Question:
My Doctor told me that I need to loss about 20lbs before he would
even doing my surgery. What kind of diets would you'll suggest that I try to loss the weight. — Mary C. (posted on October 14, 2003)
October 14, 2003
Why not find a different surgeon. I think such requirements are cruel.
— bob-haller
October 14, 2003
Hi Mary, a lot of surgeons are jumping on this band wagon but mind did not
thank goodness. Surgeons say that the surgical risks go up significantly
with a BMI over 50, however I know of surgeons that do lap RNY's on people
over 500 lbs with no problems. However, the liver gets fatty and it makes
it more difficult to see what they need to see. I did Atkins on one of my
other weight loss attempts and it's a quick way to lose 20 lbs if you stick
to it faithfully the first two weeks.
— Happy I.
October 14, 2003
I was asked to lose 10 - 15 pounds to get my liver into better shape for
surgery. I lost 21. I'm proud of myself, and I had no complications in my
surgery yesterday. Wanting to lower the risk of complications is hardly
cruel. All I had to do was follow my surgeon's presurgical diet of salad,
lean meat, cottage cheese, and protein drinks. Good luck!
— Maria N.
October 14, 2003
Contrary to previous posters, I do not find the common requirement to lose
some weight before surgery to be evil. It puts you in a better state of
health to have the surgery and to recover from it. It also gives you
practice in changing your eating habits, and less to lose after surgery.
Lots of people find Atkins to be a quick method, but it can be very
difficult, especially early on. Two of my employees are currently doing
the South Beach diet, which is smilar to Atkins, but not as restrictive.
Another of my employees is doing Weight Watchers (my weight loss has
inspired them all). WW can be a good choice as the eating style is more
"normal" and might be easier to stick with. Best wishes to you
on your momentous decision to have the surgery, and much success to you in
your upcoming diet.
— Vespa R.
October 14, 2003
You know, if the doctors would change their thinking and approach about
pre-surgery weight loss their patients would be happier.
What if they said, "Here is your pre-surgery nutrition plan. It is
designed to give you the best chance of having a successful surgery and
shorter post-op recovery and pain. We want to build up your blood levels
with vitamins and protein. And you also need to do these exercies -- deep
breathing and stretching. That's all you can do them sitting or lying down,
but you must do them 4 times a day, every day till surgery".
What do ya think? Don't you think that would be much better received AND
followed than, "You have to lose 20 pounds before surgery"?
You say "you have to diet" to someone who is at the end of their
rope and facing WLS as their last option and who has dieted for more than
half of their life.....
well, that's just silly (read stupid).
— Marrilee M.
October 14, 2003
Personally I think it is cruel to say you have to lose X amount or you
can't have life saving surgery. I agree with Marrilee that if it was put
differently then people wouldn't think it was as bad. I can see saying
"for your own benefit it would be advicable to try your best to lose X
amount." But to refuse to do surgery because of it? It's not right
in my personal opinion. I did lose weight preop, but that was because they
had just upped my syntroid again because my thyroid was continuing to fail.
I don't think 20 pounds is that harsh, but I've heard of some doctors
saying 20 percent of excess weight and that could be quit a bit for someone
200 pounds over weight. And how about people who are at 40 BMI? They
would lose enough to get below 40 BMI, and then what about their
qualification for surgery? What about people who are also required to quit
smoking before surgury? Even non MO people are proned to gaining weight
when trying to quit smoking. OK, obviously I just think it's wrong to not
provide a needed surgery because a patient is having difficulty losing
weight preop. I could probably continuing ranting about it, but I'll stop
now. :o) To the poster: The only time I lost 20 pounds or more preop was
on diet pills. I'm sure the doctors don't want you to use those prior to
surgery either. Sorry I don't have a better suggestion. S
— sherry hedgecock
October 14, 2003
Amen, Marrilee
— vitalady
October 14, 2003
Mary, I have had good success with the South Beach Diet. It focuses on
lean high protein and low/good carbs. It has really helped me tremendously
to give up bread/rice/potatoes and high sugar items. I do allow myself a
Uturn bar (protein bar) once a day as a meal replacement and often use a
protein shake as a milk replacement also. When I saw my surgeon for my
consultation I had written documentation (I'd seen one of his associates a
few months before) that I had lost 26 lbs as of that date thru Weight
Watchers. My surgeon still asked for 20 more lbs by surgery 2 1/2 months
later and told me there was no negoitation on it. So I have to be at 259
by my pre-op date of 10/28. As of today I am at 262, so only 3 more pounds
to go. I'm pretty sure I will make it. It has added a more stress to all
of this. However, he did explain that that by doing this my BMI would be
below 50 (it had been 56 at the start of my referral) and that would make
the surgery so much safer and less chance of complications for me. Another
thing that has really helped is my exercise bike. I had arthritis in my
hips and knees, so walking at times is pretty hard. However I can ride the
exercise bike. I have ridden 341.4 miles since the end of May and it has
been fun to track. I ride at least 4 times a week. In the beginning I
could barely do a mile. Now I can do a minimum of 3 miles and even have
ridden as far as 12 miles at one time. Has it been worth it???? You bet,
About six week ago I was able to cut my blood pressure medicine in half and
they are sure I will be able to stop it at the point of surgery. Not bad
for someone who has been on it for 10 years. It was a major milestone for
me. I have dropped 2 full sizes and feel better than ever. Many people
have had success with the weight loss by doing a protein shake or bar as
their breakfast and lunch then eating protein with veggies for dinner. One
item that has really helped me is a snow cone machine. Amazon.com still
has them available (go to http://www.amazon.com ) and do a search for snow
cone. If you buy one be sure to get one that uses regular ice cubes not
formed ice. For flavorings you can buy sugar free syrups, use crystal
light, sugar free fruit juices etc. It's filling, crunchy and taste good.
Sugar free syrups are often available locally, also http://www.vitalady.com
carries them. She can not ship them during the winter months tho because
of the possibility of freezing and breakage. http://www.davinci.com
carries a huge varitey and are great with speed of shipping. I've order
from both of them. I buy mine locally at Cost Plus World Market. They are
in the sugar free section and also back by the coffee section. Good luck.
— [Deactivated Member]
October 14, 2003
I agree with Bob.I would find another surgeon. Talk about added stress.
— Debbie W.
October 14, 2003
While I do disagree with the pre-surgery weight loss requirement and didn't
have it imposed on me before my surgery, I can somewhat understand what the
doctors are doing. On one hand it goes against the very reason that they
are doing this surgery in the first place - because it has been proven that
most people without surgery who lose will gain it back anyhow and that we
are genetically pre-disposed to being obese. On the other hand, any weight
that you can lose before surgery will lessen your risks. I think, too,
that some surgeons are trying to make sure that their patients are serious
about making the drastic changes that come about as a result of the surgery
because it won't be necessarily easy.
Good luck losing the 20 lbs and with your upcoming surgery.
— Judy R.
October 14, 2003
To play the "devil's advocate"... (as if the surgeon is the
devil!??!), I think that we don't know what was said in that office other
than that she needs to lose 20 pounds before surgery. Personally, I would
rather have my surgeon feel that I was at a safer, lower-risk weight for
the procedure, especially if it makes a significant difference in the WLS
outcome. I think that taking the time to hunt down another surgeon is only
prolonging a life-saving procedure, especially if it requires another
insurance approval. Why attack the surgeon? Do we honestly believe he is a
monster or something? I have a good friend going through the same thing,
and I feel for her with all my heart. That being said, she has the same
surgeon I had, and he only has the patients overall best interest at heart.
Let's help her lose the 20 pounds, not attack the doc.
— kultgirl
October 14, 2003
This seems to be a requirement for more and more surgeons now. When I had
my WLS, my Dr didn't require it. However, he now does. I think it's a
trend that we're going to see more of. I think it's more of a compliance
issue for many surgeons than a weight loss tactic. I believe that your
surgeon want's to see that you can comply with a restricted plan, and the
side effect is weight loss- which helps lower risk for surgery, so, it's a
win win for them. I should hope, however, that if you demonstrate, through
a food journal and exercize program, that you have tried for a length of
time and haven't lost the amount of wt. your surgeon wants, that he would
be flexible enough to understand and work with you. If it's just a matter
of 20 lbs, period, and don't bother me until you've lost it, then I would
consider looking for a surgeon with a more empathetic and flexible program
that can meet each individual's needs. Having said all that...try South
Beach, it works pretty good for many and has great menus to follow.
— LMCLILLY
October 14, 2003
I didn't have to do this but like the previous poster said, more and more
doctors are requirning it. I would think that the Adkins Diet would be a
good one to try as it is high protein, low carb - similar to what you will
be doing after surgery. Good luck.
— Patty_Butler
October 15, 2003
I would think doing something along the same lines as we do post op would
be appropriate as well as exercising as much as your body will tolerate.
As far as requiring it before surgery, I tend to believe it is a good
thing. My doctor didn't require it but I've read so much about people
eating, eating and more eating before surgery. That can't be good. And to
suggest you find another surgeon is well, stupid. I would suspect before
you picked out this surgeon you did all the research necessary to decide he
was the right one. If losing 20 pounds is the impetus for getting to have
WLS then why on earth wouldn't you do it? If you can't stick to a weight
loss program prior to a surgery that you know will change your life, why
would the surgeon think you will abide by his rules post-op?
— D L.
October 17, 2003
I agree with Bob and others that this requirement is cruel. I hope you'll
consider another surgeon AND another surgery, the DS; you can learn about
it at http://duodenalswitch.com/. Dr. Elariny is excellent, and his
patients have an online support group at
http://groups.yahoo.com/group/DS_Elariny/ Good luck! Chris, DS 6/02
— Chris T.
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