The operation changes your body, not your mind

Young woman smiling

Miriam, 30 years old

“I always thought, I don’t look too bad, and I feel good. But I was fooling myself. Nothing was okay at all!“

I started becoming overweight during puberty: I just kept gaining weight. My parents tried to intervene, but I always found a way to secretly stuff myself with anything I could find. At first, my weight gain didn’t bother me. Neither did the things my parents or others around me said about it. Later, I noticed that somehow, things hadn’t gone that well.

I then tried lots of different diets to lose weight and keep it off; I tried all kinds of things and exercised, too. Nothing really helped. At most, I would lose 6 kg and always gained the weight back. I was very frustrated.

Eating for comfort

At some point, I gave up and thought, I guess I’m just an overweight person. There’s nothing I can do about it. I just lived with that attitude for some time.

Eating comforted me: In that moment, I was happy. I always thought: I don’t look too bad, and I feel good. But I was fooling myself. Ultimately, nothing was okay at all!

I never felt full any longer. I could eat, eat, and eat some more. My body had stopped telling me when it was full.

Support group and more exercise

As I gained weight, my blood pressure rose, too, and I started worrying about my joints. That’s why I decided to get some more information about excess weight and weight loss and contacted a support organization.

There, I got a lot of information and talked with other people with weight issues, including people who had had weight loss surgery. They told me about successes, as well as the drawbacks of such a major procedure. That gave me a good idea of the surgery.

I then decided to take part in a multimodal program. , also known as a “multimodal concept.” It's a combination of exercise and sports, nutritional therapy and psychological support. The goal is to lose weight and change your lifestyle. You now have to take part in a program like that before applying for health insurers to cover the costs of your surgery.

During that time, I also started doing water aerobics. In those classes, you’re in the water with people just like yourself. And you don’t have to be ashamed of your bumps and fat rolls. Everyone there has problem areas. I’ve always felt very comfortable there, and I’m still doing it today.

Also, I started taking my parents’ dogs for walks and being active in a dog sports club. Because of the dogs, I was physically active every day. I now have my own dog, too.

Deciding to have surgery

As part of the health insurance program, I got plenty of advice about surgery and thought a lot about it. It was then that I realized I don’t have the discipline to stick to a strict regimen for a longer time. It was especially hard for me that I never felt full even after I changed my diet.

I saw various doctors to check whether surgery may be a good option for me. They all thought that it was a very good choice for me. That sealed the deal for me: I was going to have surgery.

About two months before the planned surgery, I was diagnosed with a chronic illness. I was very worried that I wouldn't be able to have surgery because of it, but the doctors said it was no problem. They did advise me to have a gastric sleeve rather than a gastric , though. And that’s what I did.

The surgery

Within 14 days of applying for my insurer to cover the cost of surgery, I had their okay and could go ahead with the surgery.

When I was admitted to the hospital for surgery, I hesitated for a moment and second-guessed my decision: Should I really have surgery? I was very worried about the anesthetic, and not so much about the surgery itself. I worried that I might never wake up. But then, the surgeon came to see me again, reassured me, and explained what the anesthetic and surgery involved. The whole staff was very caring and kind to me! That helped me a lot to put my worries aside a bit.

And then I woke up, the surgery was done, and I was happy! There were no complications, and no pain. The only uncomfortable thing was having too much air in my body. You get some air pumped into your body to help the surgeons operate. So, you wake up a little rounder than you were before surgery. And the air has to find its way out of your body again … but it wasn’t that bad. Otherwise, I had no pain or problems with scars or anything like that. I recovered quickly, too. The day after surgery, I was already walking the halls of the ward.

As far as food was concerned, they gave me only liquids at first, then pureed foods, and finally solid foods. By the time I left the hospital, I had already lost 11 kilograms. I would never have expected that!

After surgery

Back at home, I had to slowly try out each food to find out if I could still tolerate it. I was totally surprised to experience real explosions of taste! I started to truly enjoy food – I really enjoyed every bite, even the tiniest one! Because my stomach told me very quickly and very clearly when it was full. Somehow, that was nice. I hadn’t felt full in forever.

My thoughts were the real challenge! The surgery changes your body, not your mind. Your head often tells you: It’s so yummy; one more bite won’t hurt. But afterward, you pay the price. That extra bite actually does hurt; it’s painful and you vomit.

I had to learn to listen to my body, and my stomach, again. If my stomach says it’s full, then it’s full. Only one time did I eat beyond that point of feeling full. Afterward, I felt really terrible! Since then I really do stop eating when I’m full. I have that worked out really well now.

I don't have to do without anything

Before the surgery, I also worried about never being able to eat some things again. I needn’t have worried! I can still eat everything. Only in small amounts.

I don’t have to go without anything. But after surgery, I started to enjoy my meals, and taking time for them. And I eat higher quality food. I stopped eating convenience foods. Now, I treat myself to better products and celebrate my meals. I take the time to cook and then sit down to enjoy my food. And I don’t eat anything in between meals, like I did in the past.

I had surgery two years ago in the fall. For Christmas, having a tiny piece of meat, a small piece of potato, and some red cabbage was a true highlight. That was great! I was able to eat something and was full. Now, two years later, I can eat a little more, but I still get that feeling of being full! I don’t care how much is still on the plate. When I’m full, I’m full.

I still see myself as a fat person

Others saw the changes in my body after surgery faster than I did. Many said that I’m only “half of what I used to be.” In my own mind, and when I look in the mirror, I still see myself as a fat person.

But when I look at pictures from before, I see that I’ve become pretty thin now. I notice that with my clothing, too: I can wear very different sizes and types of clothing than I did before. My old pants kept getting wider over time, and I regularly had to buy new, smaller things. Which was nice. I can choose from a much greater selection of clothes now. But the sizes I take into the changing room are often much too large since I still see myself as fat.

I’m not losing any more weight at the moment. But my body is still changing; and my proportions are changing. I have a lot of excess skin on my tummy now because I lost weight. Exercise doesn’t make it go away, either. That’s why I want to have a tummy tuck at some point.

Exercise is an important part of my life

Before my surgery, I didn’t go to the fitness studio; I thought I was too heavy and was worried about my joints. At that time, I did a lot of water aerobics, which is easy on your joints, and you wouldn’t believe how much you can sweat in the water!

When I got my weight down to 100 kilograms, I joined a fitness studio. There, they developed an exercise plan for me, which I work through regularly, about twice a week. Plus, I do water aerobics once a week and go to the dog sports club three times a week. I’m really very physically active now, am outside everyday, and go on long walks with my dog.

This year, I also took part in a 5 km walking race. I would have never dreamed of doing that during my “fat times”! In the fall, I want to take part in a race through mud and water and over obstacles. I’m super proud of that! To me it’s not about setting records, but about participating and finishing.

My lifestyle has totally changed. I do different stuff, am more self-confident, and just tackle things. I don’t let anybody or allow anyone to tell me I can’t do something or won’t manage.

Follow-up care is important

Once in a while, checkups need to be done. I have those at the obesity center that did my surgery. They have my complete file, which is perfect. I feel like I’m in very good hands there. Directly after surgery, I had checkups every three months; now they’re every six months.

The doctor takes a blood sample, and I’m physically examined, weighed, and asked how I feel and how I’m doing. They also check whether I have enough vitamins and minerals in my body. I recently had an upper endoscopy since I had some problems with my stomach, and they found that I had of the mucus membranes of the stomach, called gastritis. I am treated with medication for that now.

I changed my diet

My diet has changed a lot since the surgery. Before, I always ate a whole lot of meat and a lot of fast food like French fries and pizza. A lot of things that are fast and easy to prepare and tasty, too.

I still eat meat, but not much. Now, I eat a lot more side dishes, especially vegetables. I get my meat directly from a farmer, and it's high quality. Then, I really savor it and have it with a lot of vegetables. Plus, potatoes and rice – and pasta once in a while. I cook a lot. As a snack, I really like carrot or kohlrabi sticks with dip. Before, I tended to snack on chips and chocolate.

But I don’t deny my body anything. If I feel like chocolate, I will eat a chocolate bar. At parties or birthdays, I may have a hand full of chips or some pizza, too.

I don’t count calories or weigh my food. I rely on the cues my body gives me. But it does take some time to be aware of your body’s signals. My body now tells me what it wants and when it’s full.

In total, I’ve lost about 50 kilograms: 5 kg before surgery and about 45 kg afterward. I’m very proud of that! That’s beyond any of my expectations. I never thought that I would have a figure like that at some point!

I’d like to lose five more kilograms now. Then, I think, I’ll have reached my feel-good weight, and I don’t want to lose any more than that. That would be okay. It’s important to me to stay away from the 3-digit kilogram range. Right now, I’m far away from that.

It’s important to take action yourself

The support group helped me a lot on my journey. Sharing experiences with others who have the same problems, worries, and obstacles to overcome was good for me. You help and support one another. In the beginning, I was a little worried and afraid to join a support group. But no one laughed at me! There’s no need to worry because everyone goes there with the same feelings. And I’ve made some very good friends in the group.

When dealing with excess weight and weight loss, it’s important to decide to make a change yourself. Taking action yourself. No one else can make that decision; you have to do that yourself. But it’s nice to know that you’re not on that journey alone, that you have someone who has your back, whether that’s a partner, your family, or good friends.


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 23, 2022

Next planned update: 2025


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

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