It may seem that there are a lot of myths about bariatric surgery. Don’t be over affected by what may appear to be a large amount of negative information. The key word here is compliance. If you are healthy and follow Dr. Simpson’s very easy user friendly program, you will get results and you will keep yourself thin and in better health for the rest of your life. We write these things to warn the very few weight loss surgery patients who have no intention of working with the Lap-band the way it was designed to be used.
MYTH: All your health problems will vanish when you lose some pounds.
FACT: Skinny people get diseases too.
Strange as it might seem, skinny people get sick too.Yes, they do tend to live longer, but they still get sick. Skinny people develop diabetes, heart disease, high blood pressure, joint problems, sleep apnea, and a host of other problems. Just because you go from morbid obesity to a Slim Jim (or Jane) does not mean you are free of disease. Nor does it mean you won’t develop the diseases that are commonly associated with obesity.
Orthopedic surgeons who need to replace a patient’s knee or a hip refer them to me when the patient also needs to lose a hundred pounds. A good friend of mine was a general surgeon in Hawaii. He had a busy practice, and then his hips started to hurt. Eventually this thin, active man became debilitated and couldn’t stand the pain. He needed both of his hips replaced. So, still in his 30’s, John had both hips replaced, and is now doing quite well—although he moved to the east coast from Hawaii for some strange reason. Joints get replaced in skinny people all the time, and there are a lot of reasons that you may need to have the joints replaced besides being too heavy.
MYTH: You will not need to take medication any more
FACT: Skinny people need medicine to manage their diseases too
There are plenty of diabetic people who are thin but still need insulin to regulate their blood sugar. Some have proposed that weight loss surgery will cure diabetes—it won’t. While there are plenty of patients who have undergone weight loss surgery, and many require less insulin or go from insulin to pills, or use fewer pills, or even no pills—this does not mean you will be one of those. When you have diabetes, you will always have the tendency to have high blood sugar levels. While it is true that when you lose some pounds, insulin works better—it is not true that bariatric surgery will cure diabetes (in 2008 it was proven that weight loss surgery can cure type two diabetes). You may still need shots or pills, and most certainly you will need to have a diet which contains a mid to low glycemic index.
Some people need several medications to keep their blood pressure under control, and after weight loss surgery, while your heart may have a hundred less pounds to push blood through; you will probably still need high blood pressure medication. Thin people develop high blood pressure, and die of the complications of untreated high blood pressure. Franklin D. Roosevelt died of a stroke. His blood pressure was well over 200—and he was a rather thin fellow.
The Thin Person in those Big Blue Jeans
Don’t you love those before and after photographs? I don’t. A lot of my patients have done great following weight loss surgery, but I try not to post their photographs. Somehow, I think of that as a bit of false advertising. Bariatric surgery can, by itself, only get you so far. Those patients who have gotten to a BMI of 20-25 did it with a lot of hard work, rigidly sticking to a diet, perhaps some exercise. We consider weight loss surgery a success if there is a decrease of 65 per cent of the excess body weight.
Ideally, we don’t want to cut this too close (pun intended), and weight loss surgery is designed to so that we don’t. People who lose those extra thirty pounds really do it with help from the procedure, but they can’t give the operation all the credit. Weight loss surgery, in whichever form, is a tool, not a solution to obesity.
But, keep those old blue jeans; pictures of them make great post cards or Christmas cards for the relatives.
MYTH: Gastric Sleeve or Lap-band surgery is the easy way out
FACT: Weight loss surgery is not the easy way out
You don’t have bariatric surgery and wake up thin nor do you become thin in a month or two. Weight loss surgery means you will have to live a different way than before. Weight loss surgery has risks, including death, and those who undergo a procedure are putting their lives in the hands of someone else. An operation provides a great tool for obesity, it allows you to eat less and feel full. But there is nothing about Weight loss surgery, and the risks of the procedure, which are easy.
MYTH: You can reverse gastric bypass surgery if not happy with results
FACT: Lap-band and Gastric Plication surgery are the only bariatric surgeries that are reversible
If you don’t like a diet, or the diet doesn’t agree with you, you can stop it. If you are taking a medicine for obesity, such as Xenical™, which inhibits absorption of fat, you can stop taking the pill (although some medicines have long lasting effects). Once you have the procedure, for all practical purposes, gastric bypass is not reversible. Ok, sure, we can put bowel back together, we can make the stomach look the same, but it isn’t like the original factory-installed equipment. Like remodeling a house, once you remodel it you can always change it back to where things were, but it is never quite the same.
I once had a patient who had been told that her stomach stapling was reversible, that all the weight loss surgeon would have to do is remove the staples, like they would from a piece of paper. But, that is not the case. You cannot simply remove staples, put bowel back together, and hope that everything will run the way it did before.
MYTH: Your life will be perfect after weight loss surgery
FACT: Success depends on compliance and you may still have complaints
Anyone who has hung around the internet and researched weight loss surgery has come across the name of Sue Widemark. She has many different websites, including a website about bariatric surgery. People on Yahoo Group sites write about her in hushed tones, thinking that she is the anti-weight loss queen. She has quite a reputation, so imagine the day when I received an email from her asking if she could attend my weight loss surgery seminar. She has her own Yahoo group, called WLS uncensored, that I now subscribe to. A number of individuals have had weight loss surgery and many of them have had very bad experiences.
Do these folks all have something in common? I asked. They did—most of them did not comply with their weight loss surgeon’s instructions. Most didn’t take vitamins or learn to eat well, or they didn’t follow up with appropriate It is difficult to determine who can and will complymedical care. Now, this doesn’t apply to all of them, but it is a something most of them had in common.
One of my good friends, a weight loss surgeon in another state, had this very nice lady come in for bariatric surgery. She was excited and wanted weight loss surgery as soon as possible. She had the procedure and unfortunately, afterward she developed a leak. She ate a lot of mashed potatoes, stopped taking her medicine, and didn’t take her vitamins. She became ill and had to go back into a rehabilitation hospital. She had a complicated course of recovery then. When they measured her laboratory values, they found she was in a severe state of malnutrition. Ultimately, she had her weight loss surgery reversed (as best it could be). It is difficult to determine who can and will comply, but if you don’t comply—you will regret it.