The possibility of Lindsey having her innards surgically rearranged to induce weight loss has been a topic of contention between us lately. First Lindsey wrote a post about why she is considering weight loss surgery and how strange it is that only her thin friends support it. Emily then wrote a post about why she is not in favor of WLS. Enjoy and let us know what you think...
Point: By Lindsey
I found something out recently about the people in my life--->only my thin friends and relatives are supportive about the possibility of me having weight loss surgery. To be perfectly blunt I really don't care what anybodies opinion on the matter really is because whether or not I decide to have any form of surgery is such a personal decision that ultimately it doesn't matter what anyone else thinks. But what I do find interesting are the reactions I have gotten when I broach the topic. They range from the extremes of "I'll stop being your friend" to "That sounds like it could be amazing for you and I'll support anything you decide to do". And for the most part the reactions fall in line with how large the person I am taking to is.
You might think that the more overweight the person is, the more supportive they would be, but the opposite is true. My chubby, fat, obese friends have mostly expressed shock, scorn, and disappointment that I would ever consider "the easy way out". While my thin friends all think it would change my life for the better.
Why is that? It could be jealousy about the possibility of me losing weight while they remain the same. It could be fear that I would somehow change my personality, and consequently our relationship dynamic. It could be that they think I am judging their size because I am choosing to alter mine. Maybe my thin friends couldn't imagine life as a fat person and to them a surgery where there is a 1/200 chance of death seems like a reasonable alternative to being fat.
Emily, the surprise optimist, has threatened to cancel our friendship (editors note from Emily, this is a lie) if I get this surgery because she doesn't think that I have done everything in power to lose weight the natural way. She thinks the reason we are fat is because we have deep seated psychological issues which we should deal with with a shrink, Overeaters Anonymous, and a nutritionist before I even consider surgery. Do I eat too much because my daddy yelled at me? Because Melissa and Stacy were mean to be in 3rd grade? Because I secretly don't think I'm worthy of happiness? Because I'm scared to find out what else is wrong with me under the layers of fat? Maybe so. Personally I think everyone I know should be in a therapists office twice a week, me included, but I am sick of waiting for the "Aha!" moment where the light goes off and I can trace my food issues to a particular moment in September 1986 and from then on I make that ever illusive lifestyle change and suddenly drop 150 lbs. The thing is that Emily and I have been having the "why not just do it" talk for the last 10 years. And yet we never seem to do it. At least not permanently. I am ready to take a radical step for change. I want some results before any more of my 20's fly by be. Emily is still waiting for something, convinced that one day she will figure her shit out. I support her decision entirely, and I don't think she is crazy or wrong. The question is why is she threatening to cut me out of her life if I take a different path?
I think it is because fat people are beaten over the head with the fact that being fat is a character flaw, a sign of weakness, and so to have surgery and lose the weight that way is giving up and admitting that you can't control your own body without outside help, and thus having lost the weight you cannot proclaim to the world that you have honesty conquered your flaw, but instead you gave up and had a surgeon do it for you.
Think what you want, I think that's bullshit. Most people will lose weight with a restrictive diet and exercise. I am no different. I have dieted and exercised away 100 lbs on a few separate occasions. I know I can do it. I also know that I will gain it back. Does that say that I have no will power and am a weak person? Most people would say it does, but I refuse to see fatness as a character flaw because I am a good person, and hell, Hitler was a health nut. But I do need some extra help attaining and maintaining a BMI that this society puts so much emphasis on. And I am not considering surgery simply to look good at the beach, I am considering it because I feel like shit at the weight I am and I don't want to lose the weight only to regain it again.
What I think surgery offers is a fail safe, an internal check and balance system which guarantees that I can't eat too much of the wrong food which in turn will motivate me to exercise. Because I don't think surgery is the easy way out. I think for me it's like a step in AA where I admit that I have a problem, and that I need more than a little bit of help. I am not a naive or stupid person. I don't think that by having surgery all my issues with food or weight will be resolved. I actually think the opposite, that with the surgery my issues with food and weight will come to the surface, forcing me to deal with them or regain the weight. But I would rather me dealing with those issues as a size 12 than at a size 22. Once you've had the surgery you still need to keep a strict diet and exercise. If having a four hour surgery where my internal organs are rearranged is the easy way out, then I say bring it on...
Semi Counter Point: By Emily
Weight Loss Surgery doesn't bother me. I'm not against it, nor would I ever rule it out for myself. But, in this age of microwaves and Internet access, I think people rush into things without exhausting their other options, looking for what works at the speed of light. People have lost all patience. And to me, weight loss is nothing but two things: an understanding and patience.
Results don't happen over night. We need to deal with this fact. Instead, we choose to ignore it and repeat nasty cycles. And then we get frustrated and then we turn to weight loss surgery.
This is the way I see it: Weight loss surgery and dieting are the same thing, that's a given. A restriction of caloric intake and a proper exercise plan will result in weight loss. It's just the way things are. When one chooses to have weight loss surgery, it's easier for them to restrict their diet because they can only take in so much food. It's recommended that they exercise and not surprisingly, the combination of the two cause a person to lose weight. Same happens for old fashioned dieting. Neither is easy. Weight loss surgery isn't an easy way out. Does it make it easier? Yes. Easy way out? No.
This is the thing that always gets me though, the psychology part of it. I feel that no one brings up that fat people all have a common thread...the addiction aspect of food. No one ever seems to bring up the fact that more than not, the reason we're like this is because we have an unhealthy relationship with food. We have an addiction and before we decide to lose this weight and change our lives, we need to understand the root of this evil.
I know that if I had WLS tomorrow I would, at first, have a rapid weight loss. I would feel that I was in a groove and I might, for a while, take better care of myself. I would exercise a bit. I would choose healthier foods and then my weight would level off and I would start my normal diet routine...I would stop trying so hard. And the weight would creep back on and I would return to old habits of not eating at the proper times of day, letting myself get way too hungry, starving myself to only binge later. And I would do this because I skipped Step 1 and moved right onto Step 2.
I also know that if I started a strict diet tomorrow I would, for a couple of months. have a healthy, steady weight loss. I would exercise and eat balanced, well proportioned meals. And then the weight loss would start to level off and I would get frustrated and I would start to revert back to my old habits.
So, what has to happen first? I need to understand my issues with food. I need to understand what triggers me to eat the way I do when I'm not doing so hot. I need to recover from my addiction. Horse in front of the cart people.
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46 comments:
You guys are both really good writers! And I agree with both of you!
i agree with anonymous that ya'll are good writers. but i wanted to throw in a couple of things here regarding WLS. i come from a southern family where food=love (cake especially; but Southern cookin' isn't the healthiest thing in the first place). consequently, about half of my family is significantly overweight or obese, while those of us in the younger generation have struggled with anorexia (it may look different on the outside, but it's not that different psychologically, i think). my aunt, her daughter, and her daughter's husband have all been obese (the husband "morbidly obese") and have all had WLS.
my aunt had WLS many years ago, was somewhat slimmer for a little while, but is now as large as ever and has type II diabetes. although WLS can give you some quick satisfaction, emily makes good points about how it has to also be a psychological and lifestyle change before you can take the weight off and keep it off.
my cousin had WLS 3, maybe 4 years ago. Pounds just melted off her, and she was down to a size 14 lickity-split, bought a whole new wardrobe, started really taking care of herself, and basically got a healthier self-image based on the fact that her image looked healthy (Lindsay's point about "I would rather me dealing with those issues as a size 12 than at a size 22"). She's revised her diet and she exercises, so she's still in good shape--perhaps the best of her life. However, she's also been in and out of the hospital half a dozen times since the surgery with intestinal problems caused by the surgery. i think if she had it to do over again, she would still do it. But it's not necessarily something where you go in and you come out better. You may still have health issues, just not the same ones.
Her husband, the "morbidly obese" one, has had WLS in the past year. FIrst he had to lose enough weight to get the surgery done. Even then, they had to find a doctor to do it. For a third person in the same family to get WLS testifies to how much of a positive impact it can have on your life. He's lost over 100 lbs, and recently had surgery to remove the excess skin (this is another thing to consider--follow-up cosmetic surgery. it seems kind of random whether your skin elastically folows the weight loss or whether you'll have excess skin? my cousin didn't have this problem). His obesity gave him a life sentence--his doctor predicted he'd die in his mid-30s. Now he might be able to live longer. Certainly nothing to sneeze at.
I guess my point is that WLS should be considered a valid option. It's not like breast implants; it's more like abortion--in that it's not a matter of vanity and quick-fix solutions, it's a serious decision made with serious thought, that affects your life in more than superficial ways and that is ultimately about your control over your own body. So although I agree with Emily that, well, everyone should be in therapy, I think that if this is the decision Lindsey's come to, then it should be respected (it's her body). However, I think it's good if Lindsey talks to other people who've had WLS to see what she should look out for. It's got to be a pretty crazy experience to lose weight that fast--how people talk to you, perceive you; how you dress yourself, how you feel--if you weren't in therapy before, it seems like the WLS process is a good time to pursue it, just because there are so many "side effects."
Good luck in the short- and long-term with whichever route you choose.
I like the way both of you ladies are seriously examining the pros and cons of WLS. I was thinking about Emily's point that if you start a diet tomorrow, and reduce calorie intake and increase exercise, you will lose weight. Clearly this is true. But how many times have we all intended to do better, made it 'til lunch, said oh, screw it, I'll have the crispy chicken sandwich with french fries... and then ate whatever the hell we wanted for the rest of the day, as our diet was failed already? Emily's point that we all have food issues and we have to get to the root of those to make a real change makes a lot of sense, but at the same time, even if we could all afford the time and money for great counseling (which generally, we can't - or won't), it may take years to see progress, and even then our issues may never be resolved. It will probably always be a constant battle. This is where i bring in Lindsey's point about there being a 1/200 chance you could die during the surgery. That is scary, and I am not saying that your life is not worth every protection you can afford it, but we are human, we have 100% chance of dying, and it's pretty well researched that obese people have a good chance of dying before our skinny-minnie counter-parts. so we might as well give ourselves a chance at a healthier life if we can. I have this vivid picture in my head of my high school counselor, who was very obese, and broke an ankle somehow, and was in a wheelchair for months because her one good leg wasnt strong enough to support her body. She had to spend like, two months in her basement, because it had a wheelchair accessible bathroom, and no one could help her down the stairs because she was so big, so they had to put her in the back of a pickup truck and drive her around to the backyard. I mean, she could have been on oprah or something with a situation like that. But her doctor recommended WLS, and she had it, and she's doing so much better now. I thought she was 15 years older than she actually was, and now i can't believe how good she looks every time i see her. I don't want to waste all my young fun years self conscious and feeling crappy about myself... do you?
Ok girls, now calm down!! Nobody is not going to be anyone's friend if they get surgery or don't. However, be careful of drawing lines in the sand like that. I've figured that people make decisions in their lives and every time I've disagreed and they've done it anyway, our friendship ceases. And to be honest, I miss them.
Now about WLS. I'm somebody who has done alot of work in OA, and psychological work, and I've lost and gained 200 lbs. twice. The thing is this: there is no sure-fire way. WLS is a great option, but it is not failsafe. Statistics are that you are likely to gain all your weight back even with the WLS if you don't entirely change your habits. Many people have gained their weight back. Some of them keep it off.
Carnie wilson became an alcoholic after her WLS and still gained 50 lbs back. The thing about weight is its usually food addiction....a physical craving coupled with a mental obsession. I use food to soothe. Thank goodness i've had a month of relief from addictive eating. I was truned down for WlS cuz i was too fat...maybe a blessing in disguise...i don't know.
Its definitely not the "Easy Way Out". Those people that say that have no idea what they are talking about. The way you have to adhere to the plan and take care of your body after surgery is paramount to anybody saying "easy way out"...its not like they just snip snip and its all better....you have to deal with eating really small amts of food and really be careful with your body.
I'm rambling...but I support you whatever you do and I bet the ones that say they won't...they will...possibly they are afraid for you is all...
Michele
Have either of you ever tried hiring a personal trainer or anything like that? - you know, someone to do the motivating for you, so they force you to exercise, rather than you having to force yourself. Just a thought, and it's a bit less drastic (and probably cheaper) than WLS.
Love the blog - you two are excellent and entertaining writers
Carnie Wilson became an alcoholic after WLS? I never heard that one. Anyhoo... I think one of you should get it and other should try diet / exercise and SELL THIS CONCEPT AS A SHOW called FAT BEST FRIENDS FOREVER. I would watch this show!! :-) Love you guys!
Wow, you guys are great, I can see both sides of the issue. However, the ultimate descision is Lindesy's. It's obvious that she has and will take the time to
explore every aspect of the surgery, including all possible complications ect. From what I've read and heard from friends and coworker who have had the procedure, it's not the easy way out. Regardless, it's Lindsey's body and choice and any real friend would not abandon her because she doesn't approve.
You know my take Lindsey. Do it now, you are missing some of the best time in your life. Sure, those of us who have eating issues have things we need to deal with, but you know what? I went through years of therapy that never did jack shit for me. I wasn't able to deal with my demons until AFTER I had my surgery, and food was no longer an option as a friend or as a solace. I have never been better.
I went on a minivacation up north this weekend for 4 days. When we got there I single handedly carried all of our bags (6 of them) in one trip into the house. I didn't care where we parked for the art fair, so we didn't have to spend half an hour trying to find something "close enough". We treked to a pretty secluded beach without even me being winded. I remember the year before, I couldn't do a single one of these things. I was embarassed because I couldn't keep up. NOw I am leading the pack. Don't let life pass you by! Anyone who says that being fat (and I mean significantly overweight, 100+ pounds) isn't changing your life is full of it. I could never, ever have done what I did this weekend, and then at the end of it, carry all 6 bags of our crap up three flights of stairs, without breaking a sweat. That's enough for me!
Hi Lindsey and Emily --
I read your blog faithfully, although I haven't commented before. I have some experience that's relevant to this post.
Just so you know where I'm coming from . . . I'm 40, and currently in the midst of a weight-loss journey. I'm 5'8" and never weighed more than 200 until I hit my 30s . .. then I gained up to just over 300 lbs . . . currently I'm around 235 and on my way to around 150. I am doing it the "natural" way . . . but if I felt I needed the extra help I would have the surgery in a heartbeat.
Lindsey -- I totally agree with you that it is bullshit that having surgery is admitting that one can't control one's own body. Being morbidly obese is evidence to oneself (and the entire world) that one can't control one's own body . . . losing the weight, whether "naturally" or with the help of surgery, is taking back control. People who are morbidly obese and won't have surgery because THAT would be admitting they lack control are kidding themselves - they already lack control.
My cousin (call her "A") and her best friend (call her "B") were both morbidly obese - around 5'2" and 250 pounds each. B decided to have WLS, and A opposed the decision. A couched her criticism in terms like "admitting lack of control" but didn't really come to terms with B's decision before her surgery. Their relationship ended about a year after B finished losing her weight . . . I think A just couldn't deal with the fact that B HAD taken back control while she herself was still morbidly obese.
I admire the writing talent you both have, and I admire your friendship. I hope you continue your discussions, so that you don't end up losing your friendship like A and B. Good luck to you both.
I think the reason your fat friends are against it is because if they were for it they would have already done it themselves. Thus they probably wouldn't be fat.
I'm glad you're taking the decision seriously and I hope whatever you decide your friends and family support you.
Oh, this is just a side note, but I think that many people, particularly women tend to over-think their weight issues instead of just doing whatever neads to be done. The doing can include WLS, for some people or it can just be eating right and exercising for others. I used to spend alot of time trying to get to the emotional root of my weight issues. It wasn't until I decided to turn off my thoughts about food and my emotional issues with it that I finally lost the weight. There's even a book on women over-thinking and addictions. When we over-think/obsess about an addiction we end up making it worse. As, it gets worse we obsess even more about it and become depressed turning to the addiction/food to makes us feel better. So, it ends up as a cycle that spirals out of control. Your depressed from overthinking about your fatness, so you eat for comfort, you get fatter, being fatter makes you more depressed, so you cope with your depression by eating more. I don't think this is the case for everyone. Genetics and other problems can also play a part. If all fat people were overweight for a reason then it would be some much easier for society to pinpoint and we'd all be cured. So, much of the information out there is conflicting, because people are overweight for different reasons. Anyway, my greatest tool for losing the weight has been to stop thinking about the reasons why and start eating fewer calories. I also, stopped making excuses each morning as to why I not to exercises, just turned that nagging voice off in my head and got got off my buttocks and on the the eliptical machine. That's what worked for me, and I think more people should try it if they want to lose weight. I understand that not everyone who's fat cares to lose weight though. My sister is morbidly obese, and while she would prefer losing it, she's very active and still happy anyway. It's just not a huge issue for her.
I've been in OA for over 9 months, and I've found much of it to be incredibly helpful. I have an eating disorder. I have a problem with food, but what I appreciate in OA is that the reasons are unimportant. The WHY doesn't matter. Working through the 12 steps is what helps you address issues in the past that may be obstacles to you today.
But while knowing all this is helpful, I'm still fat. Do I want to be thinner? Hell, yeah. It would make so many things so much easier. It's way easier to cave to societal pressure to be thin than endure the struggle of standing up for yourself as a worthy and deserving person - a fat person. As a thin person, I could sidestep so many horrible things: people watching me eat in public and suggesting diet tips to me, watching friends comb through all the cute junior clearance racks while I am relegated to the fat ass clothing racks, etc.
But as badly as I'd like to walk in the thin girl's shoes, I will not consider WLS as an option. (Ria, it's not about taking back control. Any one with a food addiction already admits that their life is unmanageable, they have no control. WLS does nothing to address addiction or take back control. It's creates the illusion of control.) Ultimately, I think that undergoing WLS is a capitulation to a thin-obsessed culture that stresses thinness over health. A misogynistic thin-obsessed culture, at that.
But I don't blame anyone who wants to undergo it. I blame the system for glorifying it as an 'obesity solution'. I'd probably do it myself, except that the consequences are so fucking scary: heart palpitations, cramping abdominal pain, diarrhea, anal leakage (appropriately called 'Dumping Syndrome'), hair loss, gallstones, etc. A woman in OA with me once told me about her WLS experience, and she talked about having the most embarrassing problems with gas. So bad and embarrassing that her husband has started sleeping in another room.
Would I be okay as a size 12, and have anal leakage and gas that could clear a room? No, thank you.
Morgan,
BRA-FUCKING-VO!
Morgan,
I agree with much, not all of what you posted. I do think that there are some,not most WLS's that are needed. Most obese person's that I know are successful in just about every other aspect of their lives. That's why it angers me when I hear people accuse them of lacking willpower, or being lazy. If that were the case then they wouldn't be successful in in those other areas. That's another reason why I think the overthinking depression problem starts at a normal size, because society teaches that normal sizes are actually fat sizes. When a person starts thinking they have weight problem, even when none exist, then their becomes a tendency to obsess over food, and seek comfort in the food. This can lead to an actual eating disorder.
I'm not an advocate for WLS, in fact I'm strongly against it. I won't preach my thoughts on the subject too strongly except to suggest that WLS is a very traumatic alteration of your body with many unintended consequences. Combined with the failure to successfully result in significant weight loss after a two or three year period, it is a bad gamble unless you really have no choice.
But, the 1 in 200 number that you have used as your bogeyman is too safe a number. 2 or 3 in 100 is more reasonable.
I believe Lindsey is a little niave in believing that weight loss surgery will keep her from regaining the weight once it is lost. There are cases in which patients who had this surgery have regained the weight just like they would have if they had simply dieted. Yes, this is contingent on the type of surgery, however it is possible with most of these surgeries because there is a pouch of some sort and these pouches can stretch...Emily is correct in saying that it is one's relationship with food and the primary cause of their obesity, whether it be emotional or physical, that must be addressed before any sustained weight loss, whether through surgery or diet, can be achieved.
Thank you Emily and Lindsey for talking about this important issue. I agree with both of your arguments. I do want to point out that the accute mortality associated with WLS may be “only” 0.5% (1 in 200) but the incidence of major complications is as high as 5% (1 in 20) depending on the actual procedure and where you get it done. On the other hand, you’re young without any serious health issues yet, so you have the very best chances of having a smooth, event-free surgery and recovery. I do feel negative about WLS for me or for my loved ones, but I hope I am supportive of all the options, and I’m sorry Lindsey has had such negativity from her fat friends. On the other hand, I do think that many thin people would rather be dead than fat.
My sister (Kitty) is thinking of WLS, and I feel like I’m in Emily’s position. Kitty has diabetes, sleep apnea, and depression. She has mobility and hygeine issues, and is just full of aches and pains. Something has to be done to help her, and her doctor has put in the paperwork for her insurance to cover WLS. Yet, I think back just 2-3 years ago, when Kitty lost over 100 lbs through diet alone. She was down under 200 lbs for the first time in over 20 years, and she looked and felt great. She got a whole new wardrobe and swore that she was never going back. But she didn’t do anything concrete like join a gym or a support group. Now, just 2 years later, she’s back up over 320 lbs. I think (but haven’t told her) how is WLS going to be any different? After Kitty loses 150 lbs with WLS, why will that be different than just 2 years ago? Also, my sister is older (45) and has significant health issues, so I do not feel she is a good risk for the surgery. I don’t know how to talk to her about all this without sounding like Lindsey’s fat friends.
Lemaloon
Someone comented that people are told that larger sizes are fat sizes rather than "normal" sizes. What is normal in the US is totally abnormal in much of the world. If it was normal, weight would be the same across place and time. This is not the case. Very large sizes are common, but common does not mean normal. Normal is a dangerous word.
Lindsey,
I'm sure that you're aware that YOU CAN gain weight after having WLS, as a matter of fact, you can revert back to your starting size and wreck havoc on your intestines to boot. WLS is no guarantee of anything.
I'm not against WLS but what troubles me about it is that it's essentially a surgery that tricks the body into eating less without addressing the dysfunctional mentality that has caused the eating disorder in the first place. Also, WLS can be AGING to the body, especially on the skin. I personally know of a 21 year old who looks some 15 years older because her skin just couldn't cope with the drastic and taxing weight loss. Her facial features became lax and soft. A dermatologist will tell you that drastic weight loss is terrible on the skin. And of course, you'll end up needing cosmetic surgery to remove excess skin on your stomach, breasts, etc.
I also disagree with your statement about dieting and exercising. I am one of those girls that lost weight by ADDING healthy food to my daily diet rather than restricting calories.
I do not believe in deprivation. I slowly shed pounds without even trying to lose weight. What I changed about myself was my attitude towards caring about my health. I made my health a priority, whether I was chubby or not didn't factor into my mindset - I didn't have that pressure to lose weight - I am not a dieter I am someone who eats healthier than before.
Again, Emily makes the most important of points - the root of the addiction to food is not addressed by WLS. Lindsey, I urge you to consider all the cons before you make your decision. Whatever that decision eventually is, I wish you the best of luck.
I want to be able to eat a half a pizza and a box of ring dings. Both WLS and dieting stink.
Wow, where even to start?
Lindsey, I know that when I had a friend who decided to have WLS, I never said anything that wasn't supportive, but I was terrified for her. As it turns out, her surgery was (so far as I know) complication free. She's a great deal more slender than she was, but she's not svelte. Ironically, I thought that she was breathtakingly beautiful at 300 pounds, not so much so at 200.
Also, I have to comment on the idea that seems universally accepted in these comments. Not everyone who eats well and exercises daily is within the recommended BMI range (our own dear BuffPuff springs to mind). Studies done on twins (both fraternal and identical, raised together and raised apart) show that much of one's weight is hereditary. Identical twins tend to have near-identical BMIs regardless of how they were raised. They also gain in the same places on the body when they do gain weight. Fraternal twins tend to be much more varied, even when raised in the same household. (http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C0CE0DF1E30F937A15756C0A966958260)
Even a 1992 NIH study concluded that only 2% to 5% of dieters managed to maintain their weight after significant weight loss. Most are caught in "weight cycles" that actually cause the body to store fat more effectively each time there is any significant weight loss, leading one researcher to comment that "dieting is the leading cause of obesity in the US." What other medical treatment that worked exclusively in the short term and actually exacerbated a patient's condition would be tolerated by the medical community? Yet both doctors and much of society at large tend to blame the obese for their "failure" to maintain a socially-idealized weight.
Lemaloon, you may want to suggest that Kitty talk to her doctor about the possibility that she has fibromyalgia. From what you've said here, her symptoms appear to fit the profile.
This is only tangential to the topic at hand, but regarding the role of mental health in physical health, have you tried anti-depressants? I ask because one's digestive tract is lines with serotonin--the chemical that SSRIs act upon. For me, taking SSRIs has led to feeling less hungry and hungry less often. I supplement my SSRIs with 5-HT (which can be dangerous), which is serotonin. This makes me feel better mentally, but it also has the benefit of drastically reducing my sugar cravings, which means I eat less junk food. I'm just thinking that the combination effect--the way that an SSRI addresses depression, combined with the side-effect of decreasing appetite--might be of some use to some people in stopping the food-comfort cycle.
Anonymous said...
Someone comented that people are told that larger sizes are fat sizes rather than "normal" sizes. What is normal in the US is totally abnormal in much of the world. If it was normal, weight would be the same across place and time. This is not the case. Very large sizes are common, but common does not mean normal. Normal is a dangerous word.
11:20 AM
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Hi anon,
Sorry, I should have clarified. When I stated "normal" sizes, I meant for people of healthy weight being taught that for example: anything above a size 8 is fat, even if your 6'2, like my ex mom-inlaw. I did not mean "very large" sizes. At the age of 22, my downward(or upward)spiral began once I started getting complex, because I couldn't get into a size 5 anymore, because I was taught that anything larger on my 5 ft 2 in body was chubby.
Hi Peppa,
About your comment "I also disagree with your statement about dieting and exercising. I am one of those girls that lost weight by ADDING healthy food to my daily diet rather than restricting calories". I really wish that could have been true in my case. However, I tried it and sadly it just didn't work for me. Instead, I am one of those people who have to restrict their calories to a healthy amount, for me it's 1300 -1400 and exercise at least 30 minutes 5x weekly to lose weight at a slow yet steady pace. I'm happy that the sensible eating of healthy foods works well for you though.
Kate and Morgan have already posted such great stuff I have little left to say. I personally am not a fan of WLS because I feel the thin-at-any-cost mentality has lead to horrible medical "solutions" that are worse than the problem. Weight loss drugs -- the kind that cause fatal heart problems and oily anal gysers -- are a joke and weight loss surgery to me seems so medieval and horrendous, with risks that would be unfathomable with other procedures. Yet people are always giving the same excuse, "You'll be dead from being fat anyway so you might as well try it."
But I'm also an advocate of people doing whatever they want with their bodies. Tattoos, breast implants, face lifts to make them look like cats, whatever. It's your decision.
I had gastric bypass surgery on 6/16/06 (for the record: laproscopic, 1 night in hospital, no complications thus far). It was a decision I made after a year of research, therapy, and intense soul searching. It was not something I did to fit into cute clothes or make myself more "socially acceptable", it was something I did to save my own life. A year ago, at age 27 and over 300 lbs., I was hospitalized because of a BP of 195/130, borderline diabetic, and basically on the verge of a stroke. 3 1/2 weeks after WLS, 30+ lbs gone, BP and blood sugar normal, and cholesterol levels rapidly falling into line. This is the best thing I've ever done for myself.
Anyone who catergorizes WLS as "the easy way out" is, frankly, an uninformed idiot. Changing your body and the way you use and relate to food is anything but easy. For some of us, it is the hardest thing we will every do in our lives. WLS is a tool, and to use it sucessfully you must be commited to changing self-destructive behaviors and working your ass off in terms of diet and exercise. It gives you an opportunity to break the food food has on you. and like any opportunity, it can be wasted. If you are anything less than absolutely commited to taking control of your health and your life, DO NOT HAVE WLS! You'll only be setting yourself up for a failure of epic proportions.
WLS is a very personal decision, that unfortunately, everyone you know will have and opinion on. Many people will claim to "know someone" or "know someone who knows someone" that had some horrible complication. Don't listen. This is a major change to your body and your life, and second hand information ain't gonna cut it. Do your research, consider all the different options, interview surgeons, and talk to people who have ACTUALLY HAD THE SURGERY.
WLS won't cure your compulsive overeating, your depression, or your low self-esteem. Don't fool yourself into thinking it will. But ultimately, only you can make the right decision for you. Good luck, whatever you decide!
PS.: To the person who mentioned "Dumping Syndrome". Please be aware that dumping occurs in Gastric Bypass patients as a consequence of consuming too much fat and/or sugar at one time. You don't just randomly develop "anal leakage". Dumping symptoms vary WIDELY from person to person, some have a little tummy ache, and some, unfortunately, can faint or develop diarrhea. Also, some people who have had Gastric Bypass surgery do not dump at all, no matter what they eat. In people who do dump, the symptoms normal disappear 6-12 months after surgery. LAP-BAND and Duodenal Switch patients DO NOT DUMP!
k.c. touched on something I meant to include in my earlier post - Lindsey, please, please, PLEASE, research not only the surgery, but the surgeon. Get referrals. Check him/her out with the local Chamber of Commerce, Better Business Bureau, and the AMA to see whether s/he has a history of complaints. You are literally putting your life in your surgeon's hands. Any surgeon worth his/her salt won't be offended by your performing due diligence.
k.c. I'm very glad that your experience has been positive so far. I hope that it continues to be so. :D
Kate and K~~
Since when did we think Lindsey was a total moron? Because, I don't recall thinking she was retarded but maybe you girls know differently.
Who the hell has WLS without doing a mass amount of research???
I don't think Lindsey is a total moron, quite the opposite, but sometimes when something is so emotionally weighted, we lose perspective. I'd rather appear stupid by pointing out the obvious than uncaring for failing to.
As for who has WLS without doing a mass of research, you might be surprised.
Lindsey is not considering a gastric bypass, she is considering a Duodenal Switch which is a totally different animal. There is no dumping, you are left with a normally functioning stomach, and honestly, if you met any of us who had the DS you'd be hard pressed to believe we had weight loss surgery. We are NORMAL people. This isn't just me, or someone's friend I know of. There are over a 50 people in my local support group, and atleast twice that amount in my online support group. When we meet, we meet at Perkins and we order normal sized meals off the menu. We eat sensibily but if we want a piece of pie, we have it. The DS has DRASTICALLY different weight regain statistics than the RNY. Very very few people regain weight after their DS, something like 80% of weight lost is kept off after 5+ years. There are people in my group 15+ years out that haven't regained. It is currently accepted by Medicare as the best option for weight loss, and many many sutdies are underway AND have been published showing the results of this surgery to be surperior to an RNY. (This doesn't make the RNY a bad surgery, its just that the DS tends to leave you with a more normal life).
Sure it is a drastic option, but its a whole hell of a lot healthier than yo-yo dieting. The vast majority of dieters will regain their weight, and I can show you study after study that shows this. Once you get to a point of being 100+ pounds overweight, not only are your eating habits engrained enough that you will have a nearly impossible task of relearning them, but your metabolism is fucked up beyond belief.
This is going to turn into another one of those threads where everyone chimes in about how horrible WLS surgery is, and I have to tell you, unless you have done a year+ research like many of us have, and really understand the surgeries, then you have no clue what you're talking about. All you ever hear in the press is horror stories. You can't base your opinions on that shit, or what NAAFTA puts out. You have to read medical journals. You have to read ACTUAL studies, and I can guarentee most of you haven't. Did you know the death rate for ANy abdominal surgery is about 1/200? It ain't just WLS folks. It makes me so sad to hear all this blatent misinformation about this subject out there. Therapy isn't going to do fix most fat people's issues, if it did, then you know what? WLS wouldn't exsist. I'm done here. You guys enjoy deluding yourselves that having surgery is soooo much worse than being fat. 'Cause honestly, I'm here, and I have met hundreds of others who are here, healthier, and living their life, normally, because of the Duodenal Switch. I'll enjoy mine. You enjoy yours.
Thanks Dani,
I wanted to write something about the duodenal switch earlier, but I was at work...and you said it all for me!
Although both Lindsey and Emily say the surgery is not the easy way out, the surgery website seems to imply that you won't have to diet after the surgery. Excerpted:
"Can't I just diet?
You can! You can diet and diet and diet. There is a reason why the diet industry is making billions of dollars- DIETS DON'T WORK."
To me, dieting means paying attention to and limiting one's food choices to a reasonable quantity of healthy food, and dieting always goes hand in hand with exercise. My understanding of dieting is that it DOES work. I think this surgery website is talking about fad "diets" and other scams that are not about healthy eating and exercise. But the surgery website's FAQ doesn't exactly make that kind of distinction clear. The website just says diets don't work, surgery does. IMHO, that's simplistic and misleading.
I think Lindsey and Emily have it right, but the surgery website is just trying to draw in business. (The surgery website does give more nuanced answers to other FAQ questions, though.)
A great abstract on the DS: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1360120
emily sounds fatter and bitterer
You are friends. Friends are meant to stand by each other through thick and thin (no pun intended).
My best friend and I have been up and down in weights separately over the years. I have envied her weight loss while I struggled with my own and vice-versa.
People have no business judging your choice. You do what is best for you.
get the surgery, get a makeover, and congratulations, you'll still be annoying. Get over youself. I'd tell you to kill yourself, but your to lazy to even do that.
Lose weight. Lose weight. Lose weight.
So many of you folks that are encouraging us to do more research about the various types of WLS - and rightly so, good information is key - are writing in a manner that suggests your new found health is directly tied to your weight loss. Not exercise or eating well, but because you weigh less. Size is NEVER an indicator of health. (Unless you researchers would like to show me the medical study that shows a causative link between size and health. Hint: It doesn't exist.)
That is not a reason to hack open your abdominal cavity and screw around with your intestines and stomach. I think it must be a rare individual with no other choice that WLS. Otherwise, I suspect there must be a significant vanity component that writers here don't seem willing to discuss.
K.C.: You wrote: 'WLS is a tool, and to use it sucessfully you must be commited to changing self-destructive behaviors and working your ass off in terms of diet and exercise.'
Was working your ass off to eat well and exercise not an option when you were fat? Or was it because there was a chance that you would be healthy and stay fat, and that was unacceptable? Your rhetoric above just reinforces the tired stereotypes that fat folks are lazy, out of control, and unwilling to work for something.
GREAT post(s). Lindsey, I'm sorry that you're not getting the support that you're looking for. Before I started reading various DS-related weblogs, I probably would have been similarly negative if a friend came up to me with this possibility. I'm still wary (major surgery, big change, possibility of complications), but I've seen how much it helps people who are really dedicated to making the most of it, and if you do decide to do it, I'm confident that you'll be one of those folks.
AND I totally see where Emily is coming from. The surgery is a way of providing help for us heavy folks, but it doesn't provide direct assistance in dealing with the factors that helped bring the weight on in the first place. It shakes things up and places new demands on your body, which can often be enough to jump start the process of creating a new relationship to food, but you've still got to keep the elements that derailed you in the past from doing so again.
My opinion? Think think think, think some more, and then think a bit longer. Then do what feels right.
And while I don't want to directly engage some of the above commenters, I do want to say that decreasing your mass can help with some *particular* medical conditions - type II Diabetes and other types of insulin resistance, joint problems, heart problems, etc. It helps because you're relieving the stress on those systems, even though the extra mass wasn't the cause of the condition.
I also don't like the trend in society of looking at physical health as a linear thing - that all of our physical realities combine and become Healthy! Moderately Healthy! Not Healthy!
I've got great flexibility, pretty good endurance, a lot of fine motor control and great lungs, BP and hearing. I've got crap allergies, passable vision and heart strength, and an increased risk of type II diabetes due to being big and having a family history of the disease. What am I? Complex, and unwilling to use terms that try and ignore that fact.
Unless you researchers would like to show me the medical study that shows a causative link between size and health. Hint: It doesn't exist.)
Sleep Apneia patients are commonly advised that the weight of their body has a causative association with their (potentially fatal) illness. This has causative relationship with a potentially fatal illness has been tracked with body builders who present with under 5% body fat.
Osteo-Arthritis is commonly identified as caused by size, abnormally tall and heavy people often present with size related arthritis regardless of their body fat. Several of the tallest people on record despite being quite thin have had crippling arthritis as a result of their size.
Doesn't exist translates to isn't convenient to your argument?
Anon--
Like many people, before my surgery I had lot and regained a lot of weight through diet and exercise. The problem was keeping it off. WLS is a tool increases the likelyhood that I will keep the weight off this time, as long as I'm willing to do the work required.
I'm fat, but I'm not, never have been, and never will be lazy or unwilling to work. Nor was my surgery motivated by vanity. I was sexy at my highest weight and will be sexy at my lowest (no self-esteem issues here). You have a right to oppose the surgery for yourself, but don't make blanket judgement about those who have/consider WLS because of your bias. We all have different issues and motivations, and it's really not your place to pass judgement on any of them.
I have three friends that have done this surgery in the last 5 months. The funny thing is, everyone of them has to eat a certain amount of protein a day and 8 glasses of water a day.
This sounds exactly like the Fatkins diet, and if I could stick to that, I'd be thin.
So really they have all said that if is a way to keep them on the fatkins diet. If they overeat, they get sick...I say, I'll just try the fatkins diet without the surgery.
Maybe I'll start that tomorrow...
Lindsey, you are so right -- it is such a personal choice, and it really shouldn't matter to anyone. But free speech, and all that crap, someone will always have something to say -- take for instance my comment! LOL
I think for family and friends mega weght loss, no matter how it is achieved, creates dischord. What I mean is, you've always played the fat person in their life; that's your "role." Well, now you're contemplating changing that, and it effects them -- more than they should let it.
For instance, I was the person my friends always called when they wanted to do dinner... or be really bad and go for dessert only -- I swear, it seemed, somehow being with me didn't make them feel as bad about themselves.
I lost 105 lbs on my own, and was still 100 lbs from my goal weight, but as the pounds dropped, so did the friends who didn't know how to deal with the changes I was making. I even lost some fat friends, because they couldn't cope. It was like because I lost a few pounds, I no longer had anything in common with them.
It baffled me; the difference in the way friends and family treated change like this. How dare I take it upon myself to change my role in their lives!
I am on the path to weight loss surgery now. And I'm as scared as I am excited, and I really don't give a crap what anyone thinks (though I did take into consideration my Husband's feelings about it).
What I love about your blog is the full frontal awareness of being fat. Every piece of it is so true! You two just have the courage to share.
Thanks
I know this is very late - but just a brief comment about WLS. Any clinic or surgeon worth their salt will make sure potential patients have a complete psych eval. This is because WLS should only be done as an absolute last resort - after all other options have been exhausted. Further, it should be done on people who have any kind of binge eating issues (not saying this applies here) or depression, or some other psych issues. The reason for this is that any of these is predictive of not only a lack of success with the surgery - but also complications. Again, I'm not saying any of these are present in you - but I feel like it's important to note that this is a truly important part of the process.
Frankly, I think a good therapist (with experience in eating disorders) can help far more than surgery. But, I'm extremely biased.
Emily, you said:
"A restriction of caloric intake and a proper exercise plan will result in weight loss. It's just the way things are."
This may be true for some; but certainly not for all people.
Emily you also said:
"...fat people all have a common thread...the addiction aspect of food."
That is definitely not true. I am a fat person. I am not addicted to food - unless you mean that without food we would all die!?
Miranda Priestly, I love you so much that you have just become my world.
All of you, actually...can you be my new best friends? Please? I have never...and I mean NEVER...enjoyed a blog post session as much as this one. I have freakin goose pimples from this.
You are all wildly intelligent, well-spoken, and fantastic. I LOVE YOU SO!!!
Karen
www.gbgirlisin.blogspot.com
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