Bariatric surgery... to do or not to do?

You won't find very many people on MFP that are fans of surgery. The main point is that it is just a tool, not a solution, and even though people like to say they understand that and will change their habits permanently this often doesn't end up being the case. Surgery actually tends to require a lot more responsibility than just changing your diet because you also have to make sure you are getting enough of all the nutrients with limited capacity. From the people that I've seen get it done and from the stories on MFP it generally ends up being a lot of aggravation and pain for a short period of results followed by slowly regaining. It's good that you are going to try the old-fashioned way first. Hopefully you'll realize you can do it on your own without putting yourself through an ordeal with surgery.

Well, I'm not "supportive" but I'm also not trying to be "mean". There are no shortcuts. Everyone can lose weight, but for many of us, the FOOD matters. No amount of willpower can overcome malnutrition. Yes, morbidly obese people are often malnourished. So, when I changed WHAT I eat, all of my health problems vanished and weight loss has been effortless (not always FAST). No lie.

The surgery comes with all kinds of risks, including life long digestive issues, possiblity of chronic malnourishment, and even DEATH. There's a lot going on with metabolic disorder, none of which have anything to do with a stomach that is too big.

You have to be 100% committed. Weight-loss surgery is only a tool and you can and will gain the weight back if you don't follow the diet and exercise plan. This isn't something you can halfass

DON"T do it. Google Jim Obley's story...or Crystal Phillips story or Dr. Nick's story

I had a 61% bmi and now a year later 34%, this was done without surgery. Have you tried to reach your goals without getting the procedure done? and by try I mean really 100% commit and try.

I decided to have a gastric sleeve surgery. I have a 49.6 BMI!!! Now my wife and my daughter are ganging up on me telling me not to do it!!! I decided I'll give this three months to see if I can do it on my own. This is the most serious attempt I have done to lose weight in a few years.

First thing I suggest you do before you have this surgery is have a long talk with your doctor (without your wife and daughter). Ask him or her exactly what is involved in this procedure.

If you want to lose the weight on your own, this is a good place to be.

Well, I'm not "supportive" but I'm also not trying to be "mean". There are no shortcuts. Everyone can lose weight, but for many of us, the FOOD matters. No amount of willpower can overcome malnutrition. Yes, morbidly obese people are often malnourished. So, when I changed WHAT I eat, all of my health problems vanished and weight loss has been effortless (not always FAST). No lie.

The surgery comes with all kinds of risks, including life long digestive issues, possiblity of chronic malnourishment, and even DEATH. There's a lot going on with metabolic disorder, none of which have anything to do with a stomach that is too big.

Totally agree with this. A friend of mine had the surgery three years ago and all was swell at first--she lost 136 pounds and was thrilled. BUT, now she is starting to have a lot of digestive issues. Has a fair number of days when she doesn't get out of bed. Who wants to sign on for that?

My experience has been the same as that of Akimajuktuq and Binkie. Keeping the carbohydrates down harnesses the metabolism to work FOR you rather than against you. Sugar is the real culprit that is causing so much malnutrition. Our thin ancestors ate more fat and about the same amount of protein as we do BUT they ate very little sugar (if any at all) and thus a lot less carbohydrate. The average person in 1900 ate 5 pounds of sugar per year. Now it is estimated that the average person eats 150 pounds of sugar per year (half of which is buried in the massive amount of processed food that "first world" people eat). Eat fewer carbs (and no sugar) and move a little more. You won't need any mutilating surgery.

If you wish to put your money towards something, get a dietitian or nutritionist to help you out and keep you accountable. They will show you how to read food labels and what to watch out for and so forth, that is were my journey started and I am glad I went to one for a month to just figure out what I needed to start this journey all on my own and my ticker shows the proof.

I was told by everyone around me ( minus my husband and his family) that I would need surgery to stick to my lifestyle change and to lose weight and I have nothing done to me and I am happier I am doing it this way!! Teaches me responsibility

The reason I've lost 110lbs without surgery is because I watched what my mother had to go through after having hers. She's 4 years post op, still struggling to keep food down, still struggling with all the same food issues that she had before the surgery. She throws up all the time. Her hair falls out because she can't keep down any protein, and the shakes fill her up too much to finish them. She says surgery's the best thing she's ever done, after living with her I wasn't convinced. Yes, she lost 130ish lbs but is still 20kg/44lbs from her goal weight.

On the other hand, I've lost my weight through sensible eating and exercise. I eat everything in moderation, including plenty of carbs. I started with a BMI of 51.6, it's currently 34.3. I also started out at a higher weight than my mother was when she had surgery. I still want to lose another 25kg/55lbs. Sure, I didn't get results quite as fast as I would have with surgery - I've lost 75lbs since the start of January this year, after losing some and then taking a break (and regaining a bit that I had to lose again). But I feel fantastic, and I've learned to deal with my food issues along the way. And I'm so much healthier.

Good on you for making the decision to try losing weight yourself first. As others have said, surgery can be a useful tool but it certainly isn't a miracle cure. And it can be done without surgery!

While I agree that weight loss surgery is unnecessary and may be a real health risk, I speak from experience when I say that going lower carb (not very low carb, mind you) is the only way to avoid regain. I was a yo-yo dieter for years--I was always either on some kind of calorie-restricted diet (and some of them were downright dangerous and made me sick) or I was eating "normally" and gaining. Even though I was still counting calories and was supposedly on "maintenance", the weight gain seemed almost inevitable when I was eating a higher proportion of carbs (especially sugar). I have been on my present lower carb regime for a bit over 3 years and in all that time, I have taken breaks from losing but I have not gained one ounce. Now, when I want to take a break from losing, I simply let my "slow" carbs (that is, carbs that contain a lot of fiber as in vegetables and fruits) drift up toward 150 grams per day. I know that if I stay below that 150 gram threshold that I will not gain --and that I can eat whatever I want (in moderation, of course--I don't stuff myself). The impetus to eat more than you need comes from sugar in the diet. When you merely count calories, it is difficult to determine the line between what will cause a loss or gain--there is a VERY small margin of error. Average just 100 calories more than you burn per day, and it will put 70 pounds on you in ten years (or you will gain even faster). But you must eat nourishing food because it helps to avoid cravings (as your body has a built-in drive toward nutrients that it needs to perform). No doubt there is a lot of tempting high carb "food" out there--especially at the holidays. But if anyone really wants to get the monkey off their backs they will avoid it and enjoy much better health. It took me a long time to learn to nourish my body properly but now that I have discovered what works long term, I would NEVER go back to eating high carb. The pleasure of eating empty carbs is just not worth the pain.

I decided to have a gastric sleeve surgery. I have a 49.6 BMI!!!

Now my wife and my daughter are ganging up on me telling me not to do it!!!

I decided I'll give this three months to see if I can do it on my own. This is the most serious attempt I have done to lose weight in a few years.

My only comment is that this seems a hell of a drastic solution when you yourself say that you have not made a serious attempt to lose weight in years. I have not had weight loss surgery but I have had joint surgery for a shoulder that in restrospect should have been managed without a knife... surgery definitely has its consequences and although none of us ever think we'll be that 2% who have problems it is a hell of a road to find yourself on if you are the unlucky percentage. For weight loss surgery the risks are even greater.

If you wish to put your money towards something, get a dietitian or nutritionist to help you out and keep you accountable. They will show you how to read food labels and what to watch out for and so forth, that is were my journey started and I am glad I went to one for a month to just figure out what I needed to start this journey all on my own and my ticker shows the proof.

I was told by everyone around me ( minus my husband and his family) that I would need surgery to stick to my lifestyle change and to lose weight and I have nothing done to me and I am happier I am doing it this way!! Teaches me responsibility

The only problem I have with many dieticians is that many of them counsel seriously obese people to go low-fat and high carb. Granted, going very low fat will take weight off, but it exacerbates obesity-causing blood sugar issues (and yes, ALL obese folk have blood sugar issues whether they are diabetic or not). Since the advent of the growth of the amount of sugar in Western diets, blood sugar levels have climbed and continue to climb. What are considered "normal" blood sugar levels now would have been considered elevated in the 1920s when they first began to measure those levels routinely. The rise in the prevalence of obesity perfectly tracks the rise in sugar consumption. Look at the labels of "low fat/no fat" food--sugar is almost always added to make up for the lack of flavor that taking the fat out causes. By the way, you need AT LEAST 45 grams of fat per day just to stay healthy. I once had a dietician tell me that anything over 25 grams of fat per day was "unhealthy"!

You can spend thousands of dollars getting the surgery just to eat less, and having to completely cut out some foods due to your body not able to digest (you get used to throwing up a lot, ive seen it firsthand with a friend of mine.....you like oranges? Forget about those guys) or you can use mfp as your tool, and its free.

The surgery only makes you lose weight, it doesnt attck the reason why you are obese in the first place. You can control one addiction with a surgery, but often addicts turn to another bad habit. Or often, people just eat themselves back to the size they were. People think the surger is easy, you just gomin, get snipped andnthen you lose weight.

Before the surgery, you have to go on a special diet for a bit, and then after you are supposed to work out and eat a special diet. So basically you are paying all that money just to do what you are supposed to be doing anyways to lose weight.

As a physician, I've seen a lot of things that go wrong with these patients. That said, I've also seen a lot of people who do well. There are many options, from the traditional Roux-en-Y to the more temporary Lap-Band to the hot new gastric sleeve. Some the initial questions you should consider are: how much weight do you have to lose? Is it enough that you are willing to live with an altered anatomy and in a malnutritive state? are you willing to give up your favorite foods? are you willing to eat very little? are you willing to put up with the potential side effects, including pain, nausea, and scars, which could lead to bowel obstruction and other issues of the sort? This decision remains your own, but be aware that if you choose this path, it will be a long and potentially painful course. Surgery is not the preferred solution, but if you have severe comorbidities such as diabetes and high blood pressure, this may be a good option.
Good luck!

The best option is to get added sugar out of the diet. It is addictive and obesity is the result but obesity is just part of the trouble that sugar causes. Research done by the team of Richard J. Johnson (head of the renal division at the medical center at the University of Colorado) has pretty well proved that it is sugar (and specifically the fructose portion of it--sucrose, i.e. table sugar is 50% fructose) that causes metabolic syndrome--high blood pressure, diabetes, etc. They discovered, somewhat by accident, that they could cause 60% of normal weight males to develop metabolic syndrome in TWO WEEKS when they gave them a special daily high fructose drink to drink, in addition to their meals. Dr. Johnson has been given an NIH grant to study the epidemic of renal disease and failure among sugar cane workers in central America. What he expects to find, as the base of the problem, is their habit of drinking lots of soft drinks and sugar-sweetened fruit juice, during their long days in the very hot sugar cane fields. Uric acid levels rise dangerously high under the condition of excessive fructose and dehydration. It apparently blows out their kidneys.

My opinion is try it on your own. If you see you are struggling then you may need the help. But keep in mind the struggles are what teaches you to be stronger and not give in to food for the comfort factor instead of the I'm eating to stay alive and healthy factor. You must eat to stay alive, but most of us who struggle with being over weight eat for other reasons. I also agree with the carbs. Stop eating complex carbs, rice, pasta, breads, flours. And enjoy the good carbs, fruits and veggies. Stay away from as much processed foods as you can. I can now bake sweets and goodies without eating the whole batch of what I make. I have a couple treats but mostly bake to give away to others. Weigh your food and be precise, log everyday, every bite. Good Luck

I like the fact that you are giving yourself 3 months of true dieting. Don't cheat yourself though just so you can end up having the surgery. If you have already made up your mind then go ahead and do it. I know several people who had the surgery and are doing great and I know someone who died on the table during the surgery. All surgeries are risky and come with possible complications. Save the $10,000+ to reward yourself after you hit your goal wait. I was up to 330lbs and had several meetings with surgeons who told me that I really needed the surgery. I decided to try dieting with MFP and I am now down 115lbs and feel great. When you work hard it is super rewarding. Good luck with what ever your decision is. You have a great support group here.