TLDR; Does anyone here have experience with medically assisted weight loss programs? I’m looking for something with weekly check ins, at least one medical professional, and a dietitian that doesn’t push a really out there diet like juice cleanses, low carb, etc. Just normal, healthy eating with reasonable portions. A focus on fitness would also be nice. I like the idea of a long term support system that isn’t weight watchers or Jenny Craig or whatever.
Long version:
Over the course of my life, I’ve gained 100 pounds four times and lost it three times. One of those times was through intuitive eating, the other two times was through classic CICO. Regardless, each time I gained the weight back. I have a very hard time maintaining my weight once I lose it, and I’ve been considering more intensive (and invasive) measures to ensure this time is different.
I do have diagnosed binge eating disorder that I’ve addressed with therapy, dietitians, outpatient, and PHP multiple times in my life. It’s been four months since my last binge and six months since I started my last round of treatment for BED. I also take vyvanse and topamax which have been helpful. At this point, I’m considered in remission. However, eating disorders are fickle and I know it could pop up again. I do have a support system if it does.
I started looking into bariatric surgery as my next step, specifically the gastric sleeve. My thought process was based on the 5 year statistics available for the surgery compared to my own track record. Patients who get the surgery on average only gain back 50% of their excess weight after 5 years. I’ve always gained back 100% (and studies show something along the lines of 80-90% of people gain back all the weight they’ve lost, so I fit right into that statistic). 50% vs 100% of my excess weight would be a huge win for me! I’m all good with that. My doctors were happy with my decision to get the surgery. So were my parents.
But then I had a really unpleasant session with my therapist, who specializes in eating disorders. She believe that regardless of remission status, no one with an eating disorder should ever get bariatric surgery. The mere suggestion of it earned me a referral back to PHP (partial hospitalization). Now I feel like I’m making the wrong decision, and I’m looking for alternatives. All I know is now would be a really inappropriate time to go back to PHP. Patients in the program are expected to maintain their current weight. They up your calories if they see that you are losing, and if you don’t finish your meal they force you to drink Ensure before you can leave the meal room. Exercise is actively discouraged in case it triggers binging. I don’t see how any of this will be helpful when my eating disorder is in remission. I’m trying to move on with my life.
As far as I see it, I’ve done everything right. I addressed my eating disorder. Now I need to lose weight. I’m heavy, I’m unhealthy, I will feel better in a smaller body. I’m not married to the idea of bariatric surgery, though I thought it might be a good tool for longer term results, but I’m open to other suggestions.
One thing I’ve heard of is medically assisted weight loss. Something with weekly check ins and long term commitment. I just don’t want “weird” diet things. Like keto only, or juice cleanse only, or cabbage soup diet only. Does anything like this exist? Has anyone had any lucky with? My PCP doesn’t know a thing about nutrition and recommended I try the Whole 30 or whatever. Most dietitians I found were very against calorie counting, particularly when they found out my history of BED. However, I work hard on my BED and it’s not a constant in my life. I’ve only had it show up during very stressful times, and it generally only lasts for around 6 months. It’s not triggered by calorie counting. I’ve had 3 BED episodes, none of which had any relation to restriction. It was always after I moved or changed jobs or experienced a death of a family member. Life changing, often traumatic events.
Anyway, sorry for the long rant. I’ve already start counting calories on LoseIt and I’m down 10 pounds. I’m not as worried about the weight loss as I am about the long term maintenance. Normally this wouldn’t be stressful decision for now… but I have to decide soon because I just barely have the BMI for bariatric surgery. If I lose much more it won’t be an option.
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