Is Weight Loss Surgery Really Worth It? Things You Should Know

Hola amigos! Welcome back!

Weight loss surgery is major decision for some people. Is it worth it? What are some factors to think about that are not advertised in the brochures? David unpacks the details in this episode.

(Please note this episode does contain concepts of weight numbers, BMI, and obesity for the purpose to tell an individual’s story.)

Highlights of this episode:

• Isabelle’s weight loss surgery story
• Types of weight loss surgery
• Claimed benefits
• Risks and Lifetime Outcomes

Announcements:

• David’s new book is being published this April, which highlights real clients’ journeys of finding their peace with food. Curious? Read more about it here: https://orozconutrition.com/one-small-bite-book/
• If you would like to be in the book launch team to get first access to David’s book to write your review on Amazon.com, visit: https://orozco-nutrition.teachable.com/p/launch-team-for-one-small-bite-book

Episode Show Notes: 

Warning: this episode will mention numerical weight, body mass index (BMI), obesity, and weight loss surgery or bariatric surgery, in order to share an individual’s story through her intuitive eating journey and bring criticism to bariatric surgery. Weight loss surgery and bariatric surgery will be used interchangeably throughout the episode.

[01:38] Meet Isabelle, a Shero’s Tale

When we lose weight, we get positive attention from society. This creates a chase at thinness. What if that desire for weight loss is gone?

Isabelle is a 51-year-old grandmother, who did an amazing job of persevering through life. She survived an abuse relationship and raised her kids beautifully. She earned a master’s degree and works as a CPA position in a large accounting firm. Wow, right? What a shero.

And through this, she dieted to lose weight. When she wore out of trying diets, she found David’s services for nutrition consulting. Isabelle hoped that intuitive eating would ultimately result in weight loss. However, intuitive eating does not promise or predict what happens with a person’s weight. What it does offer is interceptive awareness, that connection with your body’s signals so you can take care of it.

Ultimately, Isabelle went in for weight loss surgery. This resulted in a loss of 100 pounds at first. Later, she gain weight, maybe 40 pounds. The pounds don’t really matter though. What matters is that she felt that she was doing something wrong because the weight was coming back.

David and Isabelle worked through intuitive eating approach again so she could be nourished and feel good in her body. The focus of her nutrition care was discovering her own self-kindness, self-gratitude, and a radical self-love. This was a major shift in mindset from seeing weight loss as a panacea to her life.

[10:39] Weight Loss, or Bariatric, Surgery – What You Should Know

Bariatric surgery is a surgical procedure that is done for the purpose of weight loss. The two main types in the United States are the sleeve gastrectomy and the Roux-en-Y Gastric Bypass (RYGB). The qualification for weight loss surgery was developed from BMI ranges, and there are conditions like high blood pressure and Type 2 Diabetes that qualify a person for one type of surgery or another.

David’s first dietetic job, about 18 years ago, was at a premier bariatric center. They had everything associated with the surgery in-house and were identified as meeting the gold standard for weight loss surgery. The lap band was popular when David worked there, but it fell from favor due to complications that were documented over time.

[13:50] Roux-en-Y Gastric Bypass (RYGB) Bariatric Surgery

The bypass surgery outcomes predict an “elimination” of Type 2 diabetes. However, this type of language is misleading. There is no known cure for diabetes at this time. The surgery may temporarily normalize insulin function and blood sugar range, but this is a honeymoon period.

The bypass surgery creates a highly restrictive diet and micronutrient regimen because of the major alternation of the digestive tract. Post-surgery care means taking vitamins and minerals for life, and not just one multi-vitamin daily. It requires a strict schedule of multiple supplement pills and sometimes B12 injection shot once a month.

The digestive problems post-surgery is a laundry list: acid reflex, constipation, nausea, vomiting, diarrhea, and more specifically, dumping syndrome. It’s really no surprise why these digestive problems happen. The surgery reduces the stomach to the size of a ping pong ball. Parts of the small intestine are removed and reconnected at remaining intestinal sites.

The outcome is poor malabsorption of food and its nutrients for life, which leads to its own risks. People are more prone to Clostridioides difficile, or C. diff, infections, which is life-threatening. (C. diff causes severe diarrhea and intestinal inflammation that requires hospitalization and a very specific antibiotic regimen. However, people can still have it reoccur and die from it.)

David knows 3 people who have past-away due to complications following weight loss surgery. To be clear, the rates of death are low within the population of people who elect to get the surgery, but the surgery is not risk free from dying.

[19:18] Malnutrition After Bypass Surgery

People who had weight loss surgery and lost weight are often still in large bodies because “large” is a relevant term. Post-surgery, malnutrition is common because the body is having trouble digesting and absorbing adequate protein.

Some possible outcomes:

• Dry and brittle nails, hair loss, dry skin

• Red blood cells are now hard to produce, which compromises the immune system.

• Gallstones (more common in women, for reasons unknown) following the rapid weight loss.

• Acid reflex can develop into GERD, which erodes the lining of the esophagus, creating a risk for cancer.

• Constipation is common for a few reasons. It’s hard to eat enough fiber, which relieves constipation. Fiber is hard to digest due to the smaller stomach pouch and it has to compete for space and processing with protein.

• Excessive skin can lead to an out-of-pocket “tummy tuck” surgery, which is not preventative against weight gain.

David sees post-bariatric eating style as disorder eating. Individuals are trying to follow the post-surgery plan and reduce their digestive symptoms. The long-term physiological effects include a very poor relationship with food. They are hungry, but cannot eat.

[25:11] Sleeve Gastrectomy Surgery

The sleeve gastrectomy surgery leaves the stomach in a banana shape. It does not alter the intestines. This surgery does not have the same risks as the bypass and it does not have the same weight loss results. David sees more people post sleeve surgery who were frustrated by the experience.

[26:40] Weight Loss Surgery is Not Worth It

David sees people who underwent the surgery over two years ago, because they are looking again, to lose weight. It’s really just like another diet, which comes with weight regain. Anything that forces your body to lose weight, is seen as a threat, a stress response.

[30:17] Financial Burden of Weight Loss Surgery

Let’s do the math. The average cost of weight loss surgery in the United States is $20,000 (without any interest from loan plans). The number of Americans getting surgery is 252,000, that’s a 5-billion-dollar industry. That does not include any of the other costs individuals invest into the process that are attached like education classes, therapy, nutritionists, co-pays, medications, supplements, or any other testing deemed medically necessary, co-insurance, or time off work for recovery.

In David’s experienced opinion, weight loss surgery is the most extreme weight loss treatment with little long-term benefits and high health risks. When something works at the beginning, then does not work anymore, that sounds like a diet. Bariatric research does not extend over five years. For research to exist, they would have to retain its population. It’s unlikely that a person would go back to the same people they worked with before the surgery. David suspects the American Society for Metabolic and Bariatric Surgery (ASMBS) is not interested in doing the long-term outcomes on weight loss surgery.

[35:40] Final Considerations of Weight Loss Surgery

1. Weight loss surgery does promise weight loss to improve health. Yet, this don’t work for everyone.
2. If the weight loss surgery had to go through FDA approval, it wouldn’t be approved. The time line of results, the percent of efficacy, and the side effects.
3. Weight loss surgery is rooted in fatphobia and is dehumanizing.

[40:09] Weight Loss is Not For Health

Let’s look at the updated research for health and large bodies. The National NHANES survey found that “overweight” category had a longer life expectancy. The relative risks of mortality associated with obesity were lower in NHANES II and NHANES III than in NHANES I. Which means, the categorize of obese did not show a shorter life in the most recent studies.

When someone reaches a higher weight, typically in the “overweight” BMI category, this is when the dieting to lose weight starts. Then, that unsustainable chase to reach their ideal weight backfires. The person ends up gaining more weight than they started with.

Bottom Line:

There are a many different bodies out there and you cannot tell a person’s health from the outside, nor their relationship to food.

From the book, Think Again, “when reconsider the something we believe in deeply, [like weight loss,] can threaten our identify,” after all, who are we if we are not in thin body?

Resources

Book, Think Again: The Power of Knowing What You Don’t Know by Adam Grant

Studies:

·        Excess Deaths Associated With Underweight, Overweight, and Obesity

·        Body mass index and mortality: a meta-analysis based on person-level data from twenty-six observational studies

·        Elevated body mass index and mortality risk in the elderly

Complimentary Episodes:

·        Jeff’s Story

·        Is Dieting Causing You More Trauma? with Guest Patrick Bryant

·        Diets and Weight Loss Plans: A 95% Failure Rate Long-Term!

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Once again, I greatly appreciate you for listening and supporting my show. Remember, it really only takes One Small Bite to start transforming your life.

 

Chop the diet mentality; Fuel Your Body; and Nourish Your Soul!