Plastics

Interesting article I came across!

http://wolterskluwer.com/company/newsroom/news/health/2013/1 0/body-contouring-improves-long-term-weight-control-after-ga stric-bypass-says-study-in-plastic-and-reconstructive-surger y.html

My thought: many plastic surgeons require that patients have maintained their weight for a period of time (at least a year) prior to having their PS done. Therefore, there's a bias in that population towards people who've already been successful at maintaining a lower weight; folks *****gain in year 2 wouldn't be having plastic surgery.

Therefore, I don't know that it's fair to equally compare "people with PS" against "people who don't have PS."

That's an interesting thought. One of the factors I wonder about is that plastics are so often self-pay, so I wonder if the "I paid for this myself so there's financial investment" goes into the greater chance of success as well. But that leads to "do people who have greater financial resources also tend to have better support networks in general and that's a factor in success." And then I wonder if people who self-pay for WLS have better outcomes than people who get it covered by insurance and aaaah. So many factors are involved.

It's one of those confounders/"isolating the variables" things that are often hard to separate. I've had much the same thought about one of the cliques of patients that we had here a few years ago, who came from surgeon who charged a very high "program fee" (as in $5-6000 or more) above and beyond insurance copays. By all reports and signs he did have very good results, but how much of that is attributable to this financial buy-in pre-screening of patients and how much to his skills and experience (he was one of the "early adopters" of the sleeve), how much to his diet program that they all gushed over, how much to the greater than average hand-holding and support that the fee provided....

Anecdotally, it seems that many of the people who simply copied his diet because they saw it promoted by his patients didn't do as well long term as his patients did.

OTOH, if this plastics study is of patients in Switzerland, perhaps they were all self-pay on their bypasses (if they were not covered by their national health plans) so that it is a more level playing field than we typically see here in the US (or maybe both the WLS and plastics were covered there?)

Wow - you raise some great questions Gwen! Any thorough study should be considering all contributing factors and I bet there are some.

I was thinking along the same line. If you have money for plastics, you can pay for good quality food, pay gym fees, trainers and when you go out you can pay for healthier take out meals.

But, it could be that remove fat cells, can expand again. Soooooo more research needs to be done.

Here's a more recent journal article - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372753/

Interesting. This research was performed on Saudi patients, I wonder how much would change on a sample of American patients given prevailing cultural attitudes towards body image.

Agreed!

Very interesting article, as I've often wondered about this same issue. Question then is WHY the difference, which the article doesn't even seem to suggest.

My 2 cents, though - after spending $10K-$40K+ for PS I think I would work harder to keep the weight from coming back and ruining it all!