gastric bypass etc
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I only have one complaint about weight loss surgery and that is the people who continually bring it up to me as an option because they know I have dieted forever.
Weight loss surgery scares the heck out of me. I don't want it and if it takes the rest of my life to take of the weight I put on so be it.
I have friends who have had WLS and they work just as hard at getting their weight off as I do. Oddly enough they are not the ones pushing the surgery at me.
IF I have learned anything in all my years of dieting it is this "THERE IS NO QUICK FIX. IT IS ALL HARD WORK".
right now through MFP and the support I get here I am doing better than ever at losing.0 -
ETA: Specifically, I'll be looking for support for the other poster's assertions that WLS patients overwhelmingly "don't have years"; exactly how many years they don't have and why, for instance, taking two years to lose the weight via non-WLS methods would more likely result in death than not....
It is from here, citation 4 in the Cleveland Clinic paper which is on page 13.
http://www.ncbi.nlm.nih.gov/pubmed/15319713
5 year mortality with surgery, 0.68%, or 1 in 147
5 year mortality without surgery, 6.17% or 1 in 16
And the Cleveland link has a typo - they wrote 16.2%, not 6.2%, but did appropriately list the risk reduction as 89%.0 -
ETA: Specifically, I'll be looking for support for the other poster's assertions that WLS patients overwhelmingly "don't have years"; exactly how many years they don't have and why, for instance, taking two years to lose the weight via non-WLS methods would more likely result in death than not....
It is from here, citation 4 in the Cleveland Clinic paper which is on page 13.
http://www.ncbi.nlm.nih.gov/pubmed/15319713
5 year mortality with surgery, 0.68%, or 1 in 147
5 year mortality without surgery, 6.17% or 1 in 16
And the Cleveland link has a typo - they wrote 16.2%, not 6.2%, but did appropriately list the risk reduction as 89%.
6.2% isn't anything to sneeze at, that's still 6.2% of people now dead, and that's sad, but...in what world does 6.2% constitute "most"?
The assertion was that "most" WLS-candidacy (by weight) individuals "don't have years."
Apparently, 6.2% of WLS-candidacy individuals who don't have WLS, don't have five years.
93.8% do.
Rounding off, obviously.
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Two things:
1. I didn't write "most" so I will not defend it.
2. There is a bit of a continuum between "alive and healthy" and "dead" that involves the accumulation of debilitating medical problems. It is entirely possible that if 1 out of 16 people is stone cold dead in 5 years, that a huge number of the survivors have developed progressive debilitating health problems which are, in fact, destroying them. "Not having years" does not have to mean they are dead, it may mean that they are no longer healthy enough to make positive changes in their lives.0 -
Two things:
1. I didn't write "most" so I will not defend it.
2. There is a bit of a continuum between "alive and healthy" and "dead" that involves the accumulation of debilitating medical problems. It is entirely possible that if 1 out of 16 people is stone cold dead in 5 years, that a huge number of the survivors have developed progressive debilitating health problems which are, in fact, destroying them. "Not having years" does not have to mean they are dead, it may mean that they are no longer healthy enough to make positive changes in their lives.
1. You don't have to defend it. I asked another poster to support her assertion, not you. You just jumped on in, waylaying that and inserting snarks that you later deleted. Because I was asking about her assertion, I was also answering to her assertion. Your link then supported a mortality rate. I answered the original assertion with that link as that is all I have to go on regarding this thread, anyway, and as the person I was speaking to (that wasn't you originally, remember?) asked me to reference your link. I'm afraid there isn't much tap-dancing around this one. You are the one who wanted to show the numbers; you did; those numbers do not support the assertion of the person I was actually speaking to that "most (morbidly obese) people don't have years (without WLS)."
2. The assertion wasn't regarding quality of life. Thin people can have a horrible quality of life too. Life isn't singularly about weight. And you are now going from supporting those "silly little numbers", to now vague hand-wavings and dire non-referenced predictions of debilitation. Which way do you want it?
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I think you are either mis-remembering or the podcaster is exaggerating reality. It is not possible to live on an oral diet with 90% of your small bowel removed. People have about 300 cm of small bowel. Short gut syndrome - in which the bowel is too short (from repeated surgeries) to absorb enough food to sustain you - results when you have less than 125 cm of small bowel and no right colon, or less than 75 cm of small bowel with an intact right colon. To remove 90% of the bowel and have a remaining 30 cm of small bowel would require lifetime intravenous nutrition, not a liquid diet..
I don't claim to know details and even then the details don't detract from the seriousness of having a life threatening complication 8 years after the initial surgery. The woman has reported that she "may" be on a feeding tube or a liquid diet for the remainder of her life.
The issue was that things moved inside causing a kink or obstruction which resulted in the death of the tissue which then had to be removed.0 -
1. You don't have to defend it. I asked another poster to support her assertion, not you. You just jumped on in, waylaying that and inserting snarks that you later deleted. Because I was asking about her assertion, I was also answering to her assertion. Your link then supported a mortality rate. I answered the original assertion with that link as that is all I have to go on regarding this thread, anyway, and as the person I was speaking to (that wasn't you originally, remember?) asked me to reference your link. I'm afraid there isn't much tap-dancing around this one. You are the one who wanted to show the numbers; you did; those numbers do not support the assertion of the person I was actually speaking to that "most (morbidly obese) people don't have years (without WLS)."
2. The assertion wasn't regarding quality of life. Thin people can have a horrible quality of life too. Life isn't singularly about weight. And you are now going from supporting those "silly little numbers", to now vague hand-wavings and dire non-referenced predictions of debilitation. Which way do you want it?
I don't need your essay. I said I'm not defending it as a means of explaining why I'm not defending it. Your long-winded monologue is not necessary.
The assertion wasn't regarding quality of life, neither was my explanation. Life isn'tsingularly about weight, as you say. Is it your position that health only is measured in the dichotomy between Alive and Dead? "Which way do you want it?" IS quality of life important, or is it only important how many are dead?
Heart attacks, strokes, neuropathy, sleep apnea, venous stasis ulcers, osteoarthritis... these are all non-lethal outcomes of obesity that may make it true for someone alive to "not have much time." What good is being alive when you're tied to an oxygen tank with one amputated leg and get short of breath with the effort it takes to scratch your chin? You're only intersted in alive and dead, but there are some states of life that would make me wish for death, and most of them are related to obesity and are are on the road to death anyways.
I reject your implication that "not having much time" only counts if the mortality rate is high. The morbidity rate is far more important to me. I don't empathize with dead people - they don't have symptoms any longer. I empathize with the miserable living ones.beemerphile1 wrote: »I think you are either mis-remembering or the podcaster is exaggerating reality. It is not possible to live on an oral diet with 90% of your small bowel removed. People have about 300 cm of small bowel. Short gut syndrome - in which the bowel is too short (from repeated surgeries) to absorb enough food to sustain you - results when you have less than 125 cm of small bowel and no right colon, or less than 75 cm of small bowel with an intact right colon. To remove 90% of the bowel and have a remaining 30 cm of small bowel would require lifetime intravenous nutrition, not a liquid diet..
I don't claim to know details and even then the details don't detract from the seriousness of having a life threatening complication 8 years after the initial surgery. The woman has reported that she "may" be on a feeding tube or a liquid diet for the remainder of her life.
The issue was that things moved inside causing a kink or obstruction which resulted in the death of the tissue which then had to be removed.
The details, my dear, are what makes the anecdote meaningful. Is the "complication" severe or not severe? Without the details, it's an unanswerable question.
Further, the presence or absence of complications, even late complications, is meaningless without comparing to the presence or absence of benefit. For example, there are complications of labor and delivery that will have negative health impacts for your entire life or even kill you, but we don't tell everyone to get sterilized, right?0 -
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1. You don't have to defend it. I asked another poster to support her assertion, not you. You just jumped on in, waylaying that and inserting snarks that you later deleted. Because I was asking about her assertion, I was also answering to her assertion. Your link then supported a mortality rate. I answered the original assertion with that link as that is all I have to go on regarding this thread, anyway, and as the person I was speaking to (that wasn't you originally, remember?) asked me to reference your link. I'm afraid there isn't much tap-dancing around this one. You are the one who wanted to show the numbers; you did; those numbers do not support the assertion of the person I was actually speaking to that "most (morbidly obese) people don't have years (without WLS)."
2. The assertion wasn't regarding quality of life. Thin people can have a horrible quality of life too. Life isn't singularly about weight. And you are now going from supporting those "silly little numbers", to now vague hand-wavings and dire non-referenced predictions of debilitation. Which way do you want it?
I don't need your essay. I said I'm not defending it as a means of explaining why I'm not defending it. Your long-winded monologue is not necessary.
The assertion wasn't regarding quality of life, neither was my explanation. Life isn'tsingularly about weight, as you say. Is it your position that health only is measured in the dichotomy between Alive and Dead? "Which way do you want it?" IS quality of life important, or is it only important how many are dead?
Heart attacks, strokes, neuropathy, sleep apnea, venous stasis ulcers, osteoarthritis... these are all non-lethal outcomes of obesity that may make it true for someone alive to "not have much time." What good is being alive when you're tied to an oxygen tank with one amputated leg and get short of breath with the effort it takes to scratch your chin? You're only intersted in alive and dead, but there are some states of life that would make me wish for death, and most of them are related to obesity and are are on the road to death anyways.
I reject your implication that "not having much time" only counts if the mortality rate is high. The morbidity rate is far more important to me. I don't empathize with dead people - they don't have symptoms any longer. I empathize with the miserable living ones.beemerphile1 wrote: »I think you are either mis-remembering or the podcaster is exaggerating reality. It is not possible to live on an oral diet with 90% of your small bowel removed. People have about 300 cm of small bowel. Short gut syndrome - in which the bowel is too short (from repeated surgeries) to absorb enough food to sustain you - results when you have less than 125 cm of small bowel and no right colon, or less than 75 cm of small bowel with an intact right colon. To remove 90% of the bowel and have a remaining 30 cm of small bowel would require lifetime intravenous nutrition, not a liquid diet..
I don't claim to know details and even then the details don't detract from the seriousness of having a life threatening complication 8 years after the initial surgery. The woman has reported that she "may" be on a feeding tube or a liquid diet for the remainder of her life.
The issue was that things moved inside causing a kink or obstruction which resulted in the death of the tissue which then had to be removed.
The details, my dear, are what makes the anecdote meaningful. Is the "complication" severe or not severe? Without the details, it's an unanswerable question.
Further, the presence or absence of complications, even late complications, is meaningless without comparing to the presence or absence of benefit. For example, there are complications of labor and delivery that will have negative health impacts for your entire life or even kill you, but we don't tell everyone to get sterilized, right?
You don't need my "essay" but apparently I need yours, right?
You know - the one that goes off on tangents and borders on the hysterical near the end, down to the strawman "analogy" about sterilizing patients in order to waylay complications of labor and delivery?
You just aren't even making sense any more, but my you do love to tap dance. However, with your odd tangents, I can't even address your questions any more...in the middle of all that, I'm not even sure which parts ARE questions.
Have at it, I guess. (shrug) And good luck on your weight loss journey.
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Just to add to the discussion, being alive in 5 years does not mean that you are not dying.
From the same Christou et al paper, the 5 year incidence of conditions in the surgery versus no surgery group:
Cardiovascular disease: 4.7% versus 26.7%
Cancer: 2% versus 8.5%
Infectious diseases: 8.7% versus 37.3%
Endocrine disorders: 9.5% versus 27.3%
Musculoskeletal disorders: 4.8% versus 11.9%
Respiratory disorders: 2.7% versus 11.4%
I certainly think that "not having much time" is reasonable when you consider that, in 5 years, the surgical-candidates who don't have surgery have a 1 in 11 chance of getting cancer, a more than 1 in 4 chance of getting heart disease, and a 1 in 9 chance of getting a chronic respiratory disease.0 -
You don't have to undermine someone's accomplishments in order to try to validate your own struggles.0
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beachhouse758 wrote: »You don't have to undermine someone's accomplishments in order to try to validate your own struggles.
Which was my original point - the intimation, via the walking analogy, that people who lose weight without WLS simply have it, to reference the analogy again, ten times easier.
But that seems to have gotten lost in the shuffle of tap-dancing.
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4legsRbetterthan2 wrote: »On the other hand, I would argue that that IS how they did it, just with the additional help of that tool (bypass). If not they would have gained it all back, happens all the time
I'd also argue that weight loss surgery is NOT the easy way out! Those with weight loss surgery (I did not have it) have to eat sensibly and exercise to lose and maintain plus they have had the extra element of extremely invasive, life-threatening surgery. Often times with difficult complications and side effects that I certainly wouldn't want to deal with. In fact, maybe losing weight without surgery is really "the easy way out?"
In all seriousness, losing weight and keeping it off is not easy - no matter how you do it. I'm willing to listen to advice from *anyone* who has been successful - surgery or not. Everyone has to find what works for them. For me, I chose to go a non-surgical route and that has worked, but that doesn't mean I have found the key to success for anyone but myself and myself only.0 -
beemerphile1 wrote: »I don't claim to know details and even then the details don't detract from the seriousness of having a life threatening complication 8 years after the initial surgery. The woman has reported that she "may" be on a feeding tube or a liquid diet for the remainder of her life.
The issue was that things moved inside causing a kink or obstruction which resulted in the death of the tissue which then had to be removed.The details, my dear, are what makes the anecdote meaningful. Is the "complication" severe or not severe? Without the details, it's an unanswerable question.
Further, the presence or absence of complications, even late complications, is meaningless without comparing to the presence or absence of benefit. For example, there are complications of labor and delivery that will have negative health impacts for your entire life or even kill you, but we don't tell everyone to get sterilized, right?
I would think most people consider hovering near death as a "severe" complication. Also getting your food through a tube is a "severe" complication.
What horse do you have in the race? Others are trying to have a reasonable conversation and you are coming across as a salesperson. Do you own a bariatric surgery/treatment center or something?
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beachhouse758 wrote: »You don't have to undermine someone's accomplishments in order to try to validate your own struggles.
But that seems to have gotten lost in the shuffle of tap-dancing.
So did the point that you don't get approved for surgery unless you already have 2 or more other life threatening conditions. If you want to argue that people who had surgery could've taken years to do it without surgery, you have weed out everyone who had mobility issues, heart conditions, diabetes, and circulation issues. You can maybe work with the ones who have advanced arthritis, if they can still walk.
People who lose without surgery don't have it any easier or harder, but it's more likely they weren't as close to death as someone has to be to even be approved for the surgery.0 -
beachhouse758 wrote: »You don't have to undermine someone's accomplishments in order to try to validate your own struggles.
But that seems to have gotten lost in the shuffle of tap-dancing.
So did the point that you don't get approved for surgery unless you already have 2 or more other life threatening conditions. If you want to argue that people who had surgery could've taken years to do it without surgery, you have weed out everyone who had mobility issues, heart conditions, diabetes, and circulation issues. You can maybe work with the ones who have advanced arthritis, if they can still walk.
People who lose without surgery don't have it any easier or harder, but it's more likely they weren't as close to death as someone has to be to even be approved for the surgery.
It was my understanding that generally, qualifiers were BMI of 40 or higher with or without comorbidity, OR BMI of 35 or higher with comorbidity..is this incorrect?
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That was correct for my insurer, and I believe those are the NIH guidelines as well.0
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The problem with gastric bypass or any other surgical procedure is that it treats a symptom and not the root cause. Additionally the enzymatic regimen one must abide by for the rest of their life surgery is certainly not an easy option in the long term, although the short term gains are certainly appealing. It is a short term strategy and should only be used as a last resort.
Except for the last resort comment, your conclusions are very wrong. It is an extremely intense evaluation that take months and months. The surgery doesn't treat the symptom. The surgery is one of the tools. WLS patients (at least the program I went through) undergo a psychological evaluation, nutrition classes, nutrition counseling sessions, meeting with a physical therapist/trainer, lab work, colonoscopy, sleep apnea evaluation, kidney and liver function diagnostic testing, abdominal and pelvic US and CT scans, and pre-surgery weight loss. It was the best thing I have ever done for myself. I am nine years out and have maintained over 100 pound weight loss. So it's not really a short term strategy. Yes I may have been able to lose over 100 pounds without the surgery but never would have been able to maintain it.
LAWoman72 posted that she'd feel differently about WLS if patients at least said that they had decreased hunger. One of the things that happens with WLS is that it affects the release of the "hunger hormone", ghrelin. I absolutely had no hunger pains for the first year or so after my surgery so I just ate on a schedule following the nutritional guidelines I was given.
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