A weighty decision

Not sure if you saw it, but The Wall Street Journal recently ran a front-page story on bariatric surgery being able to cure diabetes. According to the story, studies have revealed that more than 75% of patients with a certain type of diabetes who undergo the surgery see their disease disappear. As in, no more insulin. (Granted, even staunch proponents of gastric bypass say it's too early to recommend it for all diabetics.) But still, that’s quite an outcome. As Francesco Rubino, a pioneer in the field, said in the article, "Clearly there's something big going on here that can't be ignored."

Clearly. Last year, nearly 178,000 people underwent the $25,000 procedure, according to the American Society of Bariatric Surgery – that’s nearly four times the amount in 2001. And with nearly one of every three Americans considered obese, it’s obvious something needs to be done to get us Americans back on a healthy track. The question is, is surgery it? Promising results like these diabetes findings are exciting…but this is a potentially life-threatening procedure that limits the amount one can eat to just a few bites. Surely there must be some middle ground?

Gastric bypass is a touchy subject – for some people, the procedure can be a life-saver…but there’s definitely a stigma associated with it. For a celebrity example, look at how many years it took Star Jones just to admit the obvious – that she had undergone an operation in which, traditionally, the stomach is surgically reduced to the size of an egg and the often the intestines are rerouted. This is serious stuff. For a more extreme example, this time a real-world one, consider Annie, a woman in her 40s who I interviewed for Locker Room Diaries: Annie opted for an operation even more radical than traditional gastric bypass called the duodenal switch, which removed the majority of her stomach, allowing food to bypass 80 percent of her intestines. She lost 200 pounds. Size 30 to size 4. Three hundred and thirty five pounds to 135. Damn.

The surgery left her with a railroad-like incision from below her braline to her belly button, held together by staple after staple. And as her body rapidly shed the excess pounds, her skin lost its elasticity, leaving her once plumped-up body resembling a deflated balloon. She wound up needing multiple surgeries to remove excess skin, including a tummy tuck which took off five pounds.

Annie’s body image went on quite a roller coaster ride, as one might expect. Prior to “the Switch,” Annie would go to great lengths to avoid any display of the skin, so afraid was she of being stared at or ridiculed. But then after she lost the weight, that long scar served as an ever-present reminder of “what I wasn’t able to do on my own. I had to go and get someone to change my entire digestive tract.”

I feel like this last quote is the essence of the stigma I referenced earlier: “What I wasn’t able to do on my own.” I’m really interested to hear from readers who may have undergone G.B. – does Annie speak for many when she alludes to a feeling that her surgery represents failure? Is this a procedure to be embarrassed about? Or rather proud you ultimately took the step to get healthy?

Looking forward to the discussion.

Comments

I've never had GB so I can't answer your questions but your post did make me think about a book I read recently. Have any of you read "Rethinking Thin" by Gina Kolata? It is a fascinating look at the studies that have been done on obesity. In it, she says the good effects of GB (like lowered cholesterol & blood pressure) disappear two years post surgery, regardless of whether the subjects kept the weight off or not. I don't know if it would be the same for diabetes but it would be interesting to find out. I'm still a little mixed as to how I feel about the book, so if anyone else has read it (Leslie??) I'd love to hear your thoughts!!

I think that gastric bypass surgery, although extremely risky, may be the only avenue for the morbidly obese to shed the pounds they need in order to attain a healthy weight. It obviously works. I wouldn't condemn anyone for undergoing the surgery if they have found that diet and exercise alone aren't working for them.

My mother opted for gastric bypass in 2002. At the time of her decision, I was extremely upset and judgemental. I just couldn't wrap my head around why she would risk her life under the knife just to be thin. But my mother was also diabetic (note: "was" diabetic). From the day she left the hospital, she no longer had to give herself insulin shots. And after only 3 months she was able to stop taking medication for her diabetes. She lost 205 pounds in a 9 month span and became a completely different person. She was healthier and happier than I'd ever seen her. 5 years later, her weight still fluxuates but has leveled out in the normal weight range and she is still diabetes free. I saw the struggles she's had to go through and still goes through to change her relationship with food, so it's obvious that this surgery isn't for everyone, but it did change her life for the better and I know that without it she might not be here today.

In all honesty... I was EXTREMELY embarrassed about my having G.B, to the point where I would lie to people about what surgery I was having done- I told some people I was having my gallbladder removed!

Now that I have actually had the surgery, I'm seeing results and I'm having to go shopping for new clothes ...I don't shut up about my RNY!

This procedure is saving my life.. how can there be any negative in that?

I had Gastric Bypass surgery in June 2006. I've lost 138 pounds and I'm still losing. I had sleep apnea, acid reflux, high blood pressure. I was on 8 medications that I was embarrassed to go pick up at the pharmacy. They were medications my 70 year old Mother isn't even on. Within weeks of my surgery all of my co morbidities were resolved. I'm not embarrassed I had weight loss surgery. I made the best decision of my life.

By the way I'm also proud I had it done in Mexico.

I had RNY Gastric Bypass 4 1/2 years ago. I weighed over 502lbs at the time and would go to bed in tears thinking I would not wake up the next morning. Did I mention for 2 years before I had surgery I was doing physical therapy daily and had made changes to my diet...and when I finally went to a junk yard to weigh myself because I couldn't find any other scales in my small town to hold me...it read 502lbs! Now after my intial surgery and a follow up plastic surgery to remove a 16lb pannus I weight about 250lbs. I'm half the person I was, and I am a size I can't ever remember wearing. In middle school I wore a 26 jean, now I wear size 16 pants. I do have more plastic surgery in my future. I would have to say the only thing that is embarrassing is the fact that despite all the success I have acheived, to people who don't know my history I am still morbidly obese and need to "lose some weight".

Charlotte, I have not read "Rethinking Thin" (tho I love the cover) - I should out that on my list. Interesting that her findings may contradict some of the more recent research.

Thanks to everyone for writing about your experiences with GB - it's enlightening to hear it from people who have lived thru it. I'm so happy it's worked for you so far.

x,
Leslie

I had a VBG in September of 1997. I was 5' 8" and 350 lbs, did not have high blood pressure, high cholesterol, or diabetes. Diets did not work (who would have guessed it?) and fen-phen had been taken off the market (side effects, who would have guessed it?). All my numbers were good. Why did I have it? Because I had problems standing for any length of time without severe back pain, and I couldn't walk for any distance without the same. My results? Well, once I started eating regular food again (at the doctor's recommendation), instead of everything mashed or pureed, I couldn't keep anything down. My stapling came undone, and I regained the 70 lbs I had lost, and another 40. 10 years later, I am fatter than I would be if I had never had the surgery and my mobility issues are even worse. Would I recommend this surgery to anyone? Not just no, but HELL NO!!!!! The only results widely published are those that will convince people this is an option that will help you get thin and stay thin. Not always true.

Addendum to my post above: I had a friend who had the same surgery. She went from 400 lbs to 160 in less than a year. Where is she today? Dead from complications less than 2 years after her surgery. I lost my best friend because of society's obsession with being thin at any cost, no matter what your health is at your current weight. I'm not buying into it ever again. I now go with Health At Any Size, and if I never lose another pound, I DON'T CARE! As long as I am healthy, THAT is what matters, not the size of my ass or my thighs.

You seem to discount the fact that some people have actually regained the weight after surgery, and that the reversal of immediate reversal of diabetes in surgery patients suggests it's not fat-related (the weight loss is not immediate). Surgery patients have to basically give up sugar and fat, which of course is the diet recommended to help with diabetes. It doesn't necessarily mean they live healthier and happier lives, though - lots of people have had complications and even died. And at the risk of sounding like a lazy fat-ass, I'd much rather be obese than leave out sugar and fat.

Also, just because 60 % of Americans are considered something doesn't mean it's obvious something needs to be done. BMI statitics are a terrible way of measuring people's health, and a lot of recent studies actually that show being slightly overweight can be beneficial to one's health. It leads me to question if we should be drawing a line between overweight and normalweight at all, and if we're drawing the line wrong.

Regardless of the surgery, what everyone needs to be aware of is that a lot of us, as mentioned by Emily, need to change our relationship with food. Two of my co-workers had gastric bypass done. I was shocked when I walked into our lunchroom and found them eating baked potatoes - those huge mammoth on-steriod baked potatoes - which would have been find, mind you, had they not been smothered in butter, sour cream, bacon, and nacho cheese. And this was POST SURGERY! Hello, ladies, isn't this how you ended up getting the surgery done in the first place? Granted, I myself am 125 pounds overweight, but I've also come to the realization that I have mental issues to overcome before I even consider something as drastic as surgery for my weight loss.