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View Full Version : Obesity surgery--tell me about it!


Chanteuse
07-31-2004, 11:03 AM
I'd like to ask anyone out there who's had obesity surgery to give me the straight dope on it. The good, the bad, and the ugly. What type you had, the pros and cons, and was it worth it? I'd like to know about recovery, how and what you eat, long term effects, the whole enchilada. Can you ever return to "normal" eating (and by this, I don't mean OVEReating. I mean normal portions to maintain a healthy weight.)? I'd like to know it all. Sometimes, I get terribly discouraged about my dieting and consider having this done, but I don't want to make any uninformed decisions. So I need to know all I can, and that includes the best and the worst of it.

Please help me if you can! :)

MinniePurl
07-31-2004, 01:09 PM
I had a roux-en-y in December 2002. I was just over the borderline for the surgery with a BMI of 41. The reason I did it was that I looked into all the methods, compared the statistics, and surgery simply has the best chance of working in the long run. With diet and exercise only--5% keep it off. With surgery (and diet and exercise, because any surgeon will tell you you need all three), about 80% keep the weight off. There is also the advantage that with surgery the weight loss is quicker. Jerk-offs will try to tell you it's the "easy way out". Bullshit. It's not easy-- it's painful at first, and for the rest of your life, you must keep up a regimen of vitamin supplements, especially B12 in the case of roux-en-y, because you can no longer absorb it from food. What it is, is the most EFFECTIVE way currently to keep weight off.

For me, in some ways the surgery "didn't work". I didn't lose a lot of weight (only 40 pounds) and I have gained it back since my pregnancy. (This may have something to do with being hypothyroid, as I was diagnosed with that a few weeks ago. But it remains to be seen how getting treated for thyroid will affect things.) Even so... my diabetes is much better. Even when I had gotten down to a lower weight through diet & exercise alone, my blood sugars were never under very good control. My hA1c was barely in acceptable range (right below 8) and my daily readings were quite high. Now, even though I've been at this weight before-- my diabetes is completely under control. My hA1c has been near 5 throught out my whole pregnancy and ever since. My daily readings are nearly always within ADA goals. I don't know if this is how it works for everyone, but this is my personal experience. Although FWIW, an endocrinologist told me a few years back that some doctors are starting to see Type II diabetes as a surgically curable disease. My other co-morbidities are better, as well. My asthma is completely controlled-- I haven't used my rescue inhaler in months, and I'm not taking any other asthma medication. Lower back pain hasn't recurred in a while. The only thing that still bothers me is carpal tunnel, and that is related to the hypothyroid (it was going to the doctor for the carpal tunnel that revealed the thyroid condition, but looking back, I've had symptoms for years.) The surgery didn't make me thin, but it did improve my health-- which is actually the point of the surgery. You have the surgery to improve your health, not to look better. Also, most surgeons won't do the surgery unless there are "co-morbidities"-- serious conditions that will be improved by losing weight. (Like diabetes, asthma, lower back pain, sleep apnea, etc.) Some insurance companies will pay for it right off, like mine did, because they've realized that it saves them money in the long run. Others will make you jump through hoops for years before they will pay (like Kaiser). Others won't pay at all.

I had laparoscopic surgery and spent three days in the hospital. My surgeon made me take classes before surgery on how to eat after the surgery and what vitamins to take. If you eat to much, it can be extremely painful, especially if you get the horrible "dumping syndrome". After a while, I was able to go back to "normal" eating. (You aren't supposed to eat and drink at the same time, as you can eat more than you should this way. I struggle with this more than anything else, because I always want to have some tea, water or diet soda while I am eating.) My husband has had this surgery as well, although a long time ago. He still can't really eat normal portions. It's just a difference in our surgeon's philosophy (his surgeon made his "pouch" much smaller than mine) and how it heals. And he's still heavier than me, despite the fact he eats a fraction of what I do, and is more active. He does feel that without the surgery, he'd be much, much heavier, or probably dead by now.

What they've recently discovered is that the surgery tricks your body into feeling that your stomach has been full a lot. (It used to be thought it worked mainly by calorie restriction, but now it seems this is only a small part of it.) Your body then doesn't put out the hormones that cause a powerful urge to eat. Back in the caveman days, when food was scarce and difficult to get, having a hormone mechanism that motivated you to get out they and slay something or dig up some roots before you got too thin and weak was definitely an evolutionary advantage. Today, when food is much more calorie dense and doesn't require nearly any expenditure of energy to get, it doesn't work so well. They think now that this is why diets fail so often. Your body responds to dieting (therefore not being full) by putting out this hormone. If you resist your hunger, your body just cranks out more and more, until you crack. They also think in some people this mechanism is defective, and the body pumps out this hormone all the time even when the stomach has been full a lot. In the future, I think as we gain better understanding of how these hormones work, there will be non-surgical treatments that will do essentially the same thing as the surgery. For now, though, surgery is the most effective thing.

I knew someone who had a lap band surgery, and I think my husband and I have a much better quality of life than she did. After a while, we both were able to learn what works and avoid dumping and vomiting for the most part, while my lap band friend still was vomiting several times a day years after the surgery.

I don't remember where exactly I found the thing about how surgery is thought now to work. I'll continue to research when I have a chance. Here are some articles about recent hunger hormone findings:

http://www.msnbc.msn.com/id/5323305/

http://news.bbc.co.uk/1/hi/health/3889185.stm

This article is kind of along the lines of what I'm talking about above, but I know what I read had much more detail:
http://www.drmirkin.com/nutrition/2514.html

presidebt
07-31-2004, 01:22 PM
My mom had bariatric surgery last October. She had (spelling this wrong, I just know it) a duidenal switch. Her stomach could only hold five ounces when she first had it done. I doubt it can hold mush more even now. She has kept up with the precribes diet, but her age (58) and her health (osteo-arthritis) have caused problems for her with excercise. Still, she's lost 90 lbs since last October and she feels and looks so much better. She weighed almost 300 lbs when she went in and she is just over 200 now, and continues to lose weight.

It's a good thing she had it done too, because they discovered while she was having the surgery in Califonria (we live in Southern Indiana) that she had cirosis (spelling?) of the liver due to a lifetime of obesity. She will have to deal with that the rest of her life and it is, according to her doctors, untreatable and terminal. However, her chances for longevity are increased by her continued weight loss.

Live Better Electrically!
07-31-2004, 01:37 PM
I have two close friends and one acquaintance who have had gastric bypass surgery. One has lost tons of weight and is doing fine. The other ended up with a perforated stomach from the surgery and nearly died, but is now doing fine and has lost tons of weight. The third has what amounts to surgically-induced bulimia--she frequently vomits after eating, has had to go to the hospital several times for IV hydration, and has had to have her stomach dilated more than once. She, too, has lost lots of weight, but it hasn't been pretty.

Maastricht
07-31-2004, 04:54 PM
I had a stomach balloon installed last October. I'm not overweight, (BMI of 28) but I thougt the same as MinniePurl: if I was serious about wanting to lose weight, and knowing myself (I can't diet) I wanted to try something that actually might work regardless of my own sabotage. Somthing that's proven clinically effective.

I did some searches and found a study that the majority of people with a stomachballoon is not satisfied, even if they do lose weight (the lose, on average, 15 kgs). I still took the chance, hoping I would be among the satisfied minority.

After six months, I only lost 10 pounds or so. :(
The upside was that after the first four days of nausea, I hardly noticed the ballon was in my stomach at all.

So no, I don't recommend it.

lavenderviolet
07-31-2004, 05:18 PM
I had the Lap-Band done in May 2003. I have lost 130 lbs so far and am still losing.
Basically, the lap-band is a band that is buckled around the top part of the stomach so you feel full on less food. Nothing is done to your intestines so you still absorb nutrients and calories normally, and don't experience "dumping syndrome".
One advantage with the lap-band is that it is adjustable. I have a port in my left lower abdomen which cna be accessed with a needle to fill or deflate the band with saline in order to increase or decrease the tightness of the band around my stomach.
And, no, the port isn't really noticeable unless you KNOW it's there and push on my belly to find it. Which of course, casual acquaintances aren't going to be doing. :)
The reason I chose the lap-band is because it has a much better safety record than the gastric bypass. Since you aren't messing around with the intestines, there is a much lower risk of dying from the lap-band surgery. In the event of problems, the lap-band is fairly easy to reverse (since all you have to do is remove the band, rather than trying to re-route the intestines like in reversing a gastric bypass).

I do eat pretty much normally now. The only thing I try to avoid is liquid calories like ice cream and milkshakes because those slide right through the "pouch" that the band creates from the upper stomach. Solid food keeps you full longer obviously.

Over all, I would say the band has been fantastic for me and vastly improved my quality of life. It's still not very well known in America for some reason, but I think many people who are afraid of the risks of gastric bypass would be better off with the band. If you want more info and advice from people who have the band, http://www.lapbandtalk.com is a good place to start.

Chanteuse
08-01-2004, 08:59 AM
Thanks everyone, for all the info! The more I have, the better! Sometimes I want to do it, other times, I shudder at the thought. At least now I have some personal testimonials to throw into the mix!

I still don't know what I'll end up doing, but I really appreciate the input, guys! :)

Wesley Clark
08-01-2004, 09:06 AM
I would consider the lap-band method. I looked into obesity surgery a year ago and the lap band is lower cost, reversible, and lets you still have a normal diet. Plus in 10-15 years when nutritional and pharmacological advances make maintaining weight loss more plausible for people you can get the lap-band removed.

here is a list of 5 types of obesity surgery

http://www.whiotv.com/health/2941281/detail.html

kittenblue
08-01-2004, 10:18 PM
I just had the surgery done (Roux-en-Y)ten days ago, and I've lost 15 lbs already. I watched my friend, who had it done 2 years ago, like a hawk whenever she ate to see how normally she was living. She's lost 120 lbs, and eats like a normal person. With the exception of refined sugar, she eats everything. She just doesn't eat more than she should now. I'm still in the recovery phase, which is hard, but not horrible. I'm done with full liquids (where I was eating constantly to get in enough calories) and tomorrow I start pureed foods for one month. Then it's back to normal food after all the healing is done and the swelling (internal) goes down.

I was able to qualify for a laparoscopic surgery, and I feel great...climbing stairs, bending, reaching...though I'm still pretty exhausted. I did have some complications with my blood pressure after the surgery and ended up staying in 7 days and getting 5 units of blood, but none of it was painful or even scary.