largely I think because I walked quite a bit more than usual. Simple stuff may make a difference. Best of luck.

 

[bulkbiker]

Hi @Jemz
In the past I had a diet sheet for the pre bariatric surgery protocol for Guys and Thomas hospital in London which I can't find at the moment. However one of its aims pre surgery was to get the patient into a state of ketosis to "shrink the liver" before surgery.
I would suggest that you check out a ketogenic way of eating which for me has helped enormously with weight loss (as well as lowering blood sugar dramatically) and you may be able to avoid surgery altogether.

 

[ringi]

She told me that high fat meals will give a false blood glucose reading because they take longer to digest and my blood glucose will continue to go up hours after the meal. Is she right?

She is right but only if the meal contains more then a few grams of carbs. If someone with a CGM want to try it, have a baked potato with and without a lot of butter. The butter is likely to make the peak BG lower, but increas the length of time with high BG.

 

[ringi]

Remember that with a low carb diet the ideal fat input is 50‰ of energy if you are aiming to lose weight. A ribeye steak gives you that without adding any more fat to it. (fat has a bit over double the energy density of protein, so 20% fat by weight is close to 50% of the energy from fat.)

 

[ickihun]

I wonder why high fat with low carb doesn't give me any weight loss?
Is it my underactive thyroid which doesn't like fat @ringi?

 

[ringi]

I wonder why high fat with low carb doesn't give me any weight loss?
Is it my underactive thyroid which doesn't like fat @ringi?

The underactive thyroid would not be helping but my underactive thyroid has not stopped me losing 2 stone. Remember that just avoiding weight gain while taking insulin is an unusual achievement for anyone with Type 2.

Virtahealth does not report a 100% weight loss success even out of the people who with ketone testing are confirmed to be keeping to low carb.

 

[kokhongw]

She told me that high fat meals will give a false blood glucose reading because they take longer to digest and my blood glucose will continue to go up hours after the meal. Is she right?

Since you ask here is my favourite glucose chart...a plate of roast pork belly at 11:53am...do you see any glucose rise for the rest of the day?

In contrast, a couple slices of wholegrain bread, butter and eggs...

 

[kokhongw]

Just for completeness...here is the full day graph after the plate of roast pork belly... I think you get the point.

 

[ickihun]

The underactive thyroid would not be helping but my underactive thyroid has not stopped me losing 2 stone. Remember that just avoiding weight gain while taking insulin is an unusual achievement for anyone with Type 2.

Virtahealth does not report a 100% weight loss success even out of the people who with ketone testing are confirmed to be keeping to low carb.

I wasn't keto when I lost weight. Low carb is definitely the best diet, for me and underactive thyroid but insulin injections and fat don't give the best weight loss achievement. I'm sure insulin manufacturers wouldn't want weight loss for type1s when these insulins are being tested. Type1s have a muscle building issue compared to type2s, in general. Obviously not all diabetes do. Like not all diabetics are higher risk of heart disease. Nor kidney disease. If on the right treatment.
Synthetic insulins are tweeked before release for optimum help. Only pigs insulin is closest to natural insulin. I believe.
I too lost 3st with underactive thyroid. Our underactive thyroid likes less carbs. I avoided certain veg to get more weight off, additionally to avoiding root veg. Did you avoid cauliflower and broccoli?

 

[ringi]

The only veg I avoided are high carb veg, I eat lots of broccoli but don't have cauliflower as my wife hates it.