Since mid-April of this year, I’ve lost about 100 pounds. I did it by having weight loss surgery. While some may consider surgery “the easy way out,” I know better – especially because of all the life changes and hurdles it requires. After many years of weight highs and lows, and some debilitating side effects related to the extra weight I carried on my frame, it was a tough decision, but thus far I have no regrets. If you’re looking to make a similar decision regarding weight loss surgery (WLS) here’s what you should know:

It’s very permanent. Your digestive anatomy be changed surgically, and the common forms of WLS are not reversible (except in some rare and extreme cases). On top of the physical changes, most surgeons will ask you to quit smoking and give up alcohol for six months to a year, and you will need to take vitamin supplements for life. You also can never take NSAIDS (e.g., Aspirin and Advil) again. And these are usually just the minimum requirements!

You may not be happy with the end result. Depending on what surgery you have, you could lose 50-70% of your excess weight, meaning you may not wind up being above your ideal goal weight or clothing size. Some people also regain after a few years, particularly if they go back to old eating habits. Many more people hate the way they look with loose skin, under-eye bags and more. As “fat” people, we are so often sold on the fantasy of being thin that it can be disappointing to discover that losing weight is not a recipe for happiness. The only way to be happy with yourself is to work on your self-esteem. There are enough miserable thin people in the world who can attest to that.

The process can be slow and frustrating. In Ontario, some hospitals have up to a three-year wait time to have the procedure. The starting mechanism for referral is an online form filled out by your family doctor (and some patients have such trouble convincing their doctor). Once you are referred to the hospital, you will likely need to complete an orientation as well as visits with any required specialists (e.g., social worker, psychologist, dietician) and possibly perform in an overnight sleep study to determine if you suffer from sleep apnea.

There are some wonky side effects. In my case, I currently can’t stomach apples, plain water, deli meat or bacon. For many gastric bypass patients, fatty and sugary foods are off-limits for good, with unpleasant side effects if you don’t follow the post-surgical diet. I get dizzy spells when I stand up, which have been explained to me as being related to the body adjusting its blood volume after rapid weight loss. Like many surgical patients, I have also experienced some hair loss, although I am luckier than most due to having incredibly thick hair to start with. (Some people even find their hair grows back curlier or with a different texture than before!) Lastly, one weird positive side effect I’ve noticed is that I no longer experience motion sickness in cars or when I read on transit. This may be due to some nerves being cut in surgery, and may also be temporary. Fingers crossed it isn’t!

There is a possibility of more serious complications. The most common post-surgery complications are dehydration, constipation (which, in extreme cases, can lead to full-on bowel impaction), and strictures (a closing of the new openings made in your stomach due to scar tissue). While the ones named can be treated fairly simply, there are some life-threatening complications.

For every dozen successful weight loss surgery patients, there is one who regrets his or her choice, either in the short or long term.

In Ontario, you will most likely have one option. While self-pay patients in the US or Mexico are able to pick from a whole slate of surgical options, the “gold standard” in Ontario is the Roux-En-Y Gastric Bypass. This surgery sections off a small portion of your stomach into a tiny “pouch” and then bypasses the upper part of your small intestine altogether. The combination of restriction and malabsorption (the bypass) seem to provide the highest amount of weight loss for the longest time, based on long-term data. So while some WLS patients might prefer the VSG or Gastric Sleeve, you will not be offered that surgery unless it is medically necessary. Fortunately, the vast majority of patients I have met, myself included, end up perfectly happy with the Roux-En-Y. Every surgery type has pros and cons – it is up to you as a patient to do your own research before you decide.

Being vegan may not be an option. Limiting protein-dense foods such as eggs, milk, whey, cheese and lean meats will make life exceedingly difficult for vegans who wish to have WLS. While technically it can be done using vegetable, soy and grain-based proteins, they are not the easiest for your new anatomy to absorb and can also slow post-surgery weight loss due to high carb loads in these types of proteins. Even those who are lactose intolerant may have a hard time finding an ideal protein shake that meets all the criteria set out by your nutritionist.

There are online resources to help you. Searching on Facebook alone will find you hundreds of groups dedicated to helping educate would-be gastric bypass patients. Other popular sites include Obesity Help, Bariatric Pal and others. My personal favourite for recipes has got to be The World According to Eggface.

You will need to advocate for yourself as a patient. Many of the frustrations of this process lay firmly at the feet of the professionals shepherding you through the bariatric process. For example, some doctors won’t want to use the online form, and your referral may get lost. While you’re in the hospital, the nursing staff might even serve you foods you aren’t cleared to eat yet!

The solution? Know your stuff and facilitate communication between the various medical professionals who are charged with your care. “But the nurse told me to!” is not a good excuse if they are asking you to do something your surgeon said to avoid. Advocate for yourself loudly, proudly and often.

You will need routine check ups and blood work for life. Many people become a bit cavalier and think, “I don’t need to take my vitamins,” or “I don’t need to track my protein intake,” and they are wrong. Nutritional deficiencies are one of the main culprits of negative outcomes more than five years after surgery. You will need to get your blood work done regularly, for life. You will need to take multiple doses of vitamins and minerals every day, for life. You will be prone to dehydration and constipation, for life! Catch my drift? This is the price you pay for weight loss that is significant, and – for the majority of patients – permanent.

All of these points aside, at six months post-op I am very satisfied with the process overall. I have found it to be less difficult than I anticipated in most ways and the benefits to be even greater than I anticipated.

If you want more information about Gastric Bypass as well as Catherine’s Post-Op Updates, please check out her YouTube Channel.