It sounds like you're dealing with several overlapping health concerns, and I understand how frustrating and overwhelming this can feel. The weight gain you've experienced from Lupron and Prozac is a known side effect for some people, and it can be challenging to manage while still addressing your underlying health conditions. When it comes to considering weight loss procedures like gastric bypass or liposuction, it's important to understand that these two options serve very different purposes. Gastric bypass is a metabolic and bariatric surgery that changes how your body absorbs and processes food, leading to significant and sustained weight loss. It’s typically recommended for individuals with a higher BMI, especially if other weight loss efforts haven’t been successful. With a BMI of 49, gastric bypass could be a more comprehensive solution because it not only addresses excess weight but can also improve or resolve other health issues like metabolic disorders. Liposuction, on the other hand, is more of a cosmetic procedure. It removes localized fat deposits but doesn't affect your metabolism or prevent future weight gain. This means that if the underlying issue contributing to weight gain (like medications or hormonal imbalance) isn't addressed, the weight can return, often in different areas. Liposuction wouldn’t be the best option if your goal is long-term weight management or addressing health conditions associated with higher BMI. Regarding the weight gain and the role of hysterectomy, it's possible that the hormonal changes from the chemical menopause and medications are driving the weight increase. If your doctors are planning a hysterectomy, there’s a chance that addressing the root cause of your hormonal imbalance might help stabilize your weight, but it may not reverse the weight you’ve already gained. Gastric bypass could offer a more structured path to weight loss, especially if the weight gain has been rapid and difficult to control. However, it’s crucial to discuss this thoroughly with your medical team. They can help assess whether the benefits of surgery outweigh the risks in your situation and ensure you have the right support in place to manage your weight and health long term.