My weight loss journey started many years ago, however perusing the idea of surgery started last year after speaking with a friend who was knowledgeable in the area. I asked what her thoughts were, and she said that it was a reasonably safe operation and the research on long term outcomes was looking very favourable.
So I started to do my research, and found a good surgeon. I spoke to my GP and although she did not object to referring me told me that all I needed to do was to eat more vegetables “that grow above the ground” and practice intermittent fasting. That would cure my weight issue. Although I appreciate that my GP thought she was being helpful, I found it patronising. If it was as easy as she said, then why had I struggled for so many years? I didn’t feel like my GP was up to date on the advances in WLS, or the long term results that it was getting.
I believed that surgery was the correct choice for me as I had tried for many years to address my weight. I had been successful at times, losing 20+ kgs on a few occasions however I was never able to keep it off… and in fact I would gain a couple of kilos. I was at an age that I knew that co-morbid health concerns were knocking on my door and I had no long-term ways of keeping them at bay.
I have always struggled being the chubby one in my family. I have always eaten reasonably well, nothing out of the ordinary, but I have always been bigger than my family and friends. Not significantly bigger, but it was an issue and I knew I needed to do something different in order to maintain a healthy weight.
Although I have an active social life, with lots of wonderful people in my life, I feel that I am a relatively private person when it comes to disclosures such as surgery. I spent a fair bit of time reflecting on my choices and considering my options. I knew that surgery was the correct choice for me but needed to cognitively prepare for what that meant in reality. How would it affect my lifestyle that revolved around social activities and shift work? My family and friends often caught up over meals and nights out. How would I negotiate these activities without excluding myself and feeling left out? I had to prepare for surgery and this significant change by talking to my partner, family and close friends. Only one family member felt that I was having the surgery because I had poor self-esteem and attempted to reassure me that I was loved and didn’t need to do something so “drastic”. She was quite distressed. I knew that this person would struggle with my decision, as she is a classic gym junkie. I felt that this was more a reflection of her lack of education and knowledge, and perhaps a lack of their understanding of me. I, in no way, have low self-esteem. I’m a logical and practical person that had not made an impulsive decision. It was my job to sit through this distress and listen to her concerns, and then support her through the process. I had many months to come to this decision and needed to give others the same respect. I had many teary phone calls from this family member who struggled with my decision. She was worried for me and concerned that I might suffer long-term side effects. This decision was never made about wanting to fit into size 8 clothes, it was about my health and wanting longevity for my life. Saying this though, I have been overwhelmingly supported by everyone I have told.
I have not spoken to anyone outside my circle of trust, and keep my WLS journey to myself at work. I told work colleagues (who are reasonably intrusive) that I was having my gallbladder out – which I also did, and that was the reason for my weight loss.
I cognitively prepared by taking on board all directions and advice from my surgeon, nurse and specialist dietitian (Nicole West). I lived in fact, and didn’t let any emotions cloud my judgement. I told myself that this surgery was necessary just like any other previous surgeries that I had had. I blocked out rumour and scepticism that is spoken about in the general community, and relied on the experts in the field to guide me. I trusted in the process. I focused on each step, and didn’t let myself worry about what might happen. My choice had been made and I felt calmness and acceptance in the decision that I had made.
I would tell someone who was thinking about surgery to expect it to be difficult. There is no cheating or taking the easy way out. You need to follow directions to the letter and accept that it is hard work. Fluids will be your friend and overconsumption of food will never be an option again. Your tastes will change, your favourite foods will change, your lifestyle will change… and it will all be totally worth it.
I would also tell people not to listen to arm chair professionals giving advice without any training, knowledge or experience. Listen to your body and respect the process. I would also tell people not to prepare any food or fluids until they speak with their specialist dietitian or until after surgery as tastes change.
Being a great lover of drinking water, I was most worried about fluid restriction. I was scared about feeling dehydrated and not being able to consume large amounts quickly again. I had previously enjoyed drinking water quickly by the glass, in one go. It’s something I still feel anxious about not being able to do but continual fluid intake during the day helps. This, for me, has been the habit that has been most difficult for me to break. I was also concerned about losing strength and becoming weak, but that has not happened. In fact, I feel like I have gained muscle with the increase in protein.
I haven’t been open with many people, especially work colleagues. I don’t want to be the centre of gossip and I have found stigma is still a factor with this surgery. I have heard my colleagues make fun of people that have had the surgery. I expect that they assume that I have had surgery and I have been told that there are rumours, but I deny it. Looking back now, I wish I had of been honest and proud of my decision. I feel dishonest and disingenuous. Recently I asked a waitress if I could have a take away container, she said to me “Oh I’m surprised that you couldn’t eat it all”. I felt like she made a judgement about my size and assumed I was an overeater. I wish I had the courage to honestly respond however I didn’t, I just told her that I had a big lunch. These are the decisions that I regret. Openness, proudness and transparency.
Being guided by Nicole has been absolutely fabulous, and without doubt, she is the reason for my success. She has been direct, honest and knowledgeable with all aspects of my care. Nicole, step by step, walked me through what would happen for me and informed me what I would experience. I found it surreal when she would tell me what my body would do and what foods I would crave. She gave me clear instructions and ideas of how to meet my nutritional needs, showed me examples of things that I would need, gave me options, and explained why I needed a certain amount of protein / carb / fluid. I responded to her no nonsense approach and wealth of experience in this area, and I felt confident in her care.
I also appreciated that she asked me what food I ate prior to surgery and worked a plan around that. It felt like I was important, and the plan was set around me as opposed to me trying to fit around the plan. I was also never blamed for my weight, or made to feel that this was my fault. It was never about a number on the scales, more about me as a person. This was something that I had never experienced. I had always felt that I was responsible for my obesity. I remember once being told by a GP who kept weighing me every visit (despite my objections) that it was required because “they even weigh dogs at the pound, it’s no different here”. I never experienced anything close to this type of persecution from Nicole. Everything was written down so I had all the information I needed. I valued her straightforward and accurate description of what I should expect. I would take that information home, write it up in language that I could remember and use it as a base to work from. She also showed me examples of food that I enjoyed which had the highest protein content. These choices remain with me today and this has changed my life completely.
During the nourishing fluid stage, I found chicken salt added to my broth the most useful, as well as adding berocca to water. This made it so much easier to drink. These were both personal recommendations Nicole made. One thing that would be helpful is having a little more notice of what I would need to get organised post-surgery would be helpful ie – food / fluid choices.
My advice to anyone having weight loss surgery is be kind to yourself, get days under your belt and know that all these stages will pass. Listen to your body and enjoy this time without putting any pressure on yourself. Listen to the experts and follow their recommendations. Don’t deviate from the plan or rush your body. Just because you can’t see your stomach, don’t assume that it has not been through a trauma. Be gentle with it.
I leant so much from my specialist weight loss surgery dietitian (Nicole West) – I wish I had of seen one earlier in my life to address my weight loss concerns. I thought I knew a fair bit about nutrition, I didn’t. I think the correct specialist dietitian that suits your needs / personality is important. A friend also had surgery on the same day as me, and has had a different dietitian. We have had vastly different experiences from day 1. I had very clear expectations of what I needed to do, and how to do it. My friend was a little vaguer, with a less clear plan. I genuinely feel like my success can be attributed to my dietitian. I don’t think I would have done so well without her.
I don’t think anyone should have surgery without someone like Nicole. I can’t even image why you would want to either. That wouldn’t be safe decision, and I would have concerns about anyone having this surgery without a specialist dietitian’s guidance. Make sure you have expert nutrition advice that is written down, listen and follow advice given to you by the experts. Don’t listen to Facebook groups, gossip or hearsay. Don’t get caught up in the catastrophising.