Question:
Help for all our new members and ones still deciding...

Help for all our new members and ones still deciding... <p> When I first started researching WLS I happened on this site view the history of Gastric Bypass Surguries with description of the different procedures and pictures.. <p> http://www.asbs.org <p> I'm not pitching any particular procedure (that is your choice) all of these sites you need to read for yourself, gather all the information you can then once you decide on a surgeon discuss these with him/her..<b>What is right for one may not be right for you.</b> Read all the information and data collected and research the issues on each surgery procedure.. Good luck in your quest for knowledge on the best procedure for you.. I see PRO & CONS in all surgery types... Bottom line is do your research and then do some more research.. I have collected some links that might help you in your quest... <p> There are many procedures available for weight loss. Most can be categorized as <p> RESTRICTIVE: <p> vertical-banded gastroplasty, roux-en-y gastric bypass, laparoscopic roux-en-y-gastric bypass) or <p> MALABSORBTIVE: <p> (biliopancreatic diversion, distal roux-en-y gastric bypass, jejuno-ileal bypass). <p> Below additional sites to visit in your search for knowledge. <p> See Gastric Bypass Types: <p> http://www.angelfire.com/ok3/vbowen8/index.html <p> The Mini-Gastric Bypass: http://clos.net <p> Academy of Bariatric Surgeons - Suggested Links <~~Great links here..... <p> http://www.obesityhelp.com/abs/links.htm <p> Great abstracts from Surgeons of Surgery types: <p> http://www.amedeo.com/medicine/obe/obessurg.htm <p> Obesity Search Engines: <p> http://www.loop.com/~bkrentzman/links/ob.search.html <p> http://www.asbs.org <p> This is a webpage made by people that have had this surgery.. http://www.duodenalswitch.com <p> PLEASE GO BACK TO THE MAIN PAGE OF THIS SITE AND VISIT ALL THE LINKS IN THE LIBRARY... THERE IS A MULTITUDE OF INFORMATION THERE: <p> ************************************************************ <p> This was my selection after 8 months of research... Open RNY 12/8/99...Nashville, Tenn. Dr. John Husted, M.D... Dr. Husted only does proximal.. <p> Open Roux en Y (Rny) <p> The Stomach is separated into two parts. The small Stomach pouch(A)receives food. The lower part of the stomach(B) received most of the gastric juices coming from the liver and other organs. The small intestine is carefully measured and cut.One end(C) is connected to the small stomach pouch. The other end(D) is reconnected to the small intestine, forming a "Y". <p> ==================================================== <p> If you choose Laparoscopic Roux-en-Y <p> same as open Roux-en-Y except instead of opening you with a long incision on your stomach, Surgeons use a pencil thin optical telescope, to project a picture to a TV monitor. Having surgery this way, smaller scars , usually 3 to 4 small incisions. Quicker recovery time and less pain. <p> Roux-en-y Gastric Bypass Surgery offers a successful combination of weight control with minimal nutritional or other risk, when follow up and nutritional guidelines are followed. Many obesity experts consider the surgery to be the "Gold Standard" of modern obesity surgery the benchmark to which other bariatric operations are compared. The operation achieves its effects by creating a very small stomach, from which the rest of the stomach is divided and separated. The small intestine is "attached" to the new stomach, allowing the lower pan of the stomach to be bypassed. A thorough description, including diagrams, of the operation will be provided to you during your consultation or as part of the free seminar we encourage potential patients to attend. Suffice to say, that no bodily functions are altered as a result of the operation, and it is completely reversible if it ever needed to be. <p> For complete descriptions with illustrations of the surgery go to (http://www.angelfire.com/ok3/vbowen/index.html) <p> Following surgery, there is little interference with normal absorption of food. The operation restricts food intake and reduces the feeling of hunger. The result is an early sense of "fullness" followed by a sense of satisfaction. Even though the portion size is small (2 to 6 ounces per serving), there is no hunger and no sense of being deprived. Patients continue to enjoy eating all types of food after surgery. They just eat a much smaller portion than they used to. The Roux-en-y Gastric Bypass is an excellent tool for achieving longterm control of morbid obesity (the state of being 100 or more pounds over ideal body weight). Weight loss of 80-100% is achievable by most patients, as internal and external outcome studies demonstrate. And maintenance of that weight loss is likely with adherence to a straight forward behavior regimen. <p> The Roux-en-Y Gastric Bypass Surgery helps you lose weight in three ways <p> 1. You eat less (Volume restriction) With a separate small stomach pouch, you feel full after eating a small amount of food. This approach is much more effective in restricting food volume than other surgical techniques, such as stomach stapling. <p> 2. Your appetite changes (Behavior modification) The procedure reinforces a change in your eating habits. After the procedure, most patients find that their body will not easily tolerate foods that are high in refined sugars and fats. With this built-in control, called "the dumping syndrome," which produces short-term discomfort and flu-like symptoms, you naturally learn to avoid these foods. (Our Bariatric Treatment Centers nutritionists help you avoid the foods that may cause discomfort and help you choose from a wide variety of foods you can enjoy.) Other surgical procedures don't provide this important benefit of behavior modification. <p> 3. You absorb fewer calories (Malabsorption) Food bypasses part of the small intestine and digestion occurs in the lower part of the small intestine. These two factors reduce the amount of calories your body absorbs from the food you eat. <p> The reduced stomach pouch size, change in eating habits and absorption of fewer calories allow patients to be successful at long-term weight loss, as opposed to short-term weight loss programs or diets that rely on willpower, costly meal replacements, or dietary supplements. <p> What are the risks? <p> Bariatric surgery is performed to enable patients to lose excess weight and reduce the serious weight-related health conditions they experience. Every surgery involves risk and bariatric surgery is considered a major abdominal surgery. Patients need to understand these risks and weigh them against the significant risks related to being seriously overweight. Bariatric Treatment Centers' surgeons review these risks in detail in their consultations with patients. <p> For list of PRO & CONS... http://www.angelfire.com/ok3/vbowen/index.html <p> Please visit my webpage for my online journal from beginning to present, along with great information on all the diffrent surgery types, PROS & CONS, sugar free recipes with high protein content, links to Law help if insurance is denied, links to Laparoscopic sites and much more.. Visit my recipe page link "Recipe of the day" and vote for my site if you love these recipes. <p> Open Proximal RNY 12/8/99 83 lbs gone todate! www.angelfire.com/ok3/vbowen/index.html    — Victoria B. (posted on April 4, 2000)


April 4, 2000
I thought this was an interesting Abstract..And before I get beat up over it.. This is a 1999 published report, so one would assume it's the revised BPD, however, without contacting the person who published this article I can't tell you that for sure. <p> Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. <p> -------------------------------------------------------------------------------- <p> Abstract: BACKGROUND: The authors investigated whether practice patterns of bariatric surgeons correlate with published data regarding metabolic deficiencies after Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). METHODS: 109 surgeons completed a questionnaire to determine use of supplements and frequency of lab tests. RESULTS: Regarding supplements routinely prescribed after RYGB, 96% of surgeons gave multivitamins, 63% gave iron, and 49% gave vitamin B12. After BPD, 96% of surgeons gave multivitamins, 67% gave iron, 42% gave vitamin B12, 97% gave calcium, 63% gave fat-soluble vitamins, and 21% gave protein supplements. Regarding laboratory tests obtained routinely after RYGB, 95% of surgeons do complete blood counts, 56% do iron determinations, 66% do vitamin B12 determinations, 58% do folate determinations, 76% do electrolyte determinations, and 8% test for proteins. After BPD, 96% of surgeons do complete blood counts, 80% do iron determinations, 67% do vitamin B12 determinations, 71% do folate determinations, 88% do electrolyte determinations, 84% do protein determinations, and 46% test for fat-soluble vitamins. Regarding frequency of blood tests, after RYGB, 22% of surgeons obtain them after 3 months, 33% after 6 months, and 41% after 12 months; 4% do not routinely obtain postoperative laboratory tests. After BPD, 46% of surgeons obtain them after 3 months, 33% after 6 months, and 16% after 12 months; one does not obtain laboratory tests. Surgeons estimated these deficiencies after RYGB: 16% iron, 12% vitamin B12, 14% anemia, 5% protein, and 3% calcium. They estimated these deficiencies after BPD: 26% iron, 11% vitamin B12, 21% anemia, 18% protein, 16% calcium, and 6% fat-soluble vitamins. The estimated incidence of deficiencies after RYGB was considerably lower than the published incidence. Unnecessary tests were commonly performed (electrolytes after RYGB). CONCLUSION: Despite wide variations in the performance of laboratory tests and the use of supplements, the practice patterns of most surgeons protect patients from developing severe metabolic deficiencies after RYGB and BPD. <p> Author: Brolin RE Leung M Address: Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA. Abbreviated Journal Title: Obes Surg Journal Title Code: C0V Date Of Publication: 1999 Apr Journal Volume: 9 Page Numbers: 150 through 154 Country of Publication: ENGLAND Language of Article: Eng Type Of Article: JOURNAL ARTICLE Issue/Part/Supplement: 2 ISSN: 0960-8923 MESH Headings: Biliopancreatic Diversion Data Collection Deficiency Diseases (Central Concept) Dietary Supplements (Central Concept) Gastric Bypass Human Minerals (Central Concept) Obesity, Morbid (Central Concept) Postoperative Care (Central Concept) Prognosis Treatment Outcome Vitamins (Central Concept) Article ID: 99270593
   — Victoria B.

April 4, 2000
Vick, as usual, you are a fountain of information! Thanks for posting this. I think it's safe to say that, unless there is a specific reference to the duodenal switch, these types of abstracts refer specifically to the standard BPD. But I was fascinated with the similarity in vitamin prescriptions by the surgeons following these surgeries. I guess the bottom line is, no matter how distal or proximal of a procedure you have, we ALL must be vigilant about taking our vitamins! Speaking of which... uh oh, I think I forgot mine this morning!!
   — Kim H.

April 4, 2000
Melanie: Like I said one would assume being a 1999 abstract is was the newer revision of BPD.. But it does not specify, however, there is so little information or US studies out there on the BPD-DS one can't compare.. And again I repeat so many times BPD-DS is called just BPD. So we can only go on the words of those who have had this surgery that it is not the same procedure. Time will tell on that issue and the new reports due out this summer, and hopefully more abstracts being published on the BPD-DS. I for one want to know more about this procedure.. ;-)
   — Victoria B.

April 4, 2000
Kim: Yes I do agree..and actually the Conclusion was rather good.. Surgeons are very aware of the side affects and deficiencies in both surgeries and are doing all they can to prevent them in both surgeries.. Speaking of which.. Yes, go take you vitamins. Kim: try that Ultra NourishHair from GNC I have already noticed a difference. I have long hair also and I don't want to loose a strand ;-)
   — Victoria B.

April 4, 2000

   — Victoria B.

April 4, 2000
More good reading for the members...MSO Surgical <p> Overview.. http://www.drrossfox.com/gastrby.html <p> Gastric Bypass (GBP): <p> The gastric bypass, originally done by Dr. Mason at the University of Iowa, has undergone significant changes through the years. Currently, we are doing a procedure in which a small gastric pouch is made in the same part of the stomach as is the Vertical Banded Gastroplasty. The only difference in the pouch is that we place the staple line so that the pouch is blind; that is to say, it has no outlet, and we transect (cut and suture) the stomach at the staple line. <p> We then bring up a piece of intestine and attach it to the pouch so that the food can come out of the pouch and into a segment of the small intestine. This piece of the intestine is 100 to 120 inches long and is the part of the intestine that joins the colon (the large intestine) near the appendix. The food, as it leaves the pouch, transverses the 100 to 120 inch segment of the intestine and then enters the colon. Nutrients, such as vitamins and minerals, can be absorbed; but the food is not digested until it reaches the last 40 to 70 inches. The digestive juices from the gallbladder and the pancreas mix with the food at this point and digestion occurs. This 3.5 to 5 foot segment of the intestine (called the common tract) provides the only opportunity the body has to digest the food. When the food enters the colon, no further absorption of digestive products occurs. Much of the food goes into the colon undigested, and as a result, the patient loses weight. <p> The small pouch that is used causes this operation to be a "small meal operation" (gastric restriction), but also there is an additional component that is related to the impairment of digestion. We refer to this as a "malabsorption procedure", because the patient cannot absorb all that they eat. So, the gastric bypass is a combination gastric restrictive and malabsorption operation. <p> The reason some surgeons feel that the gastric bypass is a better operation than the vertical banded gastroplasty (VBG) is that gastric bypass patients tolerate sweets poorly. If a GBP patient eats anything with significant amounts of sugar in it, that patient will often feel a little light headed and experience some palpitations (heart flutters), as well as occasionally having cold sweats. These symptoms usually only last a few minutes, but they are not pleasant. We call it "The Dumping Syndrome" and what this accomplishes is that it conditions most persons against eating sweets. For this reason, the operation is usually more successful that the VBG if the patient is a sweet-eater. <p> Because of the malabsorption, the potential for long-term complications in the GBP is greater. The complications that are occasionally seen are: low serum protein levels, anemia, low vitamins and low iron or calcium levels. One of the disadvantages of the GBP relative to the VBG is that there is a possibility of gastric ulcers forming at the juncture of the pouch with the small intestine. With the VBG, low serum protein, anemia, mineral deficiencies and the dumping syndrome are less common. In the great majority of patients, these problems do not occur or are minimial (are not problematic). In our series, the results are very impressive. <b>At five years, the average weight loss is 89% of the excess. </b>This means that our average GBP patient is at normal or near-normal weight five years are the surgery.
   — Victoria B.

April 5, 2000
MORE GOOD INFORMATION!!!! <p> HealthNews, from the publishers of The New England Journal of Medicine, is a newsletter providing straight talk on the medical headlines. It is published 12 times a year. Subscriptions cost $29 a year; call toll-free 800-848-9155. You can contact the editors by email at [email protected]. <p> Home > Diseases & Conditions > In-Depth Report <P> http://onhealth.com/conditions/in-depth/item/item,2061_1_1.asp <p> December 12, 1995 <p> More Positive Effects of Gastric Bypass Surgery for the Obese HealthNews from the publishers of the New England Journal of Medicine <p> For people who are very obese, gastric bypass surgery does more than just reduce weight. It also helps control diabetes, high blood pressure, incontinence, and other weight-related health problems ("Excess Weight Linked to Cataracts"). <b>In last month's Journal of the American Dietetic Association, Ohio State University researchers reported another interesting side effect: gastric bypass somehow made sweet foods taste unpleasantly sweet for 13 of 14 patients, and they began eating fewer sweets. This may be one reason that gastric bypass surgery is more effective than other operations used to control weight.</b> <p> Boy, did they hit the nail on the head.. This is VERY true for myself and others have reported the very same thing, I thought my surgeon had sucked out my sweet tooth somehow.. ;-) <p>
   — Victoria B.

April 5, 2000
Great post, Vick. I've noticed too that I can't tolerate sweet things like before. Heck, I still have Christmas in my cupboard at home, and it's APRIL. Before, that candy would have lasted three days max.<br><br>Here's another interesting side effect of a gastric bypass. Dr. Anthone stated a while back that one of the side effects of a GB is an increase in metabolism! He joked that surgery is like a diet and exercise all in one! Anyway, I've never seen this in the literature, but perhaps you've come across something? I believe Dr. Anthone, but I'd like to have something to refer to before I cite it as fact.
   — Kim H.

April 5, 2000
Information for our Members Deciding!! Open Roux en Y (Rny) <p> The Stomach is separated into two parts. The small Stomach pouch(A)receives food. The lower part of the stomach(B) received most of the gastric juices coming from the liver and other organs. The small intestine is carefully measured and cut.One end(C) is connected to the small stomach pouch. The other end(D) is reconnected to the small intestine, forming a "Y". <p> Roux-en-y Gastric Bypass Surgery offers a successful combination of weight control with minimal nutritional or other risk, when follow up and nutritional guidelines are followed. Many obesity experts consider the surgery to be the <b>"Gold Standard" </b>of modern obesity surgery the benchmark to which other bariatric operations are compared. The operation achieves its effects by creating a very small stomach, from which the rest of the stomach is divided and separated. The small intestine is "attached" to the new stomach, allowing the lower pan of the stomach to be bypassed. A thorough description, including diagrams, of the operation will be provided to you during your consultation or as part of the free seminar we encourage potential patients to attend. Suffice to say, that no bodily functions are altered as a result of the operation, and it is completely reversible if it ever needed to be. Complete descriptions with illustrations of the surgery are presented by your surgeon at time of consultation. Following surgery, there is little interference with normal absorption of food. The operation restricts food intake and reduces the feeling of hunger. The result is an early sense of "fullness" followed by a sense of satisfaction. Even though the portion size is small (2 to 6 ounces per serving), there is no hunger and no sense of being deprived. Patients continue to enjoy eating all types of food after surgery. They just eat a much smaller portion than they used to. The Roux-en-y Gastric Bypass is an excellent tool for achieving longterm control of morbid obesity (the state of being 100 or more pounds over ideal body weight). <b>Weight loss of 80-100% is achievable by most patients, as internal and external outcome studies demonstrate.</b> <p> The Roux-en-Y Gastric Bypass Surgery helps you lose weight in three ways 1. You eat less (Volume restriction) With a separate small stomach pouch, you feel full after eating a small amount of food. This approach is much more effective in restricting food volume than other surgical techniques, such as stomach stapling. 2. Your appetite changes (Behavior modification) The procedure reinforces a change in your eating habits. After the procedure, most patients find that their body will not easily tolerate foods that are high in refined sugars and fats. With this built-in control, called "the dumping syndrome," which produces short-term discomfort and flu-like symptoms, you naturally learn to avoid these foods. (Our Bariatric Treatment Centers nutritionists help you avoid the foods that may cause discomfort and help you choose from a wide variety of foods you can enjoy.) Other surgical procedures don't provide this important benefit of behavior modification. 3. You absorb fewer calories (Malabsorption) Food bypasses part of the small intestine and digestion occurs in the lower part of the small intestine. These two factors reduce the amount of calories your body absorbs from the food you eat. The reduced stomach pouch size, change in eating habits and absorption of fewer calories allow patients to be successful at long-term weight loss, as opposed to short-term weight loss programs or diets that rely on willpower, costly meal replacements, or dietary supplements. <p> ============================================================ <p> Laparoscopic Roux-en-Y <P> same as open Roux-en-Y except instead of opening you with a long incision on your stomach, Surgeons use a pencil thin optical telescope, to project a picture to a TV monitor. Having surgery this way, smaller scars , usually 3 to 4 small incisions. Quicker recovery time and less pain. <P> ============================================================= <P> Distal Gastric Bypass <P> The Gastric Bypass operation can be modified, to alter absorption of food, be moving the Y-connection downstream ("distally"), effectively shortening the bowel available for absorption of food. The weight loss effect is then a combination of the very small stomach, which limits intake of food, with malabsorption of the nutrients which are eaten, reducing caloric intake even further. Patients have increased frequency of bowel movements and increased fat in their stools (bowel movements). The odor of bowel gas is very strong, which can cause social problems or embarrassment. Calcium absorption may be impaired, as well as absorption of vitamins, particularly those which are soluble in fat (Vitamins A, D, and E). Vitamin supplements must be used daily, and failure to follow the prescribed diet and supplement regimen can lead to serious nutritional problems in a small percentage of patients. We. and others, have noted an increased incidence of ulcers post-operatively, in patients having this procedure. <P> ============================================================= <P> Biliopancreatic Diversion (BPG) <p> This very powerful operation involves removal of approximately 2/3 of the stomach, and re-arrangement of the intestinal tract so that the digestive enzymes are diverted away from the food stream, until very late in its passage through the intestine. The effect is to selectively reduce absorption of fats and starches, while allowing near-normal absorption of protein, and of sugars. Calorie intake is much reduced, even while normal-sized food portions are eaten. <p> Although this operation is very powerful, patients are subject to increased risk of nutritional deficiencies of protein, vitamins and minerals. Vitamin supplementation recommendations must be carefully followed, and dietary intake of protein must be maintained, while intake of fat must be limited. Patients are annoyed by frequent large bowel movements, which have a strong odor. Excess fat intake leads to irritable bowel symptoms, and may lead to rectal problems. <p> Kim, Melanie or Fran G. can assist you in the discription of the new variation of this procedure..... <P> ============================================================ <p> Adjustable Gastric Band (AGB) <P> Gastric Banding is a variation on the gastroplasty, in which the stomach is neither opened nor stapled -- a band is placed around the outside of the upper stomach, to create an hourglass-shaped stomach, and to produce a small pouch with a narrow outlet. The special device used to accomplish this is made of implantable silicone rubber, and contains an adjustable balloon, which allows us to adjust the function of the band, without re-operation. This device enjoys considerable advantage over the standard gastroplasty: <P> It can be inserted laparoscopically, without the usual large incision. It does not require any opening in the gastrointestinal tract, so infection risk is reduced. There is no staple line to come apart. It is adjustable. <P> =========================================================== <P> Loop Gastric Bypass <P> This form of Gastric Bypass was developed years ago, and has generally been abandoned by most bariatric surgeons as unsafe. Although easier to perform than the Roux en-Y, it creates a severe hazard in the event of any leakage after surgery, and seriously increases the risk of ulcer formation, and irritation of the stomach pouch by bile. Most bariatric surgeons agree that this operation is obsolete, and should remain defunct. <p> This operation has been resurrected, in order to make the laparoscopic procedure easier to perform. A fundamental principle of laparoscopic surgery is that the operation should not be compromised or degraded, in order to accomplish it using limited access techniques. The loop bypass does not meet this standard <P> ============================================================ <P> Gastroplasty <P> Gastroplasty, or Stomach Stapling (Gastric Partitioning) is widely performed in the United States and elsewhere. It is a technically simple operation, accomplished by stapling the upper stomach, to create a small pouch, about the size of your thumb, into which food flows after it is swallowed. The outlet of this pouch is restricted by a band of synthetic mesh, which slows its emptying, so that the person having it feels full after only a few bites (one thumbful) of food. Characteristically, this feeling of fullness is not associated with a feeling of satisfaction- the feeling one has had enough to eat. <P> Patients who have this procedure, because they seldom experience any satisfaction from eating, tend to seek ways to get around the operation. Trying to eat more causes vomiting, which can tear out the staple line and destroy the operation. Some people discover that eating junk food, or eating all day long by "grazing" helps them to feel more sense of satisfaction and fulfillment -- but weight loss is defeated. In a sense, the operation tends to encourage behavior which defeats its objective. <p> Overall, about 40% of persons who have this operation never achieve loss of more than half of their excess body weight. In the long run, five or more years after surgery, only about 30% of patients have maintained a successful weight loss. Many patients must undergo another, revision operation, to obtain the results they seek. <P> There are many procedures available for weight loss. Most can be categorized as: <p> RESTRICTIVE: <p> vertical-banded gastroplasty, roux-en-y gastric bypass, laparoscopic roux-en-y-gastric bypass) or <p> MALABSORBTIVE: <p> (biliopancreatic diversion, distal roux-en-y gastric bypass, jejuno-ileal bypass). The Site listed below states: That they do not perform the malabsorbtive procedures as we have not found convincing evidence that they provide a more consistent weight loss or improved quality of life. They have converted many of these procedures to the Roux-en-Y Gastric Bypass because of severe metabolic complications and malnutrition. <p> There are many other procedures that are touted as "unique". They are only presenting common procedures with known tract records and definable statistics. They advise you to use common sense in your educational process. If it sounds too good to be true, it generally is. <p> Malabsorbtive Procedures <p> Common to all malabsorbtive procedures is the apparent shortening of the intestine in contact with food. Although seemingly logical at first, making the system less efficient in its absorption of nutrients requires continued overindulgence by the patient for survival. The "eat to live" configuration can be quite harmful if adequate volumes of food were not available or if you were to contract a simple case of the "flu". Because of the shortened intestinal tract, hospitalization may be required and therefore travel to certain countries that do not have the medical facilities here in the United States should be discouraged. <p> Iron, calcium, protein, vitamin and mineral deficiencies mandate continued supplements and occasional intravenous therapy.
   — Victoria B.

April 5, 2000
This is a wonderful site and I am learning so much from the posts. I wish, however, that these nasty snipes would stop. It seems that every post that has anything to do with the duodenal switch or in which certain sets of people have posted is ultimately reduced to name calling. My question on why docs still do RNY distals was even removed from the site because of the nastiness. Please stop this behavior. You undercut your credibility and your undermine all the good work you otherwise do with this mean spirited immaturity. We are all here to learn and to share. Surely we can do that in a civil manner!
   — Kathleen B.

April 6, 2000
Mel, the work you do here is invaluable. If it hadn't been for folks like you, I wouldn't have known where to find support for DS-specific issues. I think many of the folks here don't realize what a small minority we are, and how hurtful it is to be "excluded" in what should be a safe community for us. The polarization of the DS v. RNY has led some to forget that <b>I'm just a fat chick trying to get skinny</b>, and want to support others in doing the same thing.
   — Kim H.

April 6, 2000
Kim- love your post- that is what it is all about, isn't it? We are ALL just fat people trying to get skinny. Thanks for the reminder!
   — M B.




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