Is it logical that we're warned against losing >3lbs/wk but gastric bypass is OK?

mandana · May 23, 2006

I don't completely understand that logic myself.

The other part of it that I'm not real clear on is you read that PO vitamins are never as good as dietary sources, but yet, after gastric bypass you have to take mountains of PO vitamins because you can't eat enough quantity to obtain them.

I guess the rationale is that the risk of being so seriously overweight is much higher than the risk associated with losing the weight rapidly. Interestingly, I also read that gastric bypass doesn't reduce cholesterol levels significantly whereas losing weight the old-fashioned way does.

Amanda

nursesarah · May 24, 2006

there are some instances where the patient is so completely overweight that its next to impossible for them to lose weight. however, its also interesting to note, that the more obese you are, the less likely it is that you will be able to get the surgery simply because of the risks associated with it. ultimately, i think the problem is that people like a quick fix. you can have a bypass, and lose weight so fast but still be unhealthy and have cardiovascular disease and heart problems.

the biggest issue i have with bypass is that the focus is getting rid of the weight....not getting healthy.

Johnkc8rak · May 24, 2006

You sould take a look at obesityhelp.com. It's not a easy out if you look at the site. Its not a quick fix. Its a life style change. I have not had it but from what i have read. I also have a close friend who has had it. Once people have this operation, a large amount of them have better all over health. They no longer have to take meds for HTN, Sugar and other stuff. The "Comorbids" go away for most. Spend sometime on that site and talk to people. Its what some need for better health.

John

nursie-babie, ASN, RN · May 24, 2006

:monkeydance: :monkeydance: :monkeydance: :monkeydance: :monkeydance:

Okay, first of all, I don't know why they say losing it fast the regular way is unhealthy and okay after bypass...but, what I really want to address is the comment that the focus is not on getting healthy. That simply is not true. I had gastric bypass surgery in October 2005. I meet with a dietician regularly to discuss my food choices, to make sure that I am eating healthy choices, and getting a variety of foods I also have labs drawn regularly. I take po vitamins(2 in the AM 2 in the PM), my labs check out perfectly. I am able to eat about 1200 calories a day, and am not limited to the type of foods I eat. I participate in an excercise program, as this is stressed through my program. They are very focused on helping you to acheive HEALTH, in every aspect. I personally did not have high cholesterol before surgery, but many of my fellow patients did, and they were all off the meds,and cholsterol levels were wnl in 6 weeks to 3 months. This includes diabetes meds as well. I have lost 106 lbs since October, yes that is alot, FAST. I feel great, I look great(not much extra skin due to exercise and lots of lotion!)and I eat right.

:monkeydance: :monkeydance: :monkeydance: :monkeydance: :monkeydance:

HeartsOpenWide, RN · May 24, 2006

there are some instances where the patient is so completely overweight that its next to impossible for them to lose weight. however, its also interesting to note, that the more obese you are, the less likely it is that you will be able to get the surgery simply because of the risks associated with it. ultimately, i think the problem is that people like a quick fix. you can have a bypass, and lose weight so fast but still be unhealthy and have cardiovascular disease and heart problems.
the biggest issue i have with bypass is that the focus is getting rid of the weight....not getting healthy.

This is a very expensive way to lose weight. Most insurance companies will not pay for or even consider paying for bariatric surgery unless the patient has gone though a diet plan Rx by their doc and failed to lose any weight by following it. They also have to be at least 100lbs over weight. These are some of the requirements for insurances like blue cross. Medicaid as far as I know still will not pay. Medicare will only pay if it is proven medically necessary...like dangerous sleep apnea...CVD risk ect, but most people that are not over 65 and are on Medicare are disabled anyway. I know a patient that was in her thirty's, weighted too much to even register on the office scale (including adding the weights) and was on Medicare because she would not work. She had to sleep in a recliner because her sleep apnea was so bad and had a c-pap machine. She got the bartatric surgery paid for through Medicare because it was deemed medically necessary.

You learn a lot about weight loss or lack thereof in nutrition. Some people can loose the weight, but after they have damaged their bodies from being over weight too much their bodies can no longer loose the weight they are capable of.

So unless the patients are paying for this surgery out of pocket, (generally)they have been given a diet plan before hand and have failed. Some people just get to the "point of no return". No matter how much a person diets, they are so over weight the cells in their body are damaged. Plus they may be so big they can not even exercise. I am sure you have seen plenty of over weight patients huffing and puffing just from walking down the hall. Exercise can do a reverse effect with all the fat around the heart.

The real problem, I believe, stems from not taking care of the problem before it starts. I find nothing wrong with a doctor telling an over weight patient that they need to change their eating habits and life style. It may seem rude, but if done in a professional way it can be handled and should. Over 60% of the use population is over weight. This is uncalled for! A doctor that does not at least make an attempt (yes the patient has to do their part) at helping an over weight problem is not a good doctor at all. If we had more preventive medicine we would see less bariatric sugery....IMHO. Education is key....for example,Studies show that less people know the dangers of fast food than the dangers of smoking crack!

......."You can not argue that a person should exercise personal responsibility, and then not give them the information in which to base it." - John F Banzhaf III, Law Professor.

catlady, BSN, RN · May 24, 2006

The real problem, I believe, stems from not taking care of the problem before it starts. I find nothing wrong with a doctor telling an over weight patient that they need to change their eating habits and life style. It may seem rude, but if done in a professional way it can be handled and should. Over 60% of the use population is over weight. This is uncalled for! A doctor that does not at least make an attempt (yes the patient has to do their part) at helping an over weight problem is not a good doctor at all. If we had more preventive medicine we would see less bariatric sugery....IMHO. Education is key....for example,Studies show that less people know the dangers of fast food than the dangers of smoking crack!

I don't think that anyone who's never experienced an addiction can understand what it's like to be a compulsive overeater. I am not morbidly obese and would not qualify for a GBP, but I want to eat, every minute of every day, whether I'm full or not, whether I'm sick or not. Unlike other addictions, I can't go cold turkey on food, because everyone has to eat. Drug addicts and alcoholics and smokers know they can't have that first , but food addicts have to find that middle ground, while being told they're fat ugly pigs with no self-control. I know all the dangers of fast food. I am published in a nursing journal on nutrition. I can quote chapter and verse of the food pyramids. I want to eat. All. The. Time.

(I admit I don't understand the 1200 pound folks who can't get through the door, because obviously someone is enabling their behavior. I can't blame anyone else for feeding me.)

mickeypat · May 24, 2006

And there are those of us who are overweight, eat next to nothing, exercise and STILL can't lose weight!!!! I have tried just about every diet thinkable, and I still can't lose weight! Yes, I've thought about trying GBP, but am choosing not to because I have seen what happens afterwards. I have a coworker that had it done last year and had few problems, but is going back to the same eating habits as she had before, only a lot smaller portions. It's not for me!

LoriAlabamaRN · May 25, 2006

There is one thing I do not understand. I don't understand the people who say "I can't lose weight, I don't eat much, it's in my genes." Yet following gastric bypass, EVERY ONE of them loses weight. Gastric bypass does not change your genes, just changes HOW MUCH YOU EAT. So isn't that the problem in the first place?

HeartsOpenWide, RN · May 25, 2006

I don't understand the people who say "I can't lose weight, I don't eat much, it's in my genes."

Don't get me wrong. I am not singling anyone out here. I understand that these type of people do exists. One of my best friends is Obese and she eats healthy. However, a lot of people use this as an excuse! I have seen plenty of people who use this as a line of defense and then see them down three hamburgers at burger king, have nothing but junk in their grocery cart...and wonder why they can loose weight "must be in my genes". A serving of meat is the size of the palm of your hand...not including your fingers. When is the last time you ordered a meat dish with a real serving size. People would cry rip off if we were served correct portion sizes!

Yes, for some people this is true. I get the "your anorexic" card played all the time because I am thin and eat all the time but do not gain weight. My mother is thin, my father is thin...yup is in my genes. But its like "THE COP" that gives all cops bad names....the gene factor really is true for some...and those who play that card and order two meals at a time through the McDonald menu ruin it for those who really do have a gene factor.

Marylou1102 · May 25, 2006

There is one thing I do not understand. I don't understand the people who say "I can't lose weight, I don't eat much, it's in my genes." Yet following gastric bypass, EVERY ONE of them loses weight. Gastric bypass does not change your genes, just changes HOW MUCH YOU EAT. So isn't that the problem in the first place?

Partially true. You are forgetting that the body is no longer absorbing the calories and nutrients of the foods injested.

yellow finch, BSN, RN · May 25, 2006

I also wondered the same thing the original poster queried. A good friend of mine recently went to a weight loss physician who told him that the goal was to lose as much weight as possible quickly. He started him on a goal of around 1500 calories and recommended that he not begin exercising right away. So my friend started lifting weights and lost 30 lbs the first month with a muscle gain of 8 lbs. The next month on about 1200 calories a day he lost 20 lbs with an additional 8 lbs of muscle gain and the physician still told him that exercise isn't the best option. What's amazing is this doc presses quick weight loss and I'm still scratching my head as to how my friend is going to keep the weight off after all is said and done. Besides that, back to the original topic, I'm surprised that it's "healthy". However, this man says he feels better, has more energy, isn't tired like he used to be... maybe this is the best way. I guess we'll see how things go in the long run. I'm even considering trying this plan to get my excess weight off (only with more exercise).

So to add to the questions... why would the physician comment that exercise isn't going to help him lose weight? Let's look at athletes... they aren't fat. Why does he feel this reasoning is, well, reasonable???