My thoughts about WLS and who should have (WARNING: Big Opinions You Might Not Like)

First off, let me say that what follows are my opinions.  You may or may not agree, but please don't flame me for them.  It's a vulnerable thing to share these thoughts on this board.

Before surgery, I spent years and years as a fat activist, fighting for fat rights, for an end to fatism (discrimination against fat people).  I modeled self love (and clothing), I modeled for photographers.  I educated others about the fact that fat was not necessarily unhealthy, that health could be had at any size, that fat was not a "death sentence," and that the medical establishment dressed up its own bigotry in the cloak of "scaring" people into "health."  I loved the way my body looked, as did my lovers.  I was very, very fat positive.

I still am.

At the same time, when my body had reached such a weight as I could no longer be active, I grew very concerned.  My knees ached.  I breathed heavily when I walked.  I could not really walk up a hill without stopping alot.  My body was getting so large, that basic hygiene required "extra" measures.  So I opted for weight loss surgery.  I was hugely fortunate to have known someone who did the DS, and to have chosen it for myself.  I did a TON of research before making the decision to do WLS, and the decision to do DS.  It was the right thing for me at that time and I have postively NO regrets.

Having said that, here is my opinion about WHO should get the DS (or any WLS) and who should not.  First, I think that the BMI cut-off is way too low for WLS.  It is my *opinion* that a person can be VERY healthy with a BMI of 35 or 40 or 45 or 50.  (My BMI at surgery was 72 -- much much harder to maintain health because your joints get slaughtered.)  Furthermore, things like diabetes can be managed with exercise, good eating and medicines.  There is NO evidence yet to suggest that WLS will make someone live any longer than having no WLS but having diabetes with healthy behaviors.

I see so many people who have WLS while in the 200s (usually BMIs under 50) who do it because they feel "gross" or "disgusting" because they are fat.  Damn, this is the horrible effects of society's fatism.  It's something I fight against and will fight against even if I ever get thin.  How can we perpetuate this crap?  It's like being "Uncle Toms" of the worst sort -- the victims becoming the victimizer.  Before having my DS, at least two people showed me their before pictures and referred to their before selves in some derogatory fashion.  Yet when I looked at the photos, I saw smiling, gorgeous, cherubic women.  Women who looked better (and happier) then than they do now.

We buy into so many of the assumptions and prejudices of our culture.  One of my favorite lines comes from the TV show, "Judging Amy."  The 8-year-old granddaughter asks her grandmother "What is anorexia?"  Grandma answers, "It's a disease you get from magazines."

I have been known to approach "chubby" pre-ops at support group and (in a quiet voice) tell them that perhaps they could be even healthier at their current size by enjoying movement (a.k.a. exercise) and healthy eating.  They don't listen to me, which is a shame.

Because the truth of the matter is there are NO long term studies that can show what happens to us 20, 30, 40, 50 years out (assuming we can live that long).  Despite all the vitamins and minerals we ingest, it is so very hard to keep up on things like iron, calcium, and the ADEKs, to name a few.  I find it especially troubling when a young person (under 35 is my definition, YMMV) decides to do WLS, because nobody knows how their bodies will do over their natural life spans.  We literally DO NOT KNOW whether we would live longer with WLS (DS or RNY) than we would live with a 40 or 45 BMI.  (Did you know that people with an "overweight" BMI who exercise actually live LONGER than people with an underweight or "normal" BMI who don't exercise?  In fact, people with BMIs of 30-35 live longer than those with BMIs under 20, regardless of exercise!)

Okay -- so there it is.  My opinion.  I would love to hear yours.

I try not to flame people but I do hope you'll see other folks' situations and try not to squeeze all us lightweights into the same mold. We all have traveled different journeys and had different comorbidities that pushed us towards WLS. I fought weight and won for 30 years in the Army until I did so much damage to my back (permanently disabled even after surgery) and metabolism that I just couldn't stand it any longer. The pain in my back and jounts was fierce and my metabolism flat busted according to my docs. With my metabolism broken and unable to exercise, the weight started piling on even while under a doc's supervsion for diet and using pills. The DS gave me back a quality of life I haven't had since my teenage years...I'm 53.  Except for a little pain in my back, I'm pain free now. I'm so glad the requirements for WLS allows docs to offer the DS to folks that find themselves at the end of their ropes, even when their BMI is only 35. 
Gina

Yeah MajorMom..
I think the OP should be asked to leave the internet...


.

I have always felt that the DS was something for people who were SMO. Or for those who had co-morbidities which dictated it was the right choice.

For a while I was happy being overweight. Felt my body was beautiful and I was wonderful. This was AFTER the RNY and the weight started coming back on. I wasn't gonna get cut again. No way.

but then the arthritis started up again. I was close too being diabetic, again. Somewhere deep inside, I knew that fat just wasn't me.

You can be overweight and healthy. Hey down right beautiful. Fat does not equal ugly. I whole heartedly believe this and advocate it.

I also know that some people think this surgery is a quick fix. Without knowing the dangers and commitment involved.

There's nothing EASY about this, trust me.

It use too bother me when light weights got WLS. I would think, they really don't need it. Look at me, I'm 400 pound. They're 200 something.

But I know there are reasons behind everyone's surgery, that others don't know about. Everyone has their own reasons and I support them, as long as they are an educated decision.

WLS is not a whim. Consider the complications that can happen after years with an RNY or a lap band. Sometimes I think doctors are doing these operations without really considering the patient.

Which is why YOU MUST BE EDUCATED. Do the work, consider your lifestyle, your TRUE reasons, your long term health.

Sure, who knows what my health may be when I'm 80. With malabsorption and vitamins etc. I may be a wreck, or I may be better off than I would have without the surgery. No one can truly tell.

Wanting too be a size 10 is no reason for WLS. In my opinion. But wanting a better quality of life is a stellar reason.

This is not cosmetic surgery. You can be overweight and healthy and beautiful. Not everyone can live with this type of surgery, DS, RNY, lapband. It's a head game as well as a body issue.

I agree with some of the things Big B says. But I also understand Gina's point of view. Some may disagree with me, but it's your right too disagree. Have opinions etc.

Just voicing my thoughts on this sensitive matter.

Amen!  I think you got exactly what I was trying to convey (but in far too many words in my case!).

Bull****

Now, where are your profound apologies to the many people you have grossly insulted with your pig assed "opinions" and bogus "medical facts"?

I had surgery with a BMI of 49 and at age 32 so I guess your opinion falls into what my situation was.  I can't speak for others but I know how *I* feel about it.  I had been overweight my entire life, until about a weight of 220 I was ok with it.  I felt beautiful, smart, pretty, had a wonderful home, family ect...(and still did at 300)  However I spent so much time trying to become thinner.  Not because I thought I was ugly or because a magazine told me I was to fat, but it was because I wanted to be able to do MORE with my life... I wanted to be able to hike without pain, have sex without worrying if my body could do this or that.  My entire family is/was overweight and I didn't want to over the years get worse and worse.  And alot of other things too.

For me surgery was the best decision of MY life.  I see people now that are overweight and struggling and I hurt for them, I want to embrace all of them and tell them there is a better way, they don't have to live this way.  I can't see for the life of me why someone should wait until there BMI is over 50?  Why go through all of those extra years in pain and missing out on life?  We all know for a FACT that diets don't work and people that are on the path of becoming SMO can't just wake up and say, "im gonna be more active so I can be healthy even while I am fat".  I just don't think it works that way.

I am certainly not a doctor, but I don't think someone overweight can be healthy.... Fat around your organs cannot be good for you.  And no, while I cannot argue the point of if people with WLS will live longer than those that are fat and exercise/have healthy behaviors, I can tell you now that I have lost almost 120 pounds, there is no reason for ANYONE to live in a fat body... just no reason at all.  Even if this surgery gives you the same or less life span as someone who is overweight, the quality of life is AMAZING, just truly amazing to me.  I will encourage anyone who is overweight and has tried to diet before and failed to have the DS!!

I value your opinion, I am sure many will, but at 6am these are my thoughts - probably a little scattered but I didn't plan on getting online again today and wanted to respond :)

Sometimes I person can have a BMI of 60 and have not a single comorbidity.  Others can have a BMI of 37 and have a boatload of them.   It's a highly lindividual thing.   At a starting weight of 268 (highest ever was 282) I did not at that time have any comorbids, but I knew that at 50 they'd all be knocking at my door.   My family history demonstrates that quite distinctly.    ALso, at my BMI, I was miserably uncomfortable.   Just walking to the corner and back was painful.   My job is extremely physical, and I was exhausted at the end of the day.   My back and feet always hurt.  Now, nothing hurts!   For that reason alone, I would have (and am grateful to have) had the DS.   

Why would I have waited until I reached a BMI of 50???  I wanted to stop that train in it's tracks, so I had the DS.  And it's working for me, just like it works for someone with a BMI of 50.  I have 3 kids that I could barely keep up with having a BMI in the 40s.  I was eating for 3.  I could no longer exercise.  I had no energy for housework etc.  I could barely make it up the stairs.  Now after my DS, I can do all those things again and am getting my life back...it had absolutely NOTHING to do with being a size 10!!!!  My father and mother both had high cholesteral and diabetes due to obesity.  Had I not had the DS, I would have slowly become like them.

The question I ask you is, if you could have had the DS at a lower BMI and saved yourself years of struggling and deteriorating health, would you have had it?  I'm thinking you would have...