On the 25th of November 2015, I has weight loss surgery. I underwent a sleeve gastrectomy, also known as a gastric sleeve. It has now been just over 3 months since my surgery and I have lost nearly 30 kg. YAY!
The first month after the surgery was the most uncomfortable physically, but I quickly recovered. The second month was all about eating tiny portions of mushy foods and just trying to get on with everyday life. But after the second month I felt like I was completely back to normal - there was no physical discomfort and apart from just a few foods, I became able to eat pretty much anything, only in far smaller quantities than before. So far, so good.
Polycystic Ovarian Syndrome
I have PCOS, something I touched on in "My Gastric Sleeve and Me", the first blog I wrote about my weight loss surgery. I wrote about how my PCOS was one of the main factors I became obese in the first place. Before I had my surgery, my surgeon explained to me that a sleeve gastrectomy could help me immensely because I have PCOS... I wasn't aware of that before and that hadn't been part of my reasons why I thought surgery was an option for me.
Hungry All The Time
All I knew was that I couldn't lose the weight on my own. I had tried... I mean, I had REALLY tried. And it was impossible. I was hungry all the time, I mean ALL THE TIME. I wasn't losing weight no matter how little I ate, when I was on a diet it took over my life, my thoughts and my whole being. I couldn't do it. And the bigger I got, the more impossible it seemed. And then I felt weak and like a failure... those who know me will tell you that failing is my least favourite thing, I have to be the best at everything and I have to win. Well, I wasn't winning... no matter the effort. And as my failing meant that I was becoming dangerously obese, I had to do something, and this was the reason I came to the realisation that surgery was an option I simply had to look into.
So when I met with my surgeon and he told me that my PCOS was a large part of the reason I was getting bigger and bigger and not succeeding with diets, I felt..... understood. I felt like someone FINALLY believed what I had known for years: My inability to lose the weight and keep it off was REAL, and not caused by me being greedy and weak!
Insulin, Leptin and Ghrelin
Recent medical research has shown that an incredibly complex biochemical signalling disorder is responsible for a lot of the weight problems experienced by women with PCOS. Basically, the cells in your body act on signals received from the stomach and throughout the body.
Insulin: Hormones like insulin tell the cells in the body how to act, and in PCOS sufferers, this signalling is dysfunctional. When you have PCOS, your body has a form of insulin resistance. Insulin stores blood sugar (glucose) in cells, and women with PCOS have higher insulin levels than they should have, meaning the insulin in their body isn't able to work in the way it's meant to, and the body then produces much more in order to get the blood sugar stored into cells. And that causes your body to retain fat.
Leptin: The fat cells in our bodies produce hormones, which is one of the reasons that overweight women often also have hormonal issues. One of the hormones produced by your fat cells is leptin, a hormone that sends signals to your brain when fat cells are full. Your brain then uses this signal for your body to maintain it's energy balance. Leptin is an important factor in the overall weight management and in the regulating of appetite. When the leptin level in your body is not in balance, this is when you feel hungry and crave food. The more overweight a person is, the more leptin their fat cells produce and the more the leptin signals to the brain, but when the brain gets overloaded with leptin signals, it becomes unresponsive to them. This is what's known as leptin resistance.
Ghrelin: Ghrelin is our "hunger hormone" and for severe PCOS sufferers it is the main culprit! Ghrelin is produced in the stomach and it's main function is sending hunger signals to our brains and thereby regulating how hungry we are. In non-PCOS sufferers, the ghrelin level will spike before a meal and down afterwards. Women with severe PCOS have high levels of ghrelin, leaving them to feel far hungrier than others. And as if that wasn't enough, ghrelin also slows a person's metabolism, reducing their fat burning abilities.
So how exactly does a sleeve gastrectomy help? Well, Ghrelin is produced from the fundus of the stomach and the proximal intestine, but with the removal of the majority of the stomach in a sleeve gastrectomy, Ghrelin is no longer produced in the same abnormal quantities and you are, effectively, cured from that malfunction in your body. And with the stomach being 85% smaller than it was before, you take in far less food and lose weight, and as you become less and less overweight, your insulin and leptin levels become normal and the resistance to both disappears.
I Feel The Difference
Now, that was all a lot of technical talk, but let me tell you something real: I feel the difference. I feel normal. I have now lost that constant hunger that meant I was either thinking about food, thinking about my weight, thinking about my failing health... or eating and getting on with what I had to do. I am now on the right track to becoming healthy again.
I still have about 45 kg. left to lose, but what a relief to know that I WILL lose them in the next year or two, as I have been given the tools to do so.
I hope that by sharing my journey and writing about it openly and honestly, I can help others with weight problems. Because whether your reason for being obese is PCOS or something else, YOU NEED HELP. And you need to know that you are not a failure and that you are not alone! I am sharing my journey publicly with anyone who cares to read about it here or on my blog, Mummy Loves You. Perhaps my experiences can offer someone comfort or even courage.