OT Rant - Pissed Off About Hearing People Need To Lose Weight To Have Surgery To Lose...

MultiMom
on 4/29/13 8:00 am - NH

There are a few reasons that some require this. I'm not saying that I agree or disagree with any of them, just informing. One reason is compliance. Some doctors want to see you be able to comply BEFORE you have surgery and in most cases that will result in some weight loss. The part of losing weight to shrink the liver is very important so that your stomach is more easily accessed by laparoscopic surgical method. The liver lays over the stomach and intestine, so the larger the liver the more difficult it is to work around. Surgery can be done open but for myself, I would prefer to not have the open procedure. 

The reality is that if you don't want to do what your surgeon asks discuss it with him or her. I don't blindly follow doctors orders and often ask why and what if type questions. If I still don't agree, then I find another dr at I feel I can work with.

Marthaenlightened

High 250/Consult Weight 245/Surgery 205/Now 109
Height 5'4.5" BMI 18.4
In maintenance since June 2009

dahoodman
on 4/29/13 9:15 am - VA
RNY on 03/26/13

Again, completely cool with compliance and liver shrinking just not YOU HAVE TO LOSE XX POUNDS OR MORE OR NO SURGERY. Where do they come up with the numbers?

[Highest: 303] [Surgery Day: 295] [Current: 199.8] [Goal: 180][To Go: 19.8[Height: 5' 8"]

  I have a tendency to wear my mind on my sleeve   

  I have a history of losing my shirt Barenaked Ladies - One Week

Citizen Kim
on 4/29/13 8:47 am - Castle Rock, CO

There is a school of thought that mandatory pre-op weight loss is by surgeons who hate fat people!   

I didn't have to do it, neither my insurance nor my surgeon needed it - but I think that 9 years ago, it wasn't such a big business as it is now - I actually had less than 3 weeks from the time I Googled WLS to the time I was on the table ...

Proud Feminist, Atheist, LGBT friend, and Democratic Socialist

dahoodman
on 4/29/13 9:19 am - VA
RNY on 03/26/13

Now I don't know if I can get in to that school of thought, but who knows. There has to be something to it. It's just weird when  they talk about exact numbers as if it really made that big of a difference. How does a doctor know that if EVERYONE follows this particular 6 month supervised diet that they will all lose X% or Xlbs of weight? Not all of us are created equal. There just seems to be no rhyme or reason for a specific weight loss requirement in pounds or percentage in order to have the surgery and/or "prove" that the diet was followed. Some are given the "challenge/requirement" without given a particular diet plan to do so. I've seen that too.

 

[Highest: 303] [Surgery Day: 295] [Current: 199.8] [Goal: 180][To Go: 19.8[Height: 5' 8"]

  I have a tendency to wear my mind on my sleeve   

  I have a history of losing my shirt Barenaked Ladies - One Week

Cicerogirl, The PhD
Version

on 4/29/13 9:30 am - OH

Why does it make you SO angry if you didn't have to do it?  Why does it bother you so much that some other people have to?

As others have pointed out, there are a number of legitimate reasons, not the least of which is to shrink the liver (making lap surgery much safer) and to be sure that you can (and a willing) to follow a meal plan. if you cannot or will not do it pre-op, it might indicate that you will have trouble following the eating plan post-op.  I read a study that showed that people who lost just 10% of your weight following a low fat diet had a decrease in liver size (and in some liver enzyme that I had never heard of). That may be part of the basis for determining how much weight a surgeon wants a patient to lose before surgery.

I also find it interesting (that's psych code for "explore this more", LOL) that you went to such great lengths to make it look like you weighed more than you did. Just sayin'...

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

dahoodman
on 4/29/13 10:40 am, edited 4/29/13 10:48 am - VA
RNY on 03/26/13

I took out that "psych" portion you referred to in case you want to remove it from yours so as not to give others that idea. 

Maybe pissed off wasn't the best way to describe it. Maybe frustrated I don't know. I understand there are legitimate reasons for losing weight pre-op. I don't see legitimate reasons for exact amounts. If a doctor says 10% should it really mean exactly 10% or if a patient comes up a pound or two short we can still deal with that. Seriously? That's what I'm frustrated over!

I guess that's why I'm not a surgeon!!

[Highest: 303] [Surgery Day: 295] [Current: 199.8] [Goal: 180][To Go: 19.8[Height: 5' 8"]

  I have a tendency to wear my mind on my sleeve   

  I have a history of losing my shirt Barenaked Ladies - One Week

Cicerogirl, The PhD
Version

on 4/29/13 10:55 am - OH

I agree that it seems VERY extreme for a surgeon to hold someone to the required weight loss to the pound.  I mean, really, if someone loses 24 pounds pre-op instead of 25, it seems ludicrous to refuse to do the surgery until they lose another pound... or even if they need 2 pounds.  I only remember reading about one person on here whose surgeon was so rigid (but that, of course, doesn't mean there have not been many more).

I guess I am sort of on the other side of the fence in terms of weight qualifications.  I know a woman who was not quite heavy enough to qualify for surgery and the SURGEON told her to start drinking milkshakes and eating Big Macs and then to come back in a month for her official weigh in.  I find it appalling that a surgeon would actually tell someone to go out and eat crap for a month to gain weight in order to qualify for WLS (and I chose NOT to use that surgeon based on that incident).

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

mzlaura
on 4/29/13 12:05 pm - Litchfield, NH
RNY on 03/05/13

I had to lose 8% of by body weight before surgery so around 27 lbs. I didn't wine about it i just DID it! My surgeon was very skilled and went to college for many years! A very highly sought surgeon at that. The surgeons require it for a reason whether we like it or not. I didn't question it and just did it and i had a very safe surgery.... Just like everyone's post-op diets and pre-op diets are different personally some post op diets i see people starting soft foods or regular foods right out from surgery i think that is crazy! I had 2 weeks full liquids - 3 weeks pureed - 4 weeks soft foods - and May 9th i start back on all regular foods.

HW: 401  SW: 297  CW: 200.8
RNY gastric bypass surgery on March 5th, 2013

  

honestlinzel
on 4/29/13 1:33 pm - CA
On April 29, 2013 at 5:40 PM Pacific Time, dahoodman wrote:

I took out that "psych" portion you referred to in case you want to remove it from yours so as not to give others that idea. 

Maybe pissed off wasn't the best way to describe it. Maybe frustrated I don't know. I understand there are legitimate reasons for losing weight pre-op. I don't see legitimate reasons for exact amounts. If a doctor says 10% should it really mean exactly 10% or if a patient comes up a pound or two short we can still deal with that. Seriously? That's what I'm frustrated over!

I guess that's why I'm not a surgeon!!

I can only speak from experience. My surgeon gave a 5-10% weight loss rule to lose. However, if you are 1-2lbs shy, he is fine with that. I think most surgeons are like this.

RNY Surgery was on 4/12/2013. Now currently on the Never hungry ever bench

Starting weight: 320lbs

Current Weight:  203lbs

 

honestlinzel
on 4/29/13 9:43 am, edited 4/29/13 1:35 pm - CA




My surgeon said he wanted and required a 5-10% weight loss a month before surgery. This was to shrink your liver. He does not believe in the 2 week liquid diet because in his opinion, that's not a healthy way to lose weight. They want you to learn eating habits that are healthy so after the surgery, you continue those habits. Honestly I feel so lucky to have a surgeon like that. Learning those things before surgery was so helpful. I feel like learning after surgery would be hard because of all the emotions I am going through.

A friend of mine just had to show up for surgery. She had no diet plan before or liquid instructions. She had surgery at the end of march. She texted me the other day to tell me that she at THREE Kit Kats and didn't get sick and was very excited. In my opinion, had she learned anything pre-op, she may not be going down that path.

RNY Surgery was on 4/12/2013. Now currently on the Never hungry ever bench

Starting weight: 320lbs

Current Weight:  203lbs

 

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