It takes a long time to give up old habits

Photo of a woman

Sandra, 46 years old

“Surgery is not a cure-all. You really have to think about it and decide whether you actually want to take that step.”

I've actually felt far too fat for a long time. I first became overweight during puberty. I always weighed more than my friends. And when my first child was on the way, my weight just skyrocketed: I put on 28 kilos in 3 months. I did lose a little after the birth but then quickly put it back on.

My parents were never overweight. My mother and father were both very slim and paid a lot of attention to their figures. But my grandma, who brought me up, was overweight – just like my aunt and uncle on my mother’s side.

I've tried to lose weight over and over again for decades. I think I've tried every diet out there. And I always managed to lose a few pounds. For a while I managed to keep my weight under 100 kilos. But then my weight shot back up again, like a yo-yo. By the end, I weighed about 130 kilos at a height of 1.73 meters.

A doctor prescribed me something that was supposed to stop me absorbing fats from foods. I took it for three weeks but I had tummy ache and headaches the whole time, and didn't lose any weight. So I stopped taking it.

I really tried everything in the book. I went to a clinic for parents and children, and was put on a diet there. A few years later, I went to a psychosomatic clinic where I had an obesity consultation. After that I also got involved in an obesity support group.

I switched my brain off when eating

Of course doctors kept telling me that I had to do something about my weight. But it’s always easier said than done. With five kids, you don't really have much time for yourself. It was always clear to me in my head, but I think my heart wasn’t in it.

My mother always found it hard to understand because I'd always achieved everything I wanted in life. But I never managed to control my weight.

Sometimes I think the fat was a bit like a suit of armor for me. I would always eat if I was stressed, be it positive or negative stress. I would eat when I was happy and eat when I was sad. But also as a distraction when I had nothing to do and was bored. I found it relaxing to sit down and eat.

And I just switched my brain off when eating. Even though I felt sick after eating, it still didn't stop me from tucking in again.

Decision to have surgery

At some stage it got too much, though. That was about three years ago. I reached a point where I just didn’t want to carry on living like that. I’d recovered from a pulmonary embolism and my lungs and heart weren’t that strong anymore. My knees were also starting to pack up. I had arthritis in both knees.

I simply wasn’t physically fit anymore. I struggled to do the housework. I often felt down, too, and was doing less with friends and family. The fear of not living to see my five children grow up was what did it in the end, though.

It was clear to me that I had to do something soon, and that I couldn't do it by myself. Surgery was the only option left. I then went to an obesity consultation at a local hospital. I just needed someone to confirm that surgery was the right path for me. Because I had a of 40, I was able to apply to my health insurance provider to cover the costs of surgery.

Six months of preparation

In Germany, you have to take part in a six-month “multimodal concept” weight loss program before having surgery. It also prepares you for the surgery and what comes after, like changing your diet.

The program includes diet advice, exercise programs like aqua aerobics, talking therapy sessions, and contact with a support group. The obesity outpatient department supported me really well through all of that. They explained everything to me and guided me through it, from diet advice and the health insurance application to information about the effects of the surgery.

Unfortunately, my health insurer didn’t agree to cover the costs. That was very stressful. Their reason was that I possibly had an eating disorder and that should be treated first. Even though a psychologist had said that I didn’t have an eating disorder.

Three months of disputes with my health insurer then followed until they finally agreed to cover the costs. But that really took its toll on me.

I felt liberated

I then had the operation two years ago and was given a stomach . At first I thought I only wanted to have gastric sleeve surgery because it's quicker and not such a big procedure. But they recommended a because it was more suitable for me.

The operation itself wasn’t stressful at all. I had a bit of pain afterwards from the gas that they pumped into my body before surgery. The pain spread up to my shoulder, but quickly went away again.

I felt fine from the very first day. It was a liberating feeling. I was able to get out of bed on the same day. And most importantly: I didn't feel hungry at all and felt ready to start a new life!

Diet changes after the operation

You have to follow certain rules after the operation to be able to digest your food well. I took them very seriously. Like only eating mushy food at first, and always leaving a bit of a gap between eating and drinking anything. And making sure that you drink one and a half liters each day. I found that difficult because you're only allowed to take small sips at first. You also have to take dietary supplements to make sure you don’t get any deficiencies. I have to take extra vitamins and , for instance.

Meat and pasta didn't agree with me at first. I still have to chew meat very well for a long time. And pasta always feels uncomfortable in my stomach, no matter how well I chew it. Fizzy drinks are no good for me either, I completely avoid them.

I found it difficult to learn to take more time over my food. I was only able to eat small amounts and had to chew everything well. That’s not how it used to be. I used to just chew a couple of times and swallow. I had to get used to doing things differently.

I don’t want to eat sweet things anymore and cook differently

A lot of people say that their tastes change after the operation. Before having the operation, I used to drink three liters of diet cola every day. I don’t like it anymore, though. I find it far too sweet now. If at all, I put a spoonful of proper sugar in my coffee and savor it. I don't crave chocolate anymore, either. I’ll eat a small piece, but not a whole bar like I used to. I actually much prefer savory things now, which is new.

I buy different, better quality things, too. I don’t buy "light" food products anymore. I sometimes buy full-fat quark, but I eat less of it overall. I also make sure the children get a healthy diet.

I've lost 56 kilos in just under a year. I weighed 129 kilos before the operation and always said I'd have a party when I made it to 80 kilos. My weight is now stable at just under 72 kilos.

The long-term check-ups and support after the operation are very important for me. All the things you read on social media about vitamin and protein deficiencies after that kind of operation can be a little unsettling. But I was able to ask any questions I had at the check-ups, which were every three months at first and then every six months after that. They also put me at ease because they did blood tests too.

Your head doesn’t always keep up

I'm really motivated now. I want to be healthy and stay healthy. And so much has changed. I can tie my own shoelaces again and don’t end up gasping for air when I paint my toenails. My knees are in really good shape. These may just be little things, but they’re really important in daily life. I can go on the trampoline with my little boy without needing an oxygen tent. I’ve become self-employed and take very long walks with the dog. My depressive thoughts have gone away.

One thing I've noticed, though: My head doesn’t always completely keep up. I still think and feel like I’m too fat and truly get a shock when I look in the mirror or see a photo of myself and realize I’m slim! I had that other image of my body for a long time and it takes some time for that to change.

I would have surgery again in a flash. We actually just went for a day out to a large park that we went to as a family three years ago. It didn't compare. We walked a long way, climbed up trees... it was great! It feels like I’ve got my life back.

Make sure old habits don’t creep back in

Two years down the line, I now notice that I can eat more again because my stomach has stretched a bit and more food fits inside it. But I definitely want to be careful not to slip back into old habits. Because the operation is only on your stomach, not on your brain. It takes a long time to give up old habits.

The support group really helps me here. Some people in the group have had a gastric band for a long time and can give me good tips for everyday life. I’ve also made some really good friends through the support group. We recently took part in a fun run as a group. It was great!

My family always supported me

My family and my husband have always supported me. My husband said I didn’t have to have the surgery for him, but if it made me feel better, we would do it together.

My five boys never told me I was too fat. But I think it did bother them. Afterwards, they all gave me a hug and were happy for me. And they now also see how much more I enjoy life.

It’s always a personal decision

Even though having surgery was the right thing for me, it might be totally different for other people. There are no one-size-fits-all tips. I know a lady from the support group whose surgery also went well but it didn’t have the desired effect.

Surgery is not a cure-all. You really have to think about it and decide whether you actually want to take that step.

There are overweight people out there who weigh two or three times what I used to weigh but don’t want to have the operation. It’s up to everyone to make their own decision. There is no right or wrong. The main thing is to be at peace with yourself.


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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Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

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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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