My doctor broached the idea of bariatric surgery for me; his suggestion was a stomach stapling. I’m amenable, and was about to ask him about surgery anyway.
Who’s had bariatric surgery, and what are/were the advantages, disadvantages, and gotchas?
I am three months out on bariatric surgery, and I’ve lost about 65 lbs. I had a gastric bypass (Roux-n-Y) through laparoscopic surgery. My surgery went well, though I had some complications due to blood pressure that kept me in the hospital a few extra days. And I had to have an endoscopy and a dilation of my pouch about a month ago, which is quite a common thing…basically the outlet from my pouch healed too well, so they expanded it with a balloon…30 minute procedure.
Aside from the minor complications, I feel well. I’m still not eating as much as I should, but everyday gets better. I had my surgery at a well-respected, experienced hospital (The Cleveland Center For Bariatric Surgery at St. Vincent Charity Hospital) where several of my friends have also had the surgery done.
As long as you remember that the surgery is just a tool…a very effective tool…to help you lose weight and keep it off, it works well. Like any tool, it can be used incorrectly. And it doesn’t work exactly the same way for each person, so you still have to have self-discipline. It just makes it easy to be disciplined. Now what do I mean by that? Take one aspect of the surgery…it builds in an intolerance for foods containing refined sugar. Anything having more than 10grams of sugar per serving will cause some very unpleasant side effects…diarrhea, vomiting, chills, cramping, etc. The thing is, some people can tolerate a bit more sugar…maybe 12 grams, maybe more…so they keep pushing the envelope, choosing higher sugar options instead of just avoiding those options. Same with carbohydrates. we are to keep to about 25 grams a day, and most people find they just can’t tolerate bread, rice, potatoes, pasta, so they wisely avoid them. But other people tolerate those things a bit better, so they go back to choosing a slice of pizza over a salad, or they fill up on spaghetti, and then have no room for the important protein. You still have to make the right choices. The surgery just makes it easier to do that.
Currently I have no desire whatsoever for rice, potatoes, pasta…things I could barely live without before. Not only do they make me uncomfortable when I eat them, but I no longer crave them. I haven’t even tried rice yet. I walk by Godiva Chocolates every day…a place I used to work…and now have absolutely no craving for a raspberry truffle. Do I still eat sweets? Yes, but sugar-free ones, and in exteme moderation. I crave protein now, but even cheese doesn’t hold the same power over me it once had. It feels great not to be controlled by food anymore, even though I now spend more time thinking about what I’m eating than ever before.
The option I chose was drastic, but it was the only one that guaranteed fast and dramatic results. To struggle with a diet for weeks, only to lose one or two pounds, was self-defeating for me. Now I see a change in my body everytime I undress, which gives me even more incentive to follow the guidlines and restrictions the surgery imposed. My feet are no longer swollen over the tops of my shoes. My need for a C-PAP machine has lessened. I feel better every day, even the days when I struggle to eat something that agrees with me. For me, it has been worth it.
I don’t think I’ve ever heard a first-hand account of it, but in some cases, bariatric surgery can make depression much harder to deal with. If food is your favorite coping mechanism, the surgery will take that away, but it won’t necessarily eliminate your need to cope. That’s a pretty bad situation, I think.
I honestly don’t understand why people who aren’t morbidly (can barely walk) obese, would go this route. I have watched the “I lost it” show on some cable channel, as well as dozens of other “reality tv” type shows on people who’ve done this in real life.
What I don’t get is that most of these folks aren’t all that overweight, like 300 lbs or so. And after they become successful, they line out their routine, which consists of the proper types and amounts of exercise, and and appropriate type and amount of food (though in slightly smaller portions that what most weight training regimes require).
My thoughts on it are “but why don’t they do this BEFORE having the surgery”??? I am a fitness instructor, as well as being a bit too chunky myself, so I well understand about the emotional aspects of weight gain, and the difficulties involved in losing weight.
My opinion would be that anyone considering this should first try a certified trainer, who is experienced in helping the severely obese, before resorting to surgery.
I imagine the prospect of losing 150 lbs is rather daunting.
Heck - I’m sort of in the mood to lose 5 and I’m having trouble getting motivated. 150 and I think I’d wanna eat some mashed potatoes with butter just to get up the will to think about it.
And for the record, I’m thin and always have been. I’m always amazed when I hear stories about people who lost huge amounts of weight - either with surgery or without.
Secondly, the surgery isn’t a guarantee - as I mentioned in another thread, a former co-worker of mine was large, had the surgery and got small, then got VERY large (400 lbs +) and died of the complications. She was 33. I think the surgery is a very serious step for people in a very serious position. The fact that someone is considering it says to me that they’re getting desperate. “Diet and exercise and you’ll get thin!” seems overly simplistic, not to mention a bit insensitve and condescending.
Hi, {b]Canvas Shoes**. Try strapping on 150 lbs. of additional weights to your body and you’ll have a better idea of why we don’t go through the exercise routines.
I have a small frame. I am 5’3" and I weighed 300 lbs. That is morbidly obese. That much weight was literally a threat to my life. I could barely walk. I carried a cane with a seat attached everywhere I tried to walk. A trip across a department store would require that I stopped and sat down several times.
I had tried weigh loss through all of the usual ways. Once I had nothing but liquids for six months. I would have been very content to stay on liquids and continue the weight loss, which was substantial, but the doctor overseeing the program would not allow me to. Once I began refeeding, I could not control the compulsion to eat and I regained all of the weight and more. It was like asking an alcoholic to limit her drinking to three whiskies a day.
My doctor recommended the Roux-n-y procedure which was done in 1998. I lost 155 pounds in 8 or 9 months. There has been pain involved – usually when I forget and eat a little too much. The first time I did that, I thought I was having a heart attack. It was awful. It has never been that bad since. And it doesn’t happen much anymore.
When I weighed 145, I started to regain and after a couple of years I had regained 30 pounds. My doctor put me on a medication that controls compulsive behaviors and in the last few months I have lost 14 pounds without really trying. I’m just not hungry anymore and I have to remind myself to eat.
Two others that I have known have regained all of their weight. For me, the surgery coupled with the medication (topamax or topomax) has made the difference. The medication affects the brain chemistry. It was originally designed to help control seizures and weight loss was a side effect. It also helps to control mood swings.
Someone mentioned depression and surgery. I’m not a psychiatrist, but I would think that if you are using food to stuff your feelings, it would be better to unstuff those feelings and deal with them – perhaps with professional help. But again, maybe it is your body chemistry that is making you compulsively dependent upon food. There is still so much that is unnknown about the brain and why we relate to food as we do.
I have never regretted having the surgery. I eat anything I want. I just don’t want dry rice or dry chicken and I don’t want to eat a whole lot of anything. But I don’t feel cheated. I can just make it last longer.
Research the procedures available carefully and research your doctor carefully too. You want someone who has done this many, many times.
BTW, with the Roux-n-Y, you never have heartburn again. I didn’t find that out until a couple of years ago.
I had the lap-band done in May 2003 and I have lost about 130 pounds since then. I feel the lap-band is a great choice and not emphasized enough by most American surgeons.
Pros: Lap-band is not as risky surgically as the RNY gastric bypass. The risk of dying from the lap-band surgery is something like 1 in 10,000 compared to about 1 in 200 for the RNY. The band can be adjusted tighter or looser depending on how you’re losing weight, and of course it’s nice to have that kind of control. Since the intestines are not altered, you still absorb nutrients normally and don’t really have to take vitamin supplements like you do with the bypass.
The band doesn’t cause “dumping syndrome” so I basically eat whatever I want, just in smaller quantities.
Cons: There is a slower rate of weight loss with the band, and some people get discouraged by that. Some people consider dumping syndrome a way of “training” themselves to stay away from sweets. I find that when you feel stuffed to the gills from a small quantity of food, you’re not as inclined to eat junk food anyway, so I don’t feel dumping is necessary for success personally.
I have no regrets about having the surgery. Losing the weight has helped me feel a lot more normal and happy. I know I could not have lost this much weight without the surgery. It was such a big struggle before to stop eating. With the band, I can finally just listen to my body’s cues to avoid overeating.
If you want more info on the band from people who have firsthand experience with it, there is a nice support group at http://www.lapbandtalk.com that you can check out.
Good luck!
My dearest friend had the surgery last November. This was in San Diego, but I’m not sure of the specifics other than that it was some variety of bariatric weightloss surgery. So far it’s been an excellent thing for her. Mo and I are in our mid-40s and have been friends since kindergarden. She has been heavy as long as I’ve known her. She is a very tall (5’10") girl and, except for one period in her early twenties, when she lost down to 195 with the help of diet drugs, has weighed at least 250 lbs her entire adult life. At her height 250 lbs was not unmanageable – even at 300 lbs she was able to have a high quality life, with good health (other then controlled high blood pressure) and the ability to engage in activities (she was very active in square dancing, in particular) she enjoyed. However, at around age 36, she began the climb above 300. 350 lbs seems to be to point at which, for her, her weight began to effect her life. She started to have a number of weight-related health problems, had to stop dancing (although she was, for a time, able to continue with administrative posts in her square dancing clubs), and found it increasingly difficult to do day-to-day things. When she reached her all-time high of 385 lbs, she found a weight loss surgeon.
Her particular doctor required that she follow a strict diet and visit nutritionists and counselors for a year before the surgery was performed. Mo lost 80 lbs before the surgery and 95 more after it. She now weighs 210 – only 15 lbs above her all-time low!
She visited me here in Virginia for my 40th birthday when she was approaching her highest weight – it was heartbreaking. We couldn’t do anything. Even a half-day jaunt to the mall left her exhausted and in pain. She had to buy two airplane seats for the plane ride out. She couldn’t sleep flat in the guest-room bed, but had to sleep sitting up in a recliner. She visited again this summer – at 220 lbs – and the difference was astounding. Flying had been a stress to her for years – even before the days when she had to buy two seats – because she always felt bad for crowding the people to her sides. This trip, she bought one seat and didn’t ‘hang over’ it to the smallest degree. We ran around every day – to the mall, to museums, to Colonial WIlliamsburg – and had a great time. She slept well – and in a normal bed. The day she called me and told me she’d gone to a dance (wearing a square dance dress I made for her in 1995 and that she had to have her sister take the elastic in on all around) and danced every tip, I sat down and cried. This surgery has given her her life back. It has been beyond a blessing for her.
Side effects – certain things will make her throw up. This was commoner in the beginning, when she was learning what she has to avoid. Even now, she is cautious with ‘new’ things – she will only try something new at home, just in case. She misses soda – she had been a Big-Gulp-a-day girl, now she can’t tolerate it at all. And she lost a lot of hair. Apparently this isn’t an uncommon side effect – some people lose it all. Mo’s got very, VERY thin, but it’s recently stopped falling out and her doctors expect it to grow back in, although maybe grey or with a different texture than before. We’ll see about that. She will have to have some plastic surgery later to remove the excess skin on her abdomen. Her arms and legs bounced back really well, but she has at least 20 lbs worth of extra skin around the middle. Her doctor wants her to wait until 18 months post-op before plastic surgery, though.
Here’s a picture of us taken when she was here this summer. Doesn’t she look great?
This should be mandatory for ALL surgery candidates, IMHO, particularly in instances such as ultrafilter mentioned, where eating is a person’s only coping skill.
I have 3 friends who have had bariatric surgery. Friend #1 had the lapband procedure. She went to ONE nutritionist visit and that was it. No group, no extra counseling, nothing. Had the surgery, did not follow the prescribed diet b/c it was “too hard”. Not only has she not lost much weight, but she has had 6 additional surgeries for hernias. Mostly these are caused by repeated vomiting after overeating—not necessarily self-induced vomiting in the bulimic sense, but she continued to eat as though she had not had the surgery and her body would just reject the food.
Friend #2 had the Roux-n-Y surgery. She had an evaluation before the surgery, attended 6 months of nutritional counseling and group prior to the surgery, and continues with the group on an as-needed basis. She takes it all very seriously. Even though she had a similar history to Friend #1 in terms of disordered eating, she has successfully found other ways to deal with her feelings and has lost 175 pounds. More to the point, she has maintained that weight loss for over a year now.
Friend #3 just had the same surgery. She had a LOT of depression afterwards, but ahd family staying with her and friends vsiting her every day and dragging her out for walks and the like. She has lost 75 pounds so far and it looks as though she’ll continue.
I have a client who is interested in this surgery. I can’t possibly recommend it for her because she doesn’t seem willing to give up certain behaviors—i.e., drinking 6 liters of soda a day and not exercising at all. She somehow thinks she can change all that after the surgery, but it doesn’t work that way. Fortunately, I am not an eating disorder specialist and it’s really not up to me to recommend her or not—that’s for her team to decide, with my input.
My point? Do everything you can to change your behaviors and cognitions prior to the surgery and your rate of success is likely to increase. Making sure you have tons of support afterwards is key as well.
I had a gastric bypass (laparascopic RNY) in July 2003, so I’m almost 16 months post-op. I’m 5’1" and was 220 pounds. I was considered “morbidly obese”, but just barely. I made the decision to have surgery because I had other obesity-related health issues.
Like Zoe, I couldn’t go to a mall or department store and walk around for very long. A 20-minute trip to the mall would leave me in severe pain in the back, hips and knees. I also had gastric reflux and irritable bowel disease.
I had complications in the first 3 months. I was vomiting 10-15 times a day and couldn’t eat, which was because my stoma kept closing, so I had that dilated 3 times. I was re-hospitalized after 2 weeks for dehydration because of my stoma closing. I lost a lot of hair, but that has since grown back in.
I had lost 110 pounds, but I was still in the “honeymoom” period and I was too thin. I’ve gained a little bit back, so I’m now a healthy 130 pounds.
Since my honeymoon period is over and I’m able to eat just about anything I want, I have to make better choices. I still have issues with food that have cropped back up, so I’m thinking of seeing a therapist to deal with it.
The only thing I don’t eat is steak, but that’s because I had a bad episode with it about 6 months ago and I’m afraid to try it again. I’m able to eat carbs and need to work on limiting them. I can eat sugar, but in very limited quantities.
A word of caution about the sugar-free products: watch out for the sugar alcohol content. It can give you serious gas. It took me awhile to figure it out, but once I cut back on sugar alcohol (like switching my sugarfree protein bar to a regular one), the painful gas went away. I can have about 15-18 grams of sugar before having the dumping syndrome, which as kittenblue described, is not pleasant! In addition to the symptoms she listed, the first one I always feel is my heart racing and I break into a cold sweat.
What makes you assume we haven’t tried everything possible to lose weight? In my case, even though I was overweight, I worked out. Until I hurt my back, that is. In fact, at one point, I was on Weight Watchers, Phen-fen and worked out 5 days a week and still was unable to lose more than 15 pounds in 5 months. When I hurt my back, working out was impossible, so everything just snowballed at that point and I gained more weight.
Please don’t assume that everyone who makes the decision to have surgery hasn’t already tried other ways. Plus, it was 10 months from the time I decided to look into the surgery to actually having the surgery. There are many things that my surgeon required of me before we set a date:
- A visit and recommendation from a psychiatrist
- See a nutritionist for several appointments
- Upper GI, EKG, electrocardiogram, colonoscopy (because of my IBD)
- Clearance from my gastroenterologist
- Lose 15 pounds
- Go to support group meetings and speak with at least 3 other WLS patients
- Start a walking program (very difficult for me, but I tried)
Despite complications in the beginning, which were shear HELL, I would do it again in a heartbeat. I feel so much better and I’m much more active and healthy. The only advice I can recommend is: Remember that it’s just a tool and you still have to do the work. I couldn’t even stand that thought of carbs for the first 6 months or so, but the cravings came back, so don’t think you’re out of the woods for a second or weight gain will happen. Just because it’s easy to lose weight for the first year, take care of any “food issues” BEFORE you stop losing weight. Now that I have cravings for “bad” foods again, I’ve noticed that I my mindset is creeping back to where it was before I had surgery. I’ve got to be more careful now.
My opinion on bariatric surgery:
Do as you please, have the surgery or don’t have the surgery, but please, oh please do not regale your co-workers with every friggin’ detail of the process, including whatever reconstruction you have afterwards. We are happy for you, but we do not want to hear the details. Thanks.
I posted a while ago about my coworker who is extremely overweight but in fine health otherwise. She was ecstatic to be okayed for the surgery, she said, and she had been fighting the insurance company for a year because they didn’t think it was necessary. She didn’t have any health issues (according to her) aside from the weight.
She made no changes to her diet before the surgery, which was on October 7 or 8. She sat in her chair in the next office and ate candy and drank pop pretty much all day. She isn’t going to return to work on November 8, so I can’t address how she’s doing, but I really wonder if it will be possible for her to succeed.
IMHO, it’s possible for her to succeed, just not likely. What might happen is that the initial weight loss will really motivate her to do what she’s supposed to do. OTOH, maybe not so much. I have the same reservations with my husband’s best friend. His friend had the procedure about eight weeks ago; he’s lost about 40 pounds since then. But prior to the procedure, he never did anything preparatory that his doctor told him to. I think chances are slim (heh) that he’s going to start following the rules now.
I should have mentioned beforee – I do think that Mo’s long preperation has made her continued success more probable. The girlfriend of my brother-in-law has also recently had the surgery and I don’t feel anywhere near as positive about her chances. I spoke with her about the procedure and Mo’s experiences at length when we were in Wisconsin this summer and I can’t begin to stress the different approach to the surgery that this woman has. First of all, her doctor did not require the pre-surgery counseling and dieting that Mo’s did. I saw her just a few weeks before her surgery was scheduled and she was pounding down beers and shoveling in BBQ with no apparent concern. Also, she didn’t seem nearly at the life-or-death point that Mo was at pre-surgery. This woman has only about 75 lbs to lose – I wouldn’t consider her morbidly obese by any means. Evidently her doctor suggested the surgery as a way to deal with some non-weight related digestion problems? Which brings me to my third area of concern – she is not a bright woman. Mo did massive amounts of research about the surgery, it’s possible side effects, the best way for her to eat in the future, on and on… This woman wasn’t even capable of articulating how the doctor expected the procedure to help her digestive problems. And this wasn’t a case of her not wanting to share personal medical details with a near-stranger, either. She brought the subject up and, when I tried to continue the discussion wasn’t able to give me even a broad explanation of the doctor’s intent. I can’t imagine planning a major surgery for myself, or any member of my family with such a pitiful grasp of the need for the surgery. I don’t feel very positive about her chances for success – especially since she is, IMO, at least a trouble drinker if not an actual alcoholic.
Jess you sound like a wonderful friend. You could hear the pride in your friend’s “getting he life back” come through loud and clear. And the pic is great, the identical hair color was a neat surprise!
A friend of mine has had the Roux en Y surgery and had great success. She is quick to say that the surgery was a tool for her and not the whole reason for her success. As soon as she was cleared to do so she began to work with a personal trainer who has guided her throughout her weight loss. The key is that now she can exercise as instructed, whereas before there were huge gaps between what she wanted to do and what she was physically capable of doing.
vunderbob, if there is a well regarded bariatric practice convenient to you, you might consider going for an evaluation. If they are worthwhile they will focus on educating you and helping you decide what is right for you. Then you decide. It’s their job to do the front work with you.
Good luck!
Don’t judge too harshly her pre-op behavior. Between the time of my pre-surgery testing and weigh-in and the actual surgery (I think this was a few weeks) all I was required to do was not gain any weight. I had many “last meals” of things I knew I would be giving up after surgery, and I’ve given them up with no problem…including caffeine and pop. Then two days before surgery I had to have only clear liquids, along with laxatives, etc to empty the bowel. But I wasn’t going to quit eating favorite foods before I had to! I just didn’t pig out, because I didn’t want to gain.
Yes, I know, I KNOW. I understand that it’s hard to lose weight with any method that one chooses to lose it. As I said, I’m not saying that there isn’t emotional baggage to go along with the weight, nor am I saying that it’s easy either way.
My question/problem with it is that the people who have it end up doing EXACTLY what would have gotten them the weight loss without surgery. So, if you have to do the same thing after surgery in order to lose the weight, why not do that without the surgery? Sorry, the OP didn’t say what she’d tried prior to surgery.
Trust me, anyone who’s seen me in some of the “fat threads” will know that the phrase “eat less, exercise more” is one I consider the MOST ineffective enemy of overweight people ever.
I trounce this stupid myth thoroughly in my PE classes. And provide much better information about how it all really DOES work re: muscles, BMR, LBM, how to burn fat, how to get fit etc.
And I am not against the surgery, I just wonder at the reasons someone who is still able to be relatively active (around the 300 or so mark) choosing something as serious and potentially deadly as surgery, when the things they’ll be required to do after surgery (small frequent meals, weight and resistance training, proper type and intensity of cardio) will work without resorting to surgery.
Sorry, I didn’t mean to be so unclear in the first post. :o
Actually, the doctor approached both of us independently with the idea. I have no doubts that I could make it work for myself. My concern is my wife, who refuses to do anything for herself, and actively tries to sabotage my diets and exercise.
I’m big, but I’m not to the point that it’s bogging me down. I do long bike rides, distance swim, etc. No problems walking long distances. I try to eat the right stuff, and not to excess (not alway successful, however)
My wife, however, outweighs me considerably and has to use a scooter, eats the wrong stuff almost continuously, and revels in her near-invalid health status. It’s a major shock to me when she even vacuums the floor.
I was unaware of the diet restrictions afterwards, other than having to eat to lose weight and then eat to maintain. The sugar restriction would not bother me, but would be major for her. One other concern I have is that there’s a long history of cancer in my family, and I’m bugged by the idea of having a reduced stomach or shortened intestine just when I’d need them the most.
Wow. That’s a huge issue, and I dare say one that will need to be addressed before you even consider having the procedure. I seem to recall from an earlier thread you started about your marriage that your wife is unwilling to go to marriage counseling. If that’s still true, talk to the doctor who suggested the surgery about finding a good counselor for yourself. You can’t change your wife (of course I’m sure you already knew that), but you may be able to clarify your own goals and desires, and work on some strategies for coping.
Best of luck, and keep us posted!