Gastric Sleeve Surgery

[camerong]

maybe for some, for the vast majority who do choose bariatric surgery they have other, sometimes multiple health concerns, such as diabetes, other hormonal disturbances, which make weight loss nearly impossible simply by dieting. Most reputable programs require an extensive period of supervised dieting, even liquid diets, behavior modification, counselling and treatment of underlying conditions before surgery is considered. People on such regimens typically do lose some weight, but nothing as dramatic as weight loss after surgery, plus with some procedures reliance on insulin or other hormonals support is not necessary after surgery, reason enough to consider it. It can actually reverse diabetes so the benefits are real and go beyond weight loss.

OP’s decision is a prudential one, not a moral one

As I said, it certainly is moral to have such a surgery.

None of what you wrote shows that strict dieting is less effective than bariatric surgery. Again, the simple truth is that all bariatric surgery does is make it so effectively the patient eats less food. Bariatric surgery is simply an elaborate way to take one’s appetite (or whatever drive one has to eat) out of the equation. People on strict diets often no longer require insulin or hormones, without surgery. AL of the benefits you mention come from the weight lost, not the surgery. And that weight can just as easily be lost if people just eat the same amount as if they had underwent the surgery…

Since you mentioned it, nothing makes dieting “nearly impossible.” Perhaps if one is 1,000 lbs, exercise is impossible. If dieting was impossible, the surgery would have no effect. As I’ve said many times, and as no one has shown otherwise, bariatric surgery is just a way to force someone on a strict diet. If a person complied with such a strict diet without the surgery, the results would be the same, and the person would not have spent a great deal of money and assumed a very significant risk of severe or deadly complications. Many people have lost hundreds of pounds through dieting and exercise alone. These people have gone from severe health problems, requiring dozens of medications daily, to a generally clean bill of health with no daily medications required. Surgery is not required for such results. Its simply the easier way to get there. Nothing more, nothing less.

 

[camerong]

OK, which is not analysing by intention to treat at all!

So far, I’m a bit frustrated by your habit to inject conclusions without giving reasoning for them. Please consider explaining your responses so that I can understand your assertion.

Specifically, would you please explain what the analyze intention to treat is, and why my point fails to meet it. I briefly googled the term, and perhaps I misunderstood it. The term may be widely known by others on this forum, but it is jargon to me.

 

[ciero]

Affecting satiety centres is another way of saying it makes you feel full. Feeling full is not a prerequisite to cease eating.

Let me rephrase this way. Bariatric surgery is no more effective than sufficient discipline to simply stop eating. Would you agree? Let’s take two overweight people. One attains enough discipline to eat only what his dietician proscribes per meal. Another has bariatric surgery. After a year, who is better off? Assuming the bariatric patient avoided any serious complications–which happen in approximately 25% of cases–they are exactly the same. This shows that bariatric surgery is no better than pure, old fashioned discipline.

Why do you suppose it is that are overweight today? Because our food is unhealthy? Doubtful–in the 1800’s they ate pig lard (talk about calorie dense foods!) Because we are more sedentary? Perhaps, but there have been desk-workers, such as lawyers and accountants, for hundreds or even thousands of years, and I’ve never heard such professions historically being home to obese people. No, the more likely factor is that today, we lack the discipline we once had.

Viewed from this perspective, the tougher but infinitely more beneficial answer to the obesity epidemic is not surgery that permits irresponsible behavior–encourages it, in fact, as many people with a BMI of less than 40 have been known to get FATTER to qualify for the surgery. What we need is greater emphasis of discipline. A more difficult solution, no doubt, but the only solution for the predicament we’re in.

Most people who have bariatric surgery (myself included, RNY gastric bypass) are overweight due to a metabolic issue. The gastric banding is the only surgery that only limits how much you can eat. All the other types of bariatric surgery also entail some malabsorption which means our bodies do not absorb all the nutrients from the food we do eat. People with these issues can NOT deal with their weight issues strictly with discipline!! The body does not deal with the food in a normal manner. The surgery I had put my diabetes of 20 years into remission, cured my high blood pressure,high cholesterol sleep apnea and Acid reflux.

I wish people who had no idea what they’re talking about would keep their mouths shut!!

 

[momor]

Most people who have bariatric surgery (myself included, RNY gastric bypass) are overweight due to a metabolic issue. The gastric banding is the only surgery that only limits how much you can eat. All the other types of bariatric surgery also entail some malabsorption which means our bodies do not absorb all the nutrients from the food we do eat. People with these issues can NOT deal with their weight issues strictly with discipline!! The body does not deal with the food in a normal manner. The surgery I had put my diabetes of 20 years into remission, cured my high blood pressure,high cholesterol sleep apnea and Acid reflux.

I wish people who had no idea what they’re talking about would keep their mouths shut!!

I am sorry this thread makes you angry but sometimes the truth can hurt. All of the issues you mention can be directly caused by being overweight and they go away (or into remission) due to the weight (fat) loss, not due to the surgical procedure itself! It is the excess weight and the overeating, especially of calorie dense foods, that cause these metabolic and mechanical issues.

 

[camerong]

Most people who have bariatric surgery (myself included, RNY gastric bypass) are overweight due to a metabolic issue. The gastric banding is the only surgery that only limits how much you can eat. All the other types of bariatric surgery also entail some malabsorption which means our bodies do not absorb all the nutrients from the food we do eat. People with these issues can NOT deal with their weight issues strictly with discipline!! The body does not deal with the food in a normal manner. The surgery I had put my diabetes of 20 years into remission, cured my high blood pressure,high cholesterol sleep apnea and Acid reflux.

I wish people who had no idea what they’re talking about would keep their mouths shut!!

I appreciate that this is a sensitive issue for many and I’m sorry I have offended you. That said, I firmly stand by my comments. However, I can see that continuing to trying to prove my point will only exasperate the offense I have caused you, so I bow out.of this conversation. This academic debate is not worth hurting anyone’s feelings.

 

[Doc_Keele]

So far, I’m a bit frustrated by your habit to inject conclusions without giving reasoning for them. Please consider explaining your responses so that I can understand your assertion.

Specifically, would you please explain what the analyze intention to treat is, and why my point fails to meet it. I briefly googled the term, and perhaps I misunderstood it. The term may be widely known by others on this forum, but it is jargon to me.

I assumed that when using the term you were familiar with what it meant…if not you should have asked for clarification at that stage!
I doubt it is widely known, in fairness

If I have a treatment that is not widely tolerated or adhered to for some reason, the results of treatment have to be analysed by how many patients were designated to that treatment, not by how many patients completed the course of treatment. So in the case of a strict diet, you would have to include all those who dropped out or didn’t comply with the diet to assess its effectiveness. This would be true for NFP as well. Then you would find the effectiveness is much less than if you just looked at those who complied with the regime.

 

[ciero]

I am sorry this thread makes you angry but sometimes the truth can hurt. All of the issues you mention can be directly caused by being overweight and they go away (or into remission) due to the weight (fat) loss, not due to the surgical procedure itself! It is the excess weight and the overeating, especially of calorie dense foods, that cause these metabolic and mechanical issues.

Not true!! These issues are resolved immediately with surgery WITHOUT loosing an ounce of weight!! By bypassing the dueodenum and a large portion of the large intestine these issues are resolved. The medical community still is not sure WHY this happens but it does happen. There are a number of studies going on around the world to find out why.

 

[Ella]

Not true!! These issues are resolved immediately with surgery WITHOUT loosing an ounce of weight!! By bypassing the dueodenum and a large portion of the large intestine these issues are resolved. The medical community still is not sure WHY this happens but it does happen. There are a number of studies going on around the world to find out why.

That is really interesting. I can’t remember if I read it in National Geographic or saw it in a documentary on PBS but I recall learning that in bypass surgeries there seems to be something in the operation itself, a cutting of some nerves perhaps? we don’t really know, that induces weight loss. This was a surprise and illustrates that there is much about our digestive system that we still do not know about.

 

[momor]

Not true!! These issues are resolved immediately with surgery WITHOUT loosing an ounce of weight!! By bypassing the dueodenum and a large portion of the large intestine these issues are resolved. The medical community still is not sure WHY this happens but it does happen. There are a number of studies going on around the world to find out why.

Can you provide some references on this? Gastric bypass is not that common anymore because it has such dangerous side-effects. More common are the gastric stapling or banding procedures which do not bypass part of the intestines. You will naturally get immediate improvement in blood glucose levels just by eating less, which the gastic limiting surgeries do. But the reduction in belly fat, especially internal fat, is very important in the control of Type 2 diabetes.

 

[ciero]

Can you provide some references on this? Gastric bypass is not that common anymore because it has such dangerous side-effects. More common are the gastric stapling or banding procedures which do not bypass part of the intestines. You will naturally get immediate improvement in blood glucose levels just by eating less, which the gastic limiting surgeries do. But the reduction in belly fat, especially internal fat, is very important in the control of Type 2 diabetes.

Once again you are showing your ignorance of the topic being discussed. The old stomach stapling surgery is not done any longer and is the surgery that had had the dangerous side effects. Roux en Y gastric bypass is the most common of the weight loss surgeries being done today. It has less side effects and a lower mortality rate then gall bladder surgery. The improvements with the blood sugar has no bearing on weight loss or even that you are eating less, it has more to do with your body no longer being resistant to insulin and other metabolic issues. I had my surgery to correct my diabetes at the recommendation of my endocrinologist. I did NOT have a weight issue, nor did I have a problem with food. I ate a healthy diet, exercised and maintained a healthy weight, yet my diabetes continued to get worse and worse. At the time of surgery I was on insulin injections 5 times a day and also on 5 prescription drugs. I left the hospital without the need for ANY of these drugs…Weight loss surgery has come a long way in the last 20 years. Unfortunately most people still equate it all with the old stomach stapling.

I would recommend the web site www.obesityhelp.com for more information on this topic.

 

[puzzleannie]

As I said, it certainly is moral to have such a surgery.

None of what you wrote shows that strict dieting is less effective than bariatric surgery. Again, the simple truth is that all bariatric surgery does is make it so effectively the patient eats less food. Bariatric surgery is simply an elaborate way to take one’s appetite (or whatever drive s.

be that as it may the prudence of choosing this surgery is not the topic of the thread. you need a bit more education on the surgery and the needs of those who qualify for it. you like most of us could also benefit from more education on why people become obese and the reasons diet alone cannot allow them to lose enough weight to benefit their health.

since discussing the merits of the surgery is verging on giving medical advice, banned on this forum shall we stick to the moral issue

 

[puzzleannie]

I am sorry this thread makes you angry but sometimes the truth can hurt. All of the issues you mention can be directly caused by being overweight and they go away (or into remission) due to the weight (fat) loss, not due to the surgical procedure itself! It is the excess weight and the overeating, especially of calorie dense foods, that cause these metabolic and mechanical issues.

This is simply not true. with certain types of bariatric surgery, even if the same percentage of weight loss could be achieved by diet alone, only the surgery reverses diabetes and assists other metabolic conditions. It is not true of all surgery types in this category, which is why OP has been advised to seek a second opinion to make sure his wife is getting the treatment best suited for her. to repeat and stay on topic, no this surgery is not immoral. the discussion should be closed because the question has been answered.

 

[camerong]

be that as it may the prudence of choosing this surgery is not the topic of the thread. you need a bit more education on the surgery and the needs of those who qualify for it. you like most of us could also benefit from more education on why people become obese and the reasons diet alone cannot allow them to lose enough weight to benefit their health.

I angrily responded to this post initially, but I thought better of it. Hopefully we can all remain more charitable in our future debates.

 

[ciero]

I angrily responded to this post initially, but I thought better of it. Hopefully we can all remain more charitable in our future debates.

What about this topic would make you angry?