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.
BigB you are such a hypocrite...... why when you had a BMI of 40 to 50 did you not "exercise and eat healthy"?? If it's that bloody simple to maintain your weight and stay healthy why did you reach a massive BMI of 72??
I have a BMI of 48 and have already had a stroke (31yrs old) and Ovarian Cancer (32 yrs old).
Your logic is twisted to justify your own WLS surgery. Good thing I don't give a **** what you think or it might actually **** me off!! 
HW/SW/CW/Orig GW/New GW 328/311/161/153/142 LOVE my RNY!!!!
Vanessa
Morbid obesity is a PROGRESSIVE disease, as your own experience so clearly illustrates:
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.
My own experience: I was never MO until after the age of 30, though I'd struggled with my weight (20-30 lbs.) my whole life. Between the ages of 35 and 55, I lost large amounts of weight (90, 100 lbs.), only to gain it all back, and more. My top weight went from 270 at age 35 to 336 at age 56. At 56, and at least 150 lbs. overweight, my body was crumbling - horrible pain in my knees and feet. I could barely hobble to the bathroom when I got up in the morning. I was terrified I would just keep gaining, and I could see that in a few years, I would need a "Hoveround" or one of those Scooter Store chairs just to get around.
I was also really debilitated by the lack of energy - I'm single, with a mortgage to pay, and it was getting more and more difficult to keep working. It took all the energy I could muster to drag myself from one end of the day to the other. Forget about doing anything for fun. Even going out to eat with friends seemed like too much of an effort. And the movies? I stopped going, because I could no longer fit in the seats.
Longevity runs in my family. My mom is now 91, and her mother lived to be 99! I was very lucky that I hadn't developed diabetes, or hypertension, or heart disease - yet. I could see that I might have a lot of years in front of me, but I couldn't see a life.
I think you're mixing up two separate issues here - one is this society's insane obsession with weight and hatred of the obese, and the other is the medical issues associated with obesity. I agree with you on the first point. Unfortunately, you're ignoring the second, and that is simply irresponsible, especially when you yourself have found that out the hard way!
You know, you could argue there are "healthy" smokers too, in a certain sense. My dad's father smoked his entire life and was healthy and active right up until he passed quietly in his sleep at 89. My dad wasn't so lucky - he died of lung cancer at 60. And I fear for my older brother (who I love dearly), who's still puffing away at 63, even after his best friend died last year from emphysema. And most smokers will end up like my dad and my brother's friend, not like my grandfather.
Same with those of us who are MO, and especially SMO. A few may escape the ravages as they age, but that's no basis for deciding against WLS.
Totally lovin' my DS!! HW 336/ SW 326/ CW 147/ GW 160 13 lbs. below goal!
I lost my dad at the age of 60 (he was overwieght and healthy as a horse UNTIL his heart stopped) from all the extra weight he carried daily....
I am not going to let that happen to me ---- I am by no means an ugly person and know I can turn a head or two but I an NOT healthy even with my low BMI.....
I tend to agree with darned near every post here. Someone pointed out that WLS is not for a teen who is chunky in her size 6. So, I agree with you on that.
But one thing to note is that the ASBS very SPECIFICALLY changed its name to the ASMBS, adding the word Metabolic to the American Society of Bariatric Surgeons for a reason. Specifically to include those poor souls whose BMI falls between 35-40, but who are dying, regardless of the numbers on a page. They were addressing diabetes more than any other comorb, but sleep apnea was my personal killer, and they nod to it. Had I been able to have surgery at BMI 35, I'd never have even HAD sleep apnea. My husband wouldn't have, so two car accidents might have been skipped. Who knows? Both of us had diabetes staring us in the eyes. Again, our own experience is moot.
I just attended a conference in which the reminder for the need to be healthy (not just "healthy enough") at a lower BMI was making good sense, for life, and even for insurance dollars. Who wants to live life just 80# over? I see my kids at "just 80#" over, both with sleep apnea, both facing diabetes (skipped me, but everyone else before me AND their dad), and wait for the first heart attack. My ex was at 39, dead by 49. My oldest will be 39 in June, same weight, shape and diet as his dad. My baby is 36, a bit taller, but otherwise, his dad's clone.
They are not interested in WLS. It's a sign of weakness, doncha know. Even tho both wives have had some version, Don & I have had it, both perceive that they are not "that sick". Yet. Neither was their dad. But he's just as dead as if he was.
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
My brother, with a BMI of about 48 or 49 DIED at age forty-eight of a massive brain hemorrhage caused by complications of his Type II Diabetes and Hypertension.
Did I mention he had post-polio syndrome and had difficulty walking so that exercise was nearly impossible?
Yes, your theory is the cure-all.
PRE OPS ... Want a surgery that has the least chance of long-term re-gain, is BEST at curing your Diabetes (98%+), removes much of the hunger hormone Ghrelin, NO DUMPING, NO MARGINAL ULCERS and NO STOMA / STRICTURES? CURIOUS WHY I CHOSE THE DS? VISIT MY PROFILE.
Even now, sometimes I look and think, they had surgery to lose _____??
Then, I think, why didn't I?? Why didn't I have the surgery years ago before I got this big. Why didn't I do it before, so I'd have less to lose. I have no answers --- but I can say this..losing weight, maintaining weigh is hard and everyone has their own struggles and reasons for having surgery....
and no one----
no one, should be denied the right to better their health and their life.
14 pounds lost before surgery. My first ticker is when I hit onderland: this was my goal when I started on this journey. I want to focus on that right now...once I get there I can reevaluate.
My second ticker is my dream goal. Even if I only visit there for a short time, it would be nice to see that number just once. I am pretty sure I'll need plastics to hit this goal.
It is also insulting to insinuate that those of us who disagree with you somehow hate fat people. My DH has a BMI of 50 and is struggling to lose weight-no insurance for WLS. My daughter is 13 and wears a size 16. I battle beside them every day and love them and would fight anyone that said that they were what they weigh. I also am working with my daughter in exercise and correct eating habits because I do not want her to have to have surgery one day. Yes it is better to never get fat, but the DS gave me back my life. Who am I to tell others that theirs is OK at a BMI of 40. Isn't that their call?
(With my apologies to those posters for oversimplifying their very good posts.)
