Many people feel that having Weight Loss Surgery (WLS) is taking the Easy way out.
I recently read a post where someone said they were offended by people who have WLS because the people do not take responsibility for their own actions.
I will attempt to show in this blog that while there may be a few who have WLS where this is true, for the most part, this is the furthest thing from the truth. WLS patients take even greater responsibility for their health above and beyond someone simply dieting.
First of all, there seems to be a misconception that Weight Loss Surgery means those of us who have surgery can still sit around all day long on our bottoms eating bon-bons (or ding-dongs etc). That there is no dieting or exercise involved. This is very far from the truth. Take for example the surgery I had – the Lap Band - The band does not keep me from eating chips, chocolate, pretzels or even ding dongs. Those are restrictions I have to take myself. All the band does is it helps me by making me full sooner and full longer. But what items I put into my mouth are still 100% my decision. There are some surgeries types that help with metabolizing food easier by having the food bypass usual digestion but even with those types of surgeries people need to be pretty strict about what goes into their month. Many people who have those surgeries (RNY or DS) are not able to even choose high sugar or high fat foods or they end up physically sick so they need to carefully read labels and make healthy choices.
As for exercise; it is as important for weight loss with or without surgery. And perhaps it is even more important for those who have had surgery. Many of us experience rapid weight loss due to our highly restricted caloric intake so we can end up with problems with excess skin. Many people who have WLS end up needing plastic surgery to remove skin, but daily exercise can really help and keep us from facing that added expense.
So, regardless which surgery you had daily diet and exercise is part of the plan.
The surgeries are just a tool to help. I again would like to use the analogy that my sparkbuddy OZAVIZE used because it is so brilliant. Our surgeries are like a Nicotine patch. When people try to quit smoking and they use a patch, no one thinks any less of them. People congratulate them on trying to quit. Everyone knows it is still a ton of work and that the person still has to daily make the choice to not smoke. WLS is EXACTLY like this. It is a tool that helps but the daily decision to eat right, diet and exercise is completely up to the WLS patient. It is not a magic bullet and it doesn’t do the work for you.
There is also a myth that people who have WLS do not deal with the root cause and assume the surgery will fix the issue. This may be true for some people just like it is true for some people who diet without surgery. There will always be people looking for a magic pill. But, the facts are that WLS is successful 70% of the time. Only 30% of patients fail with WLS. Do you know how many fail at diet and exercise alone? Studies prove it is 96-98%. Only 2% are successful at doing it alone. The truth is that most of us who are successful with our WLS have undergone counseling. We also are active in the WLS community. Many of us attend at least one (some of us a few) support groups. Those who are successful do look to the reason why they eat. We blog about it, we discuss it with our peers, friends, family etc. We are not ignoring it and expecting surgery to take care of it. We in fact tend to be more focused on our health than those who just casually go from one fad diet to another. That is the reason why we are so much more successful in the long run. Again 70% success rate compared with 2%.
Some more facts you may not be aware of about WLS and why it is anything but EASY!
Cost: Even for those of us who had insurance, there is still a VERY large cost associated with WLS. We have regular checkups with both our physician and our surgeon. There is also the added cost of keeping up wardrobe. I know this is a “oh waah” type of cost, but seriously loosing so much weight so fast is very expensive. I am always between sizes and very thankful to the existence of thrift stores.
Insurance Requirements: Most people who qualify for the surgery through their insurance have to go through a rigorous (usually at least 6 month) medically supervised weight loss program prior to the surgery. There often are other requirements like physiological evaluation, many physical tests and also nutrition counseling.
Surgery risks: Like all surgeries, WLS has risks. Anywhere from ½ of a percent who die from the surgery alone to up to 5% who experience complications? These facts are understood by the patient but the benefits outweigh the risks.
Food limits: There are some foods that are just not WLS friendly. For people who have RNY (Gastric Bypass) they have issues with sugars and fats and can experience what is called dumping. For those of us who have had the band we get “stuck” from foods like bread, pasta, rice. Unlike people who diet who can choose not to eat these, they can also choose to cheat and have an off day to enjoy these foods. Once you have surgery that choice is gone FOREVER. Another food on the forbidden list forever is Soda. There are many who feel that the carbonation can cause the new “pouch” to stretch so it is a forbidden food.
Loss of Food: In addition to many foods now being not good for us or too tricky. There is the whole morning of food that happens. I for example love to cook but often wonder what the point is. I only eat 2 ounces of food twice a day. I eat less than a whole can of tuna a day. So, when I cook ½ goes to my husband and the rest end up in the freezer until it goes bad because I can never eat enough to get to it all. When we go out to eat, I eat a few bites and I am done. I do really enjoy the few bites I do get, but I did have a mourning period of having to say goodbye to eating.
Supplements: With all surgeries supplements are a part of life forever. We do not eat enough calories and food to get our nutrition. Some surgeries even have added issues with inability to absorb nutrition from food. This for example is my daily vitamin routine.
I also have to consume 2 to 3 protein shakes a day to ensure I get adequate protein.
Chewing: Most surgeries require you to chew your food to the point that it is a liquid. This makes many regular “healthy” foods no longer an option. I for example have pretty much written off steak. By the time it is chewed enough for me to digest it, it no longer tastes good on my tongue.
Drinking with Meals: All surgeries have the “rule” that you are not supposed to drink with your meal. The reason for this is the food becomes a slurry when taken with food and will pass too quickly through the digestion track. For many people this can cause social issues as they can not enjoy a glass of wine or even soda with their friends. For me it has been really hard socially to see the waitress or waiters think I am NUTS not to want water with my meals. They come back often and ask if I am sure. It is a socially awkward moment.
Digestive Issues: Some surgeries are notorious for issues with diarrhea, excessive gas and body odor. Some others experience vomiting if they don’t choose the right foods or if they don’t chew enough.
Pain: There is considerable pain with the surgeries themselves, the recovery can be long and painful. There is also sometimes ongoing pain. For example when I don’t follow the “rules”. If I get to busy and I forget to chew my food to the point of it being liquid, food gets “stuck”. This is a horrible pain. I end up standing over the sink praying for sometimes up to 30 minutes before I either end up throwing up or the pain subsides when the food finally passes through my small hole.
Needles: for those of us who have the band, we have to get shots often (monthly at first) to get what is called Fills. For some other surgery types they have to do regular shots of B12.
Physical Change: Surgeries are either physically changing their own body by cutting out and or rearranging the digestion or by inserting a foreign object. This is not something that is easy and is a lifetime decision.
Social impact: Because of the stigma associated with WLS being the easy way out, many people choose to keep their surgery a secret. This is very difficult when dining out and your friends wonder why you can’t eat many foods. Why you don’t want even water with your meal. Why you stop eating after just a few bites.
Liquid Diets: Many surgeons require rigorous pre and post surgery liquid diets. I was on one for 2 weeks prior and 4 weeks post for a total of 6 weeks. 6 weeks with no chewing anything. And, no creamed foods were allowed either so it isn’t like when you had your tonsils out and lived on pudding and ice cream. 6 weeks of broth and protein shakes. I also am on a liquid diet each time I get a fill. For the first several months this was once a month so 3 days a month nothing but liquids. I need less fills now but still know liquid diet is part of the procedure each time I need one.
70% of those who have WLS are successful in loosing weight and keeping it off. There are 30% who fail. Compare that to the average of 2-4% who succeeds at just diet and exercise alone. This is because it is a lifelong decision, not a quick fix band-aid like many assume.
I will have to add that even with all of these items. It is still the best decision I have ever made for my health. The only regret most WLS patients ever have is waiting so long to do it.
I hope this will help people view those of us who have decided that we needed this tool in a new light.