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gwlolo

Bariatric surgery - Any experience or advice?

gwlolo
10 years ago

Any direct experience with people who have done elective bariatric surgery? Would love some advice on behalf of my friend.

A dear friend reached out to me and said that she is seriously considering bariatric surgery, in particular vertical sleeve gastrectomy where they cut the stomach and make it much smaller. She is petite and about 80-90lbs overweight and is developing complications like high cholesterol, diabetes etc. For all the years I have known her, she has always struggled with weight issues. She eats quite healthy and what she knows about nutrition can go in a book! Her issue is her appetite. She can eat a large salad and still have room for a restaurant size serving of pasta. She has lost 30-40 lbs in the past but always gained it back. She asked me to help her get some objective perspective on it. Her insurance will likely cover it and all the advice out there on the internet in places like youtube is mostly positive (as it is mostly posted by people undergoing the surgery). I want her to be healthy and happy but am concerned about risks which she may not be considering. She still has to work out and watch her diet and eat more protein etc. which she is prepared to do.
She is particularly concerned about social judgements she may run into if she shares she had bariatric surgery at work, with relatives and friends etc. Would it be unethical if she just shares she is doing a medical weight loss plan? Right now she is the funny smart girl and she does not want her future life defined by the discussions about the surgery. She just wants to lose the weight and move on.

Comments (31)

  • neetsiepie
    10 years ago
    last modified: 9 years ago

    I had considered it, but after going to the mandatory classes my insurance co required, I decided I'd rather try doing it thru WW and exercise.

    What I learned is that the surgery is HARD on your body. That you will not be able to eat like you are used to eating-you literally can't eat more than a couple ounces or you will vomit. You also need to take supplements as you won't be getting enough nutrition during the day.

    The classes also recommended therapy to deal with WHY you overeat. It sounds like your friend may have more emotional issues with food than surgery can fix.

    I have family members and friends who've done it and initally they all lost a LOT of weight-and frankly, looked terrible. But every single one has managed to gain the weight back once they started to slowly stretch out their stomachs, and also consuming high calorie foods.

    If your friend does decide to do it, she doesn't need to announce to everyone that is what she's doing. It's really no one's business, is it? I'm curious why she feels she will be judged. A woman at work had it done, but only a few people knew initially=and after she started losing a lot, told people what she'd done. No one appeared to judge her.

    Honestly, after I went to the class, and saw that most of the people there were not interested in making a lifetime commitment to this surgery and the consequences-they were mostly just wanting to lose weight, and fast-it turned me off. It's not a whim-this is serious surgery with long term lifestyle changes. It's not a permanent solution by any means.

  • jerseygirl_1
    10 years ago
    last modified: 9 years ago

    Great decision Pesky.

    I know several people who turned to surgery for weight loss. 3 who are sisters and a daughter had bariatric surgery. The mother and daughter never reached their goal regardless of the discomfort of eating improperly. Today they actually gained most of the weight they did loss back. The mother took cake decorating classes instead of exercise classes The sister kept the weight off for about 2 years and is now at WW. A former coworker had the rubber band method and lost hardly anything even after having the bands tightened.

    It's very serious surgery. The commitment has to come from within. It just seems that some use the surgery as a crutch and have not really addressed the true issue. I know they put you through all kinds of screening and follow-up. WW and exercise is still the best option. JMHO

  • kellyeng
    10 years ago
    last modified: 9 years ago

    We all know how to lose weight. It's the implementation that gets in the way.

    I urge your friend to go the route of behavioral modification before going under the knife. Seek out a therapist experienced with eating disorders.

    Bariatric surgery is a difficult procedure with a very high rate of complications (40%!!) and is fatal for 1 out of 200 people. I would succumb to this surgery only if my doctor determined that my death from comorbidities was knocking on my door. Even still, it's not a miracle. Lots of people end up gaining all the weight back because they haven't learned how to cope with eating less and exercising regularly.

    Finally, if her primary concern is about "social judgements" then she is no where near ready for something like this. Her primary concern should be about dying or having life long complication like chronic malnutrition, gastrointestinal disturbances and osteoporosis.

  • ellendi
    10 years ago
    last modified: 9 years ago

    My sister's cousin had the lap band surgery. She lost weight but decided to keep the lap band at a level where she can maintain a size 6.

    Big mistake. She can not eat like a norma person. She also finds only certain food easy to eat which makes going out to dinner with her a nightmare.

    I agree that over eating is a disorder and should be addressed with an experienced therapist.
    I have also read where the eating addiction can be replaced by another, like alcohol, or in my sister's cousin case, she became obsessed with shopping.

    I have found this topic so touchy. I have a cousin who will snap my head off if this topic comes up. She feels that I don't understand her struggles because I have always been able to maintain a healthy weight. And she won't listen to the fact that I work very hard at it.

    I agree that this is something that can't be taken lightly. I am dismayed at the failure rate as many are doing this as a last resort.

  • texanjana
    10 years ago
    last modified: 9 years ago

    I agree with everything Kelly said. If the underlying issue is not dealt with, the surgery will be a huge risk for nothing. A person I worked with years ago had it and died from complications.

  • chispa
    10 years ago
    last modified: 9 years ago

    A family friend had the surgery many years ago and had pretty serious complications early on that required hospitalization. He did lose weight in the beginning and exercised some, but he continued to eat too much of all the wrong things and eventually went back to his old ways and gained all the weight back.

    Obviously, lots of people seem to be able to "fool" the insurance screening and get the surgery, when they should be getting therapy.

  • tishtoshnm Zone 6/NM
    10 years ago
    last modified: 9 years ago

    My biggest concern about this surgery is a doctor's willingness to perform it in cases that are not worst case scenario. My sister just had 80% of her stomach removed 2 weeks ago. She has always been a big girl. She is 6 feet tall and big boned. She was indeed overweight, there was no doubt about it, but any health problems from that were minor at that point. I think an elective surgery that takes away that much of a vital organ should really be reserved for dire situations. I am absolutely apalled that the physicians were willing to perform the operation in this case. For my sister, she is using the situation as more of an attention seeking thing than anything else. I do think that there are people who truly need this type of surgery, but I think that it is far fewer than the numbers who are electing to go through with it.

  • redcurls
    10 years ago
    last modified: 9 years ago

    I think that today's bariatric surgeries are a LOT better...and a lot SAFER...than they were ten years ago. I think almost anyone can lose weight, but it's the "keeping it off" that is so hard. My sister had the lap band done about five years ago. She didn't have the extreme weight loss that you see with the gastric by-pass and the "sleeve" wasn't an option for her. (She now says she wishes she had done that one.). She isn't as slender as she had hoped to be, but she IS about forty pounds less than she was. I think....but am not positive...that she was down about 25 more pounds, but has regained and stabilized where she is now. She DOES have "problems" with being able to eat many foods. She went into a hospital in the morning,and left about six hours later. Was off work two weeks, but otherwise healed quickly. They put her lapband in empty and it is slowly filled with saline at her doctor's office starting a month or so later. She says she could lose more if they put more saline in, but doesn't want any more. (I don't kow why.). Hope this helps.

  • gsciencechick
    10 years ago
    last modified: 9 years ago

    Where I lived before, a lady had the Rouen-Y gastric bypass maybe 10 years ago. She lost a lot of weight and has kept it off, but she has to take a lot of supplements as she was left with a lot of absorption issues.

    I was really surprised she got the surgery because I never heard her talk about exercise or ever eat anything healthy at our meetings (which were held at a restaurant where you ordered off the menu). But she worked at a hospital, so she probably had the connections to get it done.

    I know a lady from where I work now that had it done, and she also gained all her weight back.

    I think people need to explore EVERY option before doing this: WW, other eating programs, Registered Dietician, personal trainer, behavior counseling, etc.

    I've met two women who were on The Biggest Loser. Although the training they do on t he show is not realistic for most people, it does show that people who have a lot to lose can do it without surgery. However, they currently workout two hours per day to maintain their weight.

  • jerseygirl_1
    10 years ago
    last modified: 9 years ago

    I rarely post but I find this conversation very interesting since I start classes next week to be certified by ACE for personal training. My thought was to work supporting people who have gone through this type of surgery and obese people to get them moving. The people I mentioned in my last post are the ones that have motivated me along with reinventing myself at the age of 61.

    I don't usually sympathize (at all) with insurance companies but since we have an obesity issue in the US, I can see where their concerns are for obese people gaining their weight back and yet they are now scrutinized for the screenings they put their patients through. I feel it is still not enough screening. I know my friend's daughter (who is 27 and has social issues since childhood) went through extensive screening prior to her surgery. She did see a nutritionist after surgery for a few months but she was not able to live up to her end of the program which was eat according in the recommended diet and not eat cake, sugar, and tons of carbs which I see a whole lot of in their house. I am sure this has not helped raising insurance rates.

  • 3katz4me
    10 years ago
    last modified: 9 years ago

    I only know one person who has done this - a coworker. He appears to have gained most of the weight back. It seems like even with bariatric surgery you have to make lifelong lifestyle changes to be successful. It seems like it would be better to do that to start with - healthy diet and exercise. Otherwise you're undertaking a lot of risk and adding a bunch of expense for something that may have a high likelihood of not being successful.

  • User
    10 years ago
    last modified: 9 years ago

    I know of a woman in our community who had the more extreme bariatric surgery and two years later had a serious problem while visiting her daughter in another state. She was ill for a week before she would allow the daughter to take her to the ER. A CT scan of her abdomen was performed, which revealed her prior surgery and the awful problems she had were a direct result of it. When the ER doc asked her about her surgical history, the woman lied, saying she had had an appendectomy years before and nothing else since. The doctor told her he could see the after effects of the procedure, and the woman finally admitted she'd had the surgery. She had been too ashamed to tell her adult children and let them believe she lost a hundred pounds with an herbal supplement. Her daughter was appalled ...and said she finally realized why her mom hadn't wanted to see a doctor. The woman was admitted with sepsis and over the next week went downhill so rapidly she was put on a ventilator. She died about 10 days after the ER visit.

    There are a lot of things to take away from this story--- which involved people we know directly--- but the saddest part is that patient's shame, not her weight, was primarily responsible for her death.

  • ellendi
    10 years ago
    last modified: 9 years ago

    This is eye opening. I didn't realize that the success rate is so low.
    In my sister's cousin's case, she has kept the weight off because she keeps the band very tight. As I mentioned, she cannot eat like a normal person so dining with her either in house or out at a restaurant is a horrible experience.

  • kimberlyrkb
    10 years ago
    last modified: 9 years ago

    My MIL and her sister both had it done maybe 5 years ago. MIL's sister had complications a few times after the original surgery and required additional operations and extreme measures to save her life. MIL must be very careful about what she eats or is constantly vomiting or camped out in the bathroom. Unfortunately, they are both gaining the weight back - they're almost back to where they started. They make unhealthy choices and don't exercise. Surgery is not a miracle cure.

  • iheartgiantschnauzer
    10 years ago
    last modified: 9 years ago

    Through work, I have seen more success than this thread would indicate. Our hospital has about a 70% 5 year success rate. Meaning only 30% of the patients have regained the weight 5 years later. But our hospital takes a very integrated team approach. There is at least 6 months of pre surgery therapy and 12 months of therapy after. The patients also must lose atleast 10% of weight before surgery to show dedication to their new lifestyle. After surgery they are given free access to our hospital gym for 12 months and a discounted rate every year thereafter and a few free personal training sessions.

    The take away is the patient has to be willing to change their lifestyle and face the underlying emotional issues with food. If they can do this many would have just as much success with DRASTIC dietary changes such as a low fat vegetarian or vegan diet focused on WHOLE unprocessed foods and daily exercise. Such a change would avoid the pitfalls of lingering digestive issues many patients experience.

    As for the stigma your friend fears, she has to own her decision. Many people will speculate and she may feel the need to answer. Sure she could lie; the one talk show host did it for years ( star jones i think?) If she feels she would be ashamed to tell the truth, then maybe she would be better off putting in the "hard work" and taking a more drastic immersion weightless intervention run by weight loss spa/clinics that teach a person to shop, cook, exercise while providing therapy. These usually run anywhere from 4-12 weeks. But they are quite pricey and not all insurance plans will cover it.

    Has she read anything by esselstyn, fuhrman, Barnard? Sure they are drastic approaches, but in my opinion, not nearly as drastic as bariatric surgery. She ate herself into this, maybe if she deals with the emotional issues, she can eat her way out of it.

  • chispa
    10 years ago
    last modified: 9 years ago

    ellendi said:
    "As I mentioned, she cannot eat like a normal person so dining with her either in house or out at a restaurant is a horrible experience."

    Ellendi, I kept coming back to your last sentence. What makes the experience so horrible?

  • redcurls
    10 years ago
    last modified: 9 years ago

    Another point I forgot to add when I discussed my sister's surgery above: It is my understanding that the gastric bypass is the procedure of choice in Europe to treat diabetes. My sister...even though she is only 40 pounds lighter than before her lap band...no longer has to take daily diabetes meds. She continues to have the A1C testing quarterly. So there IS some other benefit(s) to the weight loss surgery. I continue to hope that she will join me as a Y member and also become fit. I give credit to my 3x a week visits to the gym as a big factor why I haven't also joined my many other family members who have Type II diabetes.

  • User
    10 years ago
    last modified: 9 years ago

    The gastric balloon is performed in Europe, and is much safer than a bypass. However, it is not a permanent solution but rather one that requires dieting maintenance in ones own. In this procedure a deflated balloon is inserted into the patient's stomach endoscopically, then inflated once in place. It reduces the capacity of the stomach and is usually removed (endoscopically, deflating the balloon in situ before removing it) about six months later.

  • ellendi
    10 years ago
    last modified: 9 years ago

    Chispa, she can only eat certain foods that are easily digested. While everyone is eating a nice big meal in front of them, she can only pick at hers. And usually she will want a crab cake (don't know why she is fixated on crab cakes)which is not always available.
    I think watching others eat has made her miserable around the dinner table. She insists on keeping the lap band at a certain tightness. Maybe if she had it opened a bit. But this would mean surgery.
    Maybe this is just her and her over all attitude.
    Thinking about this topic, a woman at my old job had a procedure. Not sure which. When we went to a Christmas party she was across from me. She ordered the same as everyone, but ate very slowly and took the majority of the food home. You would not know that there was an issue with her.

  • PRO
    acdesignsky
    10 years ago
    last modified: 9 years ago

    Another more positive review. I have a few close family members who had the gastric bypass from 5-8 years ago. All were at least 120 lbs overweight, had been obese since childhood (in their 30s 40s at the time), and had the common comorbities(hip, diabetes,back and knee pain, sleep apnea). They all lost the majority off their excess weight. They went from size 26/28 to 6, 8, 10. Now they have gained some of the weight back, but are within the normal BMI range. No meds. One did have a blockage that put her in the emergency room years after, but she is healthy. In fact she runs marathons! They are careful bout sugar and dairy, and avoid stringy tough foods. Serving sizes are small of course. Obesity runs in our family and these ladies are among the few in a normal weight range.

  • anele_gw
    10 years ago
    last modified: 9 years ago

    I know three people who have had gastric bypass. Two died during the surgery (this was over 10 yrs ago) and someone who did it a few months ago and is doing OK (eating is not fun at all for her, however).

    I think the problem I have with these surgeries are that they are FOREVER. I know you can reverse them sometimes, but not always (and there can be complications). I think what kswl is suggesting is better (balloon) because it isn't permanent.

    Eating is a very social activity. I started eating a vegetarian diet in high school, and briefly tried a vegan one. For me, it was very isolating and I quickly went back to just being a vegetarian (which is not a problem eating out). I would not risk giving up such an enjoyable group activity. Frankly, eating IS supposed to be enjoyable. I have a condition which has deteriorated the ear of my bone, causing a lot of hearing loss (this happened in my late 30s, suddenly). One of the risks of surgery is the loss of taste. Ack! NO way!

    The way I look at it, if surgery magically did something to one's metabolism to lose weight, then maybe . . .but it is just forcing you to do something you CAN do on your own. It just seems like such a 1st world problem, overeating. It really does.

    Also, for sure not everyone is meant to be thin. I think if one has to work out for 2 hours a day, then either the diet needs to change (inc portion size), and if that is OK, then an acceptance of one's weight is in order. Look at Oprah-- she is just NOT meant to be a stick. We are simply not all built the same, and no one should be working out 2 hours a day, unless they are an athlete, movie star or something where it is part of their job.

    The part that stands out to me is "she has room for ____" after a large salad. She has TRAINED herself (probably in childhood, not her fault) to have room for more. Instead of ordering the pasta (which really messes with your blood sugar, by the way), she needs to push her plate away from the table and talk to her friends. Drink some water. Also, maybe she shouldn't be ordering the salad at all. I think she needs to order EXACTLY what she wants and then eat half of it, esp. at a restaurant.

    One thing I think would work for her would be to use (o)bento boxes. It is hard to stuff too much in these, and she can put a variety of foods in there. Now, if she eats emotionally, then that is a different story. She will be left with the emotions ( after surgery).

    I've posted about her before, but have her look into Geneen Roth.

    Finally-- the person who is doing OK with the surgery came to visit. We did some touristy things, but nothing requiring much exercise. Just what I consider to be normal walking, and I do not walk nearly as much as I should. I was VERY surprised when she said that "all of the walking" was good for her, and she doesn't do this much at home. WHAT???? I didn't say anything, but I was in shock. She is young and perfectly able to walk. Why the heck wasn't she at least walking before attempting this surgery? She has no major responsibilities during the day (no job, no kids at home, no projects), so she certainly could have spent time exercising. She spent tons of time researching the surgery and was very well-versed in it before she had it. Probably should have spent that time walking instead. She would have felt so much better, I think. She looks very depressed at mealtimes and does get sick, even though she is quite careful.

    Here is a link that might be useful: Geneen Roth

  • springroz
    10 years ago
    last modified: 9 years ago

    I say DON'T..... My good friend had an inflatable lap band, surgery was complete with all the horrible complications, infection, drains, etc., but the weight fell off. About 125 lbs. She could not sleep in a bed, could not eat anything solid. She had surgery to have all the excess skin removed. She is a "life of the party" person, but as soon as food touched her stomach, a black wall descended. It was scary! She tired of the side effects, so she had it removed. She put on about 100 lbs, then had a different band put on, and with this one she could eat, but slowly, so she never really lost weight, but still had side effects, so had it removed, too.

    I have not read up on any real studies of long term effects, but I believe the intestine is like the brain, use it or lose it. If fiber is SO GOOD, and a person cannnot eat any, how is that healthy?

    Good Luck to those contemplating this!

    Nancy

  • theroselvr
    10 years ago
    last modified: 9 years ago

    I have a very dear friend that had bariatric surgery around 2004; she was very sick; almost lost her life. She tried to find a doctor that would help her; no one would touch her. She ended up in Philly; we had surgeries (mine was back fusion) the same day August 2006... The new doctor found that she was hooked up wrong; she ended up losing her stomach.

    She lost a lot of weight; they had her eat certain foods to some how make a "new stomach" in her intestines. As of today; she's gained a lot of the weight back.

  • chispa
    10 years ago
    last modified: 9 years ago

    Ellendi, thank you for elaborating. I'm not a big eater and barely drink any wine/liquor and I find that it seems to make those that are "eating a nice big meal" and drinking uncomfortable. I have no issues with eating a salad and having a glass of water when others are eating 3 course meals with a bit too much wine. I seem to make the "big meal" eaters feel guilty! Interesting to hear your reaction/feelings.

  • ellendi
    10 years ago
    last modified: 9 years ago

    Chispa, everyone should eat what they are comfortable with. I have two vegetarian daughters. One will east fish.
    When we go out, sometimes an appetizer will become a dinner for them, and it is served when the rest of us get our entrees.

    My only concern in going out with a light eater would be that they would not be eating most of the time while the rest of the group is going through each course.

  • neetsiepie
    10 years ago
    last modified: 9 years ago

    Light eaters know they eat light and wouldnt be troubled by others who are eating more heartily. I am a very slow eater-I can stretch my little meal out for my whole lunch hour (and then some!). Never bothers me that others are done with their entire meal before Ive even finishe my salad.

  • chispa
    10 years ago
    last modified: 9 years ago

    I usually skip any appetizers and then order an appetizer and small salad as my main meal ... they don't always serve it at the right time! But in doesn't bother me that others are eating. Also if they have any tuna sashimi or poke that will be my choice for appetizer meal ... kind of like your friend and her crab cakes ... I really like raw tuna and will always order it. I don't make it at home, so I don't think it is strange to order something you really like every time.

  • anele_gw
    10 years ago
    last modified: 9 years ago

    Pesky, my mom is a very light eater and always troubled by "hearty" eaters. She has no idea how people can eat so much. She has zero temptation to eat more, but she is disturbed by the amount people eat. She doesn't announce it, though!

    Also, you have hit on one of the healthiest eating tips . . .slow down!!!! I am not at the point in my life where I can do that yet (kids, kids, kids) but someday . . .

  • kfca37
    10 years ago
    last modified: 9 years ago

    Don't know personally of anybody that has had that surgery, but would think about really hard from what I've heard about here & elsewhere. Like I stress, "heard".

    I am a moderately fast/heavy eater, but years ago I had a roommate for almost two years who was the slowest eater I've ever encountered. It did not make me uncomfortable, I just was fascinated by how LONG it took for her fork or spoon to get from her plate to her mouth. It was like watching a really, really slow-motion movie.

    She did tell me once that when she was a child, her mother, rather than stressing "clean your plate", continually told her that if she ate too much, she'd get "a tummy ache". I guess that mantra stayed with her.

  • Annie Deighnaugh
    10 years ago
    last modified: 9 years ago

    Only go there if your life is at risk if you don't. Serious side effects including significant pain, vomiting and follow up surgeries, vitamin deficiencies, significant weight regain, and the continued need for nutritional counseling...in other words, dieting...are all potential outcomes of the surgery. It is not a fix or a panacea.

  • gwlolo
    Original Author
    10 years ago
    last modified: 9 years ago

    Thanks all for a lot of good advice. I shared this thread with my friend. She is also getting additional feedback from others including professional advice from her doctor. Like some of you commented, Baraiatric surgery today seems quite different than a few years ago. I also asked our family doctor who is quite conservative and his opinion was that it depends on co-morbities like diabetes, high cholesterol etc. For many people this is resolved. However, it is but a tool and lifestyle changes are key. Unlike procedures like Lap band which has issues like slippage, vomiting etc., and more drastic procedures like gastric bypass where there is serious issues with not being able to absorb enough vitamins and such, the specific procedure that she is looking at is sleeve gastrectomy that leaves the intestines intact. She will need to take calcium everyday. A chewable vitamin is good as eating very less food initially is very stressful for the body. But once the sutures are healed, she can eat normal food for most part.. Just less of it and more protein. A very hard decision but she has a good support group among friends and family.