Saturday, January 02, 2016
Weight Loss surgery and dieting
I have heard many folks sign up for weight loss surgery because they feel they will "never have to diet again". The next step is they go to a "seminar" held by the surgeon they are thinking of hiring. But the seminars are really mostly selling sessions for the surgery (I can only think of one surgeon who actually gives very informed consent seminars, detailing risks as well as benefits - this does not cut the number of people who go to him - on the contrary, they appreciate the info!).
Today, I met a lady who had had a gastric bypass in Oct 2015 and had recently attended a weight loss group meeting. (and keep in mind, most surgeons are doing the less invasive sleeve now). She had lost 80 lbs but lamented that no one had noticed her weight loss. "But I lost it fast," she added. That prompted me to ask her how and that's when she said she'd had a gastric bypass. I explained that a fast weight loss like that was mostly muscle and that's why it didn't show a lot of reduction in size. She looked sad and said that she knew that. She was NOT told that surgery would not take off that much fat and she'd have to diet to do that - and she'd already been back to the hospital because she had developed ulcers after surgery and couldn't keep anything down so had needed more surgery. I can't help wondering if, had this lady been informed of the risks, she might have gone a different route.
But the sad thing was she really didn't lose much fat with the surgery despite her inability to eat much and ended up joining the weight loss group, even - with having had the surgery.
I gave her my web site and also, some of the informed consent info she should have had before surgery. "The advantage of a gastric bypass", I concluded, "is, it is reversible and you should probably consider having it reversed." She told me her surgeon had told her only the sleeve was reversible (it's not reversible, because they cut off most of your stomach and throw it in the garbage i.e. "send it to pathology" as the surgeons call it). I said, "no, it's the opposite - the gastric bypass is reversible" and I told her how they reversed it., explaining that a reversal would still provide her with some restriction but give her normal digestion back. Hopefully she will consider having it reversed. I told her she might have to go to another surgeon to have this done.
Some surgeons send pre ops to my website to obtain informed consent information but obviously this lady's surgeon had neither given her informed consent info nor did he send her to my website. Because the 80 lbs she lost was mostly muscle, she still was very overweight.
The bottom line with surgery is, it really, isn't that effective for weight loss. This lady told me she thought it would kill her appetite but it hadn't done this and I explained that this is because they now know, the appetite control center is in the brain, not the stomach (as formerly thought in the 1960's when these surgeries were first conceived of).
As for the gastric bypass, it's very effective at greatly diminishing the ability to digest proteins and fats (and yes, we do need some fats) which is why most surgeons have switched to the sleeve which, albeit invasive, is much less invasive than the older surgeries.
Another interesting thing - when I told this lady who had had the gastric bypass that I knew several 300 lbs gastric bypass patients, she looked shocked - she didn't know that so many had regained the weight, although she was already having trouble with this.
All I can do here is *sigh*. How I wish everyone would have the informed consent information that they need to really make the best decision for them. Informed consent after the fact, can be bitter but this lady had several friends, also of size and I'm sure my information helped them in case they were considering surgery.... (the photo is of my friend who died in 2006 from the aftermath of the weight loss surgery she'd had in the 1990's. - she spent her last days, before her untimely death, warning folks to not have weight loss surgery.)