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Sunday, September 14, 2008

After WLS: Not What I Was Expecting

I read and write a lot about weight loss surgery, and more importantly, LIVING after weight loss surgery. Recently I received an email from a disappointed post-surgical weight loss patient. This patient had only lost 10 (ten) pounds. She was discouraged and anxious. And she was 7 (seven) days post surgery ready to give the 5 Day Pouch Test a try since "the surgery did not work for her." How sad and frustrating for her and me. She does not need to feel like a failure and my words of "be patient, let the surgery work" felt trite. There are many misconceptions about weight loss surgery that lead to disappointment. This is one of my syndicated articles that addresses this topic:

Misconceptions About Weight Loss Surgery Cause Disappointment for Patients
As weight loss surgery becomes an increasingly popular treatment for morbid obesity misconceptions abound. Patients who undergo gastric bypass or gastric banding surgeries are often depressed and disappointed after surgery because they believed the popular misconceptions.

Some common misconceptions about WLS:

Surgery brings joy and boundless energy instantaneously
Laparoscopic surgery is painless
WLS is an easy fix and permanent fix to obesity
WLS guarantees happiness
Others will support the WLS decision
After reaching goal weight patients can go "back to normal"

Because patients read about the joy and boundless energy enjoyed by others after surgery they assume these feelings occur immediately. Joy is felt after massive weight loss, not after surgery. In fact, for many patients the first six weeks out of surgery are emotionally draining as they grieve for food and feel fatigued and disoriented.

We read that the laparoscopic technique used for 85 percent of all surgical weight loss procedures is minimally invasive requiring little recovery time. In truth this technique bruises the intestines, liver and ribs. The surgery is painful and recovery is not as rapid as most patients expect. Patients express feelings of failure when they are sore and exhausted from surgery.

For most patients weight loss happens quickly and easily. True to dieting tradition when patients reach goal weight they tend to go back to “normal” disregarding the high-protein low-volume diet. Weight gain results. Unless patients follow the strict WLS rules daily they regain weight.

Surgical weight loss does not guarantee happiness. In fact, patients commonly describe feelings of anger, bitterness, resentment, panic and self-loathing as they lose weight. They also express happiness, satisfaction, pleasure, delight and self-love. The pendulum of emotions swings wide.

Having WLS exposes one to attacks from others who feel entitled to criticize the gluttonous sloth that we could not lose weight by eating less and exercising more. Not all people, including spouses, siblings, parents and friends will support the decision for WLS.

Read more about emotions and weight loss

Weight loss surgery is a lifetime commitment to an extremely restrictive lifestyle that if used successfully will enable a former morbidly obese person to maintain a healthy weight and diminish the co-morbidities of obesity. It should never be considered the “easy way out” or a “quick fix.” It is a lifetime commitment with no returning to normal.


Anonymous said...

Seven days post-op, I was still on clear liquids. I'm confused as to why she felt the surgery hadn't "worked for her" so early in the game. I only lost about 15 pounds that first week, and I ended up losing 130 pounds that first year. This was five and a half years ago, and I have kept it off quite consistently (even though I'm still about 20 lbs. over my goal weight) because I follow the plan.

What was she expecting? How can you move onto the five-day pouch test in the first week, if the pouch test is actually a return to how you should be eating right after surgery? Aren't surgeons legally bound to provide a certain amount of education to their patients before operating? I had to go to several seminars before going under the knife (so to speak, since I actually had a laparoscopic procedure) and it was made very clear to me what to expect.

I don't mean to sound critical (since we are criticized so much as it is by others who don't understand what we are doing as you mentioned in the article), but this sounds like a case of either an irresponsible surgeon who did not educate his patient, or a patient who did not conduct sufficient research before undergoing a major life-altering procedure. I agree with you - this is very frustrating.

I truly wish her the best and hope that finding this community is at least a step in the right direction for her education process. Best of luck.

Anonymous said...

Education, education, education…

I’m still learning a lot about WLS but this reaction to one week post-op weight-loss is distressing to me. I wish everyone had the opportunity to receive an extensive education about their WLS prior to their surgery so that they know what to expect after surgery from day one to five years and more. Although no one can know what exactly will happen from day to day this is a clear misunderstanding of early post-op expectations. My prayers are with this person and I hope you were able to alleviate her concerns with real expectations. From what I’ve read 10 lbs is a good result for 7 days post-op.

Kaye Bailey said...

Thank you for the feedback. Sometimes when I get emails like this I wonder, "Is someone testing me to see if I'll say by all means do the 5 Day Pouch Test." I don't say that. The answer is to follow to the letter the directions of the bariatric center. Not just for the first week, but for the rest of the patient's life.

I believe a contributing factor to this problem is the "WLS Mills": so called centers that are not comprehensive programs. Some unsavory surgeons take a weekend course to learn surgical weight loss, and charge a low-cash fee to do the surgery. There is no pre-surgical counseling or psych review and no post-surgical follow-up. Invariably, patients have substandard results.

Always make sure your surgeon is a member of the American Society for Metabolic and Bariatric Surgey. Try to find a Center for Excellence at which to have your surgery.