Sue has done a great job of articulating my objections to weight-loss surgery:
About 5% of people on non surgical weight loss programs can keep off the weight. With weight loss surgery it’s only 7% even with more invasive procedures like the gastric bypass. Many weight loss surgery surgeons don’t expect patients to keep off any more than half their excess weight on the long run even when they are putting in the work, but again, how many seminars tell that to prospective patients who are typically 100 and 200 lbs over their “goal weight”? I know a person who regained 100 of the 200 lbs initially lost with their gastric bypass and they couldn’t for the world, take it off, even with diet and exercise. Apparently their metabolism had been so damaged that eating anything more than 700 calories a day, caused a gain.
How many people would agree to major surgery like weight loss surgery if they knew it would mean a lifetime of dieting and exercise as well as supplements, B12 shots, possible iron infusions, frequent doctor visits and more… and then, to only lose 50 percent of what they initially wanted to lose (for most patients)?
How many people would agree to a gastric bypass if they knew that they had a chance, even a small one, of getting a seizure disorder afterward or reactive hypoglycemia?
How many people would agree to a gastric sleeve surgery (the newest one they are touting) if they knew it called for the removal of 90 percent of their stomach, leaving a pouch the size of a thumb and that if they had any acid in their stomach, they might easily get an ulcer which could quickly ruin the stomach and require the removal of the rest of their stomach or else if they had no acid in their stomach, it could cause all kinds of things including auto-immune disorder (including MS by the way) because of “leaky bowel” syndrome where bacteria from the food eaten is not killed and instead, recirculated into the bloodstream?
How many people would go into a major surgery even with a lower death risk (the lap band has a death risk of 1 in 7000) if they really thought they might be the one to die? As for those surgeries like gastric bypass where the risk of death is much higher (1 in 50 in some studies), how many people would choose this procedure being fully aware of the death risk?
And finally, how many would agree to surgery if they knew they might not die right away but instead become ill, or require additional surgery like losing their colon from sepsis due to perforation (a sometimes repercussion of laparoscopic surgery) or lose their ability to walk?
I’ve never seriously considered weight loss surgery for a couple of reasons. For one, the idea of permanently altering your gut (in the case of gastric bypass) strikes me as just inherently wrong. And I bet that in 100 years or so, when we’ve figured out the connection between the standard American diet and obesity, this surgery will be looked at like we look at lobotomies in the early to mid-20th century: well meaning, but ultimately barbaric and not helpful.
The other reason I’ve not considered it is that for me, the surgery doesn’t adequately address the actual issue at hand, which is appetite. This past November, Rachael Ray had a young woman on who had gained back 100 of the 200 lbs she had had lost via WLS. The video clip of her story isn’t available on the site, but the article hints at the problem:
However, Tracey’s happiness started to disappear as the lost weight started to reappear. Little by little, she tested her body to see if it could handle many of the unhealthy foods that led to her initial high weight.
I remember watching this episode and hearing Tracey talk about how sick she got the first time she ate junk food (it was chips or Doritos as I recall) … and that despite that, she kept eating the food until her stomach began tolerating it.
One of the problems is that your average WLS practice is focused on a good outcome for a relatively short post-surgery timeframe. I have a family member who had her WLS done by a very respectable surgeon with a great (read: minimal) post-op complication rate. His idea of followup were a handful of scheduled visits and a monthly support group meeting. And no surprise, after a year or so, the weight loss slowed and the weight started piling back on — along with the eating.
So the way I figure it, if the problem is the overeating, then that’s what the solution needs to address — and I don’t think invasive surgery is it.
Update, 3/2: Good post from Big Fat Blog on the challenges of making a rational decision about WLS.