Why gastric bypass if calorie deficit works?
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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 -
I'm not lazy, I don't have blinders on, I was not affected by peer pressure, and it was not easy to qualify. I just passed my one year anniversary from surgery and I am being transitioned out of the program. My spot will go to someone else on the long waiting list.
My reasons are my own and frankly from all the speculations offered here, I'm in no mood to explain my reasons.0 -
dwalt15110 wrote: »Before you can have gastric bypass, you have to prove you can lose weight. My friend lost 75 pounds on his own and then had gastric bypass, because he wanted to lose weight the right way. After that he lost 25 pounds. He gained every bit of that back and a few more pounds. He had it done 4 years ago and is seriously thinking about doing it again. No matter if you're doing it on your own or with surgery or other medical aids, you still have to be committed to the process. It's not magic.
I agree with this ^^ Surgery doesn't teach you how to eat healthy, watch your portions or even how to live a healthy/active lifestyle AFTER the surgery. You still have to learn that on your own. To me, unless you're DYING, you should have to do it the old fashioned way, cals in, cals out.
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I'm not lazy, I don't have blinders on, I was not affected by peer pressure, and it was not easy to qualify. I just passed my one year anniversary from surgery and I am being transitioned out of the program. My spot will go to someone else on the long waiting list.
My reasons are my own and frankly from all the speculations offered here, I'm in no mood to explain my reasons.
I didn't mean to be offensive, there is a lot of variability in people who have surgery and the truth is that it is a logical choice for many people due to the numbers. But, I also regularly see people who I think would likely be better off without the surgery but by the time they see me, I don't think they are in a place to really hear that feedback.
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I agree it is a momentous decision. In the months on the waiting list I pondered what my life might be like if I went for surgery. I would have taken a rejection by the weight loss team very personally (yet another failure), and indeed some of my compatriots who were turned down for the surgery option were devastated. I don't think that is an exaggeration.
I believe I might have been able to lose thirty pounds and maintain that loss on my own.0 -
I've seen those shows on TV where someone weighs many hundreds of pounds and they have obvious mental issues that explain the weight gain (emotional eating, death of a spouse, childhood trauma/abuse, etc).
You also see the doctor tell them to lose 50+ lbs before he does the surgery. OK I get it, it's to get them eating better which they will need to do after surgery.
So if weight loss can be done by eating better and eating at a calorie deficit, why is gastric bypass even a consideration? I don't necessarily mean the 600 lb people because those are special cases. I mean even people that are 300 lbs. If you are 600 lbs you probably do the need the surgery as that is an extreme case.
The bypass is permanent and potentially life threatening. If you can steadily lose weight, even say 75-100 lbs per year then why go to the drastic step of surgery?
I could be wrong but to me it seems like these people tend to view bypass surgery as the magic pill or quick fix to a long term problem. People get the surgery and then rave about how amazing it was when really they could have accomplished the same thing by changing their eating habits (albeit more slowly). Guess what it took years to gain the weight so what's wrong with taking a year or two (maybe longer if you're doing it safely) to lose the weight?
I'm not trying to start something here. I'm serious, I'm trying to figure out in what cases surgery is really necessary. I think there are many cases where if people ate better and ate at a deficit, they would be better off in the long run. Surgery is extreme, dangerous, and costly.
Because the "quick fix" is percieved by people as being the better way to go. Hence bariatric surgery, diet pills, etc etc etc0 -
MeiannaLee wrote: »Because people are lazy.
Is that all you have to add to the conversation? There's nothing lazy about it. Please pick up a book, or at least use google once in a while.
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people think it will be a magic bullet0
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I think the bottom line is that there's a limit to willpower - which is why the person is in that position in the first place. You might do ok for 6 months and lose 50 pounds then when there's a slow down in weight loss, lose your momentum and quit trying and go back to old habits and gain 60. Gastric Bypass and other weight loss surgeries force a lifestyle change for an extended period of time - at least a year - and when it gets tough, they can't just fall back on old habits (well, some can - you've seen those that gain the weight back, or even don't lose weight at all - I'm not sure how that even happens). You do have a good point, but weight loss requires the lifestyle change that some just don't have the mental ability to enforce on themselves
People with gastric bypass surgery need just as much willpower for just as much time and psychological support for a lot longer.
A former neighbor of mine had the surgery, lost 55 kilos ( 121 pounds, which also can be lost the CICO way in the same amount of time, especially at her start-out weight ) in her first year and about 30-35 kilos (66- 80 pounds ) in the second.
By that time she was still over 200 pounds, which was very disappointing to her and she gave up. In 14 month she gained enough to surpass her initial weight of just over 400 pounds. She died last year a week after Thanksgiving of complications from poorly managed diabetes which included organ failure and a heart attack. Unfortunately she had hoped to lose 250 pounds in no more than two years and then go back to her " real " life.0 -
Two people I know had one of the weight loss surgeries.
One of them is back at pre-surgery weight, and then some.
The other has gained at least half back.
Both said it was crazy easy to get cleared for the surgery. In fact, it took 1 month to get a surgery date from initial consult. Both hardly changed their eating habits, and neither exercise at all.0 -
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PaulaWallaDingDong wrote: »
It is true in the case of a sleeve gastrectomy. If you eat more than your stomach can hold you will physically vomit it up. You overeat with that method.
It took me quite a while to figure out what I can hold and digest properly0 -
My apologies if I offended... I realize in some places it may be harder than others to get on the waiting list and then actually be approved. I was speaking from my own personal experience of the process here in Ontario. Start to finish (finish being the surgery date) it would have taken under 6 months and that is how long it typically averages at that hospital according to the staff working in the clinic. It is covered by OHIP, so I'd imagine you don't have to jump through as many hoops as you would if you were dealing with an insurance company to cover the costs.
It's going to vary hospital to hospital as well I would imagine.0 -
I'm not lazy, I don't have blinders on, I was not affected by peer pressure, and it was not easy to qualify. I just passed my one year anniversary from surgery and I am being transitioned out of the program. My spot will go to someone else on the long waiting list.
My reasons are my own and frankly from all the speculations offered here, I'm in no mood to explain my reasons.
This is exactly why I never pester people about it. It's really your business.
Everyone has their reasons. That's good enough.0 -
SergeantSausage wrote: »Why steroids, or implants, or synthol if weight lifting works?
Because , in general, folks are farking lazy and will do anything to avoid being uncomfortable and doing work, right? Take the easy way out.
If you think WLS is the 'easy way out', you know NOTHING about the surgery or the long process of medical evaluations (ranging from physical to mental) these folks go through prior to getting surgery.0 -
I was considering weight loss surgery and my doctor told me to diet and exercise for 6 months first. After a few months, I didn't want the surgery anymore and decided to do it on my own. In the last 13 months I have lost 130 lbs and have 30 left to lose.
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I was considering weight loss surgery and my doctor told me to diet and exercise for 6 months first. After a few months, I didn't want the surgery anymore and decided to do it on my own. In the last 13 months I have lost 130 lbs and have 30 left to lose.
Very cool, congrats on your progress.0 -
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When I watch 600 pound life, I don't understand why people who can't even get out of bed are overfed by those who are taking care of them. Is it all just to get on television?0
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happyfeetrebel1 wrote: »PaulaWallaDingDong wrote: »
It is true in the case of a sleeve gastrectomy. If you eat more than your stomach can hold you will physically vomit it up. You overeat with that method.
It took me quite a while to figure out what I can hold and digest properly
I think that happens with all the weight loss procedures (except for the AspireAssist. Blech.). However, what I'm getting at is that someone who refuses to take initiative in regulating their own intake won't be successful with the surgery. Someone who is bound and determined to overeat, for whatever reason, will find a way. I'm not saying it's not helpful. Plenty of people on MFP will tell you it saved their lives, but it's a tool, and you have to commit to using it in order for it to work.
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There are people who find ways to get around their WLS. I saw one person on YT who had the sleeve who said there are ways to get around your sleeve. She spoke about still eating a whole plate of chicken wings just eating them slowly over several hours. The point to me is that if you are looking for ways around your WLS you have not committed mentally to losing weight.0
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