Sorry not sorry, but they are stupid

[LindaDarnell]

"They are stupid " refers to all those WLS patients turned experts that blame regain and failure on the person and say things like "it's a tool, u gotta do the work". Yes it's a tool, not a magic wand. Yes, the patient has to own their part and take responsibility for their eating regimen. But if it were that easy, nobody would ever fail at WW, JC, or diet pills...and bariatric surgery would be moot!!! I just posted in a FBK group (now yall know why I'm rattled) that there are physiological and psychological issues that should be taken into account when assessing a patient for a surgery.

U can have 2 women, 260 pounds each, same age, relatively same health status, needing to lose the same amount. One has always been able to stick with a "diet plan ", can lose 20 pounds the first month on Jenny Craig, but she cant keep the weight off long term. She's probably destined to be a VSG success story, will get to goal within 8 months, and have little regain. She's hailed a hero bc she "used her tool properly".#bullshit

Woman #2 has always had problems losing weight on any plan. The most she's been to lose while doing Jenny Craig WITH a diet pill, is maybe 10 pounds. And that comes off slower...and is harder to sustain. She has VSG, loses only half of her goal weight and that's after 18 months of hard work. Then she has a regain within 2 years that steadily increases. She is deemed a failure and it's her fault. But maybe she didnt have the right surgery to begin with? Though many patients can do well with just restriction, she needed a malabsorption component as well. Maybe the wrong expectations were set for her. She shouldve been told to expect slower weight loss, lower weight loss, and possible regain..but not just because u fail ur tool, but possibly bc ur tool might fail you!

WLS as with anything medical, is not an exact science. It's why there's more than one pill or treatment for every medical condition. There are alot of different factors that go into play, and medicine is not a one size fits all approach.
Neither is bariatric surgery!

So stop beating up on those whose surgery has failed! It's not that black and white!

Ok rant over! Happy weekend y'all

 

[JackieOnLine]

now that is how you do a rant!

 

[Katie T.]

Amen sister!!!

 

[southernlady]

And then there are those of us who could lose the weight but could not stay on that diet forever, so of course we had weight regain which brought friends. It also doesn’t help when medications for other issues cause weight gain.

 

[Munchkin]

Why I don't usually comment on the FB groups!

 

[Settledownnow]

What is FBK? It is stupid, and try to keep in mind that many of the people posting have stupidity, attitude, and/or mental illness. It is a bad combination.

 

[LindaDarnell]

Why I don't usually comment on the FB groups!

Im a bruiser for a good fight, so Im always waiting for the right one lmao!!!

 

[KathrynK]

Obesity is a chronic disease. I still have it. I always will have to be careful to avoid falling back, even with restriction and malabsorption. You are absolutely right that picking the right surgery for your health profile is essential. I came close to starting with a gastric band in the late 90s, and if I had, I know I would be one of the 80% who “failed.”

This is helpful from one obesity researcher: “patients who experience weight regain may manifest a particularly powerful neuroendocrine-metabolic starvation response to their initial weight loss that favors metabolic energy conservation and weight regain.”

That’s not to say there is never a contribution from psychological or behavioral differences, like my niece, who weighs more than when she started. She thought she was now invincible from weight gain with a sleeve, and ate as she wished and still lost weight in the first year, and then gained gradually over the next 5 years. At 350+ pounds again, she isn’t eager for a revision. She told me recently, “I am not willing to give up what you are giving up to stay thin.” You could argue she had the wrong surgery (and I believe she did), but even with the DS, she might have regained over time. Is she one of those with an exaggerated neuroendocrine response to weight loss or is she someone who didn’t want to work at it? Probably a little bit of both. Obesity is a chronic disease not cured by bariatric surgery alone. Picking the right surgery helps, but even DS doesn’t work without a lot of effort.

 

[Susan in Tennessee]

What is FBK? It is stupid, and try to keep in mind that many of the people posting have stupidity, attitude, and/or mental illness. It is a bad combination.

Face Book

 

[Settledownnow]

Face Book

I know FB, but Linda wrote "I just posted in the FBK group." What is the K in FBK?

 

[Susan in Tennessee]

Bk equals book I think, a slight twist on usual FB, but again I could be wrong!

 

[Susan in Tennessee]

Or maybe it was Dr. Keshishian's FB group. FBK??

 

[DSRIGGS]

I agree that we need to be careful giving people a hard time about regain or not losing enough. That being said, I think that the science and data do ssow that there is one bariatric surgery that when performed properly (using science and not guessing) works and gives people the best chance , by far, of success. Of course I am talking about a Hess DS that is customized to each patient based on 30 years of science/data to give that patient optimal health an weight loss (and staying there). It is my strong belief that those who don't lose as much as they want with the DS isn't because they are lazy, bad patients who don't follow medical advice or any of that, but instead it is because they were left with too long of a total alimentary limb (CC + AL) based on their medical history and total small bowel length. To me it is analogous to a person needing have a quadruple bypass surgery and instead of bypassing 4 blockages the surgeon only does three. Sure you will have improved health to a certain degree but that 4th one that wasn't addressed is going to kill you. Could be tomorrow, could be 20 years from now.

There really is science & data out there that tells us what a surgeon needs to do to give a patient the DS that optimizes their health and weight.

 

[LindaDarnell]

Obesity is a chronic disease. I still have it. I always will have to be careful to avoid falling back, even with restriction and malabsorption. You are absolutely right that picking the right surgery for your health profile is essential. I came close to starting with a gastric band in the late 90s, and if I had, I know I would be one of the 80% who “failed.”

This is helpful from one obesity researcher: “patients who experience weight regain may manifest a particularly powerful neuroendocrine-metabolic starvation response to their initial weight loss that favors metabolic energy conservation and weight regain.”

That’s not to say there is never a contribution from psychological or behavioral differences, like my niece, who weighs more than when she started. She thought she was now invincible from weight gain with a sleeve, and ate as she wished and still lost weight in the first year, and then gained gradually over the next 5 years. At 350+ pounds again, she isn’t eager for a revision. She told me recently, “I am not willing to give up what you are giving up to stay thin.” You could argue she had the wrong surgery (and I believe she did), but even with the DS, she might have regained over time. Is she one of those with an exaggerated neuroendocrine response to weight loss or is she someone who didn’t want to work at it? Probably a little bit of both. Obesity is a chronic disease not cured by bariatric surgery alone. Picking the right surgery helps, but even DS doesn’t work without a lot of effort.

You are spot on!!!! Once we as a society recognize obesity as a disease, and accept that food addiction is real for so many, then we will be able to fight it better....not with just surgery, but with other tools as well!

 

[LindaDarnell]

I agree that we need to be careful giving people a hard time about regain or not losing enough. That being said, I think that the science and data do ssow that there is one bariatric surgery that when performed properly (using science and not guessing) works and gives people the best chance , by far, of success. Of course I am talking about a Hess DS that is customized to each patient based on 30 years of science/data to give that patient optimal health an weight loss (and staying there). It is my strong belief that those who don't lose as much as they want with the DS isn't because they are lazy, bad patients who don't follow medical advice or any of that, but instead it is because they were left with too long of a total alimentary limb (CC + AL) based on their medical history and total small bowel length. To me it is analogous to a person needing have a quadruple bypass surgery and instead of bypassing 4 blockages the surgeon only does three. Sure you will have improved health to a certain degree but that 4th one that wasn't addressed is going to kill you. Could be tomorrow, could be 20 years from now.

There really is science & data out there that tells us what a surgeon needs to do to give a patient the DS that optimizes their health and weight.

I do believe the DS is the best option for most patients. I knew within 2 weeks after having my sleeve that I needed it, but my doc at that time said it was too early to even think that way. 5 years later...here I am.
I do also believe that the sleeve and RNY can benefit some patients. I just think there should be more of a selective process , with realistic expectations set of what can truly be achieved. Not a one size fits all, and ur the failure if it doesn't fit you.