Obesity Discussion Forums

[MamaBear]

I considered weight loss surgery... but just barely considered it. My husband and I talked about it and decided it was just too scary and drastic. As we were talking about it, we couldn't figure out what the advantage of doing a surgery is versus just cutting back on calories.

Is the main advantage that you are physically forced to not cheat? If this is the case, then how to people gain weight after surgery (such as that gentleman on The Biggest Loser). Is there some other aspect to the surgery that causes you to lose weight? I've read something about the intestines being shortened - does that have a big effect?

It seems like it is such an extreme last resort. I am always surprised when I learn that someone who is "just obese" (like 5'7 230 lbs) gets the surgery. But, I don't know what that person has been through or what their medical situation is - so it definitely isn't my place to judge their choice. The procedure itself just seem so extreme - you'd think that very few people would qualify for it.

I am 99.9% sure I would never do the surgery, but I just wonder if there are advantages to it that I am not seeing or understanding. What am I missing?

[Fluffymomma]

Not sure. I have a friend who did it but after over a year later, I saw pictures of her and I did not see any difference. So I don't know if she did it and then just did not try to cut back or gave up.

[Obesity Discussion]

Originally Posted by MamaBear

I considered weight loss surgery... but just barely considered it. My husband and I talked about it and decided it was just too scary and drastic. As we were talking about it, we couldn't figure out what the advantage of doing a surgery is versus just cutting back on calories.

Is the main advantage that you are physically forced to not cheat? If this is the case, then how to people gain weight after surgery (such as that gentleman on The Biggest Loser). Is there some other aspect to the surgery that causes you to lose weight? I've read something about the intestines being shortened - does that have a big effect?

It seems like it is such an extreme last resort. I am always surprised when I learn that someone who is "just obese" (like 5'7 230 lbs) gets the surgery. But, I don't know what that person has been through or what their medical situation is - so it definitely isn't my place to judge their choice. The procedure itself just seem so extreme - you'd think that very few people would qualify for it.

I am 99.9% sure I would never do the surgery, but I just wonder if there are advantages to it that I am not seeing or understanding. What am I missing?

One of the main advantages of some types of WLS comes down to your stomach/pouch being much smaller therefore you don't feel like eating as much.....I think a lot of it is mental too....like a stepping stone.

However,

1. There can be side effects, and in rare cases serious ones
2. It can be costly, especially if insurance doesn't cover it
3. Though it makes you feel like eating less, if you don't change your lifestyle for the long run you're going to put the weight back on anyway (see Carney Wilson).
4. The protein diet.....

[MichaelB]

Re: #3, even though that stomach pouch is reduced to the size of your thumb during surgery, overeating will cause that thumb-sized pouch to stretch again (which is why even those with WLS will often regain their lost weight).

The body is an amazing thing. It'll adapt to almost anything, including our own abuse, i.e. if long term habits do not change.

[monique]

I have read in interviews with people that had WLS that with most of the stomach gone, the "hungry" message to the brain is much weaker. So as well as physically keeping you from being able to eat as much you actually WANT to eat less.

I agree with you though that the risks totally don't seem to outweigh the benefits over non-surgical weight loss. I think doctors are a little too quick to approve people that have really not tried any other methods first. And that's probably why the rates of regaining weight are so high. If it was saved for a last resort in extreme cases the statistics on success might be better. I have heard of some doctors requiring their patients to prove their commitment by losing some of the weight first and maintaining for a while, I think that's a great idea and that it will also show some of them that they can do the rest without the surgery.

~Monique

[Obesity Discussion]

Originally Posted by monique

I have read in interviews with people that had WLS that with most of the stomach gone, the "hungry" message to the brain is much weaker. So as well as physically keeping you from being able to eat as much you actually WANT to eat less.

I agree with you though that the risks totally don't seem to outweigh the benefits over non-surgical weight loss. I think doctors are a little too quick to approve people that have really not tried any other methods first. And that's probably why the rates of regaining weight are so high. If it was saved for a last resort in extreme cases the statistics on success might be better. I have heard of some doctors requiring their patients to prove their commitment by losing some of the weight first and maintaining for a while, I think that's a great idea and that it will also show some of them that they can do the rest without the surgery.

~Monique

Maybe I'm wrong, but it appeared that the approval process was much easier years ago. Now there are all kinds of evaluations you are supposed to have by multiple doctors, and there's a long waiting period. Jblack, one of our members here posted about his long journey to getting approved. It wasn't easy.

[monique]

I haven't been following the issue, so maybe the process is getting stricter. If so I hope people's odds of success are improving! I think you really have to know what you're getting into, because recovery sounds like a LOOOOONG and painful road.

~Monique

[SheaGrl]

In the Alli thread, the undesirable side-effect of having to run to the toilet when eating oily/fattening food was mentioned. With the weight loss surgery,a common side effect is throwing up what you have eaten if your body isnt ready yet or it is too much. People go through a "trial and error" process after the surgery by testing various foods and amounts. For instance, at month 3, they will test eating something like sushi and if they throw it up, they might try again in month 5 to see if their body can tolerate it. So you got it MamaBear, you are physically forced not to cheat!!

[MamaBear]

Does anyone know what percentage of post-ops regain the weight? (Post-op sounds transgender... but I can't think of a better word to describe it.)

I just wonder what happens as post-ops age. What is their life expectancy? It seems that having their insides cut up and rearranged would surely have some long term impact... but maybe not.

What if a post-op gets cancer and is struggling to eat enough to maintain weight? Do they have options? I know the surgery cannot be undone.

[johnita36]

From other boards I visit that have surgery forums I believe they are required to always take supplements because of where they remove some the intestines where absorption of vitamins and minerals occur. So they are always required to take these supplements from what I have read. But I thought I had read that some of the surgeries are reversible but I'm honestly not sure which ones and I could be wrong on this but I do recall reading that. For me I just think it's way too drastic I would much prefer losing the weight the healthy way because no matter how you loose your weight whether WLS or on your own you still have to make a lifestyle change in order to maintain. So I think that may be why with WLS some of them gain the weight back if they don't go into it knowing they have to change their life to maintain once they loose the weight.



Johnita

[monique]

I read that 5 years down the road the average WLS surgery patient will have gained back half of what they lost.

~Monique

[johnita36]

I have read that too Monique and I think it's because the ones doing WLS are not making a lifestyle change so they end up regaining the weight back.



Johnita

[monique]

I think you're right Johnita. If you haven't practiced limiting your calories and being more active then just having a smaller stomach isn't going to solve your eating issues. If you keep trying to stuff in the old amount of food you can stretch your stomach back to what it was.

~Monique

[hannahlee0711]

dieting is healthier

[NevOhio]

I think much is missed and misunderstood with WLS. First, if you have the bypass or the sleeve ARE you less hungry for the first couple years because of the small pouch or because of the changes to the intestines that change the hormones? I remember reading about two years ago about experiments in Europe on diabetes patients (remember that the bypass surgery basically eliminates type II diabetes). The surgeons just did the reorganization of the upper part the intestines and did not form the pouch. The results reported were that those patients had large weight loss, no appetite and the size of the stomach had nothing to do with it. I have not seen any followup on that. I wonder if anyone has? I would love to read what longer term happened.

But there is more that needs to be said here. I had lap band surgery and even though I am eating fewer calories than ever and even though I have always exercised, after losing about 50 lbs I have regained 30 lbs. I eat what I am told to eat and I am not really very hungry. But I wasn't before the surgery either. The difference for me is that I now have NO energy. And, I never had the period where I was able to rapidly lose weight and have no appetite and had energy. Never happened for me.

So, I look for answers as to what to do with my weight. I am not convinced that one of the basic themes that is present in the posts in this threat are useful. That is that the reason weight is regained is that "old habits" either come back or are never lost. (That is good, lets keep beating ourselves up for being fat whether deserved or not.) Sure, in the extreme, bad habits could be an issue. But, I wish the real research that is out would be discussed more: Calorie deprevation does not work (has nothing to do with habits). Not only does your body rebel, but dieting whether by WLS or "will power" crashes your metabolism. A psychologist with years of experience I spoke to says that no matter what WLS patients say nearly 100% have an issue with hunger at somewhere between the 2 to 5 year mark. It is not a "will power" issue.

So which is better WLS or dieting? I would tilt towards dieting (or minor WLS like the band that can be reversed). I know I have rambled here but the bottom line is this: I think much (not all, but much) of the obesity problem is ultimately held in how the hormones react to food and food deprevation and until research figures those questions out, neither WLS or dieting will solve the obesity problem. Thus, keep the options open by not having irreverseable surgery that may ultimately prove not to be effective.

[MichaelB]

Interesting thoughts, NevOhio...thanks for sharing!

[monique]

I had heard that it was mainly the hormonal changes that changed hunger, but that is interesting that the size of the stomach may not matter. I'm sorry your surgery wasn't effective, but have you had it reversed? Are you currently trying to lose weight?

I agree with you that the tendency to blame the obese for their size is not always fair. Some people really seem to have bodies that put on weight when they're doing the exact same thing others do! Just in the last 2 days I've seen my 130 pound sister who's never had a weight problem eat more than I do at every meal and being 200 pounds heavier I SHOULD be losing like crazy on this many calories. My doctor has compared it to the way horses have different caloric needs and it doesn't seem to be related to size or activity. Some are just "easy keepers" and will stay a healthy weight on less feed, if you feed all the horses in a stable the same amount some may be too skinny and others will be overweight. I see that with my dog too! I have a 20 pound dog that eats even more than my parents' 70 pound dog and is not fat. I think we all need to remember that you can't tell someone's habits by their weight, the same calories and exercise will not work for everyone. That's why my goal is just to go from obese to overweight. I don't think my body is realistically going to get down to 150 without an obsessive amount of exercise and calorie restriction. 1600 is the fewest calories I'm willing to have per day, so whatever weight that gets me to is where I'll settle! I am willing to do a bit more exercise than I'm doing now though, I just need to get in better shape gradually.

~Monique

[NevOhio]

I had the lap band installed. It is just sitting there deflated at the moment. I did not really get into the nightmare I have had with the surgeon. While I will not get into details here, the frustrating part of that (is there anything not frustrating with WL?) is that I spent a great deal of time and effort to find a good medical center with a good reputation for treatment. I basically drive 300 miles to see these guys. The frustration comes in that the center had two well known, well respected surgeons and a great team of other docs and specialists. Literally days before my surgery, but after the time I could not reasonably stop the surgery without losing a ton of money, both surgeons left and the guy who replaced them was young, arrogant, and does not seem to understand the process.

I am still trying to lose weight. I want to live. But the more I observe, the more find out, the more I come to the conclusion that those who can take a healthy amount of weight off and most importantly KEEP IT OFF is akin to those who win the lottery....the odds are about the same. And, the sad deception is that it has very little to do with food and practically nothing to do with exercise. (Both within any relevant range of course.) Again, sorry for rambling.

[Obesity Discussion]

Originally Posted by NevOhio

But the more I observe, the more find out, the more I come to the conclusion that those who can take a healthy amount of weight off and most importantly KEEP IT OFF is akin to those who win the lottery....the odds are about the same. And, the sad deception is that it has very little to do with food and practically nothing to do with exercise. (Both within any relevant range of course.) Again, sorry for rambling.

NevOhio, with all due respect I wholeheartedly disagree with this. There are a number of people who take off a healthy amount of weight and keep it off. We have quite a few here. I know many personally who have done this. To say the odds of this are similar to the odds of winning the lottery is quite a gross exaggeration. To hear you say that food and exercise have little to do with losing weight in a healthy manner and keeping it off is like hearing someone say the sky is red. I'm not sure where you're reading/observing all which you speak of....but whatever you are reading is misleading.

[MamaBear]

NevOhio - I'm so sorry you had that experience!

I understand that feeling that losing weight and keeping it off is similar to winning the lottery. Sometimes, it really does feel like the odds are stacked against us. Whether or not it is true, we shouldn't let 'poor odds' give us permission to give up.

I'm not sure where you're reading/observing all which you speak of....but whatever you are reading is misleading.

I don't know what NevOhio's source was... but I recently read a book on WLS (have another thread on this) and it presented very very discouraging statistics. He basically made it sound like diet and exercise was completely futile. I strongly disagree... but if someone read the book and believed his opinions were completely unbiased they were quite compelling. I think we hear the same studies cited over and over again from various folks with things to sell (WLS, diet pills, gadgets, etc.). I think some people sincerely believe that once you hit a certain weight, there is almost no way to return to a normal weight. (Unless you use their diet product, of course!) I disagree... but I that literature is certainly out there.

Being difficult, and having the cards stacked against us (genetics, environment, biology) is not the same as impossible. I'm trying to focus on success stories rather than focusing on all the reasons this will be hard.

Hang in there, NevOhio You can do this!! I hope you stick around the boards. There are such wonderful people here that are willing to share information and support.