I’ve been Googling “weight loss surgery” and “gastric bypass” and “bariatric surgery” for a few weeks now. It wasn’t until I did some Googling of “fat acceptance” that I finally found what I was looking for: the other, darker side of the weight loss surgery story. I found many websites and blogs, which I have added to my Blogroll*.

In case you’re new to the argument, “fat acceptance” is defined at Wikipedia:

The fat acceptance movement, also the size acceptance movement or fat liberation movement, is a grassroots effort to change societal attitudes towards individuals who are fat. The movement consists today of a diverse group of people, who have different beliefs about how best to address the widespread prejudice and discrimination against fat people in contemporary Western societies.

The fat acceptance movement advocates “health at every size:”

The major components of HAES…are:

1. Self-Acceptance: Affirmation and reinforcement of human beauty and worth irrespective of differences in weight, physical size and shape.
2. Physical Activity: Support for increasing social, pleasure-based movement for enjoyment and enhanced quality of life.
3. Normalized Eating: Support for discarding externally-imposed rules and regimens for eating and attaining a more peaceful relationship with food by relearning to eat in response to physiological hunger and fullness cues.

HAES advocates generally do not believe that the same narrow weight range (or BMI range) is maximally healthy for every individual. Rather, the HAES approach is that as individuals include physical activity in their lives, and eat in response to physical cues rather than emotional cues, they will settle towards their own, personal ideal weights. These weights, however, can be higher or lower than those described by standard medical guidelines.

This Wikipedia entry goes on to say,

…there is evidence to suggest that some weight loss treatments have detrimental effects on physical health (such as diet pills in the stimulant class, and gastric bypass surgery), and that the pursuit of weight loss is damaging to mental health.

In a directory of fat acceptance blogs, I found Suethsayings, who has a post about the RNY surgery that should be read carefully.

At this point in my reading, I was pretty well horrified. No long-term studies. No idea at all if I will live a longer healthier life than if I do not have the surgery. WTF? Living a longer life has been the whole point of all this attention to my health over the past couple of years. Am I really reading here that no one knows if this surgery will help me live a longer life or not? There are many very serious risk factors associated with this surgery:

Complications from weight loss surgery are frequent. A study of insurance claims of 2522 who had undergone bariatric surgery showed 21.9% complications during the initial hospital stay but a total of 40% risk of complications in the subsequent six months. This was more common in those over 40 and led to increased health care expenditure. Common problems were gastric dumping syndrome in about 20% (bloatedness and diarrhoea after eating, necessitating small meals or medication), leaks at the surgical site (12%), incisional hernia (7%), infections (6%) and pneumonia (4%). Mortality was low (0.2%). As the rate of complications appears to be reduced when the procedure is performed by an experienced surgeon, guidelines recommend that surgery is performed in dedicated or experienced units.

Am I to submit to this without any guarantees that I’ll get to live a longer, healthier life with my wonderful husband? I’m starting to get that same feeling I got about the hysterectomy. Damn it.

I have to admit to not being the most critical thinker in the bunch. This is why I spend so much time in front of this damned computer. I depend on other people to do the critical thinking for me, but even I experienced some vague concerns when I was reading the information pieces about the “nuts and bolts” aspects of the RNY procedure. It is called “malabsorptive” meaning that a great deal of the calories you do manage to take in through the golf-ball sized pouch are not absorbed. Hmmm….. Where have I heard this before….

Oh right. I remember. Back in the late 70’s, when I weighed in at a horrifying (to me a the time) 150 pounds, I picked up a copy of the popular diet of the day. It was called “The Doctor’s Quick Weight Loss Diet.” In my memory, I thought Atkins thought up this one and I’ve been blaming him for years but apparently I was wrong.

In my memory, I thought this diet advocated fasting for I think three days, followed by eating only low fat protein for a few days. As I recall, you were to cycle back and forth between the two stages as needed. I can’t find any evidence to support that part, but that’s they way I did it. Who knows, maybe I picked up some hippie, new age fasting plan and incorporated that into the diet.

In any case, fasting and eating one food group, in this case protein, seriously screws with the metabolism, causing the body to go into a semi-starvation mode where it becomes very efficient at storing calories. This semi-starvation mode is called Ketosis. It slows down the metabolism. Slowing down the metabolism means you burn fewer calories. Everything else gets stores as fat. How in hell, when you are trying to LOSE weight, can that be a good idea?

So what does gastric bypass do? It puts the body in a semi-starvation mode. the only difference is that you CANNOT eat more–at least not for awhile. After the first couple of years, it is increasingly possible to stretch the pouch and consume more calories to compensate for the malabsorption by the shortened small intestine. And that is why many post-operative RNY patients do regain some or all of their previous weight.

To me, this is looking more and more like some kind of group madness and right now, today. I want no part of it. I’m calling the dietitian for sure this time.

*I haven’t figured out how to get Blogroll sorted by topic; please bear with me!