Coworker doesn't eat right, never moves, having bariatric surgery

In My Humble Opinion
1

A coworker of mine is going to have bariatric surgery at some point in the next year. I don’t really care, but I am curious. She is very overweight, rarely moves from her chair, and eats large lunches and snacks all day.

But the surgeries require that a person demonstrate that they’ve made an effort, right? They wouldn’t perform such surgery on someone who was doomed to failure, would they? I don’t really like this woman, but I don’t want to see her die–either from surgery or from morbid obesity.

And, because I can’t really march up to her and demand to know if she’s following the “rules” for her surgery, I come to the SDMB.

What are the rules? Should she be demonstrating some sort of dietary commitment at this point? Should I be worried that my coworker isn going to kill herself with what looks like it may be a “lazy” choice for weightloss? Or is my concern completely misplaced?

2

Rules? Her doc might have decided that her morbid obesity is enough.

I can imagine that some docs aren’t going to follow you with a camera to ensure you have made an effort. I think it comes down to a physical, a med history, being in a risk group, etc. I am sure questions were asked.

That being said, her chance at keeping off any lost weight aren’t good. She will lose alot, and put it back on and more if she is ‘scamming’ anyone (guess she is scamming herself). The success rate for these surgeries over the long term is no better than other weight loss schemes. You lose more faster and more dramatically, but the trend to baloon up to -and over- the original weight is the same.

So, she is overwight and will stress her body through surgery, weight loss and weight gain.

3

I don’t know the “rules” as you say, but I thought people requesting bariatric surgery had to show some sort of good-faith effort before any doctors would perform the surgery, in that they made an effort at regular dieting and excercise beforehand.

I have a former co-worker like yours, who was very sedentary, was very overweight, ate a lot of food throughout the day (sometimes she’d order two lunches!), yet claimed diets didn’t “work” for her. She ended up having bariatric surgery (not sure which one exactly), and she lost a lot of weight, had plastic surgery to take up all the loose skin, and ended up gaining nearly all of it back again. How, I don’t know - if it was the one where they make your stomach really small, I can’t imagine how she gained it all back.

Anyway, as you said, I thought they had to make some sort of honest effort to lose weight the regular way first.

4

I’m no expert on any of this, but I might imagine that if the doctor thought the choice was letting the patient die because the patient had no self-control, vs. surgery and possibly improving the patient’s physical health, then the doc might have a good reason for recommending surgery.

But I do see your point, if the person is intent on killing themselves then why try to save them using surgery? Sort of like giving an alchoholic a liver transplant.

5

How can a person who’s had bariatric surgery cheat? I thought any amount of over-indulgence was usually met with extreme pain and vomiting.

6

Actually this surgery doesn’t save many people from obesity because a very large percentage of them regain the weight. I once met a woman at a health spa who had had the surgery seven years prior and she weighed 400lbs. It’s easy to eat enough calories to regain the weight, esp if you don’t move much. She had that vomiting thing and after a while I just could not sit at the same table with her at dinner. Ugh.

This is one of the few weight-loss programs insurance will cover, and combined with all the hollywood personalities getting it lately, it’s become popular. I suspect some doctors are seeing dollar signs and want to jump on the bandwagon before people find out it’s not a cure. I’ve seen ads for doctors who have left general practice to concentrate on this surgery; it’s just like the dentist where I live who only does extractions. People are poor here and can’t afford dental care so he just pulls all their teeth once they’ve rotted out.

I don’t think people realize how difficult the program is; it means you have to monitor every bit of food, every liquid, take a vitamin every day for the rest of your life. And put up with vomiting and general discomfort as your body reacts to being mutlitated; sometimes there are leaks into the body cavity. All in all it sounds disgusting and terrible. But, that’s just me.

7

I used to have a co-worker who was large, had the surgery, got small, got very large (400lbs +) and then died from complications. :frowning:

It was all very sad.

8

From what I’ve read about Gastric Bypass surgery the pain will go away. Especially if the person keeps trying. You don’t need to eat all that much to gain weight, especially if they sit down and work on it.

9

The surgery makes your stomach very very small. If you eat more than 4-5 bites at any one time, you will feel ill, sick, etc.

However, since the stomach is small, it also empties faster, so you can eat a few bites every 20 minutes or so (grazeing), then you can still eat a lot of calories.

Also, over time, the stomach expands to handle more bites.

It is my understanding that the surgery is not covered by a health plan and must be paid for out of the persons pocket. Since it is elective and expensive, the doctor might be thinking that the person has already tried less expensive/drastic measures??

10

Well, actually the only reason I know she’s having the surgery is she had a conference call last week and closed off her office (which she never ever does) to talk to the insurance company. She said that the insurance company was balking because she doesn’t have any other health issues right now. She’s just very overweight. So they didn’t want to pay for it, but after the call I guess they agreed.

What I guess flabbergasted me was that she is so casual with her food. We share a fridge, so I get to see her lunch menus every day (and today I was ogling her spaghetti!), and she doesn’t eat like someone with a plan–no matter what the plan might be. I’ve seen people try to eat low fat, low carb, low calorie, vegetarian, vegan, all of it. She doesn’t have any rhyme nor reason. I don’t tend to talk about what people eat, so we don’t talk about it, other than once she told me that she was drinking ice water instead of just plain water because it burns more calories that way and “every bit helps.”

When I say she doesn’t move much, I don’t think it’s because she can’t. She seems to get around fine when she chooses to, but her job is not demanding. She sits in her office and props her feet up and plays solitaire much of the day.

I just find it unlikely that she can be successful, even at drastic measures of weight loss, though I do wish her well with it. I don’t like her, but no one deserves to be fat and go through what being fat causes.

11

jsgoddess, how long have you known this woman? I only ask because it’s possible that she’s tried many weight-loss plans in the past, and has been unsuccessful. So, like a lot of folks who have been unsuccessful many times, she may have given up on weight loss until she decided on bariatric surgery. I’m not saying this is the way it is, only that it may be the way it is.

12

Thats what I thought too. The huge slug where I work had the surgery. He was required to stop smoking before he got it. I don’t know what else the doc required. The less I know about him the better.

Well, he went under the knife and is back to work again. Still rolls around in the chair, still eats constantly throughout the day and from what I see the portion size hasn’t seemed to decrease. And he’s smoking again. :rolleyes:

You may remember such memorable posts about this fellow in my “Cheddar cheese on Pizza” thread and the one about him arguing that “pork rinds are part of a healty diet”.

I can’t see this as a success story.

13

Two of my friends have had weight-loss surgeries, one a ‘regular’ bariatric and the other a more drastic version including bypassing part of the intestines. In both cases, insurance covered them only after concluding there were clear health risks involved if they didn’t lose weight and each had to undergo therapy and doctor-supervised weight loss efforts before they could get an okay.

The less drastic friend, who was in the moderate type range as far as morbid obesity goes ~325 lbs, has better ins. coverage that pays for pretty much everything. She basically needed to diet with dr.supervision for 3 months and attend a few nutritional counseling sessions before getting the go-ahead.

The other friend was in dire need of intervention, ~600 lbs and having serious heart issues as well as chronic back problems, but she wound up having to fight red-tape bureacracy for nearly a year before the Mayo clinic finally consenting to taking her case. Bariatric centers here in Michigan wouldn’t even treat her because she was too high-risk, they couldn’t do an MRI on someone her size to ensure that her heart wouldn’t implode during surgery, etc. The only thing everyone agreed on was that she was in serious danger but regardless of her willingness to waive all potential liability suits or whatever, no one would touch her. The Mayo finally did, mostly for the teaching opportunity and she finally got her insurance to agree to pay their 80% and then she waited another six months for supervised dieting and therapy the Mayo required before getting the surgery.

In any case, my impression from each friend was that good faith efforts were indeed a pre-req.

14

Not long enough to judge her. And if I sound judgmental, I don’t mean to be. I’m just curious about the whole thing. Her behavior seems to defy what I thought I knew about bariatric surgery, so that’s why I got curious.

15

I didn’t really think you sounded judgmental. I was only speculating that perhaps she has tried to lose weight in the past, and failed.

16

First, some of the posters seem to have serious issues with overweight individuals… All I can say is that unless you have struggled with a weight problem, it’s very hard to understand exactly what an overweight person goes through.

That said, bariatric surgery is -major- surgery. Usually (I think) it is not even considered unless the patient is morbidly obese. Some insurances cover some parts, some all, some none at all. Most do require counseling and some require that the patient show that they have tried dieting, some for 3 months at least, some longer. Many morbidly obese patients suffer other diseases, such as type II diabetes; this could be an additional reason for the surgery. Frankly, anyone who thinks that bariatric surgery is an “easy” weight loss solution is … well, they’re just not thinking things through! It changes your body and changes the way you can eat; some patients are left with complications that include vomiting and/or diareaha. I really think that in many cases, it can be the “last resort” to trying to keep the patient alive.

JMHO, mind you.

17

No chit! The tone of this thread is quite disturbing. Lots of undertones of disgust and this rather sinister sounding understatement from JSgoddess
“I don’t like her, but no one deserves to be fat and go through what being fat causes.”
I guess being fat causes sentences like this from non fatbodies. Weird!

18

My own surgeon, and most others from what I’ve been told, require that the patient have tried other weight loss plans unsuccessfully. That doesn’t mean that the patient didn’t lose weight. He or she may have lost massive amounts, but gained it back.

For example, I stayed on nothing but liquids at 475 calories for six months. I lost all interest in eating and would gladly have continued the liquids for the rest of my life, but the doctor would not allow it. Once I was forced to start “refeeding,” I was like an alcoholic that had to have three whiskies a day and no more. It was impossible for me. I compulsively thought about food and nothing would relieve that except eating.

So my surgeon did not require that I had to be limiting my food intake before the surgery. If I could have done that, I probably wouldn’t have needed the surgery.

He made it very clear that the surgery was not a cure, but a tool for weight loss. If I remember correctly, it was normal at that time (1998) for a patient to regain one-third of her or his weight loss. That is a big difference from the other programs where I always seemed to regain what I had lost and then add still more.

I did have to quit smoking before surgery. He said that smoking made the surgery itself more dangerous.

I was told that I might have difficulty digesting beef and sweets. I have trouble with neither. Chicken that is dry and dry rice are difficult for me. That’s about it.

My insurance paid for the operation because it is a life-saving surgery. Yes, the surgery itself can be dangerous, but continuing to live with that much extra weight was even more dangerous. I went into the surgery knowing that it was a serious choice, but I was very certain about what I wanted to do.

I weighed the same that Carnie Wilson did before the surgery (300) and after the weight loss (145). Over about a four year period, I regained about 30 pounds. That was eating what ever I wanted to when I wanted to. Naturally, I could not eat as much as before, but I didn’t feel the need to. In those four years I vomited only four or five times – and that was usually in reaction to eating rice. A couple of times in was a reaction to overeating (which is very painful for about twenty minutes.

Another physician prescribed topomax (2 a day) and that has caused me to lose my appetite. I am now only about 20 pounds over my lowest post-operative weight. My surgery (R-Y bypass) was on Fat Tuesday in 1998.

Oh wow. Not only do I have to take a vitamin every day, but I also have to have two Tums. I can live* with that! I can also tie my shoes with knot on top instead of on the side. I can paint my toenails. I can walk for miles. I can climb the steps of the Lincoln Memorial without stopping. I can make love and kiss at the same time.

Those who regain their weight are probably force-feeding which would indicate an eating disorder and compulsive behavior. They might want to consider talking with their physicians about topomax. This medication was originally developed as an anti-seizure medication, but has the “side effect” of controlling compulsive behaviors. (You see it’s really not about will power for some people.)

From everything that I have read, a gastric by-pass has a much better record for sustaining permanent weight loss. It worked for me when nothing else did.

I am not a physician. Some of you have posted misinformation. Are any of you physicians?

[quote]
gatopescado: The less I know about him the better.

I’ll bet that he is grateful that you keep your distance.

19

The only ‘tone’ in here as far as I can tell is about people who are morbidly obese (high risk for death) and don’t seem to be helping themselves.

The tone is not disgust about obese people, it is about people who are killing themselves and ‘resort’ to surgery to save them.

From what I’ve seen and read, surgery is another weight loss ‘scheme’ in the sense that you can expect the person to regain the weight. Will cite today if possible. (I can think of 8-10 folks and they failed).

There is nothing ‘wrong’ with obesity, but you have to understand how people can get frustrated when they watch behavior that is maddening.

Okay…maybe obese people are driven to food with a compulsion that can’t be understood, but skinny people must be driven with a compulsion to find that behavior maddening! That goes along way in explaining why thin people are thin and fat people are fat!

20

I’m sure you’re right.

I just have an uneasy feeling. She’s a smart lady, no doubt about it, but she can be a little sloppy in her work and in her thinking. When I see her saying to another coworker that “This time next year, we’ll be sharing clothes” and that other coworker is a size 2, it makes me nervous.

If it works, that’s fab. But I just have a bad feeling. Of course, I’m a worrier, so I always have bad feelings!

Zoe, your story is very encouraging. I hope my coworker has such good results.