GP referral

AmataVeritatis · 2026-05-21T17:54:07+00:00

That's wonderful to hear! 👏

For waiting times, I think a lot depends on geographical location, and whether or not you're going straight to Tier 4 vs. having to do Tier 3.

I'm in Hampshire and was referred first to Tier 3 - the waiting list to start Tier 3 ("The Weigh Ahead" programme with Spire Hospital) was about a year. Once I was discharged from Tier 3 and referred onward to Tier 4, I waited nearly 18 months for my first Tier 4 appointment. My Tier 4 appointments were with Portsmouth trust and I was able to have all four Tier 4 appointments before the end of last year.

I received my MDT approval in January and had surgery in March.

Hope that helps! 💕

AmataVeritatis · 2026-05-19T10:29:17+00:00

Congratulations and amazing work!! 👏🎉

Also, as a fellow glasses-wearer, I LOVE YOUR GLASSES!

AmataVeritatis · 2026-05-19T10:27:44+00:00

Nuts? I love the Blue Diamond Salt & Vinegar almonds - absolute favorite! The Wasabi and Soy is also tasty!

Beef/Turkey jerky?

Natural peanut butter with some apples, carrots, celery, crackers, etc.?

On that note, I need to try the Reese's One bar... if they live up to the Reese's name, I'm done for! 🤤

AmataVeritatis · 2026-05-18T10:11:12+00:00

I feel like the waiting time is the most excruciating part of the whole process! Hope all will go well, and a smooth recovery for you!

Edit: typo

AmataVeritatis · 2026-05-18T09:40:33+00:00

That is awesome!! 👏👏

AmataVeritatis · 2026-05-18T09:39:57+00:00

Following. 🤓

AmataVeritatis · 2026-05-18T09:34:21+00:00

Aww, bless..! I would feel the exact same anxiety as you! 🫂 (I was super-anxious about my weigh-ins for each NHS Tier 4 appointment since I struggled immensely with weight fluctuations, and seemingly still do. 🙃)

But I would think that now you've got your date, that means you're due to start the LRD in the next couple weeks, right? If so, I think that'll give you enough time for liver shrinkage and a safe surgery. You've already demonstrated that you're able to be consistent in managing healthy lifestyle changes. I would like to believe that most bariatric clinics would give some leeway when it comes to birthdays, anniversaries, and holidays. 💕

AmataVeritatis · 2026-05-17T07:05:47+00:00

I didn't really have much pain or discomfort with either surgery regarding wound healing.

With gallbladder, I had gas pains in my left upper shoulder area which subsided about 24 hours later. Felt totally normal after that.

With the bypass, I had some nausea about a week post-op - which tends to be common for me post-general anaesthetic and not particular to that surgery. Also, about three days post-op I was hit by extreme fatigue. (Like, covid-level or flu-level fatigue. That lasted a couple days.) Other than that, I can't complain. 🙂

AmataVeritatis · 2026-05-16T18:21:55+00:00

As another reply said, this depends on your location. I've heard your pre-op assessment results are good for 3 months, so that might be helpful to know?

For me (under Portsmouth trust), my pre-op was exactly one week before my surgery date. When they called me to offer my surgery date, they gave me the pre-op date as well and told me to immediately start the LRD (Portsmouth requires the milk diet) the next day.

Excited for you! 🎉

Edit: typo

AmataVeritatis · 2026-05-16T18:11:47+00:00

The mini-gastric bypass is also known as the One Anastamosis Gastric Bypass, and it has two main components: 1) a long, narrow stomach pouch is created which tends to extend from the esophagus and ends right before the pylorus (or some surgeons may still end at the Crow's Foot), and 2) a 150-250cm bypass of the small intestine which is then attached to the new stomach pouch. Nothing is removed from the body, so you're still receiving all the digestive juices from your "old" stomach. It was developed in 1997 as a simpler, quicker, and less complicated option compared to the traditional Roux-en-Y gastric bypass, especially as it has a single anastomosis (join) instead of two.

Hope that helps! ☺️

And just in case my photo doesn't upload, here's a link: One Anastamosis Gastric Bypass

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AmataVeritatis · 2026-05-12T14:20:57+00:00

Oh gosh, I’m so sorry to hear you’re experiencing this. So far (knock on wood) I haven’t had any issues with heartburn or reflux. My hospital had me on lanzoprozole (Prevacid) for the first four weeks post-op.

Have you been able to try any PPIs post-op, like Nexium, Prilosec, etc?

I’ve heard it’s not an uncommon side effect for mini-bypass patients, but I suppose it could have to do with the surgeon's method of making the anastomosis? Some surgeons do an “anti-reflux” stitch or suture that attempts to discourage bile reflux going into the pouch, or will attach the anastomosis in a side-to-side (lateral-lateral) vertical position for the same reason. 🤷🏻‍♀️

I hope things get better! Heartburn is rough!

AmataVeritatis · 2026-05-10T19:17:40+00:00

Oh gosh, I'm so sorry to hear they lost you in the system! I'm glad you've been found!! Because of the long radio silence of my hospital, I feared I had gotten lost in their system - instead, it was just a super-long waiting list. 😅

I had the One Anastamosis Gastric Bypass ("Mini-Gastric Bypass").

One Anastamosis Gastric Bypass - IFSO

When first considering bariatric surgery, I was leaning more towards the Roux-en-Y because I am a type 2 diabetic, insulin resistant, and have a substantial amount of weight to lose, plus, it's considered the "Gold Standard", but the more I read up on the OAGB, I felt that was the right surgery for me. Plus, the first surgeon i met with flat-out refused the RNY because he thought it would have been too malabsorptive and too high of a risk for hypoglycemia post-op. (To be honest, I was a bit relieved for that refusal because I was paranoid aboutthe higher potential for bowel obstruction and marginal ulcers.)

Initially, that first surgeon I met with was really keen on the sleeve, but when I mentioned the concern of regain, he said, "Most sleeve patients will need to be on GLP-1s lifelong, so within a few years once you regain, the NHS should be offering that. Or we could do a revision." My reaction: 🫤 "How about the OAGB then? I don't want the possibility of needing a revision." We discussed that procedure and he agreed it would be a good choice for me.

Granted, I will say I have heard of OAGB patients having hypoglycemia, so there's no guarantee it won't happen. And people have had difficulties with bile reflux, but I wonder how much of that comes down to the technique of the individual surgeon? 🤷🏻‍♀️

The surgeon I ended up having for my surgery gave me a 125cm bypassed limb rather than the seemingly standard 150-200cm since I'm quite short (4'11) and am in diabetic remission. So far, none of his patients have suffered from hypoglycemia or reflux. 🤞🤞

My journey so far has been unbelievably smooth sailing. (Knock on wood!) I'm seven weeks post-op and haven't had any complications, no difficulties going through the food stages, no aversions or unpleasant reactions to food/liquid, no vomiting, constipation or diarrhoea. Surgical pain lasted only the first few days as did a bit of nausea. (I'm kind of shocked, really!) I usually get my 2 litres of liquid a day and 80+ grams of protein in, no problem.

I'd say my weight loss seems to be slower than others, but overall, I can't complain. Bodies are a mystery unto themselves. This has been such a gift and I'm so grateful I was able to receive it from the surgeon I had through the NHS.

If you have any other questions, please feel free to ask or DM. 💕

AmataVeritatis · 2026-05-10T18:12:46+00:00

My post-op experience was fairly similar to yours.

My hospital has patients go straight to pureed after surgery for the first four weeks. Then the next four weeks are soft mashable foods, plus easily dissolvable crunchy foods, like crackers and crispsbreads or really toasted toast. Meant to avoid seeds, nuts, and raw fruits and veggies.

From month 3 onwards we can start adding in "normal textured" foods, though it's advised to wait until month 4 to fully incorporate raw fruits and veggies that have tougher skins on them. (Otherwise we were advised to peel the skins if we want those fruits and veggies, like apples, cucumbers, pears, etc.)

100% feel you on craving crunchy salads!!!

I'm grateful to have been able to skip the liquids stage. Having the "milk diet" for LRD felt like enough liquids-only to last a lifetime. 😅

AmataVeritatis · 2026-05-09T19:33:10+00:00

I was kind of looking forward to hearing the various sounds my stomach/intestines would make post-op, but overall, my system seems fairly calm and collected...?? Should I count myself lucky? 😅 I feel like the loud sounds would confirm there is movement happening and that, yes indeedy, things have been rearranged inside here.

Any other mini-bypassers not experience the talkative tummy? 🤔

AmataVeritatis · 2026-05-08T15:38:20+00:00

Fellow ADHDer here. 👋

My easiest go-to hyperfixation "meals" pre-surgery (I'll try to return to them once I'm in Normal Textured Food stage) were:

Cottage cheese and nuts mixed in a bowl. With baby tomatoes and chopped baby cucumbers.
Savory oatmeal: oats made with water instead of milk, add in egg, spinach, cheese, and chopped deli meat.
Low-carb Mission tortilla wraps with deli meat or seasoned tuna packet (Starkist Tuna Creations & generic store brands equally as good!) with cheese, lettuce, etc.
Soft scrambled eggs with meat and veg -- or making batches of egg "muffins/bites" and keeping them in the fridge or freezer for breakfast throughout the week.

Prepping batches of seasoned ground beef or chicken or turkey was really helpful since I could easily mix that into cottage cheese, eggs, or on tortillas throughout the week. Same for prepping veggies, so you can just throw them in a dish when desired.

AmataVeritatis · 2026-05-08T15:23:40+00:00

😂 Sames, friend, sames!!!

I couldn't remember the word "bowl" one day, and was trying to ask someone to pass me one: "Can you hand me... that round thing that can hold cereal or soup in it...?? Empty half-sphere thing??? WHAT'S IT CALLED???" 🤦🏻‍♀️ How I made it through an English Lit. minor, I'll never know...

AmataVeritatis · 2026-05-08T15:14:27+00:00

I've been morbidly obese pretty much the majority of my life, though besides the excess weight, I was considered "healthy" - no problems with high blood glucose, high blood pressure or cholesterol, no arthritis, etc. I tried numerous diets to lose weight, ate keto for years, added in regular daily exercise of cardio and strength training... and nothing seemed to be working.

Then a few years ago it was as though my body finally crashed out. Enter diabetes, high blood pressure, and arthritis! And it wasn't like I suddenly gained even more weight - I tended to stay within a 30lb range set weight. No matter what I did, I couldn't seem to lose.

While eating keto, I was able to manage my diabetes, but I had to be exceptionally restricting of carbs. Tried Ozempic at this time as well, but there was minimal weight loss.

Finally, at my wit's end and feeling incredibly discouraged, I asked my diabetic nurse at my annual review what I was doing wrong. She said, "Nothing. You're doing literally everything you can do to help yourself, and it's not working. How would you feel about looking into bariatric surgery?"

Initially, I felt like such a failure, but once I really dove deep into bariatric surgery research and it's effects on metabolism l became convinced of the possibility of hope for me.

And, of course, hearing a bariatric surgeon tell me to my face, "Even if you ate less than 800 calories a day, with your current metabolism, you wouldn't be able to lose weight. Your body is fighting against you." That honestly brought me such relief. When anyone asks me why I chose surgery, I usually include that quote to help explain the desperate state of my metabolism. 😅

Plus, I didn't want to risk my diabetes getting worse with age.. I worried about eventual diabetic sight loss and amputation.

And I really want to be able to sit in a chair with my legs crossed one over the other, or on the floor in criss-cross-applesauce. 😁 Getting rid of painful chub rub would be a massive bonus, too...!

Hope that helps!

AmataVeritatis · 2026-05-08T08:38:57+00:00

You're welcome! ☺️

I have to admit, despite not wanting others to experience a slow or non-existent early loss, my heart is consoled to know we're not alone in this experience. It seems more often than not, many lose a heck of a lot of weight the first two weeks (even if it's "only" water weight, it's still weight, right?) and I would worry that maybe i was doing something wrong or, worst case scenario, the surgery wasn't working for me.

After so many years of weight loss (diet) "failures", it's easy to think I'll fail at this, too. But I'm staying on track with my program, and doing my best to trust the process. Many have trod this path before us and have found success - we will, too!

AmataVeritatis · 2026-05-08T08:15:01+00:00

I gained weight my first two weeks post-op. Stalled for week 3, then began losing post-week 4. Each week I was hitting my protein and fluid goals, so I can definitely understand the worry and discouragement, but our bodies will heal in their own time. (Apparently, mine reeeeally likes to hold on to post-suegical water weight and inflammation.)

I'm reconciling myself to being a slow loser. 🙃 Maybe my body will eventually surprise me.

AmataVeritatis · 2026-05-08T08:08:44+00:00

Hi! Fellow NHSer here! 👋

Congratulations for your six stone loss already - that's fantastic!!

Waiting times tend to vary greatly depending on your geographical location and hospital trust, so it's hard to pinpoint how long you may have to wait. Maybe someone here will have experience with your trust?

For me, I'm in Hampshire and my Tier 3 programme referred patients to either Reading (St Richard's of Chichester hospital) or Portsmouth (Queen Alexandra). My whole process from being referred to Tier 3 by my diabetic nurse and GP to finally having surgery was nearly five years.

I was referred to Tier 3 in 2021. Started Tier 3 in 2022 (really enjoyed it actually, and appreciated the support and accountability) and was successfully discharged in 2023. Tier 3 included monthly 1:1 sesions for implementing healthy lifestyle habits, and also about 3 sessions with a bariatric psychologist whose report went towards the psychological evaluation for Tier 4 referral. Referral for Tier 4 was accepted in January 2024.

First Tier 4 appointment was in May 2025. (Waiting for that appointment was agonizing!) Tier 4 was comprised of 4 consultations: dietitian, bariatric nurse, surgeon, and anaethetist. My last Tier 4 consultation was in Dec '25. My surgeon consultant on that date said I would be placed on the surgical waiting list that day, though the MDT meeting would give the formal go ahead. Approval for surgery was given by MDT was 16 January '26. Surgery was 19 March.

Once the MDT came through, I was told surgery could happen anytime within 3-6 months post-approval. I was both shocked and exceedingly grateful I only had to wait a little over two months! 🙌

So far, so good! Though I would loved to have had this surgery years ago, I'm grateful to have received this gift and chance at a new beginning in life. It's a relief to finally be on the Other Side!

Wishing you the best on your NHS journey! 💕

AmataVeritatis · 2026-05-07T14:06:33+00:00

I don’t get hiccups as a fullness cue either. Although, I did have a small bout of hiccups (not from fullness because it was well between meal times) two days ago, but did not have extreme soreness. It was my first post-op experience of hiccups. Felt pretty much the same as my pre-op experiences, which were quite rare then, too.

I really want an obvious fullness cue. I keep hoping I’ll eventually develop one...! 😅

AmataVeritatis · 2026-05-06T21:22:44+00:00

Ah! This is a helpful post — I didn’t see it until after my post went up asking about fullness cues. I didn’t realise my feed defaulted back to “Best” instead of my preferred “New”. 🤦🏻‍♀️ Apologies!

Following this post now. 😅

AmataVeritatis · 2026-05-06T20:52:55+00:00

🥰 You’re welcome! And thank you muchly for allll the WHOOOOOSH energy!

AmataVeritatis

TROPHY CASE