New Weight Loss Surgery
I was interested in this New York Times article about a new, “less invasive” weight loss surgery, currently in the experimental stage, in which surgeons go down the patient’s throat and staple the stomach from the inside.
In Mexico and Europe over the past two to three years, 98 patients have had the new weight-loss surgery, named Toga (for transoral gastroplasty). On average, those who have passed the one-year mark have lost about 40 percent of their excess weight. Only time will tell whether they will be able to avoid gaining it back.
The advantages of this new type of WLS include not having to cut through muscle, fewer complications, and less scarring.
The patient being profiled in this particular article is noteworthy too, touching on the question of why have weight loss surgery in the first place. She brings up the accessories thing as a motivation, even.
Her family, friends and boyfriend say she looks just fine. But she has mixed feelings about her appearance. She weighed 175 or 180 pounds in high school and was comfortable with that weight. But she gained 90 pounds in college and could not take it off. She hopes the operation will help her lose 60 pounds, maybe even in time for her graduation…
“I don’t feel like it’s a big issue, but of course it is,” she said. “If I go out with my sorority sisters or friends to buy clothes, I probably can’t buy where they do. I’m the one who comes out with accessories. That’s a bummer.”
More important, she said, is her health. She becomes winded too easily, and her blood pressure “is not great,” she said, adding, “I just want to live healthy and not be borderline anything.”
So, this brings up a few questions. Not only “should this person have gotten WLS in the first place?” but what if this method becomes widespread and WLS becomes less invasive? Would that change your stance on the issue at all? Does the idea of getting WLS one day being as easy as having a cavity filled excite you or anger you?
Posted by mo pie
Filed under: Health, Science, Weight Loss, WLS
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Based on the information provided, I’m unconvinced that weight loss proved this woman’s only recourse to improving health. Borderline high blood pressure and feeling winded? This justifies rerouting your digestive track? This particular procedure may be a safer one, but WLS still carries long-term health risks outside of the actual operation and doesn’t even ensure long-term sustainable weight loss. Most people who have WLS simply become less obese and many regain at least some of the weight lost. I think WLS in general should be reserved as a last-resort kind of procedure for people who suffer from morbid health risks directly related to weight.
For me, personally, WLS will never be an option, regardless of how “easy” and minimally invasive it is. If researchers could invent a magic weight loss pill, maybe. But I would never have WLS for the same reason I would never arbitrarily amputate my foot — why fix what isn’t broken? I understand that others feel differently and I support their right to make informed medical decisions for themselves. I’m also glad to see such procedures becoming safer for people who opt to undergo them. Still, this new procedure acts as no magic wand: Basically, you trade safety for less weight loss and I’m not entirely convinced that people will be satisfied with the trade-off.
As a person who has a six year old lap band, I say this surgery is pretty close to worthless. A year out from my surgery I too had lost about 40% of my “excess” weight. I dropped about 5 more pounds and then started gaining it back.
Despite the fact that I still to this day eat significantly less than I did pre-op, over the next five years I slowly gained it back and now wear the exact same clothing size I did on the day I had surgery.
A year out is not far enough to really understand the full implications of the surgery. Even if there is less risk of death because it is less invasive initially, there is no greater likelihood of success. One thing I did not understand when I looked at statistics for lap-band “success” before I had my surgery is that a lot of studies remove patients who are “lost to follow up”, i.e. never go back to the initial surgeon from their failure rates. They either reduce the total number of people counted or count the lost people as successes.
So, in the first case if 100 people have surgery, if 50 people are out of contact with their doctors five years out, it only takes 40 of the original people to give an 80% success rate in the final outcome. In the second case it would take 40 of the original people to qualify the surgery as 90% successful.
I’m pulling those numbers out of air to make the point and keep the math easy, but the real numbers of lost people (including me) are significantly higher. According to my surgeon’s statistics I’m a success because I’m not willing to plunk down the $500 it would take to go see her in her office and prove I’m a failure, since none of this was covered by insurance.
So in terms of this surgery, I think the basic idea is the same as lap-band, and the failure rates will be similar long term. Some people will be thinner, most won’t, and in terms of real health, greater gains can be achieved with regular exercise.
I take a pretty firm stance on any type of WLS and that is – if you can walk you have no excuses to not change your life via diet and getting more activity to lose weight if that’s what you want. This particular case, in my apparently uninformed about her particular health/lifestyle opinion, I’d say she’s nowhere nearly enough overweight to justify having such a risky procedure. Whether it’s a “safer” technique or not, there’s a lot more at risk with the procedure than if she just changed her life. And I’m saying that as woman that is about her weight who changed my lifestyle a few months ago to get myself back to healthy.
As someone who is admittedly ignorant on most aspects of WLS, I have to ask the “stupid” question – doesn’t any type of weight loss surgery require a dramatic change in diet and lifestyle? Aren’t you limited to tiny portions, etc.? If you are that serious about losing weight that you are willing to submit to this, and are that dedicated to “changing your lifestyle”, why not give the old fashioned method of diet and exercise a try first?
Maybe I’m naive, but it seems to me that people are way to quick to jump on the WLS bandwagon as an “easy” fix. I guess I”m with April – I think if you can move, you can make changes to your lifestyle that may be more gradual, but aren’t as drastic and potentially dangerous.
Borderline high blood pressure and getting winded easily sound to me as though they could be fixed by getting a little more exercise. Start slowly and work up to something more. I, too, had high blood pressure and no endurance…until I began taking a fifteen minute walk every day instead of mostly sitting at my computer and not moving for hours and hours at a time. It happened that I did lose some weight, too, but the purpose of the exercise was mostly to feel physically better, and it worked for that.
Oh, and I was either at or pretty near the kind of weight the subject of the article was carrying. She may be more active than I was, but I know plenty of fat people who don’t get winded easily and the two things they have in common are healthy lungs and regular exercise. Unless this woman has severe asthma, or some other extreme chronic lung ailment, I can’t see why a little regular movement wouldn’t help more than WLS. And I honestly don’t see how stapling her digestive system would cure a serious lung problem, either.
WLS is nothing more in my book that mutilation of the gastrointestinal system; a system which is more delicate and more complex than most of us can even imagine. And – as Sony points out – the medical data is sometimes manipulated to make WLS seem both safer and more effective than it actually is.
I know how frustrating it is to go shopping and find there’s nothing in your size other than a purse or a pair of earrings. I know how demoralizing it is to hear people whisper behind your back that since you’re fat you must also be unhealthy, incapable of self-control, or just plain a lousy excuse for a human being. I know how magical an instant cure can sound.
I also know that I would be far more devestated to have to parse out my food carefully, take piles of vitamin pills because my body could no longer absorb the nutrients from food properly, and face the possibility of further surgery should something from the first one go awry, even if it could guarantee that the weight loss was permanent…which it really can’t.
Would I like to be magically thinner? Sure. I’m honest enough to say that. I just don’t believe that WLS is worth the trouble and potential side effects.
Ya know, my position on weight loss surgery is that if people want to have it, that’s their decision. As long as it remains an elective surgery, I don’t have a problem with it.
What I do have a problem with is people not getting accurate information about the risks and benefits of a medical procedure. It appears that weight loss surgery, right now, is being falsely touted as safer and more beneficial than it really is, and I think that’s what needs to be fixed, not the availability or ease of the surgery itself.
As long as humans have an awareness of their own mortality, there will be those who are willing to undergo all manner of bizarre modifications to their perfectly normal bodies. Making sure that people know exactly what they’re getting into when they do it is the ethical thing to do.
I have mixed feelings about this, but I do support ones choice IF and ONLY if someone has all the info to make an informed choice, I have an aunt who had her stomach stapled in the 70’s and never gained the weight back, she eats like a bird not because of will power but because when she eats a cup of icecream she feels like she had 2 gallons, so she still eats as much as she did before she just its like 20 times a day(exageration) instead of the 3 huge meales she used to eat. it has been prooven that eating many small meals as opposed to 3 big meals is better for you anyway.
and for those who say just eat right and not do WTS some people CANT eat right on their own it helps SOME people to feel stuffed on a cup of chillie because otherwise they will eat the whole pot(until they feel stuffed.). I believe in choice I choose not to diet and feel no need to be cut open, but then again I down have trouble running or walking and if I suck in I can find cloths that fit.
First of all, I don’t think it’s been proven that eating many small meals is better for you than 3 larger meals. I think this approach is used by the diet industry to promote feelings of fullness (which I think is also the point of the huge amounts of water diet programs want you to drink, too).
Secondly, if someone wants weight loss surgery, I suppose they should be able to get it.
I think we’ll find that while WLS dramatically helkps a certain percentage of people, it won’t have a huge impact on public health. Not the way people believe it will be.
To me, less invasive means fewer possible complications. Aren’t obesity researchers in Italy experiementing with pacemakers implanted in the gut? If memory serves, the pacemaker send a signal to your brain as soon as you begin swallowing the bolus (ball of masticated food) and early test subjects report feelings of fullness in the gut.
Due to my weight, I would be a good candidate for WLS. However, I’m fairly healthy, with good blood sugar, low blood pressure, and do not get winded easily. The only major problems I’m dealing with now is IBS and anemia, but those are regulated with medicine. Even with a huge weight loss, I would still be considered obese. Why should I mutilate my stomach and cause possible future complications just to fit someone’s idea of attractiveness? Also, with my IBS and anemia, I’m afraid that surgery would only complicate my digestive system further and cause futher vitamin and nutrient disorders.
The huge problem with WLS for me is how it’s marketed. It is being touted more as a way to improve appearance and achieve the “fantasy of being thin” instead of reducing severe health problems caused by excess weight. Yes, occasionally, we’ll hear how WLS can improve bad knees or “cure” diabetes. But more and more, the reason to have surgery is to get cuter clothes, visit relatives, and kiss your boyfriend under the Eiffel Tower. You can still do all of those while fat.
I know a lot of people think WLS is the easy way to get smaller. I know there are a group of people out there who have come through the surgery unscathed. I know for those whose weight is causing real, drastic problems, it’s the only answer. But the risks far outweigh the complications, especially for those that are fat and normally healthy. Now when I hear doctors try to push it on people who don’t even qualify as morbidly obese, it’s scary.
I have many, many issues with WLS, but just from a follow-up healthcare perspective there are so many potential problems that I don’t think it should be recommended to anyone. It is not a fix for obesity, in the long run, and those people who are not able to keep to their diet/vitamin regimen are at a greater risk for health complications than the obesity would have caused.
The real question to me is to these new surgeries have the same side effects as the other WLS. Dumping, vitamin deficiency, ect.
Complecations? Also 2% of patients who get WLS die, is that differnet with this new surgery. I understand there is some shame attached to WLS but I wish people would be more frank about the physical side effects to the surgery.
I also have a lot of issues with WLS. I personally don’t know anyone who has successfully kept the weight off after WLS.
I also wish we could take some of the money we spend on weight loss gimmicks and put it toward other things. Having just lost my dad to cancer, and having two kids with Autism, I’d like to see more funds going to those causes, and others like them.
Anyone who wants to have weight loss surgery who can make an informed decision about it should be able to have it. It doesn’t matter if it’s for vanity or health or if I or somebody else thinks it’s a bad idea. Other people have the right to make decisions that I think are stupid or wrong or self-destructive. It’s the same reason I’m pro-choice, support 2nd amendment rights, and believe in gay marriage. It’s your life, not mine.
So now they’re saying the 3rd class health care from Mexico is okay to use on fat people? Seriously, everyone talks about how terrible the health care is in Mexico.
Only would they consider borrowing health care advice from the lowest denominator, for fat people.
I think if a safe, cheap side effect free way to be thin became widely available, society wouldn’t care so much about fat and find something else for people to hate their bodies for. It would all be about muscles or cellulite or flexibility or the thickness of our ankles, or something else that people can’t even conceive of as a problem right now.
I greatly admire women who can be comfortable in their own skin regardless of their size. Not everyone can, and for that reason I will never bag on someone who chooses to have weight loss surgery. I only hope that this young woman truly did her research before resorting to surgery.
As for third-class health care in Mexico – these clinics and hospitals specifically recruit Americans, and apparently do a fine job of it. I know any number of people who have had a fine Mexican holiday with WLS right in the middle.
One of the biggest predictors of future weight gain is …. drumroll … dieting.
WLS is dieting enforced by reworking of the digestive tract. It is drastic and some folks do find it useful by letting them drop enough bulk that they can start working out, but seriously, someone who needs WLS to walk/shower/clean house probably also needs a physical therapist to help build muscle and ensure they’re using it properly.
Oh, and my solution to getting winded when walking was to get my asthma treated. Funny how being able to BREATHE improved my breathing better than any diet….
How this mostly makes me feel is LUCKY, like the way you feel lucky when you remember that, compared to people with leukemia or three jobs or even a couple of sick kids, your whole life is a vacation. Those of us who can choose to move more, or to eat differently, or to be healthier than the person in the next cubicle, or not to even consider drastic surgery as an option: we’re in many ways the privileged of the earth. If we have time to exercise, or gym access, or freedom from any of the dozens of factors that make addictive behaviors more likely, or access to fresh foods, or family who don’t sabotage us, or a good level of comfort generally with the bodies we have: oh, boy. How many people would kill for any of these things? And it’s not generally beacuse of much we’ve done to earn it (at least in my case it’s not.) So I’m going to settle for a rousing THANK YOU to wherever the luck comes from, and a hope that those who are considering major surgery because it’s the last resort can get some of that. And I’m going to add a shout-out to my friend Liz, who got that surgery, lost some of the weight but not, I think, as much as she’d hoped for, and is now having heart problems. That’s what she risked, and got, for this surgery, which really, really looked like the only choice she had left. That’s how important it is, the kind of luck I have and she didn’t. It can make the difference between general good health (priceless) and lifetime cardiac issues.
Do y’all ever just wonder why this stuff has to be so hard? Is this the price of living in a world with cars and chemo and antibiotics? Because if so, it’s one hell of a price; for so many people, it’s just stupid hard.
I wonder if the medical industry would push WLS so much if they did not receive any compensation for performing it? I think WLS is a scheme cooked up by someone(s) who wanted to make more money.
“Where are people weak and vulnerable?” they queried. “Aha! We shall hit them where it hurts: in the stomach!”
Thus they began battering individuals’ self-esteem, driving such people as felt insecure about being fat to the doors of the touted saviors, weight loss surgeons, cash or health insurance providers’ pre-certification in hand.
And the dough kept rolling in…
Rhonwyyn – good point, especially because insurance won’t cover the costs in most cases – which means that doctors are getting the full price, instead of one negotiated downwards by the insurance companies, right?
I’m someone who’s been on both sides of the fence. I had my stomach stapled at age 15 weighing 350 lbs. I thought it would fix my depression and make me a happy teenager. It did help but I threw up daily for years. I lose over 100 lbs and then gained it back, lost it again with a low cal diet, gained it back and more, to an all time high of 378 lbs. Finally at age 40 I started losing the weight the right way through just plain old hard work.
There is no get thin quick plan out there that will work long term. If you want to lose the weight and keep it off you just have to do the work. I think most people don’t want to do the work. Sitting around is definitely easier. Eating whatever you want is definitely easier. It’s about loving ourselves enough to want to make ourselves healthy and happier. I’m definitely happier now at 237 than I was at 378. Sure I’m not thin, but I’m healthy and still striving to be healthier.
I also have come to realize that if we don’t fix our minds we can never fix our bodies. It’s all about how we deal with ourselves and view ourselves. For me, it was realizing that anxiety held me prisoner and that it drove me to eat to stuff down my feelings. When I realized that taking a walk could feel as good (even better) than eating a pint of ice cream I was on my way.
Sure I still struggle, I go back to old ways sometimes and wanting the battle to be over. But it’s never going to be over, this is my life. I can either make it the best one I can or I can sit around feeding my face, killing myself. I am doing my best to learn to truly love myself. I think that is the bottom line.
I also think surrounding yourself with like minded people is what will help you stay on track. If you hide what you’re doing then you are just secretly telling yourself that you are going to fail so why bother. It’s about setting up a support system that will make it harder to fail than succeed.
I know I’ve gotten off track with this so I will get back to what I think about WLS. I think it’s a personal choice. I wouldn’t change having it done. I think it taught me many lessons. I think for the people that have it done they think they don’t have the power to do it on their own. I wish I could tell them all how powerful they really are. I think for me the exercise showed that to me. It showed me just how strong I am mentally and physically.
When people ask me about WLS I tell them what I think. I think if you have serious health problems and you need to get the weight off as quick as possible then it might be a solution. But I also tell them they need to be aware of the side affects (dumping, vomiting, etc). I think people that have WLS are so happy to be losing the weight the side affects seem worth it to them so they aren’t really honest about it.
I also tell people that therapy is something everyone can benefit from. We ALL have issues with ourselves so why not try to fix ourselves mentally as well as physically. I’ve been in therapy over 2 yrs now. I just go once a month but it really helps to keep me focused on what’s important to me and what I would like to change about myself and my life.
So I wouldn’t promote WLS but I also think people have to find things out for themselves. Hopefully they look into it enough to know what it’s all really about.
I had surgery 3 years ago and I have kept the weight off. For me it was a wonderful decision. I was and I still am very dedicated to eating well and taking care of myself!