Bariatric Surgery

[Big Boy]

I have been steadily losing weight for quite a while now, and my doctor here in the UK is suggesting that I supplement future weight loss with bariatric surgery before I come to live in Thailand in April or May next year. I have 3 options:

- Gastric Band Surgery - although probably the safest, I have virtually discounted this option because it requires regular adjustment afterwards, and I've never heard of this option being available in Thailand, let alone Hua Hin.

- Sleeve Gastrectomy - this used to be phase 1 of a full gastric bypass, but was so successful it is now a procedure in its own right. This is probably the one I will go for. Basically they cut away 80% of the stomach (including the part that sends out hunger signals), and staple up what is left. This obviously reduces the amount I will be able to eat in the future, and unless I go really stupid should significantly aid weight loss. This procedure requires minimal follow-up, and the way the body processes food remains unchanged.

- Gastric Bypass Surgery - this takes the sleeve gastrectomy one stage further, and actually sees the way the body processes re-plumbed. This in itself can cause significant problems because the body does not always get what it needs from food eaten. This process usually takes place 12 months after the sleeve gastrectomy, so I would not have time to complete the process while in the UK.

Now that I've bored most of you with my introduction, I will ask my questions:

- If I went with the gastric band, is there anywhere in the Hua Hin area where regular adjustment could take place? If not, is there anywhere in Thailand with the necessary expertise?

- The sleeve gastrectomy does not usually require follow-up, so no questions.

- If I felt that I needed to advance to the gastric bypass, again is there anywhere in the Hua Hin area where such a procedure would be possible? If not, is there any centre of excellence anywhere else in Thailand?

I did consider asking my question on the Bangkok Hospital, Hua Hin thread, but after giving it some thought realised the question was probably broader based.

[GLCQuantum]

Sorry I have no help at all on this but just wanted to say well done for the weight loss - keep at it. I bet with whatever you have lost already you're already feeling pretty good about it.

Regrading the prodedures you talked about...they all sound pretty scary to me. I'm sure Dr Mike will be here soon with some good info.

[Big Boy]

I've lost about 30Kg so far (my wife only weighed 42Kg when we married)

I'll be honest, its not the actual procedure that scares me (much), it's the thought of the preliminary camera down the throat into the stomach that absolutely petrifies me.

[GLCQuantum]

30kg!!

Hats off to you sir

Maybe you'll be one of those guys on the cover of the 'Weight Watchers' magazine with the before and after pic.

[lindosfan1]

BB I had the camera down the throat, got to say it was enjoyable, I had a pretty nurse holding my hand and chatting to me while they did the business. She was lovely, almost fell in love. After the first minute no problem with the procedure, they had more difficulty prising my hand away from the nurse tho.
As a matter of interest that was the NHS very good

[Big Boy]

I'm petrified just thinking about that bit. They've given me a choice of a throat spray, or knocking me out. I'm hoping I just sleep through it.

[lindosfan1]

I had the throat spray. With that the nurse holds your hand and very good, After it was taken out off for a cup of tea and home. The ones that were knocked out 4 hours before I had mine done were still feeling bad. Which I never did.Did get told off by the surgeon for trying to chat to the nurse tho I could not understand what I was saying myself
IMO they have to be more gentle if you have the throat spray and you let them know if it hurts. Cannot do that if unconscious.

[PeteC]

My first knee jerk reaction BB is to ask why? If you're doing so well with natural weight loss and diet control why go the surgical route? With the constant heat here and you walking/exercising in it, plus low calorie but satisfying Thai food you may not need to do it. Pete

[margaretcarnes]

My first knee jerk reaction BB is to ask why? If you're doing so well with natural weight loss and diet control why go the surgical route? With the constant heat here and you walking/exercising in it, plus low calorie but satisfying Thai food you may not need to do it. Pete

My thoughts exactly BB. ALL of those procedures sound pretty dodgy to be honest. Even the so-called safest and easiest of them results in the loss of a stunning 80% of your intestine - and that really doesn't sound good at all.
Look at it another way round - people who suffer from Crohns disease quite commonly have up to 80% of their gut removed and have to watch what they eat for the rest of their lives. Doesn't sound like a very normal or happy existance to me even when an essential procedure. And wouldn't you need to take supplements etc afterwards?

There may of course be underlying health risks associated with your weight which you're not letting on - but if not - and you've lost a stunning 30k already - I'd be asking why your doc is even discussing these options with you.

You are undoubtedly a big cuddly chap. If it is making you ill fair enough. If not - as pete says - diet, heat and moderate exercise in the LOS should help you to continue naturally with an already bloody good start.

[Big Boy]

I know that it sounds drastic, but I have lost similar (more, in fact) amounts of weight on several previous occassions. Unfortunately, I put it back on at an incredible rate. I don't each much these days anyway (and I rarely drink), but the damage has been done - I am diabetic. The only way to reverse the diabetes is to lose the weight, and to keep it off. The first part I can do - eventually. I failed so many times in the past to keep it off, I really need to consider something more drastic.

Going back to the original questions - I guess there are no specialist centres in Thailand. I have Googled it, and although several hospitals are offered, none come across as 'specialists'. I get the impression that they'd happily charge me to use me as a guinea pig.

[hhfarang]

I agree with Pete and Mags Big Boy. You're doing so well already, just keep it up and lose the weight naturally. As for keeping it off, if you are about to retire to Thailand, you will have lots of free time to start up a regular exercise regimen to keep the weight off even if you do overindulge occasionally.

I lost 30 pounds last year by just counting calories (while eating and drinking anything I wanted) and stopping at 2400 each day. I was also exercising (aerobic and resistance training) for about an hour a day 5 days per week.

Unfortunately, I've been ill a lot this year since around the 1st of February and have had to stop the exercise and have gained about half the weight back, but I fully intend to get back in that daily habit soon and take it off again. You can do it with a reasonable diet plus exercise.

[Big Boy]

I appreciate everybody's concern, but I've got to do something that will stop me re-gaining the lost weight. It seems everytime I stop a weightloss regime, I put the lost weight back on with interest. Believe me, having lost weight at various stages of life, the older you get the harder it gets to take those excess pounds off.

My current weight loss has been partly due to the wonder drug exenetide. While I'm getting it on the NHS I can afford it. However, it will be very expensive in Thailand - if I can get it at all.

My other problem is that I am on a low dose of insulin. The use of insulin adds to the difficulty in losing weight. My doctor believes that through sustained weight loss, my diabetes will go into reverse, negating the need for exenetide or insulin.

For the doubters amongst you, I know that the bariatric surgery alone will do nothing. I will still have to work at it in a similar way to that described by HHF.

Again, getting back to my original questions - does anybody know of a centre of excellence in Thailand for such surgery please?

[PeteC]

When I googled 'Thailand gastric bypass' BB, there seems to be a lot to read in there if you haven't already taken a look. Pete

[margaretcarnes]

In a word BB - no - I don't know if you can get that surgery in Thailand. But look - HHF speaks wisely. OK, you have had trouble sustaining your weight loss, but as far as I'm aware you haven't yet spent long periods of time in the LOS. Until you do there is no way of finding out exactly how the climate etc there can help you to sustain the loss you need.
When I moved permanantly to the LOS I wasn't even overweight. A Brit neighbour encouraged me to become properly acclimatized by going for a long walk every Sunday. We walked the beach and pathways from Patters going either North or South at a leisurely pace, with food and drink stops, for 4 or 5 hours every week without fail. 6 months later I realised I was a skinny as a rake - and the weight (half a stone - a big percentage for me) stayed off with no effort at all.
All I'm saying BB is think about it - see how it goes when you are in HH for good. If things don't work out perhaps make provision for a return trip to the UK for the surgery later if needed.

[migrant]

I can't answer your question as to where, but feel the need to pass on.
I know 5 people that have had the surgery, and for various reasons, they all regret it.

I never pushed to find out why, but if you favor one type, I can ask.

You've done great to date with your losses, yes you've gained and have the disadvantage of age (I know that one!!) and medicine, but as you even state, it will take more than the surgery, it will take a drastic life change!

But what ever your decision I wish you luck!!