For a long time, my weight didn’t bother me

Photo of a man

Matthew, 46 years old

“Surgery alone isn't enough to lose weight permanently. I know people who didn’t manage to permanently lose weight despite having surgery. Some of them even weigh more now than they did before.”

I've always had problems with my weight. They already called me “the little fatty” at school. I was very unathletic, but could only keep my weight in check with exercise. And we didn't eat especially well at home. My mother is part of the generation that always adds a nice chunk of butter to everything.

Lots of failed attempts

I tried to lose weight over and over again. Sport and various diets sometimes helped for a short while, but I always put the weight back on eventually. Then fate dealt me a few blows that I tried to compensate for emotionally with food. If I wanted to feel better, I ate something.

But I had a big goal when I was younger: I wanted to be a soldier. I did everything I could to make that happen. I really went for it with sports and reached my goal. But I still kept having to fight the pounds. In fact, it was even difficult to get army clothes in my size because I was so big and stocky.

I carried on doing sports after leaving the army, but kept having mental health issues. During bad phases I didn’t pay any attention to my diet. The weight kept piling on, and by my early thirties I weighed around 140 kilos.

For a long time, my weight didn’t bother me

For a long time, that wasn’t a problem for me: I saw myself in the mirror and thought I didn't look too bad. I just didn't see it.

But later I didn’t dare go out anymore, didn't have the confidence to go to a pool, and was worried that my bike would no longer be able to hold my weight. I became more and more withdrawn and shut off.

I had worked my way up the career ladder until I reached a position with a lot of responsibility. That involved being on the road a lot, and I had a lot of meetings with customers.

Something had to change – it took me a while to realize that

At some stage I couldn’t buy suits off the peg anymore. I had to go to special stores for large people. I was embarrassed about my weight in front of my colleagues, and that became more of a problem over time. I sweated a lot, climbing stairs was very hard work, and my bones hurt. Everything became harder to do. I also had really bad sleep problems. I couldn’t get to sleep and couldn't sleep through, I snored a lot and had breathing interruptions at night. At one point I had to have surgery on my knee after an accident, and there was a risk that I'd have to use crutches permanently because of my weight.

That all really got to me emotionally. And then I would eat to try and feel better. I kept gaining weight – until I ended up weighing around 185 kilos.

My doctor then told me that I had an increased risk of and stroke. I had high blood pressure, bust knees, didn't really fit on our sofa anymore – which I found very distressing – and socialized less and less. Then there were the jibes from friends and the worries that I didn’t have much longer to live. That all really scared me. I was only in my early 40s, and I wanted to live!

Then my wife and I separated. During and after that time, I realized that what I was doing wasn’t healthy: “rewarding” myself with food and feeling bad about it afterwards. It became clear to me that I needed help. It took me a long time to accept that I have to change something myself.

Participation in a multimodal program

My doctor then suggested that I have gastric band surgery. But I didn't want that, I wanted to do it all by myself. My doctor supported me in my attempt to lose weight the normal way. I took part in a multimodal program. That included advice from a dietitian, taking part in an exercise program and a support group, having talking therapy and also various physical examinations. I counted my steps and went to talks.

And we tried to change my diet slowly, step by step. I used to eat an awful lot of meat and almost only white bread, in huge quantities. No fruit and vegetables. And lots of cola. It took about half a year to change my diet.

The operation

I didn't lose much weight that way, though. After doing the multimodal program for a few months, my doctors and I agreed that I should have gastric band surgery after all. It took a while for my health insurer to approve it, but eventually they gave me the go ahead and I had the surgery in 2016.

I was very anxious about the general anesthetic. The doctors managed to put my mind at ease a little, though. But the operation led to complications: I had severe bleeding in my stomach after I came around. I then went straight back for more surgery.

When I was allowed to eat again after the operation, they gave me almost laughably small portions, like 20 grams of yogurt. But I couldn’t even finish that! I simply couldn’t put anything in my body. After three days I had lost six kilos.

The weight just fell off after I was discharged

You first have to get used to everything at home after leaving the hospital. That’s not easy! But the hospital arranged good aftercare. I went to a group every three or four weeks as part of the dietary advice. We practiced things like going shopping.

I then lost so much weight that I couldn’t properly get my head around it. I still felt like I was really fat even though I had already lost so much weight. It took me a very, very long time to understand that.

Surgery alone is not enough

The weight loss wasn't only a result of the operation, though. The gastric band is just a helping hand. Your stomach gets bigger again over time. Regardless of the surgery, I have to be careful about what I eat and stick to a diet permanently.

And that kind of operation also has lots of drawbacks. For instance, I have to take lots of different vitamin supplements to make sure I don't have any deficiencies.

Surgery alone isn't enough to lose weight permanently. I know people who didn't manage to permanently lose weight despite having surgery. Some of them even weigh more now than they did before.

I had severe pain at first after the surgery if I ate too much. Just one mouthful too many would do it. Your stomach stretches a little over time, so I can now eat a bit more again. I have to be very careful, though!

It's always harder to stay on track when life gets tough. My wife became very ill last year. I started eating badly again, like eating in the car on the way to the hospital or quickly grabbing a hot dog at the hospital café. I realized quite quickly that things were getting out of hand. I'm so glad I noticed soon enough! I wouldn’t have noticed in the past. This time, I was able to do something about it and get help from my dietitian. I was then able to keep my weight down even at that difficult time.

I have a balanced diet again now and am still losing weight, even if it’s in very small steps. My goal is to lose another 25 kilos. But to do that I have to get regular exercise as well as watch what I eat.

I had to adjust the kinds of things I was eating

I have lots of intolerances. Lots of things that didn't cause any problems before the surgery now don't agree with me, or I don’t like them anymore. And I still find it hard to judge what amounts I'll be able to cope with. I find it helps to put food on plates in the kitchen rather than putting the pots on the table.

Going to restaurants is difficult. I can only eat small amounts and often order a child’s portion or half a portion. Then the restaurant staff sometimes give me funny looks because I'm still very tall and chunky. But we've gathered some experience now, and know where I can order just a starter or half a portion without it being a problem.

Meat really doesn’t agree with me since the operation. But fish is fine. I often order just the fish without the carbohydrate sides, then I can manage the whole portion. You get used to it. I've also learned that a latte macchiato is now a full meal for me and that I’m full afterwards.

I generally know when I’m full now. I didn't used to have any concept of that at all. It’s important for me to take my time to eat in peace. No longer while standing, sitting on the sofa, or watching TV.

Life with less weight

It was a really great feeling for me to no longer have to go to the XXL section in department stores, but to be able to find clothes in the completely normal section. I now have much more choice, too.

My own perception of my body is a big challenge. Despite losing over 70 kilos, I still thought for a long time that my body didn’t look any different. I'm only very slowly starting to understand that my body has changed.

I'm still obese according to my . And I still have trouble finding the right clothes even though I have much more choice. Sweaters are often too short because I have an ‘apron belly.’ In other words, the skin on my stomach is a bit loose after losing weight and it hangs down. It’s very difficult to get rid of that with further weight loss and exercise. I'll probably have to have surgery to remove it.

I currently do sports about three times a week. I lost a lot of fat when losing weight, but I also lost muscle tissue. I'm gradually building my muscles back up now. My posture has also changed a lot since losing weight. I used to be very stooped over and didn’t have much body tension. I had to learn how to improve my posture. That wasn’t easy, either.

All in all, losing weight has given me a new lease on life. Changing my diet, doing exercise and having surgery were without doubt the best decisions I’ve ever made.

I've become more confident

I've become a lot more confident and made a lot of new friends, also thanks to the support group. I have a social life again, I go out and meet people.

I used to think that everyone was staring at me – for instance, at the pool or when I went to the bakery...that probably wasn't the case and nobody really cared. But that's what it felt like. That’s different now. I don't feel like I get any funny looks now. But I still don’t enjoy going swimming.

With all the changes I’ve made, I’ve also realized that the job I was doing before isn't actually right for me. I need something different and want to pursue a different career path in the future.

I often stand in front of the mirror and say: "Respect! You did it. Well done!" I now know that I can change and achieve a lot.

Relationships change

Being overweight really affected my social and private life. For instance, I had practically no sex life anymore before losing weight. My wife used to always say that she didn’t have a problem with it. But I’m not so sure. Either way, we got through that together and even got married.

I now go out a lot, to birthday parties and to carnival parties during that season. All the things that I avoided for so many years. My appearance has changed a lot and I get compliments from other women. My wife picks up on that and it's a problem for her and between us. Those are challenges that I hadn’t anticipated. Our relationship also has to adjust and develop now.

Sharing experiences in the support group has helped me with all of these challenges. I think it’s very important to really look into everything in detail before having surgery and to also speak to people who've had the surgery.

There is one thing I always remind myself of: I can get fat again at any time. Nothing can protect me from that, not even surgery. Only I can make sure I don't put the weight back on again. I'm responsible for my weight and my own life.


Our real-life stories summarize interviews with people who are affected by the medical condition. Our interview partners have given us permission to publish their stories. We would like to express our sincere thanks to them.

The real-life stories give an insight into how other people cope and live with a medical condition. Their opinions and comments are not recommendations by IQWiG.

Please note: The names of our interview partners have been changed to protect their identity. The photos are of models.

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Created on November 22, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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