Choosing the KNIFE! (great read)
G'morning gals and guys ~
Found this article on another message board and thought it was a GREAT read and wanted to share it with ya'll.
Sorry IF it's already been shared/posted and I missed it, but I figure if it has and I missed it, others might have as well.
This article touches base on a LOT of FACTS about weight loss surgery that I think a lot of people are either NOT aware of or choose not to believe. As a long term post op, I can attest to the difficulty of maintenance, the long term malaborb issues, the infamous (and expected, yet dreaded) BOUNCE BACK. It happens, it will happen, it's part of the entire REALITY of our new life. I see it time and time again, read about it, hear about it, and am LIVING IT as I type.
WEIGHT LOSS SURGERY is NOT a QUICK FIX - which is what I love about this article, it touches base on a lot of fallacies out there.
It's a great read - long but good, honest! 
Lei
~*~*~*~*~*~*~ Choosing the Knife ~*~*~*~*~*~*~
By Sally Squires Tuesday, March 7, 2006; HE01
"Today" show weatherman Al Roker and singer Carnie
Wilson are likely to have a lot more company in the
once-exclusive ranks of those who have had weight-loss
surgery.
A recent Medicare decision expands coverage for
gastric bypass and other weight-loss surgery to people
with a body mass index of 35 or greater -- about 60
pounds or more overweight -- who also have at least
one weight-related medical problem, such as diabetes,
sleep apnea or heart disease.
In 2005, about 170,000 people in the United States had
weight-loss surgery, according to the American Society
of Bariatric Surgery (ASBS). Medicare paid for 6,000
of those procedures. Ninety percent of those
operations were performed on people younger than 66,
who are disabled by their weight and other medical
problems, according to the federal Centers for
Medicare and Medicaid Services (CMS). Since private
insurers generally follow Medicare's lead, weight-loss
surgery is expected to increase significantly
throughout the country.
But experts caution that surgery is not a cure for
obesity. "It's a tool designed to help you help
yourself, not a free ride," says surgeon Harvey
Sugerman, past president of ASBS and professor
emeritus at Virginia Commonwealth University.
Some worry that the expanded coverage sends the wrong
message, since medical treatment for obesity is
limited at best. "Insurance companies won't cover the
medical care of obesity treatment, but they're willing
to pay for surgical intervention," notes Arthur Frank,
director of the George Washington University Weight
Management Program. "That's outrageous. It drives
people into surgery . . . and may create the wrong
incentives."
Here are some of the caveats to keep in mind about
gastric bypass and other weight-loss surgery, which
has a mortality risk of about 0.5 percent to 2
percent, about the same as a hip or knee replacement.
Surgery only gives a jump start. The procedures
promote weight loss in two ways: either by diverting
food from the stomach to a lower part of the digestive
tract where nutrients can't be absorbed, or by
reducing stomach size so that less food can be
consumed at a given time. Overeating after surgery can
result in vomiting or in "dumping," a condition that
lasts about 30 minutes and is characterized by
lightheadedness, nausea, flushing and sometimes
diarrhea.
"But you can always beat the system by drinking milk
shakes or eating ice cream," says Frank, who notes
that the same healthy habits prescribed for weight
loss -- eating less and moving more -- are still
required after surgery.
That may be particularly challenging since people who
become morbidly obese usually have difficulty
controlling what they eat and often don't exercise.
"Lots of people go into this with unrealistic
expectations that the surgery will take care of it all
and this will be it," says Ronna Saunders, director of
the Center for Behavioral Change in Richmond, who
counsels people after weight-loss surgery and screens
them before it.
Plan on taking vitamin and mineral supplements for
life. Weight-loss surgery alters the digestive tract
so that enough key vitamins and minerals can't be
absorbed from food alone. After surgery, "all
menstruating women need iron supplements," Sugerman
says. "All patients need vitamin B12daily by mouth or
monthly by injection." Also required: a daily
multivitamin and at least 500 milligrams of calcium
per day.
Expect to regain some of the weight lost initially.
During the first two years after surgery, an average
of 60 percent of excess pounds are lost, which can
improve the patient's health by treating such
conditions as type 2 diabetes, high blood pressure,
sleep apnea and ease joint pain. But those who undergo
weight-loss surgery almost never achieve an ideal body
weight and still remain slightly obese or at least
overweight. "If they started off with a body mass
index of 60, they may get to a body mass index of 35,"
Sugerman says. "They're not going to get to a BMI of
30 or 25."
The weight also creeps back, as Roker has found. He
shed more than 100 pounds after surgery in 2002, but
in January of this year began a diet on the show to
lose 20 of the pounds he's regained. He's said that a
back problem and a hectic business travel schedule
have contributed to his added pounds. "Typically
you'll get three to five years of benefit in terms of
weight loss," Frank notes. "But the weight almost
invariably adds back."
Prepare to pay . Even if you have health insurance, it
may not pick up much of the tab. Weight-loss surgery
averages $20,000, plus the cost of follow-up care.
Private insurers take their cue from CMS, which allows
$10,000 for hospital costs, plus up to $1,700 for the
surgeon. Medicare picks up 80 percent of the surgeon's
cost; the patient pays 20 percent. Follow-up medical,
psychological, diet and exercise treatment are extra
and can run thousands of dollars more and generally is
not covered by insurance or Medicare.
Find additional help. The often large and fairly rapid
weight loss following surgery "requires physical and
emotional adjustment," notes clinical psychologist
Melissa Kalarchian, who studies people who have
undergone weight-loss surgery at the Western
Psychiatric Institute and Clinic in Pittsburgh.
Spouses may also need some assistance. A recent
University of Tennessee study examined spouses of 63
people who underwent weight-loss surgery. They found
that 75 percent of spouses who were obese gained
weight in the year after surgery -- perhaps because
they ate food no longer eaten by their mates -- as did
38 percent who were not obese. The team suggests
counseling to prevent weight gain and that very obese
spouses be considered candidates for bariatric surgery
themselves.
Medical treatments have not proven effective for
severe obesity. "Nothing about the surgical procedures
will cure the disease," notes Frank. "It's the very
uncommon patient who will sustain the weight loss. But
if you can get five years of benefit out of it, that's
pretty good." .
http://www.washingtonpost.com/wp-dyn/content/article/2006/03/06/AR2006030601151_2.html?referrer=email
.
Lei
~*~*~*~*~*~*~ Choosing the Knife ~*~*~*~*~*~*~
By Sally Squires Tuesday, March 7, 2006; HE01
"Today" show weatherman Al Roker and singer Carnie
Wilson are likely to have a lot more company in the
once-exclusive ranks of those who have had weight-loss
surgery.
A recent Medicare decision expands coverage for
gastric bypass and other weight-loss surgery to people
with a body mass index of 35 or greater -- about 60
pounds or more overweight -- who also have at least
one weight-related medical problem, such as diabetes,
sleep apnea or heart disease.
In 2005, about 170,000 people in the United States had
weight-loss surgery, according to the American Society
of Bariatric Surgery (ASBS). Medicare paid for 6,000
of those procedures. Ninety percent of those
operations were performed on people younger than 66,
who are disabled by their weight and other medical
problems, according to the federal Centers for
Medicare and Medicaid Services (CMS). Since private
insurers generally follow Medicare's lead, weight-loss
surgery is expected to increase significantly
throughout the country.
But experts caution that surgery is not a cure for
obesity. "It's a tool designed to help you help
yourself, not a free ride," says surgeon Harvey
Sugerman, past president of ASBS and professor
emeritus at Virginia Commonwealth University.
Some worry that the expanded coverage sends the wrong
message, since medical treatment for obesity is
limited at best. "Insurance companies won't cover the
medical care of obesity treatment, but they're willing
to pay for surgical intervention," notes Arthur Frank,
director of the George Washington University Weight
Management Program. "That's outrageous. It drives
people into surgery . . . and may create the wrong
incentives."
Here are some of the caveats to keep in mind about
gastric bypass and other weight-loss surgery, which
has a mortality risk of about 0.5 percent to 2
percent, about the same as a hip or knee replacement.
Surgery only gives a jump start. The procedures
promote weight loss in two ways: either by diverting
food from the stomach to a lower part of the digestive
tract where nutrients can't be absorbed, or by
reducing stomach size so that less food can be
consumed at a given time. Overeating after surgery can
result in vomiting or in "dumping," a condition that
lasts about 30 minutes and is characterized by
lightheadedness, nausea, flushing and sometimes
diarrhea.
"But you can always beat the system by drinking milk
shakes or eating ice cream," says Frank, who notes
that the same healthy habits prescribed for weight
loss -- eating less and moving more -- are still
required after surgery.
That may be particularly challenging since people who
become morbidly obese usually have difficulty
controlling what they eat and often don't exercise.
"Lots of people go into this with unrealistic
expectations that the surgery will take care of it all
and this will be it," says Ronna Saunders, director of
the Center for Behavioral Change in Richmond, who
counsels people after weight-loss surgery and screens
them before it.
Plan on taking vitamin and mineral supplements for
life. Weight-loss surgery alters the digestive tract
so that enough key vitamins and minerals can't be
absorbed from food alone. After surgery, "all
menstruating women need iron supplements," Sugerman
says. "All patients need vitamin B12daily by mouth or
monthly by injection." Also required: a daily
multivitamin and at least 500 milligrams of calcium
per day.
Expect to regain some of the weight lost initially.
During the first two years after surgery, an average
of 60 percent of excess pounds are lost, which can
improve the patient's health by treating such
conditions as type 2 diabetes, high blood pressure,
sleep apnea and ease joint pain. But those who undergo
weight-loss surgery almost never achieve an ideal body
weight and still remain slightly obese or at least
overweight. "If they started off with a body mass
index of 60, they may get to a body mass index of 35,"
Sugerman says. "They're not going to get to a BMI of
30 or 25."
The weight also creeps back, as Roker has found. He
shed more than 100 pounds after surgery in 2002, but
in January of this year began a diet on the show to
lose 20 of the pounds he's regained. He's said that a
back problem and a hectic business travel schedule
have contributed to his added pounds. "Typically
you'll get three to five years of benefit in terms of
weight loss," Frank notes. "But the weight almost
invariably adds back."
Prepare to pay . Even if you have health insurance, it
may not pick up much of the tab. Weight-loss surgery
averages $20,000, plus the cost of follow-up care.
Private insurers take their cue from CMS, which allows
$10,000 for hospital costs, plus up to $1,700 for the
surgeon. Medicare picks up 80 percent of the surgeon's
cost; the patient pays 20 percent. Follow-up medical,
psychological, diet and exercise treatment are extra
and can run thousands of dollars more and generally is
not covered by insurance or Medicare.
Find additional help. The often large and fairly rapid
weight loss following surgery "requires physical and
emotional adjustment," notes clinical psychologist
Melissa Kalarchian, who studies people who have
undergone weight-loss surgery at the Western
Psychiatric Institute and Clinic in Pittsburgh.
Spouses may also need some assistance. A recent
University of Tennessee study examined spouses of 63
people who underwent weight-loss surgery. They found
that 75 percent of spouses who were obese gained
weight in the year after surgery -- perhaps because
they ate food no longer eaten by their mates -- as did
38 percent who were not obese. The team suggests
counseling to prevent weight gain and that very obese
spouses be considered candidates for bariatric surgery
themselves.
Medical treatments have not proven effective for
severe obesity. "Nothing about the surgical procedures
will cure the disease," notes Frank. "It's the very
uncommon patient who will sustain the weight loss. But
if you can get five years of benefit out of it, that's
pretty good." .
http://www.washingtonpost.com/wp-dyn/content/article/2006/03/06/AR2006030601151_2.html?referrer=email
. 
That was a good article, very honest. I truly hope people take the time to read this, especially if they are pre-op. I for one do not want to regain an ounce, but I have heard that this will happen. How long does it take to happen? I have been bouncing around the same 5 lbs for 5 months now. When can I declare myself *done* loosing? I would love to look into plastic surgeons for this summer. Maybe I will wait till next summer. Thanks for the good read!
Dianna
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