Confused and Demotivated

[Cathy]

Hi, I had an appointment at the Aintree LOSS service today.
In December, the GP at the service said she was recommending me for WLS. She referred me to the psychologist, and I saw her three days later, as there was a cancellation. She said I was an ideal candidate and would recommend me too. We discussed CBT and I agreed to have this, but got the impression that this may happen after the surgery due to waiting times being long.
I attended two support group meetings, one at Aintree and one at Belle Vale. I have a Bariatric Education session booked for 3rd February, again at Aintree.
Today, the dietician told me that my case won't be discussed until I've had the CBT. and that the psychologists letter made no mention of recommending surgery for me.
I asked what would happen if my BMI drops below 40 during this time (it's 43.2 now) and he said I would most likely be refused surgery.
I can lose weight, but can't KEEP it off. I've lost 6 stone three times and 4 stone twice, plus a couple of stone about ten times.
I've got a holiday in May and don't want to go away looking like this, but I'm terrified to lose weight now, for fear of being refused. I'm 60 in three weeks and was anticipating the surgery as the last chance saloon to get this weight off and keep it off.
I'm feeling bewildered, confused and totally fed up now.
Any advice? Should I keep trying to lose weight or what?
I feel all my motivation draining away......:sigh:

 

[im just big boned]

Hi cathy,

Ive just been referred by my gp, my bmi is 44 she told me on wednesday and gave me orlistat?? Tabs, im worried to that if i take them and lose a couple of stone i will be under 40 so they will refuse me.....
Im off on holiday in august and need to lose weight too, i can lose a couple of stone too but puts it back on everytime plus some more, i hope somebody can answer you who knows what to do,
Let me know how you get on
Sue x

 

[Cathy]

Hi Sue, we seem to share the same dilemma!
I'll post any useful info I get on here. Good luck with the Orlistat!
Cathy. x

 

[MayraF]

It's catch 22 isn't it? I was prescribed Orlistat too, but didn't have any success with them. Not that they didn't work, they did but i lacked the willpower.

I asked the same question to the Weight Management people when i started. I said "What if i do lose weight, and you guys just turn around and said oh you proved you can do it yourself, you dont need the surgery" and she just said "that's not how it works" which wasn't very helpful at all!

Tuesday 27th is my last appointment, so let's see what they say. Sorry i haven't got any clear info but it seems to me they have their own ways of deciding things but they can't share it...

I just wanted to wish you good luck! Xxx

 

[im just big boned]

Thanks you too, im sick of looking on google now so gunna put ipad down and watch corrie! Lol

X

 

[im just big boned]

Thanks mayra, please let us know how you get on, how long has your journey been? X

 

[MayraF]

I started November 2012... GP referred me to the tier 3 weight management but i was so discouraged and depressed i had to wait 6 more months and still could be declined so i gave up but restarted the process in April 2013, started the Tier 3 thing 2 months later, in June.

Are both of you from Liverpool? Because i have found something about the NHS Wirral's Bariatric Care Pathway, but it was published August 2012. I am just not sure how to get it to you girls because i can't PM, am i allowed to post links?

 

[Cathy]

I think links are allowed. That'd be great, thanks Mayra.
I got some info from another forum, which I'll post in a minute.

 

[Cathy]

I posted a reply, thanking Mayra, but it's "awaiting approval from a moderator"
That hasn't happened before!
Anyway, this is a response I hot from another forum...

"Selection criteria of patients for bariatric surgery should prevent perverse incentives
for example patients should not become more eligible for surgery by increasing their
body weight. Similarly the selection criteria should not forbid bariatric surgery for
patients who have lost weight with non-surgical methods".

Demonstrating your commitment to weight loss through losing weight should be advantageous to your case for WLS.
Link to guidance

http://www.england.nhs.uk/wp-content...04/a05-p-a.pdf

Hope this helps, best wishes. x

 

[im just big boned]

No, im from blackburn lancashire, thanks for replying though x

 

[angiemason]

as far as I know ( but my surgery was 2 years ago) it is the starting weight and bmi from referral they go on , not afterwards once you have started the weight programme orlistat etc they know that once you have been referred you have tried to lose weight over the years and put back on etc etc ....I had been under dietician couple of times previously and had orlistat which I lost weight but put it back on weight watchers slimming world also lost and gained again ...I may be wrong as I know things have changed over the past couple of years but I do believe the referral form is the starting point . I don't think they can just refer you on a chance they have to show you have tried and failed previously...good luck ladies x

 

[im just big boned]

Thanks for info angie, very helpful, how long did you have to wait from start to surgery? I keep thinking that im going to get knocked back, even my gp said ooooo i dont think you are heavy enough, but was surprised when she weighed me and my bmi is 44!! Will probs feel more positive when i get my dietician appointment
Thanks again
Sue x

 

[angiemason]

Hi Sue
I was refused the first time they said I hadn't done enough to try myself even though I had been through dietician etc but second time I was accepted and had done same thing lost then gained weight went through dietician she also wrote to them as well as doctor to confirm I had tried but failed it really didn't take long at all once I was accepted just couple of months then seminar about what surgery to choose to saw mr Kerrigan, his dietician, blood test all on same day ..then another appt to discuss the op and the diet I would have to follow for life after op as it is a very strict diet on DS as it is malabsorbtion which makes it work so had to follow that for 4 weeks took it back for himself and dietician to inspect and he gave date of surgery at that appt and start date for liver reducing which was for 3 weeks then op at murrayfield hope that helps xx but as I say I know things have changed a bit since then and you may have to do weight management course first which I didn't and I didn't have to see psychiatrist either as I didn't have and problems that way about food. ( I was just greedy and knew it )

 

[im just big boned]

Thanks for that,im just very i patient! Fingers crossed i win lottery tonight then private all the way! X

 

[MayraF]

Hi Cathy, sorry for the delay!

The info i found was a report and evaluation of the bariatric care pathway done by NHS Wirral. It was published August 2012 so it's not up to date but what caught my eye was the flowchart of the referral process, as you mentioned you'd have CBT and the chart also mentions it, so it seems they are still using the same system. Here's a link of the full report, i didn't read it all lol but you might want to. I also attached the picture of the flowchart. I hope this sheds some light in your situation.

http://www.cph.org.uk/wp-content/up...riatric-care-pathway-prospective-patients.pdf

Let me know how you're getting on, i hope this is useful and that you're feeling a bit more positive.

Xxx

 

[MayraF]

Also, when you are viewing the image, right click and save to your pc so you can use it for future reference, and to zoom in, as the writting is a bit small!