Slow and Steady or Fast and Furious?

So the options are to continue the diet that I have been on for the past six weeks, which involves food logging in a written journal, exercise and staying at or near 1400 calories a day and not have surgery or continuing on the path toward weight loss surgery.

I think that I have been losing about a pound a week steadily just with the insurance mandated diet. It's hard to tell, because I am not getting on the scale, except at the monthly dietician weigh in.

Now, I have never been fully successful in losing weight in the past, but I have always tried diets that were very extreme. This is pretty loose. I am not cutting out any food or food groups. I just managed to stay within my calories on a day to day basis. I try not to go too low or skip any meals.

Here is a video that my son took yesterday, which shocked me, I guess I don't see my body from this viewpoint much. Am I really this fat? Cringing.

Here is the dilemma for me: I am reading posts on two gastric sleeve facebook pages, in which patients who have had the surgery have asked some questions based upon their current situations:

• Is anyone else getting chipped teeth?  Answer: About four members said that they, too, were suffering from tooth problems post surgery. Were they taking their supplements? Unknown.

• Has anyone else stopped losing weight about nine to twelve months out and has their weight loss started reversing? Many members said that this was happening to them. Several were trying the five day pouch test to try to shrink their stomachs back. Some were turning to diet pills.

• Has anyone else started feeling a reasserting of hunger post surgery? Many members said that they had never had a cessation in their hunger.

This really concerns me to the point where I feel that I need to do everything that I can to be successful with my five month long insurance mandated diet. If I can manage to stay positive with this for the duration, then I am more assured of a healthy outcome if  I do pursue surgery. If I choose not to do surgery, then I have to be on this diet for at least eighty weeks to lose the weight that I have to lose and then to maintain. Either way, my life of eating as a free for all has to be over.

Forever.

Let's just say that I am not sold on the idea that the weight loss surgery will correct all of my problems - especially since it is not brain surgery and I am pretty sure that my brain is the biggest problem.

I am also concerned with many things which are long term issues: Vitamin and mineral loss, bone loss, what if I ended up with cancer and needed chemo? My food intake abilities would be much less than the typical patient. I don't say that flippantly, everyone in my family who has died in the last seventy years has died from cancer.

However, on the -- what? sixth hand? -- on the other hand, obesity is a serious risk for cancer. My mammogram showed slight changes that are alarming and could indicate a propensity for cancer down the road. My aunt is currently battling breast cancer. Obesity is a huge factor in breast cancer. Having said that, I would willingly lop off both breasts tomorrow, if my doctor though it was necessary.

Pros for the surgery include being able to lose the weight faster to combat my recurrent diverticulitis, which is a potentially fatal illness; getting rid of my sleep apnea, being assured of a good result and a cessation to the serious cravings and mental issues related to eating.

Cons are: dying on the table (slight risk), not losing enough weight, impacting my ability to process food correctly, losing bone mass, long term consequences are not yet known, protein liquid diet may seriously cause issues with the diverticulitis and the hemorrhoid bleeding that I have when I go too high protein.

God, I just don't know. Part of me needs to know more, part of me wants to run and hide. How do I make this decision? I am in weekly therapy to try to sort it out.