We choose strategies every day that make the choice we want to make easier. While wls works by food restriction, and reducing the absorption of nutrition, the surgery forces the desired behavior (at least at first). Physical illness is a fairly good deterrent.
Alcoholics can choose to take anabuse, a drug that doesn't prevent alcoholics from drinking, but makes them physically ill if they do so.
I see wls much the same way. It makes sense in the same way that saving money by automatic withdrawal makes sense. By making the desired behavior more convenient or the consequences for the undesired behavior more severe, increases the odds of successful behavior change. Now whether it's worth the consequences or not, is a very different and very personal decision.
Hunger and appetite has been a very big issue for me. While the behavior (calorie restriction) is not dependent on hunger/appetite, reducing appetite makes calorie restriction easier and more comfortable. Sure "mind over matter" success is possible, but why white-knuckle it if you don't have to?
WLS is not the only means to hunger/appetite reduction, but it does take the choice (at least initially) out of the individual's hands. It's like putting your money into a CD or freezing your credit cards in a tub of water. By making the desired behavior easier, and the undesired behavior more inconvenient - you've got a stronger tool than simply the desire for change.
Yes, exercise and diet almost always work (even if there are physiological conditions that make it more difficult), but short-term changes are easier than long-term changes for a host of reasons. Finding ways to make the long-term commitment as strong as short-term ones often requires more than just desire and will. It's a matter of many little efforts (and tools to make those efforts easier and/or more affective) adding up.
Finding ways to make the long-term commitment as strong as short-term ones often requires more than just desire and will.
I really do think it IS a matter of willingness. You get out of something what you put into it. When you are willing to do "it", you FIND the way to make it work. You accept no excuses. And that willingness helps you to find/develop your "tools". Having those tools though are not enough. You have to be willing to use them. Knowing is not enough - we need to apply. And keep on applying.
The problem I see with WLS is the same problem I have with a lot of modern medicine, namely, drs. see an abnormal state, such as obesity or high cholesterol, and they "solve" it by altering the body's normal function, such as food absorption in the digestive system with surgery, and cholesterol production in the liver with statin drugs. The same could be said for Fosamax. No one ever has proven that obese people abnormally absorb nutrients, or that people with high cholesterol make an abnormal amount of cholesterol, with the exception of people with familial hypercholesterolemia.
And I'm with those who say, if you're going to have to restrict diet and exercise anyway, why not do that? Besides, many people have found a way to "eat around" their lapband and end up obese all over again.
Also, if you ask a surgeon what the best approach to anything is, the answer will be surgery. It's what they do.
For most of us, the consequences of WLS are not worth the benefits. But I do think there are some people for whom weight loss surgery is more of a necessity: people who are super-morbidly obese and at extreme health risk. WLS can often result in faster weight loss, and if it's a matter of lose weight fast or DIE, then I think the equation changes.
It does sound simple, doesn't it, you know, lower your calories and exercise more. I think that gets said so that people don't get overwhelmed STARTING something.
Some people have an easier time eating a variety of foods, or the same foods (don't need that much variety). Some people are emotional eaters. Some people hate exercise, some people embrace it and find all types of activities that they love doing (or a single activity, or several).
A lot really goes into getting a weight loss plan that works and that can be maintained over a long period of time, a lifetime really. And to my mind it seriously will vary from person to person. I've had to modify/change habits, my tastes, and change the eating plans to fit my tastes. It's not a static process, it's constantly changing for me.
And for me a part of it is accepting that I need to be a responsible adult and do what I need to do make it work, because I feel like I need to lose weight to be a healthy and happier woman.
Yes, I had to give up the notion that I could eat whatever I wanted, in whatever amounts I wanted, whenever I wanted, and part of that was dealing with the emotional side so that I wasn't eating my feelings. I don't believe it has to be a white knuckling situation. It has gotten easier for me as I've gone along, the eating and exercise. I read posts that say forlornly things like "and I think I'll have to do this forever," and I want to say, you may not always look at it that way!
It's a mixed bag, sometimes filled with excuses, sometimes filled with diets that really are not right for certain people, sometimes it's a mix of both, sometimes biology and psychology makes it even messier. So, you figure it out as you go along.
So interesting...I don't think WLS takes anything out of the hands of the person who chooses that path. Because if it DID, it would be 100% effective. And it is no more effective than the traditional way of weight loss. You can "eat your way" through the surgery and gain the weight back. IF you don't follow the strict regimen of diet and exercise. And while one year statistics are good, the following years show that people can't stick with the regime and return to their previous way of eating...and lord knows, there are been MULTIPLE medications developed to remove the "hunger" aspect --fiber tabs that expand to make you feel full, phen/fen that addressed both hunger AND metabolism, SSRIs to try to "boost" seritonin levels in the brain to make you feel satisfied without eating, amphetimines that kill appetite and boost metabolism, and NOTHING has worked in the long run. So why would WLS be any different?
And what really knocked my socks off is the story of the surgeon who performed WLS on an 85 year old man, who died from its complications (see the WLS forum for this story)...85 years old! Now, of course I don't know the particulars of this case, but it just doesn't sound right at all. 85 years old! Complications of surgery seriously outweigh ANY benefits in the long term, IMHO. Makes absolutely no sense, unless you look at it from a profit perspective...
Also, I just have to say this in defense of WW -- WW is as carb-intense as you make it. I can be a low-carber on WW just as easily as a high carber, because you get to CHOOSE how you want to eat. Just for the record...it isn't the diet that fails, it is the choices one makes. A dear friend of mine LAUGHED when I said I was on WW and said she gained 30 lbs on the program. All I can say is that she clearly didn't follow the program, because the FUNDAMENTAL prinicple of the program is calorie restriction. And it is HARD to NOT be successful with any calorie restriction diet UNLESS you aren't compliant. After all, you can be noncompliant with WLS calorie restriction parameters and gain weight. You can be a calorie counter, not count the calories and gain weight...
I still would LOVE to hear from WLS guys to understand HOW they arrived at their decision, without being accused of being intolerant, judgemental, and uneducated...
No one who has had weight loss surgery has any obligation to explain their reasoning to anyone, especially as this debate has come up many times before and invariably turns to judgement. But I'll (as a non WLS patient) give a few reasons.
First, as Heather mentioned, sometimes its a "lose weight fast or die" situation, either because of some immediate health risk, or because a different critical procedure cannot be performed without weight loss occurring first (this was the situation an uncle of mine was in - he needed a medical procedure that was impossible at his weight, and due to the urgency of the procedure, was counseled by his physician to consider WLS to get to a weight where he could get the treatment he needed.
Second, physicians are recommending WLS, sometimes strongly, to patients who have comorbid conditions like Type 2 diabetes or hyperlipidemia. That's because, long-term, people who have the surgery are more likely to resolve those issues than people who do not. This may be in part because the WLS is a tool to help in weight loss, but also is a property of the surgery itself. Duodenal Switch surgery, for example, involves a change to the digestive structure such that a very high percentage of patients are able to stop diabetes medication before they even leave the hospital (before weight loss has presumably taken place). The surgery is more than a weight loss tool - it's a tool that, in and of itself, without weight loss, can help manage or treat medical conditions. In this case, the patient's doctor (who has access to their entire medical record) has decided that the health benefits of the surgery are enough to justify the risks.
Third, the insurance system is set up, in a lot of ways, to push toward WLS. Getting coverage for WLS isn't easy, but it's still easier than getting coverage for a Medical Nutrition program (which is only required for coverage in a handful of states, and only covered by Medicare in a few very specific conditions). So if you're looking for a medical intervention to help you lose weight, you're likely going to find it not covered.
Deciding weight loss surgery isn't for you - that's fine. Deciding it isn't for anyone, or even implying that, ignores some of the major factors that a doctor and a patient might take into account when opting to use a surgical intervention.
I think that the majority of the time, exercise and diet do work. I can think of very few reasons (mostly medical) as to why they wouldn't. I also think Robin is right - for most people, it is a matter of willingness.
I can't speak for WLS folks because I've never considered that option and what they've gone through to reach that decision, so I can only speak about my experience.
For me, like Robin alluded, it was a really just a matter of running out of excuses. I had my gallbladder removed 6 years ago and I put on a lot of weight afterward. Mostly because I got lazy. I got depressed. I stopped caring. So when I started to try to lose the 80 lbs I had gained, for me who had only crash-dieted previously (as well as an ED), dieting was new. I failed SO MANY times. I would start, and quit, and start, and quit. And I would be one of those people who would throw my hands up and say "Nothing works for me!" I did WW, Atkins, South Beach, 6WBMO, you name it, I felt like I tried it. I would work out 3x a week and see .5 a lb lost. I FELT like I was doing everything, but after a month at the MOST, I would give up, gain back the few lbs I'd lost, and start over again. Gosh, if I had just stuck with it that first time, I'd have lost the 80 lbs twice by now!
In reality though, I just kept making excuses... I was too tired, too busy, it was too hard. So this year, I just finally stopped making excuses. Having lost 40 lbs so far, it's definitely been worth the hard work. As my husband said to me recently, "It's taken a while to get to this point in your journey, huh?" And he was right -over 2 years of starting, stopping, being successful, failing, etc.
It's just that every time I failed, I learned something new about myself and what worked/what didn't work. Finally, I seem to have gotten things right.
It makes sense in the same way that saving money by automatic withdrawal makes sense. By making the desired behavior more convenient or the consequences for the undesired behavior more severe, increases the odds of successful behavior change. Now whether it's worth the consequences or not, is a very different and very personal decision.
Kap that's a GREAT way of putting it. I've never heard it explained quite that way...
I believe lots of people give up too easily. If anyone's really had success losing any moderate amount of weight I feel like except for the rare medical condition that we all have the capability of doing it. Even those of us who've been obese all our lives. It's just a longer road for some of us. Sometimes it takes success and failures to learn the lessons we need to learn.
(Edit to add: but I'm not anti-WLS I almost had it myself... I just think it's slightly over used. There are LOTS of cases where it makes perfect sense)
losing weight is hard, but its really worth it in the end. i know i can be impatient at times , too, (ive been exercising relentlessly for a month and half, losing 2 pounds) but on the flip side, i have so much more energy and i feel better.
its easy to give up, but remember, the weight gain didnt happen over night.
I don't know if "give up too easily" is a fair assessment. Some people, yeah. "It's four weeks and I haven't lost 20 lbs? I give up!" That's too easy. But there are people who have been on plan for many months, sometimes over a year, who hit a big plateau. They get discouraged, and slowly creep back towards old eating and activity habits. No matter whether you're a "ban diet from your vocab" activist or a "stop sugar coating it--I'm dieting!" activist, it's hard work and the mental effort that is put into it alone can be exhausting. It's the first thing we think about when we get up in the morning and the last thing we think about before we go to bed. And there's a whole lot of thinking that goes on in between.
If we had to think about work that much, how long would we last in that job before we burned out? I think that it's fairer to say that a lot of people burn out than that they give up too easily. But maybe that's me aiding and abetting bad habits. I don't know.
I believe lots of people give up too easily. If anyone's really had success losing any moderate amount of weight I feel like except for the rare medical condition that we all have the capability of doing it. Even those of us who've been obese all our lives. It's just a longer road for some of us. Sometimes it takes success and failures to learn the lessons we need to learn.
And the willingness to travel that road and stay the course.
I know, I know. I sound like a broken record. But I believe with all my heart, that is what it will always boil down to. WILLINGNESS.
I firmly believe as well that you have to commit yourself.. not just be motivated. But this thread has also reminded me of something I just re-read earlier today about why people can't seem to stick to a "diet" or it "doesn't work". It's some bits and pieces from the first chapter of Tom Venuto's ebook.. "Burn the Fat, Feed the Muscle":
Quote:
Obviously you have to exercise and eat the right foods. What I’m suggesting is that if you don’t channel your mental energies properly, even the best diet and training program won’t help because you will always “sabotage” yourself. Did you ever wonder why you have lapses and breakdowns in “willpower?” Or why some days you just can’t drag yourself to the gym? Or why you “fall off the wagon” completely? Or why you can’t say “no” to those chocolate chip cookies? It’s because negative programming in your subconscious mind is controlling your behavior.
...
The conscious mind is a lot like the captain at the bridge of a ship. The captain gives a command and sends it down to the engine room. The subconscious mind is like the men down in the engine room. No matter what orders come down from the bridge (conscious mind), the crew obeys, even if the orders are stupid ones that crash the ship into a rocky shore. The reason this happens is because the crew (the subconscious) can’t see where the ship is going; they are simply following orders.
...
Because of the way your subconscious works, it’s extremely important for you to focus all your thoughts on what you want to achieve, not on what you want to avoid. This is not mere semantics; it’s a very important distinction. If I ask you to close your eyes and not to think about monkeys, you'll (mentally) see monkeys everywhere. You can't NOT think about something! You either think about something or you don't. And you always move toward what you think about the most, regardless of whether it’s positive or negative.
...
Negative statements and self-defeating questions
I can’t lose weight no matter what I do.
Why can't I lose this last ten pounds?
Why is it so hard for me to lose weight?
I have a slow metabolism.
Why can everyone else lose weight except me? It’s not fair.
It’s not my fault because I don’t have good genetics.
I don't want to be fat anymore.
I wish I could get rid of this gut.
It’ll never work because I like food too much.
I don’t have the willpower to get lean.
I would work out but I don’t have time.
I just can’t get myself up that early to work out.
I hate being fat.
I’ll never see my abs.
I hate cardio.
I can’t.
I’ll try.
...
All day long you carry on a mental conversation with yourself. Psychologists
estimate that we think up to 60,000 thoughts a day and that 98% of these thoughts are the same ones we had yesterday – most of them negative.
...
Fortunately, the one thing in life you always have 100% total control over is your thoughts. If you want to be successful in losing body fat or any other endeavor in life, you must master your communication with yourself. You must take charge of your self-talk, “police" your thinking...
Positive statements and empowering questions
How can I lose fat and enjoy the process?
What can I do today that will help me get closer to my weight loss goal?
What can I eat right now at this meal that will help me lose body fat?
How great am I going to feel after I finish my workout today?
My metabolism is getting faster every day.
I am getting leaner every day.
I like the way I look.
I am 100% responsible for my results.
Whatever it takes, I’ll do it.
I like eating healthy foods.
I love working out.
Training early in the morning is exhilarating.
I have time for anything I am committed to.
I like myself.
I can do it.
I’ll do it.
This really hit home for me. I *know* this is why I have not been successful with weight loss in the past. I was constantly sabotaging and defeating myself with negative thinking!!!
Just wanted to toss that in there as to why some people might say dieting does not work for them.
