Why gastric bypass if calorie deficit works?
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PaulaWallaDingDong wrote: »WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said
"Health is not an occasional choice. It is a way of life"
I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?
I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there
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They start the pre-surgery weight loss to see if they can eat less without literally busting their gut when they actually have their surgery.
Depending on how they go, they might or might not have the surgery.
I saw the other day here a person who'd lost all the pre-surgery weight and then changed their mind about the WLS and was continuing to do it the MFP way.
I think that answers your question.0 -
PaulaWallaDingDong wrote: »WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said
"Health is not an occasional choice. It is a way of life"
I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?
I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there
That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?
What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.0 -
barbecuesauce wrote: »PaulaWallaDingDong wrote: »WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said
"Health is not an occasional choice. It is a way of life"
I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?
I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there
That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?
What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.
Well. Is she at least thin now? :ohwell:
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barbecuesauce wrote: »PaulaWallaDingDong wrote: »WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said
"Health is not an occasional choice. It is a way of life"
I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?
I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there
That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?
What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.
Well. Is she at least thin now? :ohwell:
I have no idea. This was about 14 years ago and we didn't stay in touch. I'd like to think she's thin and happy now.0 -
barbecuesauce wrote: »barbecuesauce wrote: »PaulaWallaDingDong wrote: »WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said
"Health is not an occasional choice. It is a way of life"
I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?
I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there
That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?
What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.
Well. Is she at least thin now? :ohwell:
I have no idea. This was about 14 years ago and we didn't stay in touch. I'd like to think she's thin and happy now.
chances are if she wasn't happy previous to it she isn't now...might be thin but chances are not happy.
I have a couple of friends who have done it.
It's not easy and the ramifications are huge.
You couldn't pay me enough to do it...esp now that I know that there are those here who have done it without it...0 -
barbecuesauce wrote: »barbecuesauce wrote: »PaulaWallaDingDong wrote: »WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said
"Health is not an occasional choice. It is a way of life"
I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?
I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there
That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?
What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.
Well. Is she at least thin now? :ohwell:
I have no idea. This was about 14 years ago and we didn't stay in touch. I'd like to think she's thin and happy now.
chances are if she wasn't happy previous to it she isn't now...might be thin but chances are not happy.
I have a couple of friends who have done it.
It's not easy and the ramifications are huge.
You couldn't pay me enough to do it...esp now that I know that there are those here who have done it without it...
No argument here. But this was a temporary job for me, I didn't make any friends there so I can only wish her the best.
I have one friend who has done it. She is still obese but has maintained her loss. A neighbor of a friend had it done, then had some plastic surgery (I'm fuzzy on the details), then regained it.
My fear is that I'm going to see people who haven't seen me in 3 years soon and I don't want them to think I've had the surgery. That's dumb but I want them to know I worked my asparagus off (and yes, I get that surgery is hard in other ways).0 -
Seems like putting the person on a choke collar
They over eat they get painfully ill
Wherever works
I watched a few episodes of My 600 lb Life. It helps many people.
I am happy for anyone that goes from 600'to 200 lbs
Pretty amazing however it happens
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PaulaWallaDingDong wrote: »WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said
"Health is not an occasional choice. It is a way of life"
I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?
I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there
This is actually a very interesting point. Harvard (I think) has a department that studies placebo effects. One thing they found was that "doctors" who paid close attention to their patients, talked to them or even touched them had a higher placebo result when performing sham therapies.
It could be that this feedback and attention helps the patients just as much as the surgery. I wonder how well a placebo weight loss pill would do when paired with regular medical attention?0 -
barbecuesauce wrote: »PaulaWallaDingDong wrote: »WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said
"Health is not an occasional choice. It is a way of life"
I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?
That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?
What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.
I used to work with a woman who gained weight to have weight loss surgery. She initially lost, then gained at least some of it back. She never had any therapy to figure out *why* she overate, and surgery can't fix emotional eating.0 -
Overall, the numbers of people who maintain significant weight losses after surgery versus dietary modifications alone are simply very different. The success rates with surgery are much higher. Surgery helps with hunger and cravings, but it's true that it is still a lot of ongoing effort.
I work in this area, and I will say that it is not very difficult to qualify for surgery these days. Where I work we don't require weight loss prior to clearance for surgery, nor do we really require people to have tried a number of diets/weight loss attempts. It's actually fairly difficult to predict how people will do with the surgery by their presentation prior to surgery, at least the literature has not really established too much in terms of clear risk factors. Even things like binge eating prior to surgery haven't been consistently linked with having that problem after the surgery.
Another thing I have noticed is that by the time people decide on the surgery they typically have some blinders on. I think it takes a lot to finally commit to this major surgery and all of the efforts and risks involved, plus just reaching out for help regarding weight is pretty tough for people, so even if they are losing weight beforehand by that point it is usually hard to say well "maybe I'll do it on my own." There is a lot of psychological pressure to "get" the surgery. I've unfortunately seen people for whom the surgery didn't really make sense, e.g. not that heavy, hunger not really the issue, losing weight during preparation, and decide to go ahead with lapband despite our counsel that the main benefit of lapband is to help control hunger. This particular person nearly died on the table and then had to have the lapband removed shortly after because it was eating into the stomach.0 -
I think it boils down to which is the best of 2 bad scenarios? Undergo a risky surgery to lose weight FAST or take your chances on dieing in the very near future from weight related illness/complications.
Weight loss surgery, or any surgery, comes with risks. You'd only consider it if it was a last resort. If you're so overweight that odds are strong that you'll die within weeks or months of heart attack or such, you may not have the luxury of time. Losing weight at the rate of 2-3 pounds a week by calorie reduction alone may not lower your other health risks fast enough.0 -
StaciMarie1974 wrote: »I think it boils down to which is the best of 2 bad scenarios? Undergo a risky surgery to lose weight FAST or take your chances on dieing in the very near future from weight related illness/complications.
Weight loss surgery, or any surgery, comes with risks. You'd only consider it if it was a last resort. If you're so overweight that odds are strong that you'll die within weeks or months of heart attack or such, you may not have the luxury of time. Losing weight at the rate of 2-3 pounds a week by calorie reduction alone may not lower your other health risks fast enough.
Unfortunately, a lot of that isn't true. Many people elect surgery aren't in immediate danger of death, and they're doing it INSTEAD of making an honest effort losing the traditional way, with help from professionals if need be. It's just given out way too freely these days.0 -
My understanding is that surgeries like gastric bypass are meant for extreme cases - where the person is considered to be in imminent danger, to the point the doctor/surgeon believes they could die or experience serious harm before the time frame in which they would be able to realistically lose the weight. However, sometimes people (even the doctors) are looking for a "quick fix" which leads to a loose interpretation of "necessary" surgery. Medications and surgeries are great advances in healthcare, but unfortunately lots of people demand a magic pill or surgery instead of putting in any work on their own health. You see that in more than just weight loss, too - it's one of the reasons antibiotics have been so overprescribed, for example.0
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I've wondered the same thing when I watch My 600 Lb Life, so it's interesting to see the comments here0
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Just to add, surgery is pretty darn easy to get approved for. I went through the process and as an 18yo female at 5'6 with a BMI of 56.5 they would have had no problem approving me for surgery had I gone through with it. A good chunk of people who have the surgery are not in imminent danger of dying within months (of the people I know who have had it done anyway). And majority had lower BMI's than I did.
I didn't have any heart concerns/diabetes/blood pressure/other health issues other than being hypothyroid and possibly sleep apnea (though I was never actually tested for it).
If you have a BMI in the 40's and 1 or more weight related comorbities there's a good chance you can be approved here in Ontario. Obviously every case is different though ^^0 -
Because people are lazy.-10
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If calorie counting was EASY, no one would be obese.
Surgery comes into play because willpower varies among individuals. It makes it physically impossible to eat large QTY's of food.0 -
I know that my weight gain was related to something that was wrong with me. For a long time, people assumed - and I even sometimes thought - that I was being lazy. It's like those people who are diagnosed with cancer and say, "I'm kind of glad I have an explanation. I kept thinking I was being lazy." That's how I felt. You sit around wondering why you're so lazy, lol. You try to be active and can't and then blame yourself.
I got fixed and BAM! All the weight stared coming off. My energy came back. Lots of improvements. Yay. Why did I ever doubt myself?! ...because people I trusted told me it was me. Because when everyone says, "This is you! You need to fix this!" it only makes sense to consider that they could be right. That's reasonable.
They weren't right. And, in fact, the very doctor who would say, "You need to eat less and move more" was the lazy one who did not do his job.
100 years ago, I'd have been considered fat, dumb and lazy for life. Because no medication was available. Everyone else would be saying, "She doesn't work hard enough. She's lazy. She can't figure out how to diet, She has a mental issue," for my whole life.
Now, people are like, "Wow! Look at all the weight she lost!" People (well, smarter people, anyway) know that it was the thyroid issue.
I have to think that a lot of obese people today have a problem. There may very well be something chemical involved. Nobody wants to weigh 400 pounds. They do try to lose and for whatever reason, they fail.
It's possible that these people have a problem that just hasn't been figured out yet. If the last thirty or forty years has taught us anything, it's that we have only begin to scratch the surface of what is going on in the body and that so many things we assume to be true are frequently wrong. There is an explanation for almost everything going on inside bodies, we just haven't figured it out yet.0 -
Bingo.girlviernes wrote: »Overall, the numbers of people who maintain significant weight losses after surgery versus dietary modifications alone are simply very different. The success rates with surgery are much higher.
Almost anybody can lose a bunch of weight. At my heaviest I was 405 pounds. I had lost 75+ pounds on more than one occasion with calorie counting and exercise. And I would regain it in less than a year, because losing that kind of weight was a full time job for me, and I was only able to successfully during times of unemployment/underemployment.
To get to a healthy BMI from my heaviest, I needed to lose nearly 200 pounds. (Almost half of my body weight at that time.) Maintaining a permanent weight loss of 100+ pounds without medical intervention is... I wouldn't call it impossible, but my understanding is that almost everyone who tries it fails. Whereas the *median* result for the surgery I had would be 100+ pounds lost, and most of that loss maintained.
Simple as that: it's about maintaining a lower weight, not about losing pounds.0
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