Should EVERYONE have the DS?

Estrogen and fat have a very horrific symbiotic relationship that's taken me all of my menstruatin' life to fully appreciate. I have renegade endometrial tissue all over my damn abdomen, and when the hormones do their thing and they swell, the pain is excrutiating-- although finally, after 25 years, I can deal with it using mostly over-the-counter meds instead of monthly narcotics, days off of work, and screaming while lying in the tub. I count that as a major plus.  As for body pain? Walked for 7 hours yesterday without a break-- and my lower back just started to twinge (I was wearing cheap shoes.) A year ago, a quarter mile would leave me winded and sobbing on the curb because the pain in my back was excrutiating. So yep, plus again! Without these improvements (plus the borderline diabetes/sleep apnea/et alia) this surgery would never had been worthwhile: the size changes just don't mean as much to me as they might I guess. Without a betterment in my health, I'd be moping about my hangy pannus and breasts, my huge arms, my deeply scarred and dimpled skin. Instead, I get to say, "Wow, check it out-I'm still kickin'!" and move on.

Mmmm hmmm, my point exactly, but on the other side of the coin - a) they may, and b) you don't heal as well (in general) when you're old.  Life's a gamble - you pays yo' money and takes yo' chances and plays wit' da cards you're dealt.  You can stay fat & healthy, and gamble that you won't develop the problems that come with being fat and aging, or you can gamble on WLS, and hope you pick the right one for you - whichever that may be. And I am in complete accord with you about the self-esteem thing.  Because once you are thin enough, there will always be something wrong with you - you're eyes aren't the right color, your earlobes are too big, your tits are uneven, your knees are knobby...  People with that kind of wiring are rarely pleased about their bodies anyway. Guess I share your prejudices...  always knew I was simple minded, anyway.

I don't think it's prejudiced. I agree the chances of succeeding go up when you were afraid for your life when you were fat. This is SO not a vanity procedure. When this message gets out to everyone, including Oprah and the insurance companies, it will be better for those who need it to survive.

I'll have to register my disagreement with this: "People who have weight losss surgery should be severely physically compromised, and not just sad about being fat". My reasons for disagreeing are: 1.  Being "sad" is a major symptom of depression and depression is deadly - I mean dead is dead whether it is from clogged arteries or suicide.  If a person's quality of life is so poor due to being obese - give them the surger!y!!!  Maybe they also need counseling, but for god's sake, let them be skinny whilst they get counseled!  2. I think that ideally, people should have the surgery BEFORE they become "severely physically compromised"  because that increases the surgical risk factors and may well put the patient at a place of irrecoverability.  For instance, if you have diabetes, there is damage being done everywhere in your body at all times - and much of this damage is irreversible.  Why must a person be irreversibly damaged prior to having a surgery that could have prevented it to begin with?  It just sounds self punishing  to me.  3. I think a person's self esteem is waaaaay worth gettin' skinny for - even if it takes surgery to do it.  Even if there are no physical issues, and even if there is no depression, why must a person be forced to face our society's prejudices against the obese if there is a way to avoid it? 4. If a person is obese, it DOES, without a doubt, compromise their body.  They WILL develop comorbidities - it is only a matter of time. Getting old increases those risk factors also - but not nearly as much as obesity and certainly not nearly as much a obesity and age combined! Maybe it will be one of the many cancers associated with being obese.  Or maybe it will be that they are at a higher risk of dying in a car accident.  Why must someone wait until they get the cancer or get in a car wreck to remove the risk factor? 5.  As far as I know, every single study ever published on the subject has proven that diets do not work for, what? 98% of obese people.  Why would we insist that people must continue to be prescribed a treatment that has been proven to be only 2% effective when the DS has such a high chance of CURING THEM? Those are my thoughts, right off the top of my head... when I should be sleeping because I  pulled a double last night and I have to be back at work at midnight. 1.

I completely, totally, utterly and emphatically disagree with you! You would also, I presume, keep antidepressants from those who drink, because they're always going to be an alcoholic?  How about not giving insulin to diabetics who think they could eat a little sugar here and there?  They'll never get what they "need" either, which is a non-existent cure, so why get their hopes up? People go into WLS for many many reasons.  Often, if not most of the time, a BIG piece of it is psychological or social -- they don't fit in, in many ways.  Their weight is making them miserable in a multitude of ways, not all of them physical or medical. Do some people have unrealistic expectations of what will improve in their lives after WLS?  Of course they do.  They think their spouse will love them more, or they will be able to find a new spouse, or get someone to love them at all, perhaps for the first time ever.  They think they will get a job that has eluded them, will become so HAWT that those of the opposite sex (or same sex if that's what they're into) will fall all over them, and that their parents will finally give them some respect.  As we all know, there's pretty much a guarantee that's NOT going to happen if that's what you're hoping for. But is that a reason to deny them WLS, even if there is no pressing medical necessity other than the simple fact of morbid obesity?  F*ck no.  Morbid obesity (and to some extent, plain vanilla obesity) even in the healthiest people, bathes our cells in hormones that induce cancer; strains and causes IRREVERSIBLE DAMAGE to our cardiovascular systems and joints; beats us down in our relationships with others and with ourselves. Should some or even most people get counseling as they lose weight?  You betcha.  But deny them surgery because they are hoping to become attractive?  That's crap. IMHO and the spirit of discourse, of course!

You make many salient points. I'll have to give it more thought. My reaction was not well considered. My perspective is unusual. I loved my body before, and now find it pretty repugnant. I learned a lot from being obese that I couldn't have learned any other way, so it probably colors my opinions in odd ways. I can tell you this: if I had this surgery in order to find myself more physically attractive or more enticing to the opposite sex, I'd be up one serious goddamn tree, if you know what I mean. There wouldn't be enough lithium salt licks to glue my noggin back together. That too colored my reaction. No, I wouldn't deny anyone surgery (I'm not qualified to judge who should and should not have it)-- but I would hope they'd give it some more serious thought than some of the cavalier people I have encountered lately. It's in that spirit that I responded. Mea culpa.

You are so right about body image before and after surgery.  One big adjustment!

I'm rowing in the same boat as you about looking attractive.  Appearance IS important.  So is improved health.  After experiencing ridicule for years, who wouldn't have their self esteem sorely challenged?   Obesity didn't dominate much of my life, even though I always felt "over weight" even when I wasn't.  As I developed MO. more and more my obesity began to incarcerate me.  I KNEW on first meeting me people initially saw a "fat" woman and I perceived that I was somehow diminished in their eyes.  The blanket of decreasing self esteem grew ever tighter.  I am one of those who didn't need therapy, probably because my childhood and adolescence wasn't defined by obesity.  When my life became threatened by my extremely high BP, WLS became an imperative.  To save my life I had WLS, to rescue my self esteem I had surgery.  I think there's NO shame in including appearance as yet another reason for WLS.   Hanging and wrinkled skin isn't life threatening, however, we come to the door of plastic surgery in real need.  A serious panni may interfere in daily activites, such as exercise.  Will we die if we don't get it?  Heck no, but will it help us live a more physically and attractive life sho' 'nuf.   (Also in the spirit of discourse.)   

I think I'd add vegans to the list.  It would be way too hard for them to get the protein in. I've always said that I think vegetarians would have a hard time living by the DS rules, but then Randy comes along and blows that theory out of the water.  If, though, a vegetarian wants to have the DS, then I think that they have to be more compulsive than the average DSer, since they have to be more fussy about finding their protein. Vitamins don't have to break the bank, and anyone with a malabsorptive procedure should be taking them, not just a DSer.  I was reading the RNY board the other day, and a woman there posted that she got cavalier about taking her vitamins and now may have damaged her heart because of it.  RNY or DS, vitamins are important! As for intelligence, I think that anyone who's going to get their innards rearranged, regardless of the configuration, should have to pass that reasonable intelligence test.  It scares me ****less whenever people post about things they don't know about their own surgery.  I worry for these people - what's going to happen to them? My two cents only...

I know there are vegetarians that are doing it, but I think they have to work much harder at it, and they have to be even smarter than us carnivores. The lack of knowledge about the procedures is frightening. Some of the success or failure of any surgery is understanding how your new anatomy works. I have to say that I knew intellectually the rearrangement that was being done prior to the surgery, had read a lot about it,  but I didn't truly understand what it meant until I lived with it.  That's one of the reasons I'm still here. I learn something new about it all the time.