Realities of Weight Loss Surgery

Today I saw a blog comment that felt like a dagger to the heart. I monitor a great many blogs through RSS feed. This comment was to a physician’s post about weight loss surgery on a gastroenterology blog. The person commenting was bemoaning a significant regain following weight loss surgery,

“My problem is, I thought it would always be surgery [controlling her weight]. I never wanted to be in control of my own weight again.”

Wow. In my estimation, pre-screening should have required this person to undergo psychological counseling before being approved for surgery. She clearly did not understand the basics of WLS. In part, I have to hold her surgeon responsible for seemingly communicating nothing to his/her patient about how the procedure works. I’m confident anyone who has had surgery would agree with me on this.

Just about everyone with 100 lbs. or more to lose considers surgery nowadays. It’s true it is a very powerful tool. The most powerful tool there is. So powerful, for awhile it can seem like a “magic bullet.” But do not be mislead. Even while the effects of WLS are their strongest, strict compliance with the limitations those effects impose are necessary, not only to maximize the results but to protect your health. Conscientious attention to nutrition is essential as is proper care of a surgically-modified stomach.

Make no mistake. The effects of WLS wear off. A significant lifestyle transformation must be firmly in place by the time this happens. I write in Powerful Hunger that weight loss by surgery is no less a story of significant transformation than a non-surgical effort.

Have you considered weight loss surgery? What are your perceptions of how it would change your life?


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    • Erin on October 24, 2012 at 8:20 am

    I have a client who is scheduled to get a breast reduction and tummy tuck in December. She is not grossly obese. She is not plagued by incredibly cumbersome breasts. She’s 40 with three past pregnancies, works full-time, married, and unhappy. I told her, “it’s going to seem like magic, having your 20 year olds body back, huh?” And she seemed excited. Then I asked her if she is willing to do the follow up maintenance to keep this renewed, youthful body, adding, “you will have to exercise and change your diet, but had you done this all along, you would not need to consider surgery.” She said she’s lazy, and likes to eat, so, no, she doesn’t want to do that… so I warned her to be prepared for surgery expense remorse a year post-op, because she will look the same again.
    On topic, my cousin got a lapband, and lost significant weight. Looked great, felt great, did nothing to change her life otherwise, and is nearly back to pre surgical self.

  1. Agree on all counts, Erin but I would say after three kids a lot of women could use a bit of tuck! Plastic surgery is most successful when a person has maintained the best they can. When I had excess skin removed from my upper arms, my weight was down and I had a regular workout habit solidly established. I NEVER want to stretch that tightened skin back out!!

    Plastic surgery requires so much effort, expense, and investment on many levels. That’s all wasted if a commitment is not made for conscientious maintenance. Ruining it causes people to experience a level of shame that I believe is truly horrific for them, far worse than any shame they felt for the original condition they were trying to resolve.

    Your cousin is one of those unfortunate cases. I hope I make it clear in my book that surgery is certainly NOT “the easy way out.” It’s the effective way that can get you results, IF you are committed to do the work for the rest of your life!

    • Erin on October 24, 2012 at 8:42 am

    I absolutely agree with you on the need to have that workout habit solidly established. Of course, my client considered me to be a ‘buzz kill’ but I am hoping that my reality check struck a nerve in there that will make her reconsider the pain and expense she is about to undergo for nothing.
    If I could help my cousin, I would… but alas, she does the best that she can, also… she is also post-polio and cannot exercise. My point in sharing her story is, if you don’t work to change your life, you won’t change anything permanently.

    • Dagny on October 24, 2012 at 1:19 pm

    All is not lost for your cousin, in fact she’s in the best possible situation if she’s willing to make the commitment. Losing weight purely by diet is challenging but not impossible. The lap band gives her a huge advantage. She can go back to her doctor and have the band tightened. It can be as tight as the day it was first implanted! She could use the lap band tool to manage her portions and keep her food intake very low. She definitely needs to go whole all the way! Stick with lean protein and fresh vegetables and she could get her weight back under control.

    As I outline in my book, calculating your basal metabolic rate is the starting point. If your cousin lives a primarily sedentary life, then she knows she’ll need to reduce her daily intake BELOW that BMR. It would be a long, slow process that she has no means of speeding up but having a lap band can make it easier to manage.

    • Stacie on December 28, 2013 at 10:42 pm

    I understand why this post was written, but as someone who had weightloss surgery, it seems as though you are putting down those who choose to have it as weak willed and out of control. I do not know you or if you have ever been morbidly obese. Maybe you have been and lost it without assistance from a procedure. Maybe you have been skinny your whole life. I don’t know. What I do know is I have been morbidly obese since childhood. Once you stretch your stomach out so far, you are pretty much doomed to never be able to stick with smaller portions. I do agree that some people go in to weight loss surgery highly uneducated and do not realize the hard work and lifestyle change you need to make in order to be successful. Yes, you CAN regain and NO, it’s not a magic surgery. It is hardly the easy way out though. It makes me crazy when I hear people talk about wls as a bad thing. Something taboo. It’s a procedure to help those who can’t get a handle on portion control. Period. I will say every day it’s been the best decision of my life.

    1. Hi Stacie—

      It looks like you’ve misinterpreted my post. Wouldn’t you agree that anyone who has weight loss surgery must make serious lifestyle changes that will have to be for the rest of their lives? I’m wondering if perhaps you happened to see a link in a Tweet and this is the only post of mine that you’ve read and have read nothing about my book. I wrote my book because I struggled with my weight all my life. My highest weight was 340lbs and I have maintained a loss of about half my body weight for going on nine years.

      If you use the tag “weight loss surgery” you can find my other posts on the issue. I hope you’ll read a bit more and then comment again:

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