Weight Loss Surgery - A Cautionary Tale From the Biggest Loser




nanj
01-07-2009, 05:38 PM
By now most of you have probably heard that there is a participant on the Biggest Loser this season that has had some kind of WLS and is now around 400 lbs. I didn't see the show and am catching bits and pieces from all my many WLS buds. I don't know the exact type of surgery he had, but it is being reported that his pouch is still pretty small. So how did he get back up to 400 lbs? Did he ever reach goal? What was his type of surgery? Does he have other health issues? Well, why even write about something with so many unknowns well.......because WLS is just a TOOL! My blood runs cold just to think that if I don't keep that in mind that I could be at the same place this person is.

Some of the older WLS people can tell that regain is possible. Why? Because they forgot the basics and didn't do protein first, carbs second, water after meals and exercise. NO GRAZING. I know this fellow's circumstances has struck fear into my heart!!!! So what you are suppose to do newbies? Set up good habits now and don't "test" the waters with sweets, carbs, fats, etc. and then you won't be sweating about rather you are going to regain, how will you take the extra weight off you regained, and start to see health problems popping up because of obesity. Some of you are going to fail, because that is the way the statistics read, but don't let that be you. I know my sister is getting heavy and she is about eight years out and has turned a blind eye and ear to anything that is being said about her need to get back on the wagon.

WLS IS JUST A TOOL. Get good nutritional advise and good counseling and things will go well for you. I'm not preaching at you all, I'm talking to you and mainly to myself!


AAAA
01-07-2009, 07:15 PM
I saw it last night. He said he had a gastric bypass, I believe, and had a very small stomach. He didn't say how he gained it. I think it was the doctor (examining him) who commented how he just ate and ate and gained a lot of weight.

missangelaks
01-07-2009, 07:51 PM
Missed the beginning of the New season! Darn it! But having very easily eaten 2000 cals in one day without trying, I can see that it would be easy to gain weight back!

I'm scared of that too, Nancy...and though I knew it was a tool when I had surgery and I'm getting better and better at swinging that hammer and hit the mark a good lot of the time, :D now, I just have to remember to take an honest look at why I eat over the stress and crap in my life when it doesn't help, it just makes it worse! BUT we all can look fear in the face and yell "Woohoo!" as we treat ourselves well with good food and regular exercise!

Angela


SpookyXXL
01-07-2009, 11:57 PM
OK I dont think I can post links yet but I know that the biggest loser is on surfthechannel.com
I dont know if the one you are looking for is there, I do know that there is tons of stuff there about it.
Personally I dislike the show, I hate how they treat big people like crap and sensationalize this.
Have any of you seen DietTribe on Lifetime? (mylifetime.com) it is about 5 friends who have gained and one of them had the by pass 3 years ago and regained and all I could think about is ...wow really?!? If you had a by pass why aren't you dieting NOW?!? Why are you JUST learning how to work out? She says "oh they dont tell you that the 150 pound weight loss is not normal" And I thought "YEAH but they DO tell you that you will have to WORK hard, diet and that it is for life." My dr says that for this to work I should be doing 60 mins a day 5 days a week of exercise.

Nanj is right it is a TOOL, a powerful and somewhat extream tool but tools only work as well as the person who uses them.

Even so I perfer DietTribe to Biggest Loser

RN BSN 2009
01-08-2009, 12:15 AM
I don't really understand it that well. If you have a gastric bypass and still have to eat right and workout, why not just eat right and workout in the first place? Doesn't cost a thing

missangelaks
01-08-2009, 01:12 AM
If that were the answer RN I would have. I was in a downward spiral, circling the drain...Like stirring a large kettle until the soup is moving in one direction. The surgery is like the wooden spoon that gets it moving in the other direction...it can help change the body's chemistry to be more resceptive to insulin, because, in my case, I just CAN'T eat sugar and simple carbs for the first year without consequenses. It can help one to change ones habits concerning diet and exercise but it doesn't change the soup...we still have to keep up the work...add the protein then veggies then the TVP ;)....that's why we stress that it's a wooden spoon, or tool, to change the direction of ones life, not a magic "eat what you want and still lose weight" potion.

diamondinthedesert
01-08-2009, 01:38 AM
He said his stomach was reduced to the size of an egg. Yet he still overate and continued to gain. Because of this Dr. H. said WLS as such is not a panacea.

nanj
01-08-2009, 07:56 AM
Miss RN: From one RN to another....Are you nuts?!?! Working in a hospital, nursing home, healthcare, etc...you have probably noticed there are tons and tons of people who are obese and suffer the health consequences from obesity. I'm 57 y/o and lost 100#, 98#, 58#, etc on Jenny Craig ($114 a pound), diet pills, low fat, low carb, Nutrisystem, TOPS, WW, nutritionist, Opti-fast, exchange diet, physician supervised diets, high multi-vitamin diet shots, etc. Paid for exercise and swim classes, done it on my own, and still stayed morbidly obese and just about unable to care for myself. Now ask again why I didn't just eat right and exercise? I'm not being smart here, but given the option of living the last, hopefully, 20 years immobile in terrible physical pain, diabetic, heart disease, and God knows what else was coming my way, I chose RNY. It is a tool, I do have to work at it, the weight doesn't just fall off, but it gives me a chance at a normal weight and life. I'm ALIVE and can't say that would have been the case in a few years. Sure I would have loved to have done it without the surgery, and from all listed, I think I tried and thank God everyday for my RNY. I knew going into it that I could regain, this man and my sister are a prime example, and I hope to that I can remember these people and my pain of MO and not regain and eat myself to death. If it were so easy, then why are you and me and so many like us here at 3 Fat Chicks, because it isn't easy. Did you happen to notice all the different plans and weight angles here at 3 Fat Chicks, not a one of them are foolproof. As for the cost of dieting before RNY, I would probably be a millionaire by now with all that I have invested in not quick weight loss schemes, but tried and true methods, that unfortunately didn't work for me. Remember when you are working with an obese patient, that they don't wish to be this way, but unfortunately they are and need all the kindness, support and encouragement that you can give them. I'm responsible for being obese, and simply couldn't get out of it without the RNY and I know that there are many who are in the same boat. I'm wonder if this obese RNY patient will be another thing for Oprah to crow about or has she finally realized that rather you have a thyroid problem or not, RNY or not, you still have to work at it. Even with all her helps, money, and availablity of the right things to eat, it is a lifelong hassel. Like to see her get off her high-horse about WLS and give WLS it's due, that it does save lives, is a tool, can be effective if used right!

tjjsmom
01-09-2009, 11:54 PM
Bob and Jill were on Oprah and alot of the people on the bL have regained their weight as well. The guy who won season three (I think his name was Eric) was on The Biggest Loser exercise show on comcast on Demand and he looked like he gain atleast half of his weight back.

kaplods
01-10-2009, 01:06 AM
Look at the drug antabuse - it's used as a tool for alcoholics so that drinking alcohol makes them sick. As a probation officer, I saw alcoholics drink through the sickness or just decide to stop taking the antabuse.

Antabuse doesn't cure alcoholism any more than wls cures the many factors that contribute to obesity.

In a sense, wls may work because it makes "not doing what you're supposed to" so darned unpleasant. If you overeat, you're going to get extremely ill. If you eat the wrong kinds of foods, you're going to get extremely ill.

As much as I know it's not the right choice for me, I support the decision of anyone choosing it, because it's one of the few "obesity treatments" with significant success rates. The success rate may "only" be 40%, but with the failure of traditional dieting being somewhere in the 95% plus range - you can't argue that it doesn't work.

If I were at the point that living another instant in the body I have was worse than death to me, I would opt for surgery in a heartbeat. It's taken me over a year to lose 40 lbs. I have a graduate degree in psychology and have helped people change their lives, and I have just as much trouble changing my own as the young adult drug users I worked with.

You can "know" everything you need to, and still find change difficult. There's no magic cures for any ills in life, as much as people on the outside will say "just do it." If it were that easy, we'd have no social ills in the world at all, we would all do what we know we should be doing, and everyone would be happy. There'd be world peace and we'd all be living eco-friendly in harmony with nature and each other.

nelie
01-10-2009, 10:52 AM
This is interesting. I don't watch the biggest loser but I thought this was about someone having WLS and then going on the show rather than having WLS then regaining it all back.

For me, I did everything as well, went to Jenny Craig (was on it a year and lost 30 lbs), went to Weight Watchers, tried diet pills, etc. From the age of 9 on, I had been dragged to nutritionalists and doctors about my weight issue. One of the last thing I did was go to weight counseling courses at Kaiser permanente. I met a lot of WLS candidates and even though I had never really considered WLS, I decided it wasn't the right thing for me at the time. Despite being heavier than most of the WLS candidates, I was much healthier than most or so it appeared. Then one day, I had a moment in which I knew I was going to lose weight and keep it off. Of course it hasn't been an easy path, a lot of it is mental and its taken me nearly 5 years to get where I'm at. I don't know if I'll ever reach the mid 100s but I'm happy with my weight loss. People look at me and see me as fat but this is my own struggle, not theirs.

jillybean720
01-10-2009, 12:21 PM
In a sense, wls may work because it makes "not doing what you're supposed to" so darned unpleasant. If you overeat, you're going to get extremely ill. If you eat the wrong kinds of foods, you're going to get extremely ill.

As much as I know it's not the right choice for me, I support the decision of anyone choosing it, because it's one of the few "obesity treatments" with significant success rates. The success rate may "only" be 40%, but with the failure of traditional dieting being somewhere in the 95% plus range - you can't argue that it doesn't work.
This isn't aimed just at you, kaplods, but anyone who may be reading and considering WLS. These ideas and stats are true for some procedures, but there are multiple WLS prodecures, including one with an 85% success rate, so dumping syndrome, and no narrow passages for food to get "stuck" (and up to 98.9% cure rate for type 2 diabetes, which is why I'm getting it). Not to say any suregry is better than another, though, as there are other tradeoffs (like having to take more vitamins).

RN BSN 2009
01-10-2009, 12:27 PM
Nanj, I'm just saying.. I eat tiny meals like someone who has had WLS, tiny meals, packed with protein, no sugar, no breads etc and I feel as if I'm getting the same results without the surgery.

nelie
01-10-2009, 12:57 PM
Nanj, I'm just saying.. I eat tiny meals like someone who has had WLS, tiny meals, packed with protein, no sugar, no breads etc and I feel as if I'm getting the same results without the surgery.

As someone who hasn't had the surgery, I think the overall point of WLS (or any weight loss method) is that everyone's weight loss is different. When you are morbidly obese, weight loss is largely a mental game and for some WLS may help them with getting over some of the hurdles of that mental game. Of course there are others who have physical issues as well. I know for me, without being on BCP, weight loss was nearly impossible and I think it gave me a little help to deal with some of the PCOS issues in regulating my hormones.

Lovely
01-10-2009, 01:10 PM
Nanj, I'm just saying.. I eat tiny meals like someone who has had WLS, tiny meals, packed with protein, no sugar, no breads etc and I feel as if I'm getting the same results without the surgery.

Even those with similar heights and weights can have different obstacles in losing extra pounds. Mental as well as physical obstacles.

It might be cheaper for someone to follow the plan without having the surgery, but what if not having the surgery means that they never start the plan? I would say it's much better for someone who has decided that surgery is the right choice for them to get the surgery and follow the plan than to think "But it'd be cheaper to do on my own" and never get started or never succeed.

Weightloss is so individual and so personal. We have to decide for ourselves what we're willing to do to get it.

As an example, there are many Low Carb members around 3FC who are having some brilliant success. And they're probably doing it a lot cheaper than myself who is paying to go to Weight Watchers each week. And I know that I probably could lose weight doing Low Carb... but I would never start. I would be setting myself up for failure.

I choose to pay for Weight Watchers and attend meetings because it's what works for me. And the price I pay each week, even if I had to pay it for the rest of my life, is worth it.

kaplods
01-10-2009, 01:29 PM
Thanks Jill,

Being on Medicare, I had to consider only the surgeries that Medicare will cover. I've researched all of those and quite a few that Medicare doesn't cover, just to compare. In general, the surgeries with the highest "success" rates (where success is generally measure only in terms of weight loss and maintenance, not other health effects) also have the highest incidence and severity of side effects. The most "successful" procedures also have the highest death risk during surgery and in the first year (and possibly further out as well, because there is a severe shortage of research following weight loss patients beyond one year - those that I found that did, did not consider any deaths after one year to be "relevent" to the study and did not attempt to explore cause of death for those patients).

Banding is probably the safest with the least side effects, and it also has the highest incidence of relapse. Probably a lot of reasons, but the lesser side effects may make it easier to "cheat." Also, it requires a lot of diligence to know when to go in to have the band adjusted, and there are often insurance problems (adjustments may not be covered, or may be severely limited).

Because of it's safety, I would consider lap band in a minute, if it weren't for the autoimmune disease, but the problem I had with the nasal button was scary enough and the doctor could SEE the inflammation at every visit. I've been in a position in which doctor's have dismissed my concerns with potentially fatal results (On several occasions, I asked for an MRI of my sinuses and was told I was being ridiculous - two years later a new ENT recommended an MRI and found a large ball of fungus growing in my sinuses and a sinus deformity that made a "perfect home" for the fungus because it created more nooks and crannies for the fungus to grow). The new ENT said that the fungus had definitely been growing for more than two years, possibly as many as eight and could have been causing a lot of the health problems I was having.

The gastric bypass procedures that Medicare covers all tend to have vitamin absorption issues. Which many people can address with supplements, but since I have vitamin absorption problems even with supplements now (even though the prescription supplements would be stronger), there's a high probability that I might not respond to them.

I'm also seriously prone to staph infections. I told my surgeon this when I had to have a breast tumor removed (luckily benign) and he dismissed my previous staph infections as being due to poor wound care (nope, I know how to care for a wound). At my follow-up appointment a couple days later, he removed the bandage for the first time, he removed the layers of bandaging and packing (obviously I hadn't disturbed any of it) and the wound was already very red and he said in astonishment "Wow, you really are susceptible to infection, aren't you?" (Uh, yeah - that's what I said).

I also have other issues that make any surgery higher risk than average.

I think everyone who is considering wls needs to know what the risks and special considerations are for each of the procedures they are considering, not only for the "average" patient, but for themselves, based on their own unique medical history, and the experience of the surgeon(s) they are considering. It's a difficult decision, and not one to be taken lightly on any level.

I've known a few people who didn't understand what they were getting themselves into, but even then some of it was "voluntary" ignorance on their part. Saying what they knew (or often were even told) the doctors needed to hear during the screening process. Even the mental exams where they're required can be fairly easily "faked."

WLS is by no means an easy choice, and if anything, doing the research to realize it isn't right for me, gave me alot more respect for those who choose it. The research is fascinating and complicated. There's some evidence, for example, that some wls procedures improve insulin function in the body - even when weight loss doesn't occur. There are also some studies that suggest that some wls procedures reduce the hunger response itself (perhaps, some of the experts theorize because of the stomach nerves that were severed during the procedure). It does disturb me that there's a shortage of long term research, especially on the folks who do suffer severe complications, but there are also some very understandable reasons for that. Following patients long term is difficult and expensive. People who aren't successful often drop out of the research, and can't be reached. The researchers often have no way to know whether a person isn't responding to follow-up requests because they've died or because they're not wanting to co-operate. Folks who aren't in compliance or who have gained the weight back or even those experiencing difficulties and complications through no fault of their own are often reluctant to talk about it, out of a fear of being blamed in some way.

Obesity is a very complicated problem, and so are its therapies.

SpookyXXL
01-10-2009, 01:33 PM
Not to mention if you have a metabolism problem like mine it radically adjust it.

jillybean720
01-11-2009, 08:43 AM
kaplods, I can't really disagree with anything you said (I won't get into the discussion of higher risks with certain procedures). I am having the Duodenal Switch (which Medicare covers), but if you have problems with vitamin absorption, then you're right that it is absolutely not for you.

In addition to people not thoroughly understanding all the possible complications/effects of surgery, I see MANY people not thoroughly researching all the WLS procedures available. Before I started researching, I thought the only options were a band or gastric bypass. How wrong I was! And yet, so many still think those are the only options. Sadly, most doctors think these are the only options, too, and even the majority of surgeons only perform these procedures, so they don't mention the others. WLS will always be more succesful when people choose the procedure that is best for them, but when only offered 2 options, sometime neither is a perfect fit.

jtammy
01-11-2009, 11:48 AM
Not to mention if you have a metabolism problem like mine it radically adjust it.

I'm not as knowledgeable about WLS as those of you that have had it or are considering it and have researched it, but I have never read anything that suggests that WLS changes your metabolism. What are you referring to here? Can you expound on it? Thanks!

kaplods
01-11-2009, 12:55 PM
I agree Jill, that patients (or prospective patients) need to know and understand their options, but it doesn't help that there are a lot of doctors out there who aren't good at explaining the medical details, and a lot of people who don't understand, or aren't interested in the medical details and treat their doctor like they might their mechanic (I don't care how you fix it, I'm not interested in the details, just fix it).

The terminology can also be confusing. Like even many doctors, I was lumping duodenal switch into the category of gastric bypass (because the stomach is remodeled and part of the digetive tract is rerouted), but you're right it doesn't fully belong there. It's really more of a "partial bypass."

Insurance issues are rough too. It can be difficult for a patient, if the procedures their insurance covers, or their network surgeon performs are limited. That's the status of medical coverage, even when you're informed enough to identify the procedure that for you would be best, you still generally have to work within your insurance coverage. If the "best" procedure isn't available to you, do you accept the second best surgical option or do you choose a non-surgical treatment? Good non-surgical treatments aren't generally covered by insurance at all. Pretty much sucks, but what are you going to do?

I would like to see more options, especially non-surgical. Our hospital has a state-of-the-art weight management clinic with an excellent reputation. The funding for the clinic was combined with funding for a YMCA, so the YMCA is open to the public, but is also a fully certified rehabilitation and physical therapy program. It's an amazing program, and includes a discounted gym membership (but they have only one patient who was able to get their insurance to cover part of the cost of the program). They do have a lot of patients who are in the program because their insurance requires proof that they've tried such a program and failed (which seems kind of sick and backwards to me, that they're going in wanting or even trying to fail, so that insurance will cover the surgical procedure they really want).

In a sense, it's kind of whacky that insurances will cover surgical procedures (because they do have a significant success rate), but not intensive behavioral programs (because there's no proof yet, that they're more effective than dieting alone), and it is the lack of funding that makes these programs very difficult to determine their successfulness. It just seems weird to me that in the treatment options for obesity there is so often a giant leap from trial and error dieting on your own to surgery with nothing in the middle.

jillybean720
01-11-2009, 10:44 PM
I'm not as knowledgeable about WLS as those of you that have had it or are considering it and have researched it, but I have never read anything that suggests that WLS changes your metabolism. What are you referring to here? Can you expound on it? Thanks!
I can say that with a malabsorptive procedure, it doesn't actually change your metabolism, but it appears so outwardly (if that makes sense). I know most people who get the surgery I am getting can eat 3000 calories a day without gaining weight because many of the calories are not absorbed.

Also, malabsorptive surgeries have an effect on the way the body handles sugar, which is why they can send type 2 diabetes into full remission while still in the hospital, before any weight loss occurs.

Candi23
01-16-2009, 01:20 PM
My sister had a gastric bypass five years ago. She weighed over 400 lbs. She is now around 200. That part worked fine. The part that is scary, is she went to her support groups, gave herself injections of vitamins, followed the doctors orders to a T. Now, five years later, she is addicted to pain meds because she has to take them daily, anti-nasuea meds daily, acid reflux meds daily. She vomits every time she eats, she had a twisted bowel that was repaired, she is skin and bone (except for the water she retains in her legs because her lymphnodes don't work.) In June of 2007 she was admitted into the hospital in Liver failure, we were told three different times she would not survive. She had to be flown to OHSU in Portland. She was in the hospital over 60 days. Her liver somehow made it through, but is permanantly damaged, and will most likely need a transplant. She was sent home with a feeding tube that she had to have for three months, it came out in November and now she is sick again, and has barely been out of bed since Thanksgiving. The doctors will not let her work, not that she could in her current condition. Has anyone else had any issues like this???

ogfarmer
01-17-2009, 09:46 PM
You have inspired me today. Can I quote you, "People look at me and see me as fat but this is my own struggle, not theirs." I love that. It makes me feel real good. Thank you:carrot:

shcirerf
01-18-2009, 11:52 AM
I just got the news that my 34 yo niece is having lapband surgery on Tuesday.

In most cases I would be thrilled and supportive, but I have mixed feelings about this.

I have several friends who have had lb surgery and done very well with it. But they followed Dr.s orders to a T!

There is no way my niece is going to do this. She does not have the temperament to take orders. That's why she's unemployed most of the time.

She's loud, mean, *****y, twice divorced, does not want her kids but keeps them because of the welfare check. Last weekend she got the s**t beat out of her at a drunken party. Now she has to go to court on assault and battery charges, since she threw the first punch.

She's been arrested several times for driving under suspension, writing hot checks, etc. All in the last year.

I don't think she is in any way, shape or form ready for the commitment or lifestyle change the LB surgery requires. Plus my tax $'s are paying for it. GRR!

Off my soapbox now. Thanks for listening.

jiffypop
01-18-2009, 01:55 PM
i hear ya, janelle. but unfortunately, there's not much you can do about it. she'll do whatever she'll do, and her surgeon will support her, or will read her the riot act.

and she'll be in for some rude awakenings when she has bad reactions. hang tight, darlin! it's gonna be a bumpy ride.

shcirerf
01-18-2009, 02:10 PM
I don't see a lot of the niece. We don't run in the same circles and she knows DH & I won't put up with her antics.

She does however take advantage of MIL (her Grandmother), a lot. Her Mom won't hardly have anything to do with her either, but that's because her husband has no use for family, it costs him time and money.

It's gonna be a mess.

nelie
01-19-2009, 02:48 PM
Janelle,

The only person I knew (besides on this website) to have WLS was in a similar situation. She had gastric bypass and as soon as I heard, I knew it was a mistake. I didn't believe she was a proper candidate for the surgery and she was looking for a quick fix. Medicare paid for it and she was happy for the weight she lost but she gained most of it back until she had other unrelated health issues which actually resulted in her death.

Shar888
01-20-2009, 05:07 PM
Hi all! Just an FYI, you can catch the Biggest Loser episodes for free on NBC.com. Just click on 'Videos'. Just watched the premiere episode last night on NBC.com and they did show the part where the doctor is talking to the patient who had the Bypass surgery.