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Thu Mar 27, 2014, 09:01 AM

So, you say I took the easy way out. A surgeon's perspective on Bariatric Surgery.

http://www.obesityhelp.com/articles/surgery-is-not-the-easy-way-out-a-bariatric-surgeons-perspective

Let's discuss ...



Obesity has genetic components, well documented in the medical literature. There are socio-economic factors involved. Many of our patients have an abuse history, and sub-consciously shroud themselves from unwanted physical attention through their weight; hence, obesity has a psychological component. There are numerous metabolic issues at play, such as diabetes, hypo-thyroid issues, poly-cystic ovarian syndrome, and leptin insensitivity.

Now consider the thought process involved in undergoing surgery. Patients need to admit to themselves and their families that they have a disease that is so profound that they need to see a doctor to treat it. Then they have to see a mental health provider, to evaluate them for untreated mental illness and coping skills. Next they have to see a dietitian, and may need to undergo 6 months of medically supervised weight loss, depending on their insurance. Then they have to have a major surgical procedure. Granted, itís typically performed laparoscopically, but they still need to undergo general anesthesia, and have someone operate on them in order to help fight this disease. They may incur significant expense, loss of time from work, and/or time away from school. Finally, they have to take vitamins for the rest of their lives, and they have to follow up with a mean surgeon (me) forever!

Does that sound like the easy way out? How do I explain to a woman at a party that, without surgical intervention, only 30% of my patients would live to see their 65th birthday? How do I explain the humiliation involved in asking for a seat belt extender on an airplane? To not be able to go to a movie, or an amusement park. To have to have a family member do your toilet care because you simply cannot reach? To not be able to run after your child when he or she is in danger? To have people judge you as lazy and slovenly before even shaking your hand? To be discriminated against when applying for a job, just because of the way you look?

Obese people are the last population that folks think of as socially acceptable to ridicule. Yet, over 30% of Americans are considered overweight. While Iím thrilled that the AMA has declared obesity a disease, how long until the rest of society recognizes that ruling and stops discriminating?

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Reply So, you say I took the easy way out. A surgeon's perspective on Bariatric Surgery. (Original post)
auntAgonist Mar 2014 OP
auntAgonist Apr 2014 #1
spinbaby Apr 2014 #2
Coventina May 2014 #3
Walk away Aug 2014 #4
GreenPartyVoter Aug 2014 #5
auntAgonist Aug 2014 #6
GreenPartyVoter Aug 2014 #7
jambo101 Aug 2014 #8
auntAgonist Aug 2014 #9
hedgehog Feb 2015 #10

Response to auntAgonist (Original post)

Sun Apr 6, 2014, 10:22 AM

1. I think perhaps this topic is of no interest to anyone.

It's quite evident in the number of 'views' with 0 replies.

I'm happy to see the group grow.

I wish you ALL , nothing but the best.

aA
kesha

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Response to auntAgonist (Reply #1)

Sun Apr 20, 2014, 08:23 AM

2. It is of interest

I just don't check in here very often.

Yes, most people think surgery is some kind of magic bullet and don't realize that those of us that have had surgery have to take vitamins and be obsessive about what we eat forever. I have to be especially careful about what I eat because I'm a "late dumper" in that even small amounts of the wrong carbs make my blood sugar skyrocket and then plunge, leaving me hypoglycemic. I'm not quite at Atkins levels, but my diet is very low in carbs, which come mostly from blueberries, low-carb vegetables, and beans. My idea of a real treat nowadays is a bowl of oatmeal. I've come to accept the idea that I will never ever again have a doughnut.

On the plus side, though, I'm within five pounds of a "normal" BMI and can walk miles and miles. Before surgery, I was seriously worried that I soon wouldn't be able to walk at all because of knee and foot issues. I still have my collection of bone spurs and calcified tendons, but now they don't matter as much.

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Response to auntAgonist (Reply #1)

Sun May 4, 2014, 01:49 PM

3. I'm brand new to this group, so didn't see your post until just now.

K & R

A very good read. I wish every skinny person would read it.

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Response to auntAgonist (Original post)

Sat Aug 23, 2014, 08:51 PM

4. Who cares what other people think. If someone isn't supportive of me I just purge them...

out of my life anyway. Bariatric surgery is a new lease on life for many thousands of people. It's what they and their doctors think that count.

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Response to auntAgonist (Original post)

Mon Aug 25, 2014, 12:09 PM

5. This subject just came up on the health message board I live at now. And it was exactly

this argument:

Taking the easy way out vs. it's not taking the easy way out.

I agree. It's not "cheating." If a person is so morbidly obese that they can't exercise, what are their chances at losing weight? I know at 265lbs and steadily rising, this could easily have become a discussion I had with my doc. If my knees were any worse, I might have had the conversation right now.

And it is sad that on a health board there are hundreds of people who feel it's cheating. They need to start seeing obesity as the disease it is, not a "character flaw." In my book, that's the crux of the whole argument. First it was immoral to put the weight on, and then it was immoral not to work hard to take it off. (Which is a lack of information on their part. People who have gastric surgery still have to watch what they eat and exercise. The surgery just helps them get to a place where they can start to do those things in a safer, more effective way.)

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Response to GreenPartyVoter (Reply #5)

Mon Aug 25, 2014, 12:20 PM

6. So true. Damned if we do and damned if we don't logic.

Surgery is no panacea for sure.

I have health issues now that might have to do with surgery or maybe not.

I'm iron deficient anemic. I always was low on iron all my life. Could surgery have worsened it? Maybe.

I have malabsorption issues but I knew that going in. That's what the surgery does. It makes you malabsorb so that you do have to take in more supplements to make up for what you're not able to get from your food.

My stomach is smaller now too. It's not a pouch. It's a stomach albeit 1/3 of the size it was in 2005.

Would I do it all over again?

YES.

I might not be here otherwise.

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Response to auntAgonist (Reply #6)

Mon Aug 25, 2014, 01:11 PM

7. Exactly! *hugs*

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Response to auntAgonist (Original post)

Sat Aug 30, 2014, 02:42 AM

8. After surgery

Do people radically alter their diet or is it just a matter of following the same old diet just in less quantity.?
And if the diet is altered what does your doctor advise as a dietary plan of action?

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Response to jambo101 (Reply #8)

Sat Aug 30, 2014, 05:18 AM

9. Hi Jambo, I can only speak for myself regarding this but the real difference in diet for me

is that I must concentrate on protein first.

I can't eat as much as I used to because my stomach, not a pouch is much smaller so fill up a lot quicker.

My surgery causes malabsorption and so I do need to take a boat load of vitamins and minerals too.

aA
kesha

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Response to auntAgonist (Original post)

Fri Feb 20, 2015, 03:47 PM

10. My GP suggested that it was time to consider bariatric surgery, and

that scared me enough to stick to a low calorie diet he advised. I've heard all the draw-backs involved - bariatric surgery is no one's idea of a free ride!

Now I'm expecting to have my very painful gallbladder removed. One cause for painful gallstones - losing weight too quickly!

Still better than having to face bariatric surgery.

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