Obesity surgery (ottoluv)

I think it's a good procedure if the benefits outweigh the risks involved. If the people understand that like any other NON surgical means for massive weightloss...not just a quick fix but a commitment to a new lifestyle.

They WILL have a reduced capacity to eat afterwards yes? And eating and eating would cause harm when one has the procedure? Just want to make sure I have a clear understanding of it.

I also have seen some TV shows about it and there's a lot of extra skin afterwards? That can lead to further surgery if the patient isn't happy with that....so that's maybe something that worries folks thinking about it...sure I will be thinner...but what if I STILL look odd?

rwbeagles

I think it's a good procedure if the benefits outweigh the risks involved. If the people understand that like any other NON surgical means for massive weightloss...not just a quick fix but a commitment to a new lifestyle.

They WILL have a reduced capacity to eat afterwards yes? And eating and eating would cause harm when one has the procedure? Just want to make sure I have a clear understanding of it.

I also have seen some TV shows about it and there's a lot of extra skin afterwards? That can lead to further surgery if the patient isn't happy with that....so that's maybe something that worries folks thinking about it...sure I will be thinner...but what if I STILL look odd?

I'm probably the type of person you guys hate - I learn about this stuff watching TV specials!  My understanding is that it can be dangerous for morbidly obese people to have the surgery because you have to cut through so much more tissue, thus more surface area exposed to possible infection, and also because those people typically have other health problems that can cause complications with ANY surgery.  Is that correct?  I also agree with Gina that I've always seen it as "not just a quick fix but a commitment to a new lifestyle."  On the shows I watch, the people have to prove that they can control their eating and deal with any emotional/psychological issues before they are approved.  I don't have any negative assumptions of them based on that and I think those are wise requirements.

Liesje

I'm probably the type of person you guys hate - I learn about this stuff watching TV specials!  My understanding is that it can be dangerous for morbidly obese people to have the surgery because you have to cut through so much more tissue, thus more surface area exposed to possible infection, and also because those people typically have other health problems that can cause complications with ANY surgery.  Is that correct?  I also agree with Gina that I've always seen it as "not just a quick fix but a commitment to a new lifestyle."  On the shows I watch, the people have to prove that they can control their eating and deal with any emotional/psychological issues before they are approved.  I don't have any negative assumptions of them based on that and I think those are wise requirements.

 I've only known one person who had a gastric bypass, and for her it was a huge success.  She is now starting a new life with a new husband and a new career as a teacher.  It not only solved the medical problems, but the personal and financial problems.  The burden on society and insurance companies have been lightened, and a life has been saved.  So yes, insurance should cover it.

However, if there is medication coming on the market, I would prefer giving that a try before surgery. 

I have 1 friend that is morbidly obese, one friend's sister is, and my MIL is.  Of these 3, I would wager to guess that 2 of them are very aware that something needs to be done.  My friend's sister is attempting to get surgery, I'm not sure which one, but one of the ones you listed.  She has had some other recent complications with her health that have pushed back her surgery though.  MIL has knee problems and cannot have them operated on until she loses some weight either.  She was doing very well, but seems to have fallen off the wagon.  She tells me about the foods that she is eating, and while they sound like good foods, nobody needs 16 oranges a week for snacks.  Sure oranges are good for you, but they still contain calories.  That is just an example.  But she clearly does not have the control that other people have.  She tries to eat good foods, but the excess is killing her.  Still, at least she knows she has a problem.  

The third on my list is my friend.  She is grossly overweight, but she refers to herself as just big.  I tend not to argue with her as I am her friend and not her doctor.  And frankly I feel that it is her doctors job to tell her.  And I don't mean, that if someone has to tell her, it should be her doc.  I mean that her Doctor NEEDS to tell her.  And to heck with it if she takes offense.  It does effect her health.  She misses a ton of work and school because of it.  She's almost always too sore to do something like going for coffee.  And forget walking around the mall.  Even walking from the bus stop to my house is too much for her, so her parents drive her everywhere.  She has accepted the fact that she's 'Big', as 'Thats just the way she is.'  But the idea of what is to come for her, is devastating to me.

Now, I don't believe that the surgery is for everyone.  Kelly, what are the requirements for the surgery?  Are there psych tests to see if you qualify?  Obviously, its not something to be entered into lightly.  But perhaps some sort of intervention group of success story patients could help. 

mostly what i know is based off of heresay.

 it seems to me (after watching al roker on the today show) that the surgery isnt a "cure" for obesity. he isnt as fat as before, but he is much more plump than shortly after his surgery. that seems like a huge risk without having a lasting impact.

 
if given a choice, i might choose the lap band over the gastric bypass. it seems like the safer choice. however, i know some insurance companies wont cover the lap band. one of my wife's co-workers just had a gastric bypass. she wanted the other one, but the insurance would not cover it.

i do know that this particular lady had to go through psychiatric counselling before and after the surgery. is that the norm?
 

huskymom

  Kelly, what are the requirements for the surgery?  Are there psych tests to see if you qualify?  Obviously, its not something to be entered into lightly.  But perhaps some sort of intervention group of success story patients could help. 

I know some people here are "weight sensitive" so, rather than risk offending anyone, I will respond elsewhere.  But, I think I can tell you exactly why so many people have a "negative connotation" WRT this surgery.

ottoluv

There are actually lots of support groups all over los angeles I just learned in clinic last week. One of the most popular is in oxnard.

My hometown

Kelly - I'm going to sound a little hypocritical here, but if I were extremely overweight, I'd be first in line for this procedure. I was overweight in my preteens and it was humiliating and I felt physically and mentally miserable. I'm obsessive about my weight now and can't imagine what life must be like for someone with a BMI of 35 or 40.  Now, having said all that, I'm also somewhat of a skeptic at times and think to myself "have they really tried to lose the weight?"  I love to watch The Biggest Loser and find is truly inspirational and motivating. If they can do it...why can't anyone who tries?  As you can tell, I have very mixed emotions. As far as it being a safe procedure, I'd have total confidence it and I think that insurance companies should pay for it if the patient meets all the criteria, such as your hospital uses.

Question - in terms of the genetic factor (not feeling full), why is it that obesity is higher and more common than before?  Why is the U.S. also the highest ranked in terms of obesity?  I'm not disputing you but I'm curious about the scientific aspect of this.

I don't think people necessarily think of the procedure negatively, but there certainly is a lot of negativity thrown at people who are obese. There is a general attitude that obesity is self inflicted and if one would just stop eating they wouldn't be fat. Is that true in your opinion or is there something particular about the procedure itself? 

I actually know a man who had the procedure done about 6 years ago. He was not a very tall man and weighed in at close to 400lbs. He lost an amazing amount of weight very quickly. In less than a year he was down to 185. Along with the rapid weight lose he also had a personality change that caused him to have violent rages and just crazy behaviour all around. Much of which he now has no recollection. He also had a lot of physical complications. My cousin (his SO) ended up leaving him as he was totally unbearable to her and their kids. She knew something was not right but could not convince him or his doctors. He just kept losing and losing. After 2, 2.5 years (I forget now)  he had to have the procedure reversed. He was literally starving to death.  He gained back all his weight +. Then this summer he went and had the same procedure. The weight gain has been much slower and mentally he seems fine. We all have are fingers crossed! Interestingly my cousin told me at the time, part of the "package" was that he was suppose to go to for counseling. Which he never did. Is that a requirement for your patients?

cakana

ottoluv

There are actually lots of support groups all over los angeles I just learned in clinic last week. One of the most popular is in oxnard.

My hometown

Kelly - I'm going to sound a little hypocritical here, but if I were extremely overweight, I'd be first in line for this procedure. I was overweight in my preteens and it was humiliating and I felt physically and mentally miserable. I'm obsessive about my weight now and can't imagine what life must be like for someone with a BMI of 35 or 40.  Now, having said all that, I'm also somewhat of a skeptic at times and think to myself "have they really tried to lose the weight?"  I love to watch The Biggest Loser and find is truly inspirational and motivating. If they can do it...why can't anyone who tries?  As you can tell, I have very mixed emotions. As far as it being a safe procedure, I'd have total confidence it and I think that insurance companies should pay for it if the patient meets all the criteria, such as your hospital uses.

Question - in terms of the genetic factor (not feeling full), why is it that obesity is higher and more common than before?  Why is the U.S. also the highest ranked in terms of obesity?  I'm not disputing you but I'm curious about the scientific aspect of this.

ottoluv

Those shows like biggest looser are cool, but those people don't have sustainable weight loss. Even with the best medically spervised weight loss you have about >90% people regain.

Those statistics have to seem very daunting to someone fighting the battle to lose. No one in my family had/has a weight problem, so I believe I was genetically lucky and I really am grateful for that.  As I said, I'd be first in line, so I'm happy that there are options available for people who want them.

I've thought about gastric bypass/banding, but I have just never been able to make a decision on it.

I was a skinny, active kid until I was about 8. Then, one summer, I just ballooned. I went from being one of the most popular kids with tons of friends to a social outcast because suddenly I was fat. No one really knew what happened. My family on my mom's side was really active and healthy, but people on my dad's side tended to be overweight, and my great grandmother was a MASSIVE woman. Apparently I got her genes. I've been fat since.

As a teenager, I really didn't exercise and I ate a lot- one of those emotional eating/vicious cycle things- I got picked on for being fat, I got depressed and ate, making me fatter. Now, at age 20, I am 5'5" and weigh almost 300 pounds. Pics of how big I am are on my Myspace (www.myspace.com/alexandri) and unless something major happens, I'm just going to get bigger. I have Polycystic Ovarian Syndrome and am borderline diabetic. Diabetes, strokes, cancer, and high blood pressure run in my family. If I don't lose weight, I'm going to be dead by the time I'm 50. I fully understand how big the problem is.

I AM very active and I'm REALLY strong- I run our small farm entirely by myself and that involves hauling buckets of water, bales of hay, 100 pound bags of grain, wrestling large animals, hauling other heavy things, etc- EVERY day, and I have no one to help me. I don't sit around like a big fat lump and eat bon bons all day- if I don't go out and do it it doesn't get done. I thought for sure once I moved out here and started working my butt off I'd lose weight. It's been almost 6 months and I haven't lost a pound. I've gained some muscle and have way more stamina than I used to, but I'm the same size I've always been.

Diet is an issue for me- I know HOW to eat healthy, I really do- my mother pretty much cured her diabetes through diet and exercise and she taught me everything she knows about nutrition. My diet isn't the best, but I don't eat Big Macs and Baconators all day either. I don't feel like I eat an abnormal amount of food, but I must, or I wouldn't be this size.

I've been thinking about gastric banding especially for a few years now...but honestly I don't know how to bring it up with my doctor. I don't want to come across as this big lazy fat person who just wants an "easy way out," and I've always been afraid that the doctor would just immediately dismiss me and just tell me to exercise more and stop eating crap food. I need to do those things, for sure, and I understand that gastric bypass means a lifestyle change- but again, I'm just not sure how to bring it up without my doctor immediately dismissing me. Do you have any suggestions on how to mention it without coming across as someone who is just too lazy to exercise?

Also, does it really mean that you can only eat a tablespoon or two of food at a time? In your experience, how do patients cope with that? I used to think it wasn't worth it if you could hardly eat for the rest of your life, but now I'm realizing that the alternative is being fat forever- which is absolutely my vision of hell. If you've never been overweight, you can't possibly imagine how much of a non-person you become to other people...especially if you're a woman. It would be nice to live as a normal person, for once in my life. You can't imagine how much being this overweight takes your life away.