Dr Recommends Gastric Bypass over lifestyle

quiltlovinlisa

Adding my support, you are doing an incredible job and 45 pounds is a significant loss showing real commitment to learning the lifestyle changes needed for sustained weight loss. Good for you!

CarolElaine25

Sounds like your doctor feels he's superior because he's an *kitten*, not because he's a vegetarian. *kitten* will act as if they're superior no matter what their preferred diet is (paleo, macrobiotic, vegan, Atkins, etc.)

This vegetarian salutes your decision to not get the surgery. Obviously what you're doing is working for you. I concur with the others on the thread - keep doing what you're doing and ditch the doc.

EDollah

The doctor doesn't make any money with you doing it your way.

Unless the doctor is a Bariatric surgeon, he doesn't make ANY money from recommending surgery at all. Most insurances don't pay for "nutritional counseling" from MDs....only from dietitians....and even then, many insurance companies don't pay for the visit.

I am an ob/gyn who is beginning my journey toward a fellowship in bariatric medicine (nutritional, not surgical) because SOOOOOO many of my patients are women of all ages who have fertility and menstrual problems because of obesity. Everyone seems to know that anorexic / extreme athletes can have these problems, but most people don't realize the opposite end of the spectrum is actually even worse (often hemorrhagic, sometimes life-threatening bleeding...or bleeding most days of the month). Unfortunately, there is very, very little I can do to stop this when a woman is morbidly obese (BMI >35 especially)....so I am making my own journey to help myself AND help other women overcome obesity and take back their health.

As patients, you should realize the days of "rich doctors" are LONG over. Those guys have, or soon are, retiring. Those of us who are left, are slaves to the insurance companies that took over medicine in the 1980s and 1990s. Because of our very long training curve (15 yrs, average), the docs JUST coming out of medical school will likely never, ever have a shot at private practice and "old school" medicine (I'm in this boat) and have HUGE student loan debt thanks to the 1000(+)% increase in college / med school tuition in the last 10 years. The ACA (Obamacare) is making medicine even more into an assembly line where more and more patients (who are PAYING for insurance) must be moved through to make enough profit to pay for the millions of patients who do NOT pay for insurance. Doctors have been taking Federally mandated pay cuts (over 25% in the last 5 years...with more coming) while simultaneously being forced to see more and more patients at the direction of whatever clinic or hospital they are employed by. Most private practices are going belly up (bankrupt) or being bought up by hospitals to spread the costs.

While I completely disagree with him recommending surgery to you after you have worked, successfully, to lose weight, you all should also know that major healthcare organizations (such as mine...ACOG) are actually recommending surgery as a FIRST LINE treatment for obesity now. Obesity is now at epidemic proportions and costing all of us BILLIONS annually in healthcare related costs. Docs have been recommending healthy weight and lifestyles for DECADES, but "no one listens"....and McDonalds advertises better than we do, apparently. So the truth is that the major health organizations have "given up" and are now recommending the, supposedly, quick fix or bariatric surgery because they know that's what the public at large wants....a "magic pill". Everyone reading this post knows this....

Are there *kitten*, ego-maniac docs out there? Sure. We aren't any more immune to personality faults as the rest of the world. There are *kitten* everywhere. The truth is that MOST of us really do want you to feel better and be happy....because, frankly, it SUCKS listening to people whine every day about stuff THEY have the power to change.

Sorry for the rant, but everyone NEEDS to get educated about what's REALLY going on in healthcare.

KT

I can't help but LOL when I read so many people advising the OP to switch doctors when an actual doctor, the MD kind, not the philosophy kind, says and I quote, "major healthcare organizations (such as mine...ACOG) are actually recommending surgery as a FIRST LINE treatment for obesity now".

So sure, switch doctors. Don't be surprised when s/he provides exactly the same advice.

luckycharm29

Surgery for obesity? Are you serious?!?! I am sure that Gastric is for some people but to be recommended to anyone that is "obese" is very shocking to me. What happened to eating healthy & exercise? It's like the whole world wants that little magic pill that will make all their troubles go away.

Yes, I would recommend another doctor!! I am sure with this guys' weight loss he has made improvements with his overall health and that should have been noticed and praised on. Not the azz hatery comments that was given to him.

recesq

Grim, I did state in my post that I think the surgery is the answer for some people, but not everyone.
If your appetite is decreased, that's great. But there many people whose appetite returns after surgery and then they are in the same emotional state but with part of their body excised from them. As I also posted, don't get me wrong, I think surgery is right for some people, but I expect more from a doctor than I got yesterday. I see an endo for low testosterone and thyroid. I'm not diabetic. My cholesterol was 201 when I started out at 405 lbs. I'm a 48 yr old male, 5'9" tall and on blood pressure meds. I'm going to continue to re-train my brain and continue to make it a habit to not only reach for veggies and protein when I'm hungry, but to actually crave them instead of the things I used to crave. Wish me luck, as I wish you continued success.

MrFrugal

Sorry that your doctor is such a jerk. One would think that the doctor would congratulate on your weight loss and encourage you to continue along the page that you were on. I agree with others that you might want to consider finding another doctor. Congratulations on your progress and good luck on your journey.

jennifershoo

Not to be a contrarian (but I will), I don't think the doctor deserves bashing just for the surgery suggestion. I get the feeling this is just standard practice to suggest the surgery when someone qualifies. Personally, my doctor, who I have much respect for, advised me to get the surgery. I didn't because, like you OP, I still believe I can achieve eventual success the old fashioned way. If you've got other issues with your doc, that's a different matter, but I wouldn't ditch a doctor just for advising this surgery. From their perspective, they see population-wide statistics showing a low probability of success without surgery and a much higher probability of success with surgery. There aren't many doctors that can look into your soul to see how focused you are (or aren't) on achieving target weight.

Also, to those saying the doc is just looking for revenue, I doubt s/he would make anything since the surgeon would be someone else.

But that's exactly the problem with doctors! They always prescribe drugs and recommend surgeries like there is no other way to reach the same result without!
ETA: that's why people bash them.

I honestly think that you need to cut doctors some slack. They have to assume that most everyone that walks into their office is of "average" willpower and may or may not be able completely do a 180 degree turn around in their lifestyle. I remember the conversation about alcohol consumption my wife and I had with her doctor when she was pregnant with our first child. We were looking at the list of things my wife wasn't supposed to consume and it had obvious issues in terms of things she actually could eat and enjoy. The doctor finally told her that a half a glass of wine 3 times of week was fine but that the medical community could not agree on a top end limit and that she had to assume that her patients would occasionally drink more than she advised. Hence she normally advised her patients to drink no alcohol whatsoever. I know another doctor here in Florida that deals with obesity issues and most of her patients simply want her to write a prescription for a scooter, rather than have her help them lose weight through diet and exercise. You have to imagine that dealing with this on a daily basis is going to eventually leave even the most optimistic practitioner a little jaded when it comes to seriously obese patients telling them that they're going to change. The reality is that if you want to change and you actually change, then you don't need the doctor's help. Just change.

I see your point and I agree.

skinnyinnotime

The doctor doesn't make any money with you doing it your way.

Exactly

grim_traveller

Grim, I did state in my post that I think the surgery is the answer for some people, but not everyone.
If your appetite is decreased, that's great. But there many people whose appetite returns after surgery and then they are in the same emotional state but with part of their body excised from them. As I also posted, don't get me wrong, I think surgery is right for some people, but I expect more from a doctor than I got yesterday. I see an endo for low testosterone and thyroid. I'm not diabetic. My cholesterol was 201 when I started out at 405 lbs. I'm a 48 yr old male, 5'9" tall and on blood pressure meds. I'm going to continue to re-train my brain and continue to make it a habit to not only reach for veggies and protein when I'm hungry, but to actually crave them instead of the things I used to crave. Wish me luck, as I wish you continued success.

I wish you luck, I really do. Nothing would please me more than having you succeed. I know how horribly difficult the battle is. And I do hope that you get a second opinion. You can't have too much information. I'd like to hear how you make out.

Snow3y

That's exactly what these kinds of doctors do... They'll MAKE you feel like crap and point out your imperfections, and insist you get something done...

They want the money, that's it.

MB_Positif

Definitely get a new doctor. Did the doctor give you specific reasons why you need the weight off more quickly? I think it's just him trying to make more money. It's horrible to bully someone like that.

ladyinredflush

um..Do you think it money could possibly be involved with the pushing of the surgery? He might have ulterior motives.

bodiva88

The only one of my doctors who ever pushed me toward Gastric Bypass was my gyno, who is a surgeon. It was my primary who suggested My Fitness Pal. My endocrinologist never recommended surgery, often suggested I work with a dietician. And when I showed up 40 pounds lighter to my annual visit in December he was thrilled and took the info on MFP for his dietician. Whatever tool works they're happy to incorporate. I also saw the gyno in Dec and could tell his idea for my goal weight does not match mine. Honestly, I know what I look and feel like at my goal and what I look and feel like lighter, and I'll be fine at 150. When I saw my primary a few weeks ago she was absolutely thrilled for me. So all of medicine is not reflected by my experience or by the dystopian rantings of others, either. If you are in a large enough metropolitan area, I think you'll be able to find a good endo who is willing and able to support you through your lifestyle change.

And anyone who thinks surgery doesn't involve a lifestyle change just as severe (or maybe even moreso) really doesn't know what it entails.

By the way, I experienced an infection that caused gastroparesis. If that had happened after I'd had bypass I'd be in a passel of trouble. As it is, with medication it's not affecting me much. And in a way, the fact that I process food slowly means I almost never really feel hungry, which is a blessing as I slowly reduce my caloric intake as I move down the steps toward my goal.

Find a new doctor who will support you, they ARE out there. And good luck to you as you continue what has to be really rewarding and self affirming progress.

josarahm

I think we have to acknowledge the benefit of this surgery in certain people. Co morbidity risks may make the surgery preferable. Sometimes, time has run out. I have a brother in law who died from complications of obesity at 48 years old leaving a 12 year old behind. Surgery could have saved his life. Diet and exercise could have too but he had not made those choices. The radical gastrectomy removes the hunger trigger and has shown by research that it reduces co morbidities.
It is not for everyone. It is also not a big money maker for hospitals even though people pay cash. Surgeons who do this are usually vested in the outcome. There are lots of easier ways for Docs to make money, trust me.
I am going the diet and exercise path but don't discount surgery. it will save some peoples lives!

arewethereyet

OP Great job on 45 pounds lost! Keep up the good work. I could totally see your doctor making this comment if you were the same weight, or up a few pounds, but to make this comment when you are down 10? Just doesn't seem right. No wait. IT WAS TOTALLY WRONG!

It has been said ad nauseum, but get a new doctor OR............dun dun dun........does this doctor know you very well? Was he having a very bad day? Is he usually like this?

I say all this because he is human, after all.

All that being said, my PCP wrote the scripts and tiredly said "lose weight". Did so for 10 years with me as my weight climbed. Then I appeared for my 6 month check up 35 pounds lighter!

I said "Well Doc I HEARD you the last time you whispered 'lose weight'"

God, I thought that man was gonna cry! He made me get on the scale and weighed me again, clapping his hands. (he shows no emotion this man, LOL.........loved seeing that!)

He did his best for all those years with me. Started out fervently saying " J, you have got to stop putting on weight. It isn't blah blah blah" Each visit less excited. Each time knowing I wasn't going to do what he said any more than my ex-husband quit the smoking. Each time up another 3,4,5 pounds.

When I did? He celebrated! THAT is what your doctor should have done.

Keep up the great work and PROVE that sucker wrong. Get a new doc, lose 100 pounds and go BACK! :drinker:

StarChanger

OP Great job on 45 pounds lost! Keep up the good work. I could totally see your doctor making this comment if you were the same weight, or up a few pounds, but to make this comment when you are down 10? Just doesn't seem right. No wait. IT WAS TOTALLY WRONG!

It has been said ad nauseum, but get a new doctor OR............dun dun dun........does this doctor know you very well? Was he having a very bad day? Is he usually like this?

I say all this because he is human, after all.

All that being said, my PCP wrote the scripts and tiredly said "lose weight". Did so for 10 years with me as my weight climbed. Then I appeared for my 6 month check up 35 pounds lighter!

I said "Well Doc I HEARD you the last time you whispered 'lose weight'"

God, I thought that man was gonna cry! He made me get on the scale and weighed me again, clapping his hands. (he shows no emotion this man, LOL.........loved seeing that!)

He did his best for all those years with me. Started out fervently saying " J, you have got to stop putting on weight. It isn't blah blah blah" Each visit less excited. Each time knowing I wasn't going to do what he said any more than my ex-husband quit the smoking. Each time up another 3,4,5 pounds.

When I did? He celebrated! THAT is what your doctor should have done.

Keep up the great work and PROVE that sucker wrong. Get a new doc, lose 100 pounds and go BACK! :drinker:

This!!!!^^^ THIS is what we hope for when you come into our offices.

Edited for removal of rant...the above still holds true. We WANT you to be healthy.

JoelleAnn78

I am a WLS patient. I struggled for a long time prior to surgery to control my BRAIN and get on track mentally before I felt I was even ready for surgery. For me it was necessary to make the lifestyle/diet change PRIOR to surgery. Even with the changes personally, I felt that that surgery was still needed to address my issues with persistent hunger. I had a larger than normal stomach and a smaller than normal metabolism. I chose the procedure that removes the part of the stomach that produces the majority of the hunger hormone ghrellin but does not change the way my body absorbs food.... I am VERY happy with my surgery and I've lost 30 pounds since my surgery 10 weeks ago... which is about a pound a week faster than I was losing before my surgery, but I don't care much about speed.. it's the fact that I can now be physically satisfied with smaller portion sizes that I am thrilled with.... So I'm speaking here as a very happy WLS patient....

You are absolutely right the surgery does not control your brain... and your doctor does not know what is going on inside you mentally. It's one thing to recommend a surgery and tell you about the benefits/risks.... but it's quite another to make you feel that there is undue pressure to have it. Surgery can be a wonderful tool for SOME people but it is not the right thing for everyone. I know personally I would have responded very poorly to anyone, even a medical professional trying to force WLS down my throat. It's a DEEPLY personal decision and not one to be taken lightly at all as it is definitely not a quick fix or magic pill. If this doctor continues to push the WLS and not support you on the path that YOU have already proven is working for you then I think you have no choice but to fire him and find a doctor who will be a bit more supportive of assisting you down the path that is right for you.

I wanted to add my 2 cents here as well -- I am a three year post WLS success story. I spent many months in therapy addressing why I was so overweight in the first place, attended every information session I could find and continued support groups for a year + after my surgery. While, I agree, surgery is not for everyone - it was for me. I was not looking for a "quick fix" as so many comments on this thread indicate WLS to be. I did not find a quick fix. I found a tool and I worked my *kitten* off to save my own life. Not every story is a horror story - those are just the ones you always hear about.

I say BRAVO to the OP who is making a go of it without surgery. Best of luck to you - I hope you are as successful as you hope to be. To the person I quoted above -- Best of luck to you as well.

This is one hell of a tough road regardless of what method you choose. We could all use the support of others and the support of a Dr - this Dr sounds like I would have wanted to punch him as well. Nice bed side manner, Doc.