This comment came in from Olivia yesterday:
i am a new reader to this blog and i am just wondering if you have ever considered getting gastric bypass. i am over 400 as well and i am 18 years old but anyway i dont know if you have posted about this topic. just asking!
Depends on the definition of “consider”.
I’ve had it recommended to me. I’ve read about how it works: usually the stomach is made smaller and the small intestine is shortened, which means you eat less and you absorb fewer nutrients from your food. I also know people who have chosen to get gastric bypass or a lap-band for various reasons, including to get rid of diabetes (temporarily or permanently)..
What initially stopped me from going to an “information session” or otherwise pursuing surgery was concern over the side affects: vitamin deficiences, hernias, incision leaks, hair loss, and so forth. I found the possible B vitamin deficiencies especially scary.
I also remember the phen-fen combination. It was tempting, too. But I was concerned about studies showing short-term memory loss as a side effect. I realized that I have a happy life as a fat woman. Screwing up my short-term memory would destroy my life – and thus made me too fearful of phen-fen to consider trying it.
Ah, you think, but what about my health? Well, what about it? The surgery is supposed to address:
- Type 2 (insulin-resistant / adult-onset) diabetes
- High blood pressure
- High blood cholesterol
- Gastroesophageal reflux disease (GERD)
- Obstructive sleep apnea
The only one of those I have is sleep apnea. So does my thin father. It runs in families. Studies show weight loss doesn’t always cure it long-term; in my particular case, my sleep doctor does not think weight loss would “fix” it in me.
So what would be the possible benefit to surgery? Losing weight, aka, being less fat. Probably not thin. Just less fat.
Then add in: Two years ago I was diagnosed with a vitamin B12 absorption problem. I already don’t absorb enough of this critical nutrient from food—which exposes me to the risk of anemia, balance problems, depression, and dementia. Note gastric bypass often causes this problem that I already have. Gee, think it might make it worse?
But the other reason is this: Yes, I’m fat. I didn’t get that way overnight. I’m used to it. I live a happy life anyway. Why should I risk death, dementia and health complications for what would be cosmetic surgery—especially since I have no reason to assume I’ll keep the weight off? It just doesn’t make sense to me.
Update: It has been shown that patients with diabetes see improvement in fasting glucose and A1C tests after gastic bypass, however, glucose tolerance tests and continuous glucose monitoring demonstrates they’re still having diabetic-level glucose spikes after eating.
Nov 2012 update: Long-term study found
Overall, 68.2 % (95 % confidence interval [CI], 66 and 70 %) experienced an initial complete diabetes remission within 5 years after surgery. Among these, 35.1 % (95 % CI, 32 and 38 %) redeveloped diabetes within 5 years. The median duration of remission was 8.3 years. Significant predictors of complete remission and relapse were poor preoperative glycemic control, insulin use, and longer diabetes duration.
Oct 2013 update: Heidi wrote about her six-year anniversary of her gastric bypass recently; she has maintained her “new” weight of 350 for many years now. (Warning: discusses eating disorders, purging, side effects of WLS, and includes NSFW before and after images.)