Obesity surgery (ottoluv)

I come from an overweight family.  My mom and Dad are both larger...not morbidly obese, but there's a lot of extra fluff there.  I grew up a very solid girl and when I stopped exercising, sports, etc. when I got to college I got fat.  Flat out fat.  I did Weight Watchers, Medical Weight Loss, etc.  I always lost the weight and I always gained it back.  5 years ago DH and I decided enough was enough and we started a new way of eating and moving.  We lost all of our weight (80+ for me) and we haven't put it back on...well, I still have 10 lbs of baby weight left. 

rwbeagles

are told "clean your plate"...boys are rewarded for having HEALTHY appetites

Gina - this is exactly what I was always told, and I catch myself doing it now, even with Riley.  Here, just take the last spoonful...etc, etc.  Not good, I am catching myself and not doing it.  I caught my mom trying to give her the last spoonful over Thanksgiving when she clearly was not hungry, and told her to think about what she was doing and how it is wrong.  This isn't the depression, we don't have to wait in line for food, we don't have to finish what we don't want....wasteful or not.

Now regarding the surgery, I feel if possible the patient must go through a weight loss management and exercise program first in order to be elidgible for insurance covered surgery.  I also realize that when a person weighs 500 lbs it's not like they can just start an aerobic class, etc.  but they need to try something where calories burned is less than calories taken in.  If they aren't having any success, then turn to the surgery.  Also, sometimes it is necessary that a change has to happen NOW and they can't wait the x years to lose the weight etc.  I know for me personally when I was overweight it was because I was lazy and didn't want to exercise and ate like garbage.  I have had friends that don't eat "anything" but can't lose weight, yet somehow Big Mac's don't count, they just aren't truthful with themselves.  I would never look down on someone for having the surgery, I honestly would feel bad that they had to go to this extreme to lose the weight.

Oddly, where I see the most obese folks are in the health care field.  I've spent an awful lot of time in hospitals, doctors offices, nursing homes and assited living facilities that past year and a half, and it strikes me as odd how many folks who work in health care, don't take care of their own bodies.  I'm not talking about folks who are a little over weight, who could stand to loose 15-20 lbs, but those that don't fit into a standard sized chair.

I grew up in the "a fat baby is a healthy baby" era.  So all those fat cells got created and I haven't found a way to kill them off.  During my first marriage, I was not allowed to weigh more than 102 lbs.  I'm 5'4" or 5'5" depending on who does the measuring.  At 102 I was "fat and lazy" and had to spend extra time every day working out.  Consequently, when I got pregnant and the doctor told me what and how I was supposed to eat, well, I packed on 68 lbs for a 5 1/2 lb baby!  My second son I think I gained 23 lbs, but when all was said and done, I decided that I looked better and healthier at around 120 and refused to fight my body any longer to get to someone ELSES goal weight.  I dumped the jerk too.

When I first got hurt, I was right around where I wanted to be weight wise, despite being older and the metabolism changes that come with that.  However, more and more of my physical activities got taken away, and the pounds packed on until I was close to 200 lbs.  Nothing worked.   And I wasn't heavy enough for a surgery, nor did I want to put on MORE weight to qualify.  I am still not certain what happened but I suddenly started dropping weight and looking and feeling healthy again.  I'd like to loose another 20 lbs, some day, but I'm not going to do as my sister does and run 20 miles per day and eat like a rabbit to do it.  She LIKES being a size 2....I think she looks less than healthy.

Because of that experience, when I'd never really had to worry about my weight....when if I put on a few lbs I just got more active for a couple weeks and it was gone.....and suddenly NOT being able to shed a single pound, I certainly can feel for folks who can't seem to make the pounds go away.  And yeah, if surgery is an option for them, I'm all for it.  BUT, I agree that they need counseling so that they fully understand that this isn't some sort of magic.  It's going to take a life long commitment to changing their life style.

I'll spare everyone my commentary on why we've become such an overweight nation......

Fat and lazy do not go hand in hand.  All fat people aren't lazy, anymore than all lazy people are fat.  My youngest son loves nothing more than to sit around all day and do nothing and he can't KEEP a pound on.

I do think that a lot of this is genetic, but there is also the "in the house" factor, and the way we grew up.  Yet, my sister didn't want to be a little heavy.  She wanted to be a size 2 and she is.  But she works HARD to keep her genes at bay.......I haven't forgotten what she used to look like.

Having been a whole lot heavier than I ever expected to be in my lifetime, I have extreme compassion for those "fat lazy slobs" and I'm all for anything that can help them look and feel better.

 My thoughts mirrored those of chelsea.  My mom has been overweight for years, since after my sister was born.  It's not because she has a genetic problem, she just snacks all day and doesn't exercise much.  Her and my dad began walking after my dad's blood pressure was found to be high.  He has lost a lot of weight and kept it off because he walks on breaks at work.  My mom?  She still snacks all day and does not exercise.  However, on the flip side, a couple of my aunts and uncles began gaining weight and it was a thyroid issue.  Once they went on thyroid medication, the weight came back off.

I feel like I am always hungry.  Always.  BUT I know that I can have a snack at 10am to keep my blood sugar up and then have a sensible lunch.  I only bring to work what I plan to eat and don't keep snacks or candy around because I'll eat it.  I then also have a snack mid afternoon because I'm hungry again.  But the snacks are relatively healthy.  Well, except for my one can of soda, but the All-bran bars are about 100 calories apiece and I bring fruit for the morning.  Lunch is a Healthy Choice microwave meal at about 300 calories.  Where I fail is dinner.    Last night was coney dogs with green beans.  The night before was a half a can of refried beans as a mexican dip.     Tonight we're doing smoked sausage, corn and a baked potato.  Another BUT is that instead of eating the two coney dogs I made, I only ate one because I was "full".  I have learned to not stuff myself over the years.  Even at Thanksgiving.  I take small spoonfuls of what I want and don't go back for seconds.  By the time I'm done eating what's on my plate, my stomach has sent messages saying it's full.  Perhaps people would be better off to get home and eat an apple while making dinner and then perhaps the feeling hungry would be less?

So I too have felt it's been an "easy" way out for overweight people.  But I dont' know many people that are really obese except those I run into occasionally at restaurants.  On family, two adult woman and 2 kids.  Both women were obese and the kids were plump.  They ordered nachos and who knows what else while we were there.  (Mexican restaurant)  My favorite there is the Chimichanga but I rarely eat all the refried beans.  I usually eat the whole Chimichanga and the rice but leave the beans.  So even restaurants don't help in this.

If I go to Scotty's (pub) and order a hamburger, why can't you give me a 1/4 pound burger with a smaller bun?  I frequently either cut it in half or take off the bun and eat it without all those carbs.  Mostly so I can eat all the waffle frys I want, but even those I leave some on my plate.

The problem with eating out is that the serving sizes are HUGE!  No one needs that much food in one sitting.

I'm glad that it works for some people, but I agree, if they can do the lifestyle change AFTER, why can't they do it before? 

 I just have to interrupt with this picture...this poor baby is in for a lifetime of problems...if he makes it to adulthood.    

http://tinyurl.com/2cmajk

inne

Surgery is seen as lazy, the easy way out, an incorrect choice that obese people are undeserving of because in general obese people are seen and treated as lacking self-determination and bodily integrity.   That stigma is extremely hard to work through.

I can only speak from my experience, but in my experience, from the people I know...the stigma is spot-on. The overweight people I know ARE lazy (including me!). They are always looking for an easy way out of their fatness. They don't want to put in the effort to lose the weight and keep it off. They sit down and eat 4 hot dogs with cheese and mayo and a huge french fry, plus down a 40 oz soda (okay, so maybe that's an exaggeration, but it's close). In the case of the people *I* know (not everyone..I'm just speaking from personal experience), the stereotype of overweight and obese people as lazy is well-deserved.

To stay overweight, most people have to basically get out of bed and choose to be fat every day. I don't know why anyone does, I don't know why I do. Why does my desire for cookies override my desire to be healthy? I do want to be healthy and thinner, badly, but I want that cookie more right that minute. It's really ridiculous.

Oh yeah...obviously people can have very different metabolisms. I'm one of four girls, and three of us have pretty much always been overweight, while one of us really never has. We grew up eating the same foods, doing pretty much the same amount of exercise..and yet we've all always been different sizes. Clearly there's some genetic/metabolic difference, but the point is, we fat ones need to ADJUST our lifestyles for our metabolisms. We CAN'T eat the same foods and move the same amount as someone with a faster metabolism.

Well, I have to say, obesity definitely runs in my family (not just immediate).  I have to say though, being the youngest of 4, the one thing I must have gotten is metabolism.  Thank goodness, too.  My sister just had the gastric bypass surgery and she's looking better and better everytime I see her.  She had the diabetes, and the sleep apnea.  I think this was the best thing that she could have done for herself.  I actually had mentioned it to her, don't know if she was offended, probably, but when a cousin of ours came into town and her mother was obese, she was getting there, her brother (my cousin) only a yr. or two older than me (I'm 42) died (I want to say 2 yrs. ago now), from heart disease, because he weighed about 600lbs.  He had always been overweight, lost it on diet and exercise, but because he didn't get support from wife and family, I believe this to be the absolute truth, he ended up gaining it all back and then some.  It was sad!  My other sister is overweight, not as bad as the one who had the surgery, but she better watch 'cause she's getting there.  My mom and dad are both overweight, but neither one of them were as big as my sister who had the surgery.  I don't know if I would call it a disease, since people in my family were able to lose the weight thru diet and other programs, but more of mental thing, maybe it would fall under depression.  I on the other hand am the skinniest of my entire family (and not just immediate), so I'm the lucky one.  I look back at how they all used to tease me about how skinny I was (am), and how bad they used to make me feel, but yet look at me now!  I'm right on the chart with my height and weight, I'm average.

I think the surgeries are a good thing, but then again, when you're realizing your getting too heavy, I think you should start doing something about it before it gets to that point where the only option is surgery! 

I wasn't lazy.  But I wasn't allowed to do much other than STROLL.  Couldn't even walk quickly without causing extreme pain.  I tried everything, including a physcian supervised diet plan with a support group.  Physical ailments, injuries, etc, can cause folks to be unable to get the proper amount of exercise.  And believe me, I didn't eat cookies or junk food.

Interestingly, Oprah has a show on about this very topic right now.  It seems many folks who have the surgery haven't dealt with the reason they got so heavy in the first place and transfer the food dependency to another vice.

I have known a few people who've had great success with gastric bypass surgery and one who had devastating, nearly fatal consequences.  He came from a family with other morbidly obese members and a sister had had the surgery with great results.  I believe he weighed over 400 lbs and was young and about 5'7 or so.  Very, very large.  Months after the surgery and a return to work (with restrictions) I don't know all the details, but there was infection.  He was septic, on life support, last rites administered.  And then he managed to rally, but it was weeks in the hospital, months of recovery. Really, really frightening.

Still, he was at high risk of health issues if he didn't have the surgery.  But it made me more convinced I needed to exhaust every option for myself before taking such a risk and have been trying to bring my weight issues under control through diet and exercise.  Have lost 30 pounds this summer, but I have a lot more to go.

I also gained a lot of weight after getting orthopedic injuries. It is an ugly cycle. The weight makes you feel worse but you can't lose the weight because you no longer have your previous level of activity. I eat substantially less than before the injury, but not quite enough less and not quite enough to be satisfied. Pre-injury DH & I both wore 29 x 34 Shrink to Fit Levi's and could do damage to a meal. He still wears them and still can do damage to a meal.

My time on my feet is limited and must be spaced throughout the day. The only thing I've found that helped was to financially and mentally commit to joining a gym with a heated pool. I go six days a week for 1 1/2 hours per day and also do some light upper body weight training twice a week. I also get accupressure from a chiropractor for pain relief. I see a physical rehab doctor to coordinate things and he prescribes a physical therapist to teach me exercise programs I can do in the pool.

The weight is slowly coming off but it's hard work and expensive. Unlike a lot of people, I can afford, with planning,  good food, a gym, orthotics and a chiropractor. It's difficult for me, but I work from home, have great insurance, can buy fresh fish etc. If I were a single mother, working full time and trying to pay rent, groceries, etc., I'd have serious doubts about my ability to make progress.

I'm grateful that doo-doo happened after I'd had a chance to establish a life. I'm also grateful for my dogs. They force me to get out and function every single day and have probably saved me thousand in mental health bills.

And gosh darn, it's frustrating, isn't it?  All the physical activities they take away from us?  To ride a bike again, or a horse, play tennis......I miss those things.

I did find Oprahs show rather interesting tho.  For folks who are extremely overweight because of emotional issues, I can easily see how those who do not resolve those issues pre surgery, COULD transfer the dependency to something else.  It's funny that I happened to catch the show, because I normally don't watch daytime TV.......it was rather timely and certainly food for thought.

 I think it's really bizarre that so many people think that surgery is an easy way out.  Has anyone actually looked at the post-op lifestyle/possible complications?

What I read recently is that the average stomach can hold a quart of food.  Post op it is the size of a walnut and can hold SIX grapes.

So we are talking a zillion tiny meals per day just to properly nourish oneself.  I tend to eat small, frequent meals myself, but not THAT small or that frequent.

I sure can't imagine it being the EASY way out.

sillysally

 I think it's really bizarre that so many people think that surgery is an easy way out.  Has anyone actually looked at the post-op lifestyle/possible complications?

 

yeah it's actually one of the most well studied surgeries.  It has such great results both in health and long term psychological results that the insurance companies for the most part cover it.  That oprah show was ok, but those patients were poorly selected, most of them probably wouldn't have gotten through our selection process.  None of these people think that it's the easy way out, they just feel there is no other way.  The health problems associated with obesity WILL shorten their lives.  The 80+% reduction in major health problems is worth the risk of the surgery for many.

Perhaps then YOUR hospitals selection process should set the standard for other facilities.  I'm thinking that counseling is a must both before and after, and I know that isn't the case in my area.

glenmar

Perhaps then YOUR hospitals selection process should set the standard for other facilities.  I'm thinking that counseling is a must both before and after, and I know that isn't the case in my area.

In a way it does, we are a COE as I stated before.  The american college of surgeons and most insurance companies are big into these center of excellence stuff.  Basically it will very soon change that most insurance companies will NOT pay for the surgery unless you have it as a COE.  The new american college of surgeons requirements now also state you have to discuss with your patient how many you have done and how many you do/week.  As you can guess, this is a very, very specialized surgery that not every surgeon should be doing.