Sunday, July 19, 2009

If it doesn't work the first time, get cut again

When people talk about Weight loss surgery, they never talk about the long term outcome. Or if they do, it's vague.

Long term patients (over 10 years which isn't that long term) tend to be slimmer. What they don't say is studies have found most still are very obese and some with a BMI over 40.

And one study found that 34 percent of gastric bypass patients who start in at BMI 50 or over, regain all or most of the weight within 10 years of surgery. (Annals of Surgery. 244(5):734-740, November 2006. Christou, Nicolas V. MD, PhD; Look, Didier MD; MacLean, Lloyd D. MD, PhD)

A bit different picture from the slim enthusiastic new ops who are paraded at the seminars or on TV's shows like "BIG MEDICINE".

And what is the solution that medicine offers? Get cut again.

Shorten the bowel so virtually nothing is absorbed. Well that works except everyone I know who's had that one is a rather sick person. As a favorite surgeon says "fat and healthy trumps thin and sick anytime".

Or pleat the stomach from the inside. That is painful, destroys the lining of the stomach, doesn't hold in place for over a year and hasn't really worked for anyone I know.

Or get rid of more of your stomach (a popular one for those who have had duodenal switch). What? People regain with DS/BPD's? Oh yes, big time.

Does it work? Maybe. Hard to tell because generally the regainers are made to feel ashamed and fade into the background.

I actually know several people who have had multiple weight loss surgeries and still are seeking more procedures! Some of these folks have had 7 surgeries after the original WLS.

I also know several folks who have had "revisions" (that's what the surgeries following the original weight loss surgeries are called) who are pretty sick.

A surgeon friend of mine says "success with weight loss surgery is 10 percent the surgery, 90 percent the patient".

How many people I wonder, actually have this surgery with the idea that they will have to work just as hard as someone on any other diet, to keep the weight off i.e. diet, count calories, measure and exercise in addition to getting blood work and dealing with the repercussions of a digestive tract which doesn't work the way it used to because it's been all rearranged inside.

Not many. I suspect most who have the surgery, have a dream in mind, fueled by the TV and the new ops they have met - a dream which has little resemblance to the reality, a dream where all the weight just falls off and then the person is "normal". But dreams are dreams and reality is reality.

Isn't it better to find out about reality before you get your body changed forever?


purplegirl said...

It's sad to think how many people go off half-cocked and get their insides totally re-arranged. If my father had his way, I think he'd have it done to me--not because he's uncaring, but because he believes my fatz, they kill me, and also because he believes the media reports about WLS being a magic cure.

wriggles said...

"success with weight loss surgery is 10 percent the surgery, 90 percent the patient".

Unless I've misconstrued the meaning of this statement, I'm surprised.

I would have thought it would be the other way around, that it depends very much if the bodyshock of WLS, continues long-term. Or the body's sometimes extraordinary powers of recovery will precede the usual swing back, or rebound.

Above the sadness of all this, it makes me admire even more the extraordinary design of-amongst other things- the human body.

If we started from that, we wouldn't be treating it this way.

Janet C. Fish said...

And the insanity continues........

I really wonder about the doctors who do WLS, but even moreso about ones who would do repeated ones.

the other thing I wonder about is why other doctors remain silent about it.

Sue Joan said...

Janet, here is Paul Ernsberger's opinion about the silence:

"In my experience, most physicians, especially academic physicians, disapprove of these operations. However, they will only admit this in private, because of an unwritten law in medicine that forbids one to speak ill of another's procedure. Thus, there is no one with an MD after their name who will appear on camera and criticize the operation."

Paul Ernsberger, PhD, Department of Nutrition,
Case Western Reserve School of Medicine, 10900 Euclid Ave., Cleveland, OH 44106-4906

Unknown said...

I also think that WLS makes a lot of people a lot of money.

I had Lap-Band surgery in 2004. It is true that WLS is 10% surgery and 90% patient. I am up from my lowest weight, but still lower than my highest. If I wanted to get back to my lowest weight or lower, I would have to DIET. That is not something I am willing to do anymore.

I had myself surgically altered and I am still morbidly obese. This amazes me. I still get to hear doctors tell me I need to lose weight. When I say I had lap-band surgery they kind of shake it off and say well you have to get back to losing weight.

To the best of my knowledge nothing works to achieve permanent weight loss for the majority of people.