I like to sit on fences. Then, ain't nobody gonna beat me up.

"I stumbled across you web site a couple of  weeks ago.  I've only been able to read bits and pieces of your website. However, I'm confused to whether your WLS pro or con."

I guess I've succeeded, then, if I've confused you.

I am not PRO or CON regarding surgical weight loss methods.  I am sitting on the fence.  It hurts my butt.

What?  Here's the thing.  I'll try to 'splain maself without confusing anybody.

I am against WLS for healthy kids like myself. 

If you are not dying from your morbid obesity (I was far far from it.  I had zero co-morbidities of obesity.) don't butcher your anatomy.  It is too likely to cause long-term problems (the studies are just now surfacing because of the sheer numbers of people turning up years later, sick), and if you were healthy to BEGIN with (like me) the only real positive is the fact that we'll fit in regular size coffins.

Now, that said, if I waited to lose weight UNTIL I was getting sick from being FAT?  (Maybe, by age 30, 40+ I'd have high blood pressure?  Diabetes?  Heart problems?) 

Maybe I'd feel differently and I'd be more "pro-WLS."  I'd hope by that point, technology/medicine would be more advanced and perhaps there would be a less invasive way to lose weight without forced malnutrition.  But, when I made the decision, I was very young, and I didn't forsee that I'd be dealing with complicating side effects of weight loss surgery before I was 30 years old. 

I did not go into this blindly.  I went through months and months of pre-operative counseling and testing.  I "knew what I was in for."  What was not considered, was that post-operatively, "you can still get sick, even with the right supplementation/diet and lifestyle."  It was said to be "exceedingly rare, if ever, to have complications."  I was more concerned with dying on the operative table, or having a leak in my new anatomy.  I wasn't really worried about anemia, osteoporosis, vitamin deficiencies, neurological problems, severe hypoglycemia, etc, etc.  Those longer-term effects weren't really discussed.  They were glossed over.

If I went into this process at age 50, already "sick" from being fat?  Maybe I'd have a different outlook.  I know many people feel that way, that they've already exhausted all methods - and time is of the essence.  So, lose weight OR die.  If your fat is going to take you OUT sooner than later, I suppose weight loss surgery should be a consideration.  The catch with this is that - sometimes you can get too obese to even HAVE weight loss surgery, and your obesity kills you anyways.  So, there's a window in the timing, you have to be sick from being fat, but not so fat and TOO sick to have it done.

I just don't think anyone (like myself) should have weight loss surgery without being sick.  It doesn't make sense.  Sure, the weight loss is fantastic, and being a normal weight is pretty damn cool, but what did I trade off for it?  My health.  Sure, my health was DOOMED to fail if I DIDN'T lose weight at all - BUT... I triggered my health to crap out at a super-fast rate, too, by HAVING gastric bypass surgery. 

It's a delicate balance, and you have to choose for yourself.  Every single persons situation is different, but... ask around.  You need input from people in YOUR PEER GROUP, with SIMILAR CO-MORBIDS. 

How did THEY turn out?

If YOU are a young female, aged 25-30 years old, in my peer group, weighing around 280-320 lbs. at an average height - with little to no co-morbidities of obesity, then you're "like me." 

Consider my experience as a warning.  Otherwise, don't.  If you're not in a similar situation, you can't.

I'm noticing a pattern of young, female, menstruating women, having similar long-term complications. 

Some of our complications wouldn't be considered a problem, if were were older, post-menopausal and having age-related issues, ie. osteoporosis.  That is generally a problem that afflicts older women, especially the elderly.  I Am 28 Years Old.  Do you see where I'm going with is? 

Neurological deficits and nerve problems, many of which surface with old age, or disease?  I have some - and I'm a "healthy" 28 year old woman.

Severe anemia, common in menstruating/pregnant females, but generally controllable by diet and "being healthy."  I can't control my blood, and I'm a "healthy" person.

Inability to control blood glucose levels, resulting in severe hypoglycemia at times.  I'm not diabetic, never was, and now I'm dealing with this for life?

I'm getting agitated, which leads to more housecleaning.  So, I'll stop now.  But, does this answer your question?

Comments

[shari]

You hit this one dead on, MM. You have to jump when the window of opportunity is exactly dead on... which I believe is a correlation of:

+ painful quality of life and morbidities AND still enough health to survive and maintain yourself after surgery
+ enough technology that the procedures are "as good as they get", but not yet dated or outmoded
+ a moment in time when you can afford to recuperate
+ a place in your head where you can fully understand the risks and responsibilities you're taking on
+ a mindset when you can honestly tell yourself that it is about health and NOT about "size"
+ real support not only for your post-surgical body but your mindset and intentions
+ a deep-seated knowledge that this is for you and not to impress any other people in your life
+ a moment when you teeter between severe depression and the last ditch notion you can set it all straight

It is a very small twilight moment I am discussing here. I have met very few people having surgery in this space-- I am very fortunate to be exactly here, exactly now... I am really sorry you were not afforded the same opportunity. :(

[Wendy Noel]

So, I'm curious. Do you feel better or worse since having your WLS? Is your life now post-operatively significantly different?

[Wendy Noel]

So, I'm curious. Do you feel better or worse since having your WLS? Is your life now post-operatively significantly different?

[MM]

Better and worse. Is that clear as mud?

[Maija]

I really found your comments very insightful! The changes in the insurance industry should hopefully create some sort of a restriction on who can have WLS. My husband's company dropped WLS at the beginning of this year because too many people were getting the surgery who probably didn't really qualify for it. I was able to successfully appeal their decsion because I have some of the co-morbidities that support WLS. I'm not sure how a person your age, would have enough life experience to make such an enormous decision. I know now that couldn't have!
I love to hear your comments...thanks! I want to have my eyes wide open!

[G Tino]

Hi MM, Some good comments so far. Hey, you may have already been asked this, but I haven't seen your answer, so Here goes...Can you or have you considered having a Revision? I don't know much about them, just a thought...

(Sure, if I had to I would. But, the functionality of the intestine that is MISSING is gone forever.)

[Tonya Luiz]

Had this conversation with a woman last night. It's all about mitigating risks.

This woman, for example, has sleep apnea. She wanted WLS to eliminate that. However, when she approached her doctor about it, he brought up something she hadn't thought of: Sleep apnea is her only co-morbidity that would qualify her for WLS at a BMI of 47; however, she has another health condition that makes going under anesthesia the equivalent of flirting with death. In her case, the risk of having WLS is not worth the possible benefits associated with losing weight (some skinny people still have sleep apnea).

In my case, I was 27 with a BMI of 58 and I felt like I was 80. My obesity had already started to make me sick. Now two years after surgery, I feel so damn good that I don't mind the hypoglycemia (mine is not nearly as severe as yours sounds), the anemia (pale works for me...lol) or the dietary restrictions.

BUT here's a dose of irony: The straw that broke the camel's back for me, the one thing that made me decide WLS was worth the risks (the idea of being thin did not appeal to me at that time) was finding out I had obesity-related infertility. Guess what? At 138 pounds, my body still refuses to ovulate. The diagnosis has changed from obesity-related infertility to unexplained infertility. I think if WLS made me super-sick, I would feel betrayed. Instead, I recognize that fertility is not an exact science. We hoped weight loss would make my body act normally. We were wrong. I'm moving on.

Thank you for your thoughtful post.

[Alia]

I know that when you talk about WLS, you mean the invasive, anatomy-altering kind. I've had nothing but a vast improvement in my health after having the lapband though, and I had no co-morbidities before. I had no high blood pressure or other issues, but I know that I would have had I waited another few years. After the lapband, however, I'm in excellent shape. I have a lot more energy, I exercise more and am generally active. My vision even improved. So, I don't know... I think the difference is that there's no interference with your normal bodily system... just a physical obstruction. My only beef health-wise is that when I go to run my marathon, I'm going to have to down liquid carbs beforehand, because if I had to eat all my carbs, I'd never be fully loaded for the race. Other than that, though, I've had no negative health effects. I can only speak for myself, though, and not other people who've had the lapband.

[Deluzy]

Well, for what it's worth, I totally agree with everything you wrote.

Even as a woman in her mid-40s with multiple life-threatening co-morbidities (uncontrolled *though medicated* Type II diabetes, high blood pressure, high cholesterol, etc.), who opted for the gastric reduction/duodenal switch, I realized I was exchanging one set of known serious health problems for another set of potential and unpredictable problems down the line.

I've been lucky at 18 months out: so far my co-morbidities have reversed and the only diagnosable problems are 1) severe anemia; 2) an abdominal hernia. However, those aren't exactly minor, particularly the first.

I'm still a toddler in the WLS game. What about 3-5 years from now? 10 years? Answer: I won't know until I get there. And that's the cold, hard reality. It's why I maintain a subscription to a daily digest of a bulletin board that discusses real and serious health problems connected to my specific form of WLS -- because they can and do happen, and until they do, you think it's not going to happen to you.

Right now? I would do this again in a heartbeat -- because right now I'm healthier than I've ever been. But by definition, given the surgical alterations in my body, I'm living on the nutritional edge, which in turn compromises my health, even if I don't see it now.

I live with hope but also with fingers crossed and with vigilance regarding complications as they develop.

[Blackthorne]

Are you considering undoing your WLS then?

I'm 20+ months out from the DS, and at present, my only complication is low D on my labs. I'm working on adjusting my supplements to correct that, and while I've seen progress, I'm not "there" yet.

While I'm about 10 years oldeer than you, the rest of your pre-op description fits me pretty well - mostly healthy with portents of bad things to come. I had high cholesterol & insulin resistance. Both were resolved by having WLS, so I don't feel like I traded my health for a smaller body. I ended up getting both.

But I do agree with you on one thing - people need to take this VERY seriously, and really think about what they are doing to themselves. I see far too many people jump in having no clue what their options are, what the consequences are, and what their role & responsibilities are for maintaining their health.

--BT

[MM (Beth)]

If, I had to, I would revise the RNY. BUT, I would not regain my lost intestine, therefore would not regain the absorption LOST that I need, correct? Although, the usage of my ex-stomach would be helpful...

That said, I don't want to --- because --- it's like asking to get fat(ter) again. So, I'm working on figuring out what works.

[Mary Mcnulty]

I hope this goes through. I am surrounded by people who have had WLS. I went to my doctor. I was 47 years years old and was 5"2" and weighed 310 pounds. I asked her to help me get approved insurance wise for WLS. She looked at my tears and told me that although I was overweight I did not have high blood pressure or diabetes. My problem was I ate too much and needed to get it under control. I went home hating her but determined to do whatever it took to get the weight off. Without going into detail 2 years later I am 140 pounds lighter with another 40 to go. I did not go on a diet, I had a lifestyle change. It has been harder than hell to do this but hopefully it is a healthier approach. I know that I will never be out of control again but it is because I changed my lifestyle and not the size of my stomach.

Mary

[bill]

This is the issue I am struggling with. My whole adult life, my weight has been more of an inconvenience than a major problem. I've never felt like it held me back from anything important that I wanted to do or accomplish, I've neve rhad the confidence problems that plague so many overweight or obese people and I've always been one of the (otherwise) healthiest people I know. I've lost significant amounts of weight before (of course gaining it back and then some each time) and I've always felt I was just one successful diet away from losing the weight.

Desipte having a BMI of 66, my only comorbidity is mild sleep apnea. I have to be the healthiest 550 pound man outside of the Sumo ring.

But I also know that both my father and uncle developed diabetes in their early forties and lost their eyesight, limbs and, in my father's case, his life from the complications.

Unfortunately, now that I have started researching and considering and finally deciding to have the surgery while I am still healthy enough to maximize my chances survival and success, and as I wait for my insurance situation to change to allow me to hav ethe surgery, those doubts and discouragement that I have avoided my entire life have begun to crop up. Now I've convinced myself that WLS is the only option if I want to lose the weight.

[Amber]

I don't understand what you mean about you "lost intestine"? Did you have a different procedure than the regular RNY or am I just confused about how they could reattach it? To my knowledge no part of my anamony was removed, just re routed and my old stomache and bypass intestine are still there adding bile and other digestive "juices" to my digestive tract. Am I confused?