Why gastric bypass if calorie deficit works?

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.

Replies

MsRuffBuffNStuff

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

daniwilford

I do not think they do the surgery unless getting the excess weight off quickly is medically necessary. The person has to have tried several diets and failed. Many can get 50 lbs off but can not sustain eating at a deficit long enough to reach a healthier weight. I have a friend that had surgery 18 months ago, her loss has slowed way down. My total weight loss is quickly approaching hers. I started four months ago. She has had tons of issues. It is misleading to say it is easier or even quicker than the traditional approach for most people. Given our two experiences, I would take mine over hers any day.

kk_inprogress

My understanding of it is that the surgery is a life saving effort to get the weight off fast because the person wouldn't likely live long enough to lose it more slowly (via calorie deficit). I don't know if this is entirely true, but it makes the most sense because given that situation, if calorie deficit were an option, I would much rather not have a hugely invasive surgery. Then again, I'm often surprised by what people choose if they think it will take weight off quickly.

PAV8888

I am confused by this myself as I've now heard of several people saying they have lost (or trying to lose) 50lbs before surgery.... and a very few people say they chose/are thinking to chose to continue doing so INSTEAD of having surgery...

Which would make sense to me! I mean... maybe if I stalled I would want to go to surgery... but if I am losing... why would I want to have surgery?

crazyjerseygirl

From a friend of mine who had it: it forces behavior change. She admitted she didn't have the will to go it alone, so she had the surgery, and when she fell off the wagon and overrate or ate too much sugar her body responded viciously. She said it re taught her how to view food. She stuck with it and by the time I met her I took her for plump and fit. She was nearing 450lbs 20yrs earlier.

Other than that I dunno. A dr suggested the surgery to me once and I got angry at him so I don't think it's for me!

dwalt15110

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.

fattymcrunnerpants

There's a limit to how much one can help themselves. A friend had it and lost over 100lbs in a year. It wasn't a life saving thing insofar she had to have it or die, but she had issue with hunger, and couldn't control it due to physical symptoms. Sometimes its really hard to maintain a deficit when you're hungry all the time. I've considered it only because of comorbid issues of hypothyroidism, it would be easier to lose on 500 cals because my metabolism is so damn slow.

amysless

A couple of things. One is the amount of time it takes to lose a lot of weight. Most get extremely frustrated. I hit a 45lb wall over and over - over the course of about 25 years. The other is the volume factor. Most people do not get that not only do they like to eat; they like to eat a lot. For a period of time, that is taken away. It is taken away for most people long enough to make serious inroads into losing weight.

I do agree with you that many think it's the answer instead of a tool. That somehow the surgery will take away all the issues, and that is simply not true. I can't even read the message boards anymore on the WLS sites because of the whole lack of accountability in how they got the way they did, and what they need to do to take off the weight after surgery and keep it off.

Surgery is extreme. It can be costly. It can be dangerous. But for me, it gave me back my life in a reasonable time frame. I do not regret any part of doing it. What I do miss since having the surgery is not caring about food. I loved not caring about food after I had surgery. I am 4 years out, so I'm able to eat enough to gain weight. I'm right back where I was - having to watch what I put in my mouth and move, but at least I am normal weight and have those issues.

bpetrosky

I've known two people who went through the surgery.

One went through months of evaluation leading up to clearance to go through it. He was significantly obese (Class III), and was a hospital admin, so he had a full suite of resources available to him for diet management before and after. He's had a very good outcome and is maintaining in a normal to moderately overweight range.

A former coworker of mine also did it. She spent years going from fad diet to fad diet with very little result. She made no secret that she doctor shopped to find one willing to do the surgery on the schedule she wanted. After she had the surgery, she did lose weight, but her compliance was very poor. The last time I saw her she had suffered several complications that resulted from how she ate after the surgery, and had put a big portion of the weight back.

For certain people, the surgery is a valid if drastic tool to make a change and enforce it. Just like any medical intervention, it works best when the doctors are actively managing the patient's case and there are resources available to support the aftercare. When it's used as a quick fix it's very dangerous.

orchidbutterflies

I went through the whole process to have the surgery a few years ago but didn't end up going through with it because I didn't feel like my mental health was good enough to be approved.
This time last year I went to my Dr and asked to have the referral put through again. Instead he suggested a weight management clinic that is covered by OHIP. Just to be clear it isn't one of those clinics that promotes crash dieting or supplements.
I decided to give that a try & now that I actually listened to what the clinic told me (set calorie goals, meal planning, food logging etc) I'm down 70+lbs in 6 months. I'm also hypothyroid and pcos with over 200lbs to lose from my highest weight of 383lbs.

The surgery wasn't right for me because I hadn't /actually/ tried to lose weight before. Now, a cousin of mine is starting the surgery process but she has been dieting for over 10 years. Losing and gaining the same weight. I can see how surgery has become a sort of last option for her. That's where I think it could be the most effective for people. I would never judge someone for choosing that option just because I know that I am doing it without surgery. Different strokes and all that.

PaulaWallaDingDong

daniwilford wrote: »

I do not think they do the surgery unless getting the excess weight off quickly is medically necessary. The person has to have tried several diets and failed. Many can get 50 lbs off but can not sustain eating at a deficit long enough to reach a healthier weight. I have a friend that had surgery 18 months ago, her loss has slowed way down. My total weight loss is quickly approaching hers. I started four months ago. She has had tons of issues. It is misleading to say it is easier or even quicker than the traditional approach for most people. Given our two experiences, I would take mine over hers any day.

It's easier than you think to have the surgery recommended. I was told that I qualified for it if I wanted to look into it. I didn't have any additional risk factors aside from my weight, and it was long before I reached my heaviest weight of 250 (bmi 44). It just made zero sense to me. I wasn't ill or dying or anything. Everything I've read about it and learned from friends and family members who had it done convinced that it was the worst thing I could do for myself. Just the drawings of how they mangle your insides were terrifying.

It's definitely not easier than counting calories (counting calories doesn't make you puke up blood in the restaurant parking lot or need transfusions because of malabsorption or wind up with a hernia from coughing), and if you don't learn to control your intake, the surgery won't have lasting results. It's just another means to the same outcome, except with lots of punishment for being naughty. It really ticks me off when people call it "the easy way out," and I haven't even had the procedure.

SergeantSausage

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.

ahkennett

Several years ago, I lost about 75 pounds over the course of 12 months (475-400.2...never broke that stupid 400 pound mark). It was the first time I had any success at losing weight, and I was ecstatic. Then I hit a small bump in the road, I lost my ability to keep up with that work, and the weight piled back on. I managed to stop the gain about 10-15 pounds below my original high weight, but it was still pretty devastating. Over the next few years, I worked and worked at the weight loss, but I never had the success I did that one time. I eventually "settled" at a weight that fluctuated between 440-450.

I moved to a new state, redoubled my efforts and shaved off another 20 pounds or so, but again couldn't seem to break through lower than 425. That's when I started the process toward bariatric surgery. My insurance required a 6-month supervised weight loss program prior to approving surgery. During that 6 months, we met with dieticians, physical therapists, psychologist, and medical (PA or NP), and they not only assessed each patient and provided advice, but also emphasized a lot of what surgery can and can't do. During that 6 month period, I lost about 25 pounds by putting into practice as much of their advice as possible.

Then I had my surgery. I went for the Sleeve Gastrectomy rather than the R-n-Y bypass, based on surgical risks, my health history, etc. It's been 3 months since I had the surgery, and I've lost 50+ pounds over that time. (I have also drastically cut the amounts of diabetes and BP meds that I take...improved health is as big an outcome for me as the weight loss itself.)

The surgery really doesn't make you lose weight. (A friend who went through the same procedure with the same doctor lost a bit, but then immediately re-gained. One of the big differences is that he paid out-of-pocket (different insurance that didn't cover any bariatric surgery), so he didn't have to go through that 6-month process of learning.) It is a tool that helps you implement the other methods of losing weight.

First, I can't physically eat as much food as I could before (this is especially true as my surgeon informed me that my stomach was about 50% bigger than the average, a wonderful genetic precondition that was screwing me over). This has very obvious benefits for weight loss. Second, and I think much more important for me, it has almost entirely destroyed my ability to feel hunger. I just am not hungry anymore (to the point that I have to remind myself to eat at regular intervals), which was one of my big downfalls with earlier attempts. Third, these surgeries can help ameliorate some diseases (like diabetes) that impact the ability to lose weight (though this seems to work better/faster for bypass than the sleeve).

For me the decision boiled down to the fact that I've failed at losing weight so many times before that it was almost pointless to try to continue with the traditional methods alone. Bariatric surgery offered me a new tool to add to these efforts and it's working wonderfully.

It's definitely not for those who need to lose a few pounds to get to some arbitrarily defined ideal weight. But it's also not just for the "My 600 Pound Life" set either.

PaulaWallaDingDong

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 it's the easy way out, then you know nothing about it.

LilannB

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

MKEgal

"prilCoe wrote:

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... 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

The ones which alter the physical structures by cutting out part of the stomach or intestines are
permanent, and cause permanent problems, and require a permanent change in eating.
But yes, there are people who manage to regain weight even after the drastic choice of stomach surgery.
They have to eat strangely for the rest of their lives, whether they want to or not.

.

daniwilford wrote:

The person has to have tried several diets and failed. Many can get 50 lbs off but
can not sustain eating at a deficit long enough to reach a healthier weight. I have a friend that
had surgery 18 months ago, her loss has slowed way down.

Diets don't work because they're temporary.
Someone who wants to lose weight has to make permanent lifestyle changes.
Someone who gets drastic surgery has to make permanent lifestyle changes.

When I hit 50 lb down, my weight loss doc told me I'd lost as much as would have been expected
if I'd had surgery... but I didn't quit there, and my body is still whole, and I can still enjoy whatever
I want to eat (in moderation).

Kalikel

I'm not slamming people who have the surgery. I'm sure they did what was right for them. I never ask people why, if they were able to lose weight before the surgery, why didn't they just keep going on their own? The only reason I don't ask online is because it might come off like, "You're lazy and should've lost it on your own," which is not what I think. I just don't get it. If you can lose without it, why go through all that, KWIM?

But that's just curiosity on my part and really none of my business.

Everyone does their best.

MKEgal

dwalt wrote:

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.

Why did he think that making a permanent change to his body was "the right way", especially
after he'd already been successful with what was probably the accepted right way of eating less
& moving more?

And what do you mean he's "thinking about doing it again"??? Once it's done, it's done. Does he
think that having them take out more of his intestines or stomach will make him lose more weight?

He's sort of stuck.

PaulaWallaDingDong

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?

fattymcrunnerpants

Surgery is never "easy". If you don't follow the docs instructions you'll have worse problems than being fat.

MelodyandBarbells

PaulaWallaDingDong wrote: »

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?

I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there

Orphia

They start the pre-surgery weight loss to see if they can eat less without literally busting their gut when they actually have their surgery.

Depending on how they go, they might or might not have the surgery.

I saw the other day here a person who'd lost all the pre-surgery weight and then changed their mind about the WLS and was continuing to do it the MFP way.

I think that answers your question.

barbecuesauce

JaneiR36 wrote: »

PaulaWallaDingDong wrote: »

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?

I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there

That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?

What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.

MelodyandBarbells

barbecuesauce wrote: »

JaneiR36 wrote: »

PaulaWallaDingDong wrote: »

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?

I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there

That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?

What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.

Well. Is she at least thin now? :ohwell:

barbecuesauce

JaneiR36 wrote: »

barbecuesauce wrote: »

JaneiR36 wrote: »

PaulaWallaDingDong wrote: »

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?

I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there

That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?

What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.

Well. Is she at least thin now? :ohwell:

I have no idea. This was about 14 years ago and we didn't stay in touch. I'd like to think she's thin and happy now.

SezxyStef

barbecuesauce wrote: »

JaneiR36 wrote: »

barbecuesauce wrote: »

JaneiR36 wrote: »

PaulaWallaDingDong wrote: »

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?

I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there

That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?

What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.

Well. Is she at least thin now? :ohwell:

I have no idea. This was about 14 years ago and we didn't stay in touch. I'd like to think she's thin and happy now.

chances are if she wasn't happy previous to it she isn't now...might be thin but chances are not happy.

I have a couple of friends who have done it.

It's not easy and the ramifications are huge.

You couldn't pay me enough to do it...esp now that I know that there are those here who have done it without it...

barbecuesauce

SezxyStef wrote: »

barbecuesauce wrote: »

JaneiR36 wrote: »

barbecuesauce wrote: »

JaneiR36 wrote: »

PaulaWallaDingDong wrote: »

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?

I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there

That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?

What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.

Well. Is she at least thin now? :ohwell:

I have no idea. This was about 14 years ago and we didn't stay in touch. I'd like to think she's thin and happy now.

chances are if she wasn't happy previous to it she isn't now...might be thin but chances are not happy.

I have a couple of friends who have done it.

It's not easy and the ramifications are huge.

You couldn't pay me enough to do it...esp now that I know that there are those here who have done it without it...

No argument here. But this was a temporary job for me, I didn't make any friends there so I can only wish her the best.

I have one friend who has done it. She is still obese but has maintained her loss. A neighbor of a friend had it done, then had some plastic surgery (I'm fuzzy on the details), then regained it.

My fear is that I'm going to see people who haven't seen me in 3 years soon and I don't want them to think I've had the surgery. That's dumb but I want them to know I worked my asparagus off (and yes, I get that surgery is hard in other ways).

professionalHobbyist

Seems like putting the person on a choke collar

They over eat they get painfully ill

Wherever works

I watched a few episodes of My 600 lb Life. It helps many people.

I am happy for anyone that goes from 600'to 200 lbs

Pretty amazing however it happens

crazyjerseygirl

JaneiR36 wrote: »

PaulaWallaDingDong wrote: »

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?

I wonder if for some patients the surgery is just a way of getting constant feedback from their medical staff? The required follow up visits, managing any discomforts or complications, etc. All just a launching pad to get ongoing counseling on the subject. They might not have that on a traditional eat less move more plan. Just throwing stuff out there

This is actually a very interesting point. Harvard (I think) has a department that studies placebo effects. One thing they found was that "doctors" who paid close attention to their patients, talked to them or even touched them had a higher placebo result when performing sham therapies.

It could be that this feedback and attention helps the patients just as much as the surgery. I wonder how well a placebo weight loss pill would do when paired with regular medical attention?

evileen99

barbecuesauce wrote: »

JaneiR36 wrote: »

PaulaWallaDingDong wrote: »

LilannB wrote: »

WLS is major surgery and it is something I would avoid unless it was absolutely necessary. However there are people who need WLS to help control their appetite and assist them to lose weight. Ultimately you have to adapt a new lifestyle whether with WLS or losing weight with diet and exercise. I was watching My 600 lb life and the surgeon on the show takes a no nonsense no excuses approach with his patients. One of the things he said has become one of my go to quotes for motivation. He said

"Health is not an occasional choice. It is a way of life"

I really like that doctor, especially when he says things like "If you're not going to be honest and do the work, I can't help you." It pisses people off, but also shows how the surgery didn't change the situation as much as the patients expected, even though they nodded and agreed to making lifestyle changes on their own before the surgery. They walk in for follow-ups and lie right to his face (or else they've been lying to themselves) and want him to do...what, exactly?

That would fit a friend of mine to a tee. She needs constant attention and assurance so perhaps that was an attraction for the surgery. Who knows?

What's crazier to me is the people who gain to have surgery. I worked with a woman who had to gain like 30 pounds to get the insurance to cover it. And she would complain that the weight wasn't coming on fast enough.

I used to work with a woman who gained weight to have weight loss surgery. She initially lost, then gained at least some of it back. She never had any therapy to figure out *why* she overate, and surgery can't fix emotional eating.