Wednesday, March 3, 2010

My Beef With Bariatric Surgery

First off, a disclaimer: Let me make it clear that I do believe that there ARE cases in which bariatric surgery can be beneficial and even necessary, as a last resort. I would also like to say that I don't hold anything against people who do opt for any of the various procedures, as it was their choice, and it does work out well for many people. This is simply how I feel about the subject, after first hand experience with my mother, who underwent a gastric bypass shortly after I started at San Diego State.

My mom had been heavyset all her life, like me. At one point she weighed ofer 400 pounds. She lost a little bit of that suddenly, before she was diagnosed with adult onset diabetes, but remained in the high 300s. It seemed like she'd tried everything: Sweatin' to the Oldies with Richard Simmons, Jenny Craig, and dozens of other programs I can't remember. Nothing seemed to stick, which I now realize was because my mom had a few road blocks in her way. She didn't know how to change the way she looked at food, she didn't know how to stick to exercise, she didn't have enough support from my dad and me, and because she had some more deeply rooted psychological issues that didn't become apparent until she was diagnosed with bipolar disorder about six months before she died in a car accident in 2005.

Bariatric surgery must have sounded like a miracle to her. She felt like she was at the end of her rope. Personally, I doubted the whole procedure. I went along with her to orientations and support group meetings where I heard about how you could lose crazy amounts of weight fairly quickly, as well as horror stories: inscisions that didn't heal fully and became infected, internal bleeding, bowel leak where the intestine is re-attached to the stomach, food getting lodged and causing an internal traffic jam. There was also the fact that the stomach could stretch out over time and become the size of a normal stomach again and you could gain all the weight BACK, undoing the whole traumatic procedure. Then there's the fact that the surgery was purely physical, so you still have to change the way you view food and work through everything that caused you to overeat in the first place.

This is what happened to my mom:
She had a full gastric bypass; she was too large to have the procedure done laparoscopically (that option was relatively new back then), so she had a giant scar running down her stomach. For a long time, she followed the program dilligently, going to both regional and local support meetings. She'd had a few blockage scares and gone to the emergency room a couple of times, but other than that she was fine. She lost about 100 pounds, and got into the high 200s. But then she hit a plateau. She stopped going to the meetings. She began to eat the things she wasn't supposed to (you're given a list of foods that you can and can't eat at various stages), and her stomach stretched. She probably experienced "dumping," which is what happens when you eat sugary things (you feel sick and faint because of a fall in blood sugar). She wasn't really exercising. She didn't gain much more weight, but she didn't lose any more either.

All of the issues she had before she had the surgery were still there. The support groups are supposed to cover that bit, but it doesn't work if you stop going. There is nothing in place to stop someone from playing along up until they have the surgery and then suddenly falling off the radar. The special diet you're supposed to follow can easily go out of the window. Handing someone a piece of paper with the right foods on it doesn't magically make someone stick to it, no matter how ill they feel if they don't.

The bottom line: there's not enough education and support for everyone who has bariatric surgery. There ARE many people who are successful, and learn about food and exercise. But there are also those who need a little extra guidance, and who are lacking in some familial support. And it's THOSE people I worry about.

To those who have had a gastric bypass or a gastric band and have kept their weight off: well done! I know it's hard, even with the surgery.

Gastric bypass surgery is not a quick fix. It is a life altering major surgery. It was intended for people who are too large to move around, and those who have immediate health risks. After looking up the qualifications, I myself qualify for gastric bypass surgery. I weigh less than 250 pounds (granted, that's large for my 5' 2" frame, but still), and am perfectly capable of moving around and exercising. I don't think I should qualify, but I do.

Most people I've run across online and in person, from lay people to medical professionals, seem to be in agreement that the best way to lose weight is slowly, over a period of time, through healthy eating and plenty of exercise. Calories in, calories out. This breadth of time also allows you to learn new habits, how to make healthier choices, and that it's okay to splurge a little now and again and still stay on track. I'm still working on all that, after gaining and losing and gaining for the entirety of my adult life, but this is the way I want to do it. Baby steps.

And if I can show just one person that it's not necessary for them to have surgery to lose weight, I will be an extremely happy camper.

1 comment:

  1. Amen! My mom, best friend and a co-worker all had gastric bypass and all gained a lot of weight back. My mom's gained back 100 lbs over 10 years. The co-worker is almost at 100 and the friend is at 50. My mom is one of those people who actually needed it but as so many people do...when the "gift" of surgery is done the same lack of desire to exercise or eat right tends to rear its head.

    The hubby and I have lost 126 and 116 lbs respectively with a ways to go but if I could do stuff like Tae Bo at over 400 lbs, then ANYONE can walk in place and do something less drastic to get off the booty and get the weight off.