weight loss surgeries

[Phlegm]

Here an article i found from msnbc.com on weight loss surgeries for those who are considering this route.

Think twice about weight-loss surgery.
In many cases, the risks outweigh the benefits


By Karen Collins, R.D.
Registered Dietitian

From 1993 to 2003, the number of weight-loss surgeries increased 500 percent. That number was predicted to increase even further in 2004. Since almost two-thirds of our population is now overweight or obese, thoughts about surgical procedures to reduce weight frequently cross people’s minds. Yet misconceptions about them are common. People especially overlook all the necessary life changes for a successful operation.

Liposuction, one type of weight-control surgery, may seem like a simple way to remove excess fat around the waistline, which is most associated with health risks like diabetes and heart disease. Yet in a recent study of obese women, liposuction that removed large amounts of waistline fat did not lower blood sugar and insulin levels or biomarkers of inflammation.

Although removing fat deposits under the skin can significantly change a person’s appearance, the health risks from excess weight appear to come from fat deep in the abdomen around or inside organs, which liposuction leaves in place.

Unrealistic expectations

Furthermore, a new study suggests that people who opt for liposuction often have unrealistic expectations about the extra measures they must take to maintain the new look and lower weight. Although the patients were generally satisfied with the liposuction surgery, 43 percent regained weight. This large percentage seems to have underestimated the importance or ease of making lifestyle changes to prevent weight from returning. Almost all of those who regained weight did not increase their level of exercise or change their diet after surgery.

Obesity surgery refers to techniques used to modify the stomach and or intestines to reduce the amount of food that can be eaten. Select another question for more information.

You may qualify for obesity surgery if:

# You are severely obese (body mass index of 40 or more) or have a BMI of 35 to 39.9 with serious medical conditions such as high blood cholesterol, high blood pressure, sleep apnea and type 2 diabetes.

# You have tried other methods of weight loss including changes in eating, behavior, increased physical activity and/or drug therapy and are still severely obese.

# You are unable to physically perform routine daily activities and your quality of life is seriously impaired.

# You are motivated to making a lifelong behavioral commitment that includes well-balanced eating and physical activity habits which are needed to achieve the best results.

There are two types of obesity surgery: restrictive and combined restrictive and malabsorptive:

# Restrictive surgery uses bands or staples to restrict food intake. The bands or staples are surgically placed near the top of the stomach to section off a small portion that is often called a stomach pouch, which can hold about a half a cup to one cup of food. A small outlet, about the size of a pencil eraser, is left at the bottom of the stomach pouch. Since the outlet is small, food stays in the pouch longer and the patient feels full for a longer time.

# Combined restrictive and malabsorptive surgery is a combination of restrictive surgery with bypass surgery, in which a surgeon makes a direct connection from the stomach to a lower segment of the small intestine. This limits the amount of food that is digested.

# Immediately following surgery, most patients lose weight rapidly and continue to do so until 18 to 24 months after the procedure. Although most patients then start to regain some of their lost weight, few regain it all.

# Surgery improves most obesity-related conditions. For example, in one study blood sugar levels of most obese patients with diabetes returned to normal after surgery. Nearly all patients whose blood sugar levels did not return to normal were older or had had diabetes for a long time.

# Patients have reported an enhanced quality of life, improved mobility and stamina, better mood, self-esteem and interpersonal effectiveness, and lessened self-consciousness.

# 10 percent to 20 percent of patients who have weight-loss operations require follow-up operations to correct complications such as abdominal hernias, breakdown of the staple line and stretched stomach outlets.

# More than one-third of obese patients who have gastric surgery develop gallstones, which are clumps of cholesterol and other matter that form in the gallbladder. During rapid or substantial weight loss a person's risk of developing gallstones is increased. Gallstones can be prevented with supplemental bile salts taken for the first 6 months after surgery.

# Nearly 30 percent of patients who have weight-loss surgery develop nutritional deficiencies such as anemia, osteoporosis and metabolic bone disease. These deficiencies can be avoided if vitamin and mineral intakes are maintained.

# Women of childbearing age should avoid pregnancy until their weight becomes stable because rapid weight loss and nutritional deficiencies can harm a developing fetus.

Other weight-control surgeries for obese people alter a person’s digestive process to cause the body to lose weight over time. One of the surgeries reduces the size of the stomach. Another type, called a gastric bypass operation, forces food to bypass sections of the digestive tract, reducing the amount of calories and nutrients that the body can absorb. Bypass operations tend to produce more weight loss, but they also pose the most side effects, including nutritional deficiencies. Both kinds of surgery, however, are significantly more effective than medications or counseling.

Lifestyle changes

Yet people may underestimate the permanent changes in eating habits they will need to adopt after either kind of surgery. Because of the changes in the digestive tract, people need to learn to chew their food more thoroughly than before. Liquids need to be consumed separately from solid foods.

Although some people adapt to the required lifestyle changes, experts say that many others continue to struggle with emotions related to food after surgery. Counseling to cope with stress and other emotions without turning to food should be a vital part of anyone’s plan to make these operations successful.

People who are considering surgery to treat obesity also need to think about the likely outcome. A 30 percent weight loss is about typical. Nevertheless, since candidates for these extreme procedures are so obese, the typical person remains overweight. Although people may not reach their ideal weight, these large weight losses can produce tremendous health benefits. However, if a person expects to be thin and envisions automatic life changes, like more friends, a better marriage and professional success, they can become depressed.

When people weigh the risks and benefits of surgery for weight reduction, complications should also be considered. Although rare, they can be severe. Severe obesity, however, also has health risks that include heart disease, diabetes, sleep apnea and cancer that can be just as harmful. Perhaps, surgery may be an ideal solution to a severe weight problem, but all the factors need to be weighed before people select this option.

[Tadpole]

Surgery for weight-loss is just dumb. Go on a diet, and exercise an hour a day, and you are fine. Jesus Christ.

[araby]

You know what though, I can see how people can be desperate for results. When I was a lot heavier I would work out a lot and never see how it was making much a physical difference, and while I felt better, I would always give up and stop working out because I didn't get the instant gratification physically as well. Now that I can see a difference every time I do a work out, it is more of a motivation than anything else. If I had the opportunity I would look into doing it and decide if it was worth the risk, I hear it's hard to do afterward. I worked with a girl who'd had it done a year before and lost 125 lbs, but still had extra skin and was going to have plastic surgery to fix that.

[Mop]

well here we go personally I hate this subject.

Weight loss surgeries for alot of people do help - those that have joint pain consitently enough that they can't work out consitently. And really use food for psychological reasons. - they create a revolving door where they work out - get hurt get frustrated eat more crap gain weight try again a couple weeks later.


That being said there are a lot of people who go through these surgeries that still eat like crap after, drink like fishes after and do absolutly nothing to change and wonder why they are not happy.

[araby]

yep. My sister-in-law's mother had liposuction on her stomach and gained it all back. In her case it wasn't as bad as Mop is saying, but the point was she didn't want to make the life-change, and if she had, her surgery would have been worth it for her I suppose.

[liquidstayce]

I am having a laprascopic RNY Gastric Bypass probably sometime at the end of April or May of this year pending insurance approval. Mop came with me to the consult on 1/31 at John Hopkins Obesity Clinic at JH Bayview Hospital.

We have been talking about it for a long time. He was dead set against it from the time we met and is supporting me today but only because he knows that it is my ultimate decision in the end. Matter of fact, I discussed even posting this subject here with him first because he is a very private person. I make my journey public only with hopes that it might help someone else. Maybe it will educate those who are suffering or just the average person open to understanding this decision. If it helps just one person that reads this forum then it is worth the 50 that might flame it. Maybe it will also dispel some of the mis-information out there.

MY STORY..........
Most of you know how active I am and that I work out almost every day. I also lift more than 90% of the women in my gym and have exercised consistently the last three years. For the most part I eat healthy with the occasional splurge here and there. I am fanatical about living a healthy lifestyle as much as Mop. I created my own health and fitness message board and have helped lots of other people looking to get healthy. Fitness and nutrition is a passion.

WLS is an absolute last resort decision. Many risks are associated with it and it does not promise that you will keep the weight off unless you make the lifestyle and behavioral changes. There are tons of rules you need to follow for the rest of your life including taking chewable and sublingual supplements/vitamins, not drinking when you eat, eating protein first, and getting labs every year.

The pouch (mini stomach) that is created from WLS is to be thought of as a "tool" only and not some miracle. Statistics do show that more people keep the weight off with WLS then other methods but as the article says it is only for people who need to lose more than 100 lbs., have other health issues, and have gone through an extensive screening process by multiple specialists.

I need to loose more than 100lbs and have other related health issues including arthritis, hypertension, ammenoreha, history of fibroids, and a back issue (disc bulge L4-5). Part of it is probably hormonal and I may have something called PCOS - Polycystic Ovarian Syndrome that contributes to my issues with losing weight. However, a big part is also the years and years of yo-yo diets and misinformation that floods the fitness industry. Perhaps the greatest contributing factor is the cycle that Mop mentions. It is a catch 22. I workout like crazy, I get injured because of the weight (ankle, joint, back injuries), I gain some back, I recover, start all over again. I've done that about 25 times in the last three years. It's a killer mentally and physically. I proved that I can lose 30-40lbs time and time again and have been on diets since age 13. I just can't keep it off and lose more. I always gain some of it back.. sometimes the all the weight plus more. It is a vicious cycle. I have a beautiful life and am very happy but I feel like this is the one area that I have not been able to achieve long term success. I am not doing it for vanity purposes but more so because I want to live an active lifestyle pain free and hopefully get rid of some of these other issues.

You are welcome to read and follow more of my detailed story here:
http://www.obesityhelp.com/morbidobesit ... 1104686271

The Procedure Today:
Many of the top clinics today such as the Hopkins center offer a very comprehensive program. It isn't like the "Stomach-stapling" procedures in the past. You are required to go to support groups, nutrional counseling, have a psyc eval prior to surgery, and go through a lot of tests prior to the procedure. It is by no means an easy or lazy way out. It's the hardest thing a person can do and it drastically changes your plumbing for the rest of your life. While it is a reversable procedure in some cases typically it is dangerous to do that reversal. You can visit my surgeons site here: http://www.smallscar.com to learn more details about the procedure or research it. He has a video if it as well on the site.

[leah]

stacy, keep us updated on how things go. i wish you all the best, and will keep you in thoughts/prayers as you go through this. i admire your strength... you work hard and believe me, i know all too well how much the dieting routine sucks. i wish i had your drive and determination to stick with things. good luck~

[Harrison]

I workout like crazy, I get injured because of the weight (ankle, joint, back injuries), I gain some back, I recover, start all over again. I've done that about 25 times in the last three years.

Not to the same extent as 25 in the past 3 years but, pretty bad for me anyways.

I used to jog every other night, religiously. I stopped because of my ankles and knees swelling to ridiculous proportions, shin splints etc.

Never had a problem with my back though.

I'm at 235 6'1"

Fine with it for the most part, but I've been trying to get in better shape. I can still run a mile nonstop, but that's pathetic in comparison to what I used to do. And I pay for it the next day with swollen ankles and pain in my shins.

Anyways, just a rant

[liquidstayce]

Leah - Thanks. That is very sweet of you.

Fin - It's a good rant. When you get shin splints, swollen ankles, or injury it is your body telling you something. You have to listen to it. I do cardio all the time (about 5 - 6x per week) but you won't catch me running anymore. At least not until I drop the weight and the pain is gone. The surgery may or may not help. From my research most of the time it reduces the pain drastically if not completely.

I stick with using eliptical type machines. My favorite is the regular or full body arc trainer. It is like a regular eliptical but on steriods and more range of motion. Just 4 months ago I was doing the stair machine which looks like an escalator and most bad ass cardio equip in the gym.. except if you develop knee problems. Which I also have right now. Just last year I was doing sprint intervals and starting to run all the time too. Now I'm lucky to do incline walking. Little did I know how much damage I was doing to my body at this weight.

The thing is, no matter what size you are, or what injuries you have, you can find ways to adapt and work around it. I think the key for me has been to evaluate how I feel on a daily basis, listen to my body, and then respond accordingly. If my lower body is bothering me then obviously I'm not going to do a heavy leg workout and do 120lbs squats and 240lbs leg presses if I'm hurting. I'm not going to pick a type of cardio that will put more stress on my joints. However, I can still do a solid upper body workout and attempt other types of cardio equipment. Sometimes I can find some lower body stuff that won't put stress on the specific areas that are having issues. If I'm really bad I will take the day off, do yoga, pilates, stretch, etc. It does get frustrating. Sometimes I have to try 5 different types of equipment before I can find what feels ok that day. I try not to fall into the pattern of using injury as an excuse to not workout but know also know when to rest up and not overtrain. It's a balancing act. Mop goes through the same thing with his muscular dystrophy sometimes.

[Oofdaa]

Let us know how things are going for you Stayce, I know how hard you work on having a healthy lifestyle. Good thoughts to you.

[Harrison]

I'm getting a $1,000 treadmill from a friend for $250

It's supposed to be low impact because of how it's designed.

It almost bounces, feels nice but didn't give it a trial run yet.

[Harrison]

A LONG trial run is what I meant.

[liquidstayce]

Sounds like a good one. Treadmills differ drastically. The good ones are usually pretty expensive. It's hard to find a gym quality treadmill for home use but then again I have not tested any of the latest ones for home use in the last few years. I'm sure they are designed a little better now. Let me know how the one you have works out.

The best gym treadmill I use is an incline treadmill from Nordic Trac. It has more bounce/give to it then the typical treadmills. The shocks feel so much different then the other treadmills in the gym.

This is similar to the one I use at the gym minus the built in flat screen TV - http://www.nordictrack.com/cgi-bin/ncom ... tcat=46525

One thing that helps improve support on a treadmill is to put it up at least .5 on the incline. I find that helps with the shock absorption a ton. Walking flat isn't good for you anyway. Also, stay away from doing downhill or decline walking. That can also put a lot of stress on places you don't want it. If using a home treadmill make sure it has a stabilizer (weight on the bottom) of it and that it doesn't shift around or rock when you use it.

[araby]

I hope insurance comes through and you get to do this! fitness is obviously a very big issue for you and you deserve ten gold medals for all you've done for yourself...I truly hope that this works out for you and all goes well.

[liquidstayce]

Thanks gals!!

The insurance end is a nightmare. I'm already going to be paying a huge amt of money out of pocket up front for the surgeon fee but I should get that back at 100%. The hospital and anesthesia fees should be paid at 80% and then I pay the balance.

I've been told that BC/BS always denies first time around but then I can appeal with the help of my HR department. I've already put my HR department on alert and they are willing to help by contacting the account representative that serves my hospital. It would be a huge shame if they don't cover this considering my employer is a hospital. The costs of the procedure are much less then the costs of dealing with the multiple issues related to obesity. Insurance companies give you such the run around too. This surgery costs 20 - 35k so they don't want to pay for it. I got different versions of what was covered depending on who I have spoken to so far. More info about it in my profile on the link in my original post.
Just today they said they wouldn't even pay for a visit I had to my primary care to discuss weight loss options. How nuts is that? You go to your Dr. for help with weight loss and they don't want to cover it??!!

Recently laws have been passed but only Georgia, Indiana, Virginia and Maryland require insurers to cover surgery for morbid obesity, which is defined as at least 100 pounds overweight. I live in Maryland. Legislation to mandate the coverage is pending in Ohio and Louisiana, and similar bills are waiting to be introduced next session in South Carolina and Missouri. Even then in these states insurers find loop holes to deny the WLS. Example: a company can have an exclusion written into the policy that says they won't pay for weight loss surgery.

I am prepared to do whatever it takes. Just how much you ask??!!!
I will contact my state's insurance commission and write to state and federally elected officials including the atty general. If that doesn't work I can contact the Office for Civil Rights - The OCR investigates written complaints of discrimination of the disabled under the American’s with Disabilities Act, in housing, public accommodations, the workplace and education. Morbid Obesity has been defined by the ADA as a qualified disability under the context of the law. I will appeal over and over until they approve me. Eventually I will even hire an attorney if I have to so I can make sure this happens. I am ready to do battle if needed =)

[araby]

Good thing you're resourceful and persistent, it will pay off, I know it will! unlike me, who gave up on trying to get compensation for my car being illegally towed and then illegally overcharged to get it out after the tenth call I made that wasn't returned...lord

Insurance is such a pain in the proverbial ass, I deal with it every single day and it's sad. I watch people get diagnosed by someone who works for the insurance company (not a DMD) who will determine with his uneducated eyes while looking at your Xray whether or not that company will pay a portion of your bill which was the reason for having the insurance, in the first goddamn place. It happens so often. Health Care is EXPENSIVE and insurance doesn't pay JACK SHIT. They make so much money, it blows my mind. Some plans, very few are the bomb diggity, and health insurance is very much the same way.

I hope most of you are lucky enough to get great health care and dental plans, they are the most expensive ways to have something go wrong beyong your control, and without good benefits on your side, it's like not winning for losing.

I think you should get an award or something, I seriously think you are awesome for being so dedicated and having so much intelligence about what goes on with your body and health and getting results! A fit woman is a strong woman! woo, I need to go run around the block now I'm all pumped hehe

[liquidstayce]

Good thing you're resourceful and persistent, it will pay off, I know it will!

Mop has his own spin on it... He calls me obsessed. Just the other day we were joking around in my physicians office arguing who had more OCD me or him! LMAO. I think both of us just really go after the things we want and are passionate about. We are very goal oriented and don't take no for an answer when it comes to reaching those goals. My problem is that I get so gung ho about something all I do is want to talk about it with everyone but even more so with the person that matters to me the most!! Poor Mop... he has heard so much about the WLS thing that I think I've worn him out on the topic. Thank god for support groups and message boards. They give him a break. <3 to u mops for being such a good hubby and putting up with me