Bariatric/Weight Loss Surgery

ki4eld

I had RNY in January. I've lost well and continue to lose. I had 4 doctors from 4 different disciplines all saying the same thing... get it or die soon. If only one or even two doctors had suggested it, I wouldn't have done it. I used the scientific evidence presented and nothing else. I went through 3 years of diet with my GP, then 3 years of diet and exercise therapy with specialists before deciding to do it. After that, it was another 9 months of learning how to eat and practicing it while preparing for WLS.

My cautions are always this...


1. WLS isn't a quick fix. If you eat poorly now, you'll eat poorly later. Spend your time learning how to eat properly and then do it and see what results you get. MFP is useful for that. Use it now, use it after WLS, use it for your lifetime. You need to use the tools available. MFP is one of them. You'll need the discipline after surgery even more than you need it now or you'll gain back the weight. Might as well start now weighing, logging, and holding yourself accountable for everything that goes into your mouth. It'll be tougher after surgery.

2. It is NOT for people who "just need to lose weight." It's a medical intervention for medical issues. If your issue is poor diet, you need a dietitian. If it's poor discipline, you need to learn some. WLS won't fix any of those problems. You should see a psychologist/psychiatrist that specializes in bariatric mental health. They can help you work through problems now and avoid problems later. You can also learn some mental tricks to get you over the rough patches.

3. And there will be rough patches, maybe forever. WLS is painful, expensive, and permanent. The side effects and complications are real and maybe lifelong. If you have bad habits after surgery, you could die. If you don't know how food, macros, and micros affect you, you could die. See #1. You should do your research and not just listen to the doctors. Doctors know medical, but you should spend a lot of time talking to people who have to live with it every day. It ain't easy.

4. Don't just jump into it. I said, "Do your research," and that was no idle advice. If you don't know why VGS would be indicated or RNY indicated, you need to learn. It's a whole different world after WLS or it should be. If it's not, see #1 and #2. Don't rush. If you can't rattle off what you're eating, how it affects you, and what you should get out of that food *right now* then you aren't ready for WLS. Do your research, so you know what to expect.

5. You'll get a lot of flack and bullshyte lip service from people like the one above that said, "If it's all about portion, you can do that without WLS." See #1 and #2. If your doctors and medical evidence say those don't apply, then seriously consider it. Co-morbidities are an important factor. If you don't know what those are or their long-term effects on your health in comparison to WLS effects, back to research you go. Once you know the facts cold, stand by them and by your decision. I like the phrase "feck off" for the lip service folks, but you'll need to find -and then regularly employ- the phrase that works for you.



In the end, WLS is a medical tool that'll help, but you're still responsible for making it work. You are responsible. Not your co-workers when they bring food into the office. Not stores when they offer free samples. Not your family when you have to eat one way at the table and everyone else is eating otherwise. Not holidays because... holidays. Not your friends when you socialize. You. So, it's up to you to deal with those issues now, before surgery is a consideration. Otherwise, WLS will end up being just another diet failure.

garber6th

I had gastric sleeve surgery almost two years ago and have lost over 200 lbs. My health is now better than ever, as is my quality of life. It is definitely just a tool, but if integrated into your lifestyle with other changes it is extremely effective. I suggest you join a couple of bariatric surgery specific weight loss groups here on MFP -

http://community.myfitnesspal.com/en/group/637-gastric-bypass-vsg-lapband

http://community.myfitnesspal.com/en/group/1052-vsgers

The people in these groups have actual experience and not just opinions, and they will be honest and helpful with you. If you have any questions feel free to PM me.

afatpersonwholikesfood

AlexisUPenn wrote: »

I'm not sure where you're getting your stats at about failure rate but that's not accurate. About 80% of weight loss patients will lose and maintain 50% excess weight loss. It's only about a 10-20% failure rate. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/

I did some Googling, and I am also now seeing a 20% failure rate (defined as losing at least 50% of excess weight from what it looks like). I saw some information on people 8 years out, and it mentioned the average loss being 65% of excess weight. Well, damn. I don't know how I had my numbers so backwards, but if it's that successful, and if obesity is supposedly costing so much money in healthcare, why the hell aren't insurance companies covering WLS?

ki4eld

afatpersonwholikesfood wrote: »

<snip>if it's that successful, and if obesity is supposedly costing so much money in healthcare, why the hell aren't insurance companies covering WLS?

Many do. Mine did providing I met the criteria and agreed to jump through a lot of hoops. Now that obesity is considered a chronic medical condition, I suspect more doctors will become more versed and more insurance companies will cover it.

AlexisUPenn

It's ok just thought I'd clarify. Still WLS requires a lot of effort, healthy choices and planning.

More and more insurance companies are but hopefully in the next few years most will.

afatpersonwholikesfood

I don't have a link, but I think what happened is that there is information on 80% of WLS patients regaining some weight over time, and that figure was used grossly out of context in an essay I read. It never clarified how much weight. Obviously, as another poster pointed out, it's not enough weight to keep the surgery from being a success for most of the people who have been followed in the studies. That info was news to me for sure. It's been bugging me, and I had to figure out where that very high "failure" rate came from.

MKEgal

There are groups here dedicated to the various surgeries.

Look for good resources online (things like PubMed, MedLinePlus, Mayo Clinic...).
The links for MedLine & Mayo Clinic go to their info on stomach surgery.

And think hard about if you're willing to put up with the severe restrictions stomach surgery will put
on you for the rest of your life. Also, the health problems which can result.

ETA: When I first met my weight doc (endocrinologist specializing in weight issues), he offered to
set me up for surgery. I'd done my research and knew it wasn't a healthy choice.
When I hit 50 lb down, he told me I'd lost as much as they'd expect from someone with stomach
surgery... only I'm still whole, can eat whatever I choose, and have lost more weight.
He also told me that they've done LOTS of reversals of the lap band.

GaleHawkins

Thanks for everyone sharing because this is an interesting subject. I only had 75 pounds to lose so I never read about it before. I have lost 50 pounds eating a typical post bariatric diet which is working well for about a year now. Well the post bariatric type diet worked after I finally broke my carb addiction and cut my carbs to the read some doctors recommend who do the surgery.

Getting the weight off that is killing us is important. The how we get it off is optional.

Cymricdragon

I had gastric bypass in late September 2000. Within 18 months I lost 200 lbs (not including the 185 lb of ex-husband). I did gain some back, about 50 lbs, which I am working on get rid of. It is more successful post-op - eat less, more more actually works for me now.

Pre-op weight was 400 lbs. I simply was not able to lose the weight. Doctor put me on an exchange type diet at about 1000 calories less than my BMR should have been and I gained! Deciding to have surgery is not easy and depends on your own situation. I was looking at being dead within 5 years without it. For me there was no other choice.

It has not been "easy". Yes, weight comes off easy but you are forced to learn a new way of eating. Some foods I cannot have. Rich, sugary foods are obviously out. But hot dogs are iffy, I tend to eat them at home if I want one. I have a serious problem with steak as well. And no al dente pasta ever!! You also have to chew your food real well or it will come back up (if you're lucky - if not, you're miserable for hours). And gaining it back is easy as well - just start grazing. That is how I did it and once I stop the grazing and watch what I'm eating, I lose. Go figure.

But for all these issues, and if I were in the same circumstances as I was, I would do it again in a heartbeat. It was awful not being able to lose unless I ate less than 1000 calories a day. So again, look at your circumstances and do your research (both on type of surgery AND your surgeon) before making your decision.