I appreciate your willingness to wade through some pretty nasty stuff sometimes in order to share your meaningful insight into this issue, Val.

I'm always surprised whenever I see any form of intolerance or judgemental nastiness towards other people's path to losing weight from others on here.

I mean, I shouldn't be, of course. But I used to think there was already so much of that out in the 'thin' world, that this would be the one safe place for sure.

I know this is the 'War Zone,' so the rules are a bit different, but being 'controversial' is very different from saying mean or nasty stuff.

Val,

I certainly didn't mean to offend, but to relate one story that I was close to. I do think it is very reasonable to assume that as the WLS industry markets itself, that there will be people who want surgery for the wrong reason and doctors who will perform it.

Assuming that all WLS patients are having it for the right reason is as big a generalization as assuming they are all having it for the wrong reasons; I never tried to say that it was that way.

And yes, if you knew the lady I know, and heard her talk of being turned down multiple times as not qualified before finding someone who would do it, you might think what I think about it. She had none of those conditions; flat out she couldn't find someone to do it because they didn't think she was radically overweight. I didn't assume. I know it because she said that was why she was turned down.

I think you may have drawn a bit too much from my reasonable belief that when there is money to be made, people will do things they ought not do. I'm not terribly anti-WLS, but I don't like being lectured to about assumptions by someone who knows a heck of a lot less about the situation than I do.

I do believe this topic will always be a hot debate. I also agree with many who have stated here that nobody can understand a decision someone else makes unless they have walked a mile in their shoes. While WLS is not the choice for me, it is for others and it is not my place to judge.

I work in the medical field with many hospitals, in particular Stanford; where bariatric surgery is performed. There are criterion. I don't know if this is the standard nationwide, but it's pretty thorough here. Reading the requirements and the regimen patients have to complete before being okay for surgery is not anything to take lightly. If you want your insurance to pay for it, you have to meet the criteria. Here is their info, if interested: http://www.stanfordhospital.com/cli...tricSurgeryFAQs

Frankly it's not all that different from other routine surgeries undertaken to benefit one's health. I think because there is such a drastic result it seems more controversial. And so what if they don't learn to eat properly or gain the weight back or many other things; it's still not my moment, not my situation, not my place to judge. I can only speak for myself at the moment I am in. I don't know what my limit for WLS is or if I would have reached it, I just know it wasn't the 280 I was at my highest. Maybe I would have at 290 or 300. There will always be as many reasons for having the procedure as there are people who have them. You just cannot look at someone and know why they did what they did.

The FAQs that Ali provided a link to include this one:

13. Is there anything else I need to know?

It is very important that you understand that this surgery will not remove your sense of hunger. It will not cause you to lose your desire to eat and it will not remove any of the psychological cravings that you may have for food. If you eat when you are stressed, you will still feel like eating when you are stressed. Therefore, it will be very important that you understand the stresses that make you feel like eating and identify other ways of resolving these issues.

____

It looks like the doctors have become aware of experiences like Val's and want patients to know that the desire to eat will not disappear after surgery.

Just when I think there is nothing new to be said on this topic, you come along and say it better than most.

I agree that there is nothing heroic about having bariatric surgery. There is nothing heroic about being successful on LC either. In fact if I could do it, I'd be sedated and fed intravenously until I woke up thin, which wouldn't exactly embody strength and willpower. From my POV, heroes in the weight arena are the ones who (1) never allowed theirs to get out of control in the first place, (2) didn't allow weight to impede their lives, or (3) had no control over a weight condition they nonetheless addressed. The rest of us are largely recovering from self-inflicted wounds and might differ in our opinions of how best to do. This discussion neither diminishes one's right to have a contrary opinion nor another person's right to ignore it and do as they please.

And this is why I care so much about offering a differing opinion. I think this is unfair. I've never seen a magazine article, interview on Oprah or even website of a medical professional offering WLS that didn't make it very clear that this was an option with risks and only to be undertaken after all other reasonable options were exhausted, and trust me, I pay attention to this stuff.

I think the quoted message is an unfair characterization of the thought processes of those that choose this option. Certainly it's possible that it's fair in some circumstances, but I'm very, very certain it's completely unfair in most.

Sane people do not choose to be cut open and have weight loss surgery when they can honestly see a better way and I find it highly insulting to myself and those who are choosing weight loss surgery for anyone to make those assumptions.

I think the quoted message is an unfair characterization of the thought processes of those that choose this option. Certainly it's possible that it's fair in some circumstances, but I'm very, very certain it's completely unfair in most.

Okay, I'm going to try this one more time, then I'm going to give up. Val, as I said, I know that you feel strongly about this and you're obviously very emotional about it. However, you are reading things into statements which are not there, or simply misreading them, as a result of your defensiveness.

The "quoted" statement did not say squat about anyone's thought process in having the surgery. It said that the *message* that seems to be going out to the public is that this is an optimal solution for weight problems. I'm surprised that you would say that you've never seen a TV program that avoided a discussion of the risks of this surgery. I've seen more that avoid it, than those that address it. I watch a lot of cosmetic surgery shows (Plastic Surgery Before & After, Dr. 90210, Discovery Channel, and the like) out of personal interest, because I had cosmetic surgery last year. These shows focus on the profound weight loss, and give a passing (if any) mention to what the risks and complications are.

On the Oprah show that I watched recently, there was almost no time given to discussing these topics either; it was all about how big the woman was, what transpired to make her decide on the surgery, and the body reconstruction surgeries that she is currently undergoing.

I believe, as Wooo stated, that the medical marketing engine has a lot to do with this. As many people have said about the medical community's condemnation of Atkins, if we all decided to simply eat right and exercise daily, there'd be an awful lot of doctors on the food stamp line.

Again, I will try to clarify: I am not down on WLS. I am not down on those who choose it. I have said from the start of this thread and will say again: I'm glad that it's available as an option for those who understand it and are willing to make the commitment to carry it through successfully. I AM exasperated that as a country, we seem to be feeding/receiving the message that it's this marvelous thing that deserves the same accolades as simply eating right in the first place.

If you are still determined in your defensiveness to accuse me of assumptions I haven't made, to make generalizations that are insupportable, then there's not much more I can do. I have stated my position in as plain English and as many ways as I know how.

I cannot find any posts in this thread that have any content that I would consider "mean or nasty stuff".

Out of curiosity barb, how long have you been trying to eat normally while conscious of your carbohydrate sensitivity? Carbohydrate sensitivity plays a hand in almost all eating disorders. Eating disorders/dysfunctional eating (binging, compulsive, etc) cannot be got under control if the blood sugar is still driving you crazy. You can't deal with the behavioral artifacts of a problem that still exists (a constant wanting for food, and an insatiability, in a physical sense).

It's not normal to eat normally if you're hungry all the time. Only once your hunger normalizes can one hope to sort out the rest. If you've just found LC, then I say you've only been REALLY working at your eating problems for a very brief time. Before, even though you really really wanted it to stop, it was not realistically possible because your metabolism was so screwy.

Same here. It's an awful feeling. My sugar is very sensitive, it doesn't take much at all for it to drop and make me feel yuck. I am very sensitive to the effects of epinephrine as well, so when the sympathetic nervous system kicks in it's even worse than the tiredness/lethargy/sleepiness of a low sugar. Low sugar (arms of lead, profoundly weak, "out of it") isn't as bad as the anxiety and shaking and that overwhelming feeling of the body trying to desperately make sugar.

I would say yes.

In fact, I would also say that almost everyone who struggles with dysfunctional eating has carbohydrate sensitivity too... which is why your situation is so common (cannot lose weight and get a handle on out of control eating). I've spoken with all types of ED people. Virtually every bulimic I've conversed with was aware of how carbohydrate triggers their binges. I've spoken with several anorexics and I'd say it was less common but still very prevalent. One confessed she feels so "clean" when her blood sugar is stable from restricting. I'm confident the rate of carbohydrate sensitivity among compulsive/binge eaters is around 90%.

I think GBS works because cheating isn't an option like it was: you cannot go on crazy binges and eat big portions anymore. A very successful bariatric surgery patient who's journal I've been following supports this view. She identifies as a severe compulsive eater/food addict and she plainly says that the main thing the GBS gives her is that it allows her to stay eating this way, and she is not capable of losing control (in a physical sense) the way she could. She just can't abuse food the way she could before. She was never able to keep weight off before because she always would have a lapse of control on her diet (even the low carb ones), which would turn into binging.

If I loose control, I can consume a gross quantity of food, and I have never reached a point where I vomited. We're talking the amount of calories in a day's worth of food. It's purely control that prevents, stops, and recovers from poor eating for me. On the other hand, someone with GBS may dump if they eat just a normal sized meal of 500 calories.

I also think GBS forces people to recover from their compulsive eating by removing the behavior as a realistic option. Most people find vomiting absolutely disgusting, a sign of something being wrong, and go out of their way to prevent it. This "innate aversion" to conditions that result in vomiting would prevent most post-ops from becoming bulimics. Instead, they would gradually tailor their eating habits and behavior to avoid it (i.e. eat normally). Simultaneously, forced by necessity, they would adapt to their new life (learning to deal with life and food without abusive eating). The GBS forces compulsive eaters into a position of "do or die"; this is one diet you can't break. This knowledge (that they have no other choice) motivates them to really really try this time since they perceive themselves as having no options to go back.

Dieting, really, is like doing it all on your own - with no assurance, no sure thing, it's really all you keeping it together and learning how to make a new life. You need to really feel like you have no options left, combined with otherworldly confidence in your capacity to exert power over yourself and succeed, in order to make a diet work. I firmly believe that.


I agree. We're all in a crappy situation and all our options are hard.
It's like we're all in prison figuring how to get out. GBS is like sawing off your foot with the confining shackle attached, limping your way to freedom. Dieting is like grabbing the shackle with your hands, and painfully, with blistered hands, dragging the weight yourself.

GBS allows for an easier escape from jail, but then again, life without a foot is kinda sucky, no? Even though they have an easier time controlling weight ("staying out of prison") they have new, additional challenges because of their mutilated insides. I wouldn't want to NOT have the option of being able to eat normally at all; then there's also the issue of deficiencies and how healthy it is...
Dieting leaves you whole (and with more bragging rights), but the journey is a lot more trying usually and few ever really make it out. Most of us, in fact, won't, and we'll keep cycling weight (and end up fatter in the long run).


Earlier I said I think it is *stupid* that weight loss is seen as a heroic feat; went on a little rant there about how ridiculous it is to place personal worth on weight status (everyone ends up unhappy in the long run, well, everyone except the naturally-weight-accepting...)

But if we are going to validate the notion, then in an objective sense it is quite obvious that GBS makes weight loss easier. If it didn't then no one would pay thousands of dollars and risk their lives to get it. So, going with logic, it is obvious that those who do it successfully without GBS are walking a more difficult road in so far as weight loss is concerned.

That doesn't surprise me.

Val, for the record, I don't think anything you wrote sounded 'defensive.' To me it sounded like you were willing to make yourself vulnerable, while sharing some of your most painful and humiliating memories with us of how it felt to feel so hopeless and helpless, all in the hope of raising awareness about the surgery from someone who has actually been there.

To me, that's heroic.

What if I started a thread about how tired I am of all the people who have plastic surgery without having what I consider to be a valid defect worthy of surgical correction? Remember, by the criteria of this discussion, aesthetic improvement ALONE isn't good enough, no matter how depressed you get about how you look even if it drives you to suicidal thoughts.

I personally get tired of all the shows that glorify new noses and boob jobs to be the be-all and end-all of self improvement.

I guess that's why I have a remote control.

I couldn’t say the journey of someone with a GBS is any less valid than my own. Eating disorders are suffering, plain and simple. The roadblocks someone with a GBS will face, may be different than what I face but they are still there nonetheless. I applaud them for their efforts, even if they chose a different path. May we all reach a place where food and body image isn’t such an issue, because we have health and happiness.

I don't watch TV, but I don't find it hard to believe that some shows play WLS very lightly, like it's easy. And people's results are glorified I'm sure - in this country we love Cinderella stories.

The Seattle Times has some good stories on this issue - they did an in-depth report about a couple who both had the surgery, and there's some other stuff on that page too. It worked out well for them in the end, I think, but the wife was back in the hospital a couple of times and it got a little scary.

Well...then take a look at this one.
I find it interesting that they perform the two main types of WLS; gastric banding and Roux-en-Y gastric bypass. Note that here they give a 'pros and cons' for the less expensive gastric banding surgery but that here when they describe the more expensive and invasive Roux-en-Y, no such list or even mention of risks and complications is given. In fact, they seem to me to rather downplay the majorness of the surgery they are describing.
Care to guess which type of surgery is performed most often?
In addition, the criteria for who qualifies for this type of surgery varies from state to state and are constantly changing with the requirements being loosened all the time to allow for the surgery to be performed on a wider range of patients. Even in this country, there are only so many morbidly obese patients willing to undergo surgery at any given time and with the cash/insurance to cover it. To stay in business requires that the bar be lowered. In my state, even as little as a few years ago, to qualify for the surgery the patient had to be more than 100 pounds over their ideal weight and also have one or more complicating conditions such as diabetes or hypertension. Patients needed a psychiatric evaluation and had to prove that they attempted a medically supervised weight loss program for a specified period anywhere from 6 months to 5 years without a significant loss of weight. Now all they need is a referral from their physician to a bariatric surgeon, sometimes not even that.
While I believe that this type of surgery is necessary and life-saving for some, I also believe that it is increasingly being overutilized. Why should I care if someone with 40 pounds to lose wants to permanently mutilate their gastrointestinal system to do it? Because it's procedures such as that being done on patients that really don't need it along with all the complications and resulting lawsuits that follow that drive up the cost of health care for the rest of us.
But that's the culture that we live in. Got a problem? Take a pill, have an operation...it's all good as long as you can pay for it or your insurance will cover it.




I read through the thread twice and I couldn't either. What I do see is two groups of people with opposing opinions each telling the other that they are wrong to have the opinion they do and some people taking generalized statements very personally.

I do get emotional and passionate about stuff, this is one of them. I don't think that diminishes what I've said though. All I did was add my rant to the rant that started the thread. The original rant was anti-glorification of WLS, my rant was anti-judgement of those who choose WLS because their reasons for choosing aren't good enough for those doing that judging.

I think we've all made our points.

I don't feel this debate has gotten nasty or mean, but I do find with this second post characterizing me as defensive and emotional that it's getting personal, and I'm not comfortable with that, so I will bow out here.

Val