I'm a newbie, just referred for Tier 3 "The Weigh Ahead"

[barbiegal5]

Hi all,

I have just signed my commitment statement for tier 3 weight management programme sponsored by Spire hospital, Southampton. I have got a blood test to have next Fri for glucose and cholesterol I think and then the GP is going to send the paperwork off!
It's such a surreal experience- fantastic to feel so supported by my GP to refer me on for weight management and hopefully surgery, but then I feel really done wondering how it has come to this!!
I have a wedding to go to abroad in July and I had planned to do a couple of weeks in very low calorie diet, but now I worry and think I shouldn't try and lose any weight before my appointment as my BMI may improve meaning I may not be offered input so easily!
My BMI is currently 46- I'm 5ft 7 and weight 130kg. I really want to be offered the surgery at the end of the programme because I constantly manage to lose weight and then end up putting it back on! The only thing I am worried about is on the 6month course if my BMI drops then although it should be great news it may mean my chances of surgery are greatly reduced!!
Any info or advice on the programme would be greatly received, and anyone who has been on programme from Southampton/Winchester area please get in touch and let me know what the whole thing involves!!
Any tips on making sure I do get offered surgery hugely appreciated, as well as input from anyone about their BMI and how much it reduced over the course.
Thanks so much in advance!
Good luck everyone xxx

 

[LinBaker]

Hi there
I had my first appointment with a tier 3 team at the beginning of March where they told me that surgery was not guaranteed after completing the tier 3 programme, but if it was considered it would be your BMI at the first appointment that would count (ie your BMI at the start of the programme)

The purpose of tier 3 is to prove you are committed to losing weight so I guess it would be counterproductive to not lose weight during that time.

My GP also told me it would be a six month course. However, at my first tier 3 appointment I was told that NHS England guidelines now apparently require patients to be in under tier 3 for 12-24 months, with an absolute minimum of 6 months before progressing to tier 4 (surgery) I've been told I have to do 12 months. Others here have done the minimum 6 months; so it's really difficult to say as it seems to vary a lot by area and whether you have other health problems.

Best of luck for your fist appointment

 

[barbiegal5]

Hi there
I had my first appointment with a tier 3 team at the beginning of March where they told me that surgery was not guaranteed after completing the tier 3 programme, but if it was considered it would be your BMI at the first appointment that would count (ie your BMI at the start of the programme)

The purpose of tier 3 is to prove you are committed to losing weight so I guess it would be counterproductive to not lose weight during that time.

My GP also told me it would be a six month course. However, at my first tier 3 appointment I was told that NHS England guidelines now apparently require patients to be in under tier 3 for 12-24 months, with an absolute minimum of 6 months before progressing to tier 4 (surgery) I've been told I have to do 12 months. Others here have done the minimum 6 months; so it's really difficult to say as it seems to vary a lot by area and whether you have other health problems.

Best of luck for your fist appointment

Thanks LinBaker, good luck on your journey. What area are you based at?? I had a call from my surgery saying I need more blood tests but can't book me in until next Friday for fasting bloods so guessing my GP won't refer me until after results are back. Hoping I don't have to wait too long for my first appointment, want to get the ball rolling and find out what the whole thing entails!!
Are there any questions in particular you think I should ask at my first appointment??
Take care x

 

[princess4d4]

they usually take your referring weight and bmi as the start as they know that while waiting you will still be dieting and losing hopefully though i didnt have to do tier 3 i got accepted just before the new changes but good luck with your journey

 

[barbiegal5]

they usually take your referring weight and bmi as the start as they know that while waiting you will still be dieting and losing hopefully though i didnt have to do tier 3 i got accepted just before the new changes but good luck with your journey

Thank you! X

 

[Curls40]

Hi all, I have just signed my commitment statement for tier 3 weight management programme sponsored by Spire hospital, Southampton. I have got a blood test to have next Fri for glucose and cholesterol I think and then the GP is going to send the paperwork off! It's such a surreal experience- fantastic to feel so supported by my GP to refer me on for weight management and hopefully surgery, but then I feel really done wondering how it has come to this!! I have a wedding to go to abroad in July and I had planned to do a couple of weeks in very low calorie diet, but now I worry and think I shouldn't try and lose any weight before my appointment as my BMI may improve meaning I may not be offered input so easily! My BMI is currently 46- I'm 5ft 7 and weight 130kg. I really want to be offered the surgery at the end of the programme because I constantly manage to lose weight and then end up putting it back on! The only thing I am worried about is on the 6month course if my BMI drops then although it should be great news it may mean my chances of surgery are greatly reduced!! Any info or advice on the programme would be greatly received, and anyone who has been on programme from Southampton/Winchester area please get in touch and let me know what the whole thing involves!! Any tips on making sure I do get offered surgery hugely appreciated, as well as input from anyone about their BMI and how much it reduced over the course. Thanks so much in advance! Good luck everyone xxx

Hello,I'm from southampton, I completed the tier 3 at the spire in March after six months.
I lost 24lbs while on it,and at the end you and your GP, get a letter of with their decision.
My recommend I could continue to manage by my self,I was devastated,as I always loose around two stone and get stuck.
I went back to my GP,they disused my case and recommend for surgery ,and I got funding.
I got a phone call, someone had a cancellation, and things just happened so quick,
I could choose my surgery date, it was decided a mini gastric bypass was suitable, my surgeon isn't keen on using the band.
Counting the days till sep 18th.
In my head I'm praying it will work.

 

[barbiegal5]

Hello,I'm from southampton, I completed the tier 3 at the spire in March after six months.
I lost 24lbs while on it,and at the end you and your GP, get a letter of with their decision.
My recommend I could continue to manage by my self,I was devastated,as I always loose around two stone and get stuck.
I went back to my GP,they disused my case and recommend for surgery ,and I got funding.
I got a phone call, someone had a cancellation, and things just happened so quick,
I could choose my surgery date, it was decided a mini gastric bypass was suitable, my surgeon isn't keen on using the band.
Counting the days till sep 18th.
In my head I'm praying it will work.

Hi Curls40,
Thanks so much for getting in touch! How was the tier 3 programme? Did u find it helpful?? Can I ask what your BMI was prior to starting it and then after finishing it??
I'm still waiting for my first appointment, but I know my GP has sent it now so fingers crossed it comes through soon!
Bet you can't wait til Sept now for your surgery?! Do u have to continue on any maintenance programme until then?x

 

[Curls40]

Hi Curls40, Thanks so much for getting in touch! How was the tier 3 programme? Did u find it helpful?? Can I ask what your BMI was prior to starting it and then after finishing it?? I'm still waiting for my first appointment, but I know my GP has sent it now so fingers crossed it comes through soon! Bet you can't wait til Sept now for your surgery?! Do u have to continue on any maintenance programme until then?x

I'm sorry I couldn't tell you what my bmi was then and now, it goes in one ear and out the other I only hear stones and pounds, I've put on 7lbs from March, but try to maintain smaller portions, I'm just starting to tell close friends now, after telling my close family, about the op,
I'm scared and happy at the same time.

 

[barbiegal5]

I'm sorry I couldn't tell you what my bmi was then and now, it goes in one ear and out the other I only hear stones and pounds, I've put on 7lbs from March, but try to maintain smaller portions, I'm just starting to tell close friends now, after telling my close family, about the op,
I'm scared and happy at the same time.

Yes I imagine its hard knowing how and who to tell! I really hope I get to your position in 6mnths time!! At least I know now from what u have said that if they turn you down for surgery initially it's worth persevering! Coz I'm like you- can lose a couple of stone then put it on again! I'm 20 stone 7lb which gives me a BMI of 46 I think currently. It's difficult because on the tier 3 programme if I lost more than 24lb then i might be only just inside criteria to qualify for surgery anyway, so don't want to lose any more than that on tier 3- sounds crazy doesn't it!?!
I'm worried about the psych assessments and what they entail because I do use food as a "crutch" if things aren't going well so don't know if this is something they look for and then won't do surgery?!? So much to think about!
Keep me posted on any developments with your situation- it's nice to be in touch with others in similar situations.
Hope family and friends are supportive!

 

[Curls40]

Yes I imagine its hard knowing how and who to tell! I really hope I get to your position in 6mnths time!! At least I know now from what u have said that if they turn you down for surgery initially it's worth persevering! Coz I'm like you- can lose a couple of stone then put it on again! I'm 20 stone 7lb which gives me a BMI of 46 I think currently. It's difficult because on the tier 3 programme if I lost more than 24lb then i might be only just inside criteria to qualify for surgery anyway, so don't want to lose any more than that on tier 3- sounds crazy doesn't it!?! I'm worried about the psych assessments and what they entail because I do use food as a "crutch" if things aren't going well so don't know if this is something they look for and then won't do surgery?!? So much to think about! Keep me posted on any developments with your situation- it's nice to be in touch with others in similar situations. Hope family and friends are supportive!

You won't believe this ,but I was the same weight as you,then lost 24lbs, it's basically following smaller portions, less carbs more protein,but I follow my fathers side of the family, who are slightly larger and have a thyroid condition.so this doesn't help.im an emotional eater ,the psych session are ok, you normally share them with one other person, due to funding costs.i couldn't truly open my heart up due to sharing the session,,it will be a year on for me when I have my op.told two work friends last night and one said they were proud of me for getting help.

 

[natclaire33)]

I am from portsmouth and did the tier 3 programme a couple of years ago and lost a little an d at the time i didn't qualify for surgery, which didn't bother me ( the pct at the time had different guideline to the nice ones), so went back to the gp who was good and said keep trying the slimming clubs and see me again in a few months. well I saw my gp again in march and yet again asked if i could be referred to the hopital to talk to the bariatric team he said he couldn't do it direct but would do it a different way.

I was referred to the bariatric physician and saw her at the beginning of may who said I met the criteria for surgery and told my gp to refer me to the hospital, I saw the consultant at the end of may, which was 2.5 weeks after the referral went in I have the appointments to see the dietian to talk about the milk diet and the post op diet stages in the middle of july and a appointment for the aneasthetic assessment at the end of august, after that I am just waiting for a date for surgery which i have been told will be fairly soon after the appointment in august. So on the whole the process has been quite quick. On the hole most of my friends and family have been really supportive and congratulated me for taking the step to surgery.

 

[barbiegal5]

You won't believe this ,but I was the same weight as you,then lost 24lbs, it's basically following smaller portions, less carbs more protein,but I follow my fathers side of the family, who are slightly larger and have a thyroid condition.so this doesn't help.im an emotional eater ,the psych session are ok, you normally share them with one other person, due to funding costs.i couldn't truly open my heart up due to sharing the session,,it will be a year on for me when I have my op.told two work friends last night and one said they were proud of me for getting help.

How funny we started same weight! Didn't realise the psych sessions are with someone else, that's strange! Glad your work friend is supportive!x

 

[barbiegal5]

I am from portsmouth and did the tier 3 programme a couple of years ago and lost a little an d at the time i didn't qualify for surgery, which didn't bother me ( the pct at the time had different guideline to the nice ones), so went back to the gp who was good and said keep trying the slimming clubs and see me again in a few months. well I saw my gp again in march and yet again asked if i could be referred to the hopital to talk to the bariatric team he said he couldn't do it direct but would do it a different way.

I was referred to the bariatric physician and saw her at the beginning of may who said I met the criteria for surgery and told my gp to refer me to the hospital, I saw the consultant at the end of may, which was 2.5 weeks after the referral went in I have the appointments to see the dietian to talk about the milk diet and the post op diet stages in the middle of july and a appointment for the aneasthetic assessment at the end of august, after that I am just waiting for a date for surgery which i have been told will be fairly soon after the appointment in august. So on the whole the process has been quite quick. On the hole most of my friends and family have been really supportive and congratulated me for taking the step to surgery.

Sounds like there are options then even if initially you get turned down. Good luck, hope it all goes well for you! X

 

[Curls40]

Sounds like there are options then even if initially you get turned down. Good luck, hope it all goes well for you! X

Seems southampton do it different, I had all these appointments in one day ,and my op date as well,which I could choose my self,but this is at a private hospital,but I'm funded by nhs

 

[mouse57]

I keep seeing 3 tier what is that

 

[barbiegal5]

I keep seeing 3 tier what is that

It's a 6 month weight management programme my GP has referred me to. We discussed surgery but apparently have to go through this programme first before they consider surgery.

 

[mouse57]

Thanks for getting back with an answer, I have done that but was never told it was anything but weight management, thought I was missing out on something lol

 

[vain]

I've been told that dependent on bmi and co morbidity they incorporate that into the whole programme well at derby that's until the new changes come into effect those already referred or waiting won't need to do tier 3 but I have been told that's in-effect now so I guess all people referred now will need to do tier 3 which I thinks wrong I know I've done similar program's over the years