Question:
Debate: Why should we limit the surgery to those MO?

We spend a lot of time sharing success stories. Here's a topic for honest contemplation: Why should this surgery be limited to those that are morbidly obese? 1. The death rate for this surgery is less than 1% - the same as any major surgery - including gall bladder, c-sections, tummy tucks and breast augmentation. Why do we call it a "life-saving" surgery and then lament about this "life-threatentening and high-risk" surgery. 2. The post-op diet is similar to most healthy eating plans - the differences being the malabsortive element and the ability to control appetite without appetite suppresants. 3. Many people (including myself) already have hypoglycemia (low blood sugar) - why is "dumping" more terrible than "normal size" people with hypoglycemia. 4. Opening up the surgical option to more people will make it much easier for EVERYONE to have this life-saving surgery. 5. Normal size people have to take vitamins, watch what they eat, excercise and drink their water, limit or eliminate alchohol - just like post-ops. 6. The risk of complications is MUCH less when you weigh less - why not give people the chance to have surgery BEFORE they become super obese? It seems logical. 7. The majority of the people on the Memorial Page were Super Obese or had a blood clot, heart attack, etc. - you very rarely hear of people dying from leaks related to surgery - which would be unique to bariatric surgery. If a person has made numerous attempts to lose weight - even if it's 50 lbs - shouldn't this be a personal decision that's available to anyone? Perhaps the medical profession should open up the requirements for bariatric surgery just as they've done with cosmetic surgery for those between 50-100 lbs overweight. Why not make it a self-pay option, just as with other aforementioned surgical options? We all hear horror stories about people dying from complications relating to face-lifts, boob jobs and liposuction. Shouldn't those seeking a weight-loss option with a MUCH higher, long-term success rate than traditional weight loss/excercise programs have the option? We believe it's something to be considered. — jnc (posted on January 26, 2003)

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January 26, 2003
I totally agree!!
— Jan S.

January 26, 2003
I don't think it would be financial feasible for WLS to be made for everyone. Given how appearance driven our society is, everyone will be seeking WLS - even people who are not fat but have a poor body image. This will cause INSURANCE rates to SKY ROCKET and it will INCREASE the WAIT for surgery for those who really need it. Simple math... if the demand for WLS increases by 10 then the wait for surgery will increase by 10 less the amount of new surgeons/support staff entering the field. As people who don't have the need signing up for WLS... My friend's girlfriend is the waif of an asian girl. She can't wiegh more than 120 pounds soaking wet. She inquired about the surgery and wondered if she could get it because she believes she is too fat and needs to lose 20 pounds eventhough her BMI must be in the very low 20s. Also they have made some wonderful breakthough in discovering a hormone that is responsible for increased appetite. Also some meds that simulate the dumping syndrome (I don't recall the name but there was a show on discovery channel about them). Take Care, Be Well, and Be Happy!
— John T.

January 26, 2003
This is an incredibly drastic and last-chance surgery. It alters, forever, the way we eat. Yes, it should be easier for MO people to have, but no, I don't think it should be available to those with 50 pounds to lose....my healthcare insurance would cease to pay for ANYONE's GB if it had to pay for everyone who is over 50 pounds, so your suggestion would make it even more difficult for those who are MO. It would further the idea that this is a quick fix, an easy way out. I don't think you have considered the incredibly slow progress we are making in getting it for people who desperately need it. It's NOT cosmetic surgery, nor should it be. It involvs chopping of the larger portion of your stomach and intestine for crying out loud!!!
— Scarlett A.

January 26, 2003
I DO NOT think that baratric surgery should be available to those just 50-100 pounds overweight- I find it interesting that this Question is posed by people who are pre surgery- you are basing your ideas on purly what you have learned thru research- many,many Post op people will tell you we face major LIFE CHANGES! It is not merely taking vitamins, drinking water, etc. "NORMAL" sized people do not NEED to take vitamins, supplements, protein drinks, face malnutrition, bone density loss (at the level we do), etc... Some "normal" peole do take vitamins for better health- but it is not required. POST OP- at least with an RNY, MD's have changed the physical aspect of how our body works, they throw away parts of your body that help you to absorb nutrients and vitamins so that you can control your disease of obesity- There are people out there that abuse plastic surgery, cosmetic surgery and yes even bariatric surgery. There are doctors doing surgery just for the $$. ANd not ALL the people that had died have been trainwrecks going into to surgery. Some have been just 100 pounds overweight, young with NO major conplications before undergoing the procedure.
— ~~Stacie~~

January 27, 2003
There are two gals in my support group that needed to lose only 60 lbs. and they had surgery, BUT, they had several co-morbidies. It was covered in full by insurance.
— Dana B.

January 27, 2003
My daughter asked me this just the other day, she is 5'5 129 pounds and got a body to die for. She asked mommy since you had this surgery can I have it so I can never gain weight. I told her HELL NO. Your mommy didn't just have this surgery to look good I had it because I was sick. If I was ok I would never, never have had this surgery. I don't know what's gonna happen a few years from now, I don't know if later on doctors will feel it was a big mistake. I just don't know, I'm scared. I wouldn't have had this surgery if I only had 50 pound to lose. According to medical standard I'm 5'5 was 320, I need to lose 185 pounds to be ideal weight. If you want to have surgery just to loose 50 pounds that find with me, but if was me I wouldn't. I know I'll get a lot a disagreement on this but it my opinion and you want the truth. Get the lap band, it can always be taken out.
— Rebe W.

January 27, 2003
I've heard of at least 3 post-ops that started out as "light-weights" (with about 100 pounds to lose) that are now fighting to stay at a healthy weight because they've lost TOO MUCH. At least one is fighting just to stay alive from malnutrition. I can't imagine what would happen to a person that only had 50# to lose. This is a MAJOR life-altering surgery. I had no idea what post-op life would be like and I had done ALL the research - spent hours online. Some people lose 50# in 2-3 months; what would an ultra-light-weight (50# to lose) do for the other 10-16 months that they were losing if that would happen to them? This is not the latest fad that anyone should rush out and have. This is a serious operation that should be reserved for those that are in serious need of help. At 5'5" and 270 pounds, I had people saying that I was too light and my BMI was 45. I couldn't imagine doing this at a BMI of 30. *stepping down from my soapbox*
— Toni C.

January 27, 2003
OK...I was considered a lightweight. My starting weight was 230 and I am 5'7". With a BMI of 36 I just barely qualified. I am now 120 pounds. My goal was to get down to 135.....but I have to admit, I love being 120. I have to say......just because I was not 400 or 500 pounds, doesnt mean that I was not just as unhappy as someone who was. Lets face it....FAT IS FAT!!! I am so thankful my insurance company did not wait until I could barely get around....before they would approve this surgery. I was approved with Aetna in less than 24 hours. They also approved my tummy tuck. All this....and according to "The Charts" I was only about 75 pounds overweight. My only comorbids were high cholesterol and sleep apnea. THANK YOU AETNA!!!
— skymaxjr

January 27, 2003
Way too many people think that this surgery is a 'quick fix' for simple overweight people. If you think the wait is long now for a surgeon, imagine if every single person who had the most minor of weight issues were fighting with one another for an appointment to see a surgeon. As a "lightweight" who lost exactly my excess body weight, I lost 123#'s, for a small period of time, I did have a problem with too much weight coming off. I had gone down to 113 lbs and looked very sickly for a few weeks. If it were that easy for me to do it, someone who only has 50 lbs to lose would probably disappear. There is also the psychological factor...someone who has *only* fifty pounds to lose is NOT going to be as willing to go through the lifestyle changes required for life post wls. They are, quite frankly, looking for a quick and easy fix. And to suggest that someone put on 50 lbs just to get surgery is like telling someone to smoke more cigarettes to qualify for an oxygen tank. It's not really good sound medical advice. I will admit that I am a fan of lap band for those who have 50-100 lbs to lose...they get the restrictive value, w/o the permanence of rny or ds...and w/o the malabsorption factor...however, I have heard a few times people discussing lap band and saying that once they are *done losing*, they are going to have the band removed, so that they can resume their *normal lifestyle*. That right there tells you that they are not emotionally ready or capable of handling life post op...It's not the easy way out and if we open it up to *everyone*, that will just further that myth...*I'll just go have surgery and lose the weight*. Too many people think that now...it's too dangerous. Just my opinion. AMOS: have a Sparkling Day!! ~CAE~
— Mustang

January 27, 2003
Hi: If you are self-pay, I would imagine some surgeons would be willing to perform this surgery on a person 50-100 pounds overweight. I don't know this for sure, but as you say, this is done for cosmetic surgery, etc., when people are willing to pay out of pocket. Insurance companies are going to set the criteria they want. Even those with high BMI's and comorbidities are often denied, which is shameful if you ask me. But self pay should be a different story. Has anyone tried self-pay at less than 100 pounds overweight or with a BMI lower than 35? Love Grace
— Grace H.

January 30, 2003
My understanding is that WLS is primarily done as a medical necessity and is not cosmetic, or at least the cosmetic result is a bonus. Unless you have SERIOUS co-morbidities I think that most insurance companies have a pretty fair cut off for needed BMI's.
— Fixnmyself

January 30, 2003
I TOTALLY AGRE. i WOULD NOT HAVE AGREED PREOP, BUT NOW, WITH THE CHANGES IN MY LIFE AND BODY I THINKS ANY ONE WHO WOULD BENEFIT SHOULD QUALIFY.
— **willow**

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