Bariatric surgery

[Ally9]

A very dear friend of mine is considering gastric sleeve surgery after years of failed dieting and excersise regimes. From where I’m standing it seems that it may be an unessecary risk and in reading a little bit about it I note there are strong opinion on either side. Putting aside those opinions would anyone patients or surgeons care to share any thoughts or experiences that I can perhaps use to give advice to him. I clearly want the best for him but worry this may not be the best route.
Patients, relatives or friends of patients or surgeons only. I think he has heard all the eat less excersize more counsel.

[Boothroyd]

I know one who has had it in my extended family. There can be complications, so that is the first thing to consider. It's a radical approach, but one still has to live with rules afterwards or weight loss will not follow as expected. It doesn't fix the problem as a result of the surgery itself, is my point.

[pickettt]

Originally Posted by Ally9

Patients, relatives or friends of patients or surgeons only. I think he has heard all the eat less excersize more counsel.

I have a longtime friend whose wife AND daughter have had bariatric surgery. They've not changed their mindsets, and so are on their way back to their former selves. The surgery is not magic, it's just a reset button. If you don't change your eating and exercise habits, it's just a waste of time. Good luck and Godspeed to your friend.

[encarter13]

I had a family member that had the surgery. One time we had a family dinner, she sat down in a solid wood chair, and the chair exploded! That was the straw that broke the camels back. She had the surgery shortly after and lost hundred of pounds. She was smaller lady again. I would say about a size 6.

Fast forward 15 years and she has gained about 50-60 pounds back. Nowhere near her heaviest, but much bigger than a size 6. Like others have said, you have to be disciplined after hitting the reset button.

[swils8610]

I can speak first hand to it. I had gastric sleeve surgery 4 years ago...not full gastric bypass. My surgeon advised against full gastric bypass. I was overweight but not morbidly obese. I was about 325 and 5’ 10’. The gastric sleeve simply reduces the size of your stomach. No internal plumbing is rerouted or anything. I had to attend nutrition classes which I did and learned a lot. Also had to have a pysch eval. It took about 6 months or so from first visit to the surgery. The surgery was easy. Went in the hospital in the morning, had the surgery done via laparoscope. 4 Small incisions. I was walking around within an hour of the surgery. I was only given Tylenol for pain which was minimal. Like I’d been doing crunches or sit ups. I went home the following morning. I wanted to go home the night of the surgery but was not allowed to. I like to be at work and was off less than a week. I think 3 or 4 days. I’ve lost 85 pound and have gained back less than 5. I could loose more but I’m comfortable where I am. My stomach size was reduced to the size of a banana basically. I try to get 60 to 80 grams of protein in a day. If I do that I’m never hungry. I’d do it again in a second. They teach you it’s a tool to loosing weight which I agree. I do pay attention to my diet more...but when I want to eat something bad for me I eat much less of it. I can’t consume big meals at all. I may be the exception and not the rule. It’s a very personal choice.


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[swils8610]

Originally Posted by swils8610

I can speak first hand to it. I had gastric sleeve surgery 4 years ago...not full gastric bypass. My surgeon advised against full gastric bypass. I was overweight but not morbidly obese. I was about 325 and 5’ 10’. The gastric sleeve simply reduces the size of your stomach. No internal plumbing is rerouted or anything. I had to attend nutrition classes which I did and learned a lot. Also had to have a pysch eval. It took about 6 months or so from first visit to the surgery. The surgery was easy. Went in the hospital in the morning, had the surgery done via laparoscope. 4 Small incisions. I was walking around within an hour of the surgery. I was only given Tylenol for pain which was minimal. Like I’d been doing crunches or sit ups. I went home the following morning. I wanted to go home the night of the surgery but was not allowed to. I like to be at work and was off less than a week. I think 3 or 4 days. I’ve lost 85 pound and have gained back less than 5. I could loose more but I’m comfortable where I am. My stomach size was reduced to the size of a banana basically. I try to get 60 to 80 grams of protein in a day. If I do that I’m never hungry. I’d do it again in a second. They teach you it’s a tool to loosing weight which I agree. I do pay attention to my diet more...but when I want to eat something bad for me I eat much less of it. I can’t consume big meals at all. I may be the exception and not the rule. It’s a very personal choice. I also had done the diet thing, more exercising regiment and lost weight but never kept it off. I do feel way better than I ever have. I was made aware of possible complications but luckily didn’t have any. I wasn’t really concerned about them. The surgeon that did my surgery only does gastric sleeve surgery. That’s his area of expertise. I also had my gallbladder out over 10 years ago with no complications done laparoscopically. Feel free to PM if you like. I’m more than happy to share my experience.


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[tyler1980]

if diet and exercise haven't worked there are not a lot of other options... the health concerns of not doing it are far more severe than the risk of doing it. Surgery carries risk but so does being very overweight.

I have a family member who has had it, and the results were very good.

[Zakalwe]

It’s impossible to answer this question without knowing more detail about the person considering surgery. I’m not asking for such details to be posted but will offer some general information. Disclaimer: I am not a bariatric surgeon and the following does not constitute advice! (Apart from the final paragraph).

The non-cosmetic benefits of bariatric surgery depend on whether the person has obesity-related health problems, especially Type 2 Diabetes and hypertension. Bariatric surgery has been shown to potentially cure diabetes. An Italian randomised control trial published in the Lancet (2015;386:964) showed that 37-63% of patients undergoing surgery went into remission from diabetes afterwards, though 44% of those became diabetic again within 5 years. Anecdotally, I can say I have seen people who needed medication for hypertension return to having normal blood pressures off all medication post-surgically, but I don’t have any trial data to offer.

As for the drawbacks of surgery, the major one is death. This outcome was analysed by a retrospective cohort study of Veterans Affairs patients (JAMA 2015;313:62), which compared bariatric surgical patients with people who didn’t have surgery. Again, the surgical patients in this study were diabetic, which is important, because diabetes kills people, so any treatment that has the potential to cure it is potentially life saving. The study showed that within a year post surgery, there was a similar mortality rate between the surgical and non-surgical group. However, after the first year, the mortality in the surgical group was significantly lower - the implication being that the surgery was indeed saving lives.

If all that makes it seem like surgery is a great idea, then bear in mind that there isn’t much data out there (that I’m aware of) that looks at outcomes in otherwise healthy obese people having surgery. It would be pretty fair to assume that the benefits of surgery (besides sustained weight loss, which isn’t guaranteed anyway) would be far less than indicated above.

Ultimately, there is no substitute for the OP’s friend finding an experienced surgeon, who is aware of all the available evidence and sitting down with him/her to have a frank, tailored discussion about the risks versus the benefits of surgery.

[TheVTCGuy]

I don’t know anything about it.. other then I will need it pretty soon

[GradyPhilpott]

I know people for whom that procedure has resulted in dramatic weight loss.

For myself, weight loss is too easily accomplished for me to even think of going under the knife.

Not all will see it that way, but I believe that such is possible for anyone who doesn't have some extreme medical problem that necessitates extreme measures.

[hdrazor251]

Had 2 different coworkers have it done and they had kept off at least 90% of their weight loss at least 5 years after the surgery when I lost contact with them. Had a family member have it done and within 5 years gained it all back and more.

Bottom line is a permanent lifestyle change is required for longterm success.