Dr Recommends Gastric Bypass over lifestyle

Anybody who doesn't find inspiration from the original poster, or better yet, finds fault with and criticizes the original poster needs to have their head checked. Seriously.

OP you are truly an inspiration - keep up the good work.

I had a PCP once who insisted i take drugs for high cholesterol (you know, the ones that destroy your liver??) so I refused. I said, "what about diet and exercise first?" and she had the nerve to tell me that I would never be able to get it low enough that way and if I refused to tak the drug she would not be able to be my doctor anymore. I promptly told her to F off and lost 35 pounds on Atkins (this was YEARS ago) and my cholesterol numbers were normal.

She had to be getting a kickback from the drug company.

That is fantastic! A healthy diet and maintaining a good weight will do more for you physically than any pill, 90% of the time. Not to see that modern medicine doesn't have it's place, but in today's society a pill seems to be the easy way out over changing your lifestyle with better habits.

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.

Of course he does! After all a healthy life-style won't line his pocket....and it's for life! which means you won't be needing him any time in the future either....just sayin s'all:) Good luck to you!

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

doctor gets a paycheck when someone gets a surgery.

Unless YOU are the doc that performs the surgery this is NOT (EVER) true. Same with "drug company" kickbacks. Those were outlawed on the federal level YEARS ago. I can't even get free pens from drug companies any more.

Your doctors are NOT the enemy.

You know if you have issues with this doctor,can't you find another? I think it is very important to have a good rapport with your physician. After all you are trusting him/her with your health--and your life. A course of treatment should take into account your wishes and the doctor should try to support you. Find someone else, if possible.

Wonderful progress so far! It's wonderful that you are advocating for yourself and are working hard to show your doctor that you CAN do this without WLS (I have nothing against it, BTW)!

I also agree with those saying that it wouldn't hurt to look for a different doctor who will support you through this process, rather than forcing something on you that you don't want to do.

good for you OP, here's the plan:

1. switch doctors
2. embrace your new lifestyle (eat a little less, move a little more)

Congratulations on your hard earned weight loss! You should be proud of that accomplishment! Your endo is an azz. Fire him and find someone who will support your choices!

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!

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.

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.

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.