Many opponents of gastric bypass surgery and morbidly obese individuals who are considering or are at least interested in it feel that the surgery is the easy way out, that it’s somehow a foolproof solution to losing the weight, keeping it off, and being skinny and healthy and gorgeous and confident for the rest of their lives. It’s not. It’s a tool, and like many other tools it can be misused or abused. Granted, you can’t just go “off” of gastric bypass like you do a low-carb diet in order to indulge in Christmas dinner or a night out with friends, but there’s the crux of the matter. There is no “going off” or “taking a break” from gastric bypass. Like it or not, you’re in the long haul. Except… except that you can sabotage gastric bypass surgery. Believe me, I’ve seen it happen myself, I may have been guilty of it myself once or twice (more about that in a paragraph or two), and there are plenty of people who are prime examples of how gastric bypass surgery isn’t a solution, but a tool, and one that can be misused. There are plenty of people who gained back not only the weight they loss after initially having the surgery, but more on top of it! There’s even a procedure known as the StomaphyX that has been invented in order to reverse the weight gain, which is caused by a gastric bypass patient’s stomach pouch becoming stretched out.
Gastric bypass surgery is a lifelong commitment that should be taken very seriously. Don’t just leap into your choice to have gastric bypass surgery. Research it. Read the medical facts on what takes place during the surgery, what the recovery is like, and what life is like three months, six months, a year, five years down the road. But don’t stop there. Find people who have had gastric bypass surgery, and ask them questions. What was life like before surgery? How has life changed since having surgery? What can you eat? What can’t you eat? Do you ever have any regrets, even if they’re just momentary pangs of remorse?
Life after gastric bypass surgery isn’t just a matter of sitting around while your body burns calories. It’s true that you burn energy just by being conscious, but just as you had to be physically active prior to surgery, you need to be physically active after surgery. Despite the surgery, it’s still a matter of burning more calories than what you consume. And even with the surgery, it’s entirely possible to consume more calories than you burn. A prime example of how this is possible is with the brand of protein powder I am using up as fast as possible, because I didn’t realize how fattening it is: while it only has 2g of sugar and a generous 25g of protein per scoop, when made into a protein shake — that’s 2 scoops combined with 6 oz. of milk — it packs over 400 calories. FOUR HUNDRED CALORIES. IN A PROTEIN SHAKE. Two protein shakes a day would put me at 800 calories. Bits of fish, a protein bar, some cheese, etc., and before you know it I’m at 1200 or even 1400 or even 1600 calories. If I’m not doing enough physical activity to burn that off (and let’s face it, with my 50+ hour work week it’s hard to be as physically active as I ideally should be), well, there you go… the wrong kind of ratio.
I can’t emphasize enough the importance of protein, and what a chore it can be to get enough of it after surgery. A lack of protein causes hair loss (been there), fatigue (been there), and muscle atrophying/wasting (hopefully haven’t been there). A protein deficiency will also slow down your metabolism, which will make it harder for you to lose weight. Bariatric surgeons generally recommend 60g – 80g of protein per day, while keeping your calorie consumption at 1200 or less (this may vary among individual surgeries). Fat gram consumption should also be minimal, as well as sugar. Protein-rich foods include meats (particularly venison and fish), cheese, eggs, and yogurt; but it’s practically impossible for a post-op gastric bypass patient to have the stomach capacity to consume enough of those items to total 60g of protein. (For reference: a 4 oz. hamburger has almost 30g of protein, but a gastric bypass patient’s stomach pouch is about the size of an egg) What compounds matters is the simple fact that many post-op gastric bypass patients are unable to consume much meat because of simple intolerance. I’m one of those patients. My stomach pouch is touchy, and besides the general intolerance to pasta, rice and bread, it also greatly dislikes ground beef, more than a few bites of chicken, shrimp, and anything more than a few teensy bites of the filet mignon variety of steak. I’ve been rendered a reluctant vegetarian for most of the time.
Gastric bypass patients must know thy enemy: sugar. Tolerance of sugar varies, but in general most gastric bypass patients can’t handle much more than 10g or so of sugar at a time, because the smaller stomach size and loss of three feet of small intestine cause the sugar to dump into the blood stream much faster, triggering Dumping Syndrome (which I have talked about here). Worth noting: high amounts of fat are also known to trigger Dumping Syndrome. I don’t know if it’s a trigger for me, because for the most part I eat a low-fat diet.
Adequate hydration is another problem that is not often talked about in regard to gastric bypass surgery. You would think the water would go down easily enough, but the reduced stomach size and small opening of the stoma (the connective tissue that creates the exit “hole” from the stomach pouch) doesn’t allow water to slip through easily, either. I learned the hard way that there is no gulping or chugging of water, even when I’m very thirsty. Small sips, and just a few at a time. Anything more than just a few small sips and I’ll wind up hurling up the liquid violently — more violently than when I throw up food. You’ll need to remember to drink a lot, as over time you’ll get accustomed to not drinking so much, and will probably run around for days or weeks at a time being a little hydrated, if not even moderately hydrated. The dehydration can lead to, among other things, postural hypotension, which is a real bitch to deal with and can be somewhat debilitating (yes, I speak from personal experience).
And then there’s the vomiting. Unless you are one of the lucky few, you will vomit after surgery. You will learn through trial and error what you can and can’t eat (I can, for example, eat a few nibbles of a soft pretzel, a biscuit, or crusty bread; but I cannot, under any circumstances, tolerate even just a bite of pretzel bread). You will probably have very little tolerance — if any — for regular pasta (egg-based noodles, on the other hand, you may have some luck with), rice, or bread. Meat is iffy — some people can do beef, others can do poultry and fish, others can do none at all. Cereals, both hot and cold, are hit or miss — though generally cream of wheat is do-able. As you learn what you can and can’t tolerate, even in just teensy little bites, you will vomit. You’ll also vomit randomly, and inconsistently. What you’ll be fine eating one day will come right back up a few days later. And if you don’t throw it up right away, you’ll get the dread “foamies” — excess saliva, triggered by your body’s need to expel the contents of your stomach, will build up in your stomach pouch, expanding the food and making you even more uncomfortable, until finally everything comes up — first the saliva, then the saliva/food mix, then finally the food itself, the culprit of the vomiting.
You will need to take vitamins and other supplements — most likely calcium and iron, possibly a few others. But you can’t just pop a pill or chew up a gummi or two and be done with it. You need to take vitamins in higher doses than normal people do, because they take those vitamins to supplement a regular diet, whereas gastric bypass patients take them to compensate for the severe lack of vitamins and other nutrients from solid food. You can’t just swallow pills, either, particularly those that are slow- or fast-release. You need to look for specialty gummis, chewables, quick dissolves, or small pills that you can cut in half (you’ll also go through a pill cutter about once a month, since you’ll be using it so much). These types of vitamins and other supplements are hard to find and pricey, and since you need to take more of them than the average person, they’re pricier still. I spend about $60 on supplements a month, and I take 12 of them a day — four halves of calcium pills plus two vitamin gummis in the morning, and then again at night. I’m getting my levels checked out next week, and will most likely be adding additional vitamins, a B12 supplement and iron to the mix once I’ve confirmed where I’m at with maintaining the proper levels of everything essential to my health.
Gastric bypass surgery forces you to think about food in a whole new way. You have to be more vigilant than ever about what you put in your mouth and how much of it is going in. You have to chew, chew, chew (when I first started eating solid food after surgery my teeth actually hurt from the amount of chewing I had to suddenly do!). You have to swallow small bites. You have to stop after a few bites. You can’t drink at least thirty minutes before or after eating, because liquid mixing with solids in your stomach pouch can cause food to push through too fast (triggering Dumping Syndrome or potentially stretching the stomach or even the small intestine, which could lead to further problems), or cause the contents in your stomach to expand, causing vomiting and/or stretching of the stomach pouch or stoma. You have to remember to eat, because the lack of appetite and hunger pains will create instances where you go around for hours, or even an entire day (guilty) without eating. You have to carry drinks with you at all times and sip, sip, sip, so that you don’t become dehydrated. You have to take loads of chewable/dissolvable/very small vitamins and other supplements on a daily basis, because you simply can’t get enough from the solid food you’re able to consume.
In addition to consuming enough protein, vitamins, minerals and fluids on a daily basis, there are also long-term risks to think about, including anemia from low iron or a B12 deficiency; weakened teeth or bones due to calcium deficiency; kidney stones; gallbladder stones and gallbladder attacks, which can lead to the need for surgery to remove the gallbladder (something I’ll probably be facing within the next few months); and even various neurological disorders that can result from poor nutrition or certain vitamin deficiencies.
With all of that said, I would just like to point out that I am not comparing the ease/difficulty of gastric bypass surgery with any other type of weight loss method. I am simply pointing out that it is not the easy choice that many people believe it to be. Gastric bypass surgery is a tool, and one that must be used properly and monitored closely if you want to lose weight, keep the weight off, and stay healthy.
Disclaimer: I was inspired to write this post due in part to this tweet, but also because these thoughts have been rolling around in my head for several weeks now, and I wanted to get them out before I lost the formatting and overall “feel” of the post.
You know what they say. Opinions are like assholes; everyone has one and they all stink. Don’t let people get you down. No matter what you do, you cannot please everyone so you might as well please yourself.
My friend in high school had to have gastric bypass because she was morbidly obese (5’11″ and 420 pounds). It was not the easy way out. She had to start an exercise routine to lose weight before she even had the surgery, and afterwards she had to make a serious commitment to her health. It’s not a walk in the park, like oh la la look at me never eating and losing weight. To say it’s the easy way out is small minded, and small minded people should learn to keep their faces shut.
Thanks for the informative article, Jenn. I happened to lose my weight (75 pounds) via an “unofficial Weight Watchers” plan. Different things work for different people and have their own unique benefits and drawbacks. My own plan had the drawback of needing to keep track of and calculate every single thing you ate. Not for everyone, but perfect for the math-geek in me.
It definitely sounds like gastric bypass has the image (in many people’s minds) of being all benefit and no drawback when it, in fact, has many serious drawbacks. Anyone who says that it is the easy way out or that you didn’t earn your congratulations is woefully ignorant.
Alot of people speak out on what they do not know or have any Idea of. Its not the easy way out. Like you stated it takes alot of work and effort to lose the weight. I know someone who had gastric bypass and not only gained all the weight but packed on even more weight that she first started out with. I admire you very much.
I don’t think it matters whether or not it’s the easy way out. Weight loss is weight loss and you’re doing it in a healthy way! You deserve all those congratulations. You’re healthier and you’ve shown that this surgery hasn’t been the easiest thing to go through.
A tool, to me is something you use to help you. Something like a food diary or an exercise machine. Altering your body in a way that you can’t change is much ‘easier’ than those things. Using tools like those you REALLY have to be motivated. You can’t change your stomach back to normal at anytime, therefore it’s always there. In five years, we’ll see where you are at…. I think that’s when it’ll count more as far as you really changing your lifestyle for a long time. My sister had the lap band surgery… sure, she lost weight, but now years later, she’s gaining weight back.
IMO, all the effort that goes in to monitoring your nutrition and diet would be better spent having a healthy lifestyle without surgery. Eating well and exercising and losing weight through making a lifestyle change. It doesn’t seem like having a bypass actually encourages healthy choices… you can’t eat in a healthy or normal way (i.e a nutritional meal with proper portions), you have to worry about ‘dumping’ or vomiting, you end up with loose skin, and you have to take tons of supplements. Another example is what you posted a few days ago about your gallbladder issues. It sounds pretty terrible that losing weight should come at the expense of needing to deal with all of these things. Life with a gastric bypass isn’t a healthy anymore than eating frozen Weight Watchers dinners for the rest of your life is. I don’t see the surgery as an easy fix but although it has definite benefits I don’t think it promotes a sustainable, healthy life.
The problem I see that most people have with GB is that people DO use it as an excuse to eat less to lose weight and then stop there. You yourself have said that you need to “tone up” and while that smaller stomach has made it impossible to make an excuse to eat more, it hasn’t kept you from making an excuse to REALLY get healthy.
I also work 50 hour weeks once you factor my commute time in, and I have a child and homework and pets to take care of and laundry and dinners to make and you get the idea. But I get a work out in almost every single day. Whether is be a quick one mile walk to and from the dog park, a 15 mile bike ride (takes 50 minutes), or 60 minutes of P90X, I do it. I have a friend on facebook that has FIVE KIDS and a JOB and she gets up before everybody else in the house to work out in the morning. Ben’s sister has three kids, a full time job and has lost 100+ pounds by eating right and working out. You get the idea.
I take 8 pills a day because even though I eat between 1600 and 2000 calories a day, I’m STILL iron deficient, have bad joints, etc.
I’m also keenly aware of my PCOS and how is effects by blood sugar the way it would a diabetic. Also, I’m allergic to wheat. I ate bread with dinner tonight because it has been SO LONG since I’d had some and I just couldn’t pass it up and I’ve spent the last 3 hours running to the bathroom with explosive diarrhea.
Anyway, what I’m saying is that what a lot of people go through what you go through but don’t have that convenient stomach pouch to fall back on to lose weight. And frankly, you HAVE had to do a LOT less work than I have to lose that weight. And I take all the pills, and I have the blood sugar to deal with and I have the bad reactions to food… but I also have to be accountable to what I eat on a daily basis. And work out. HARD. But, in the long run I have a healthy body, not just a skinny one, and I’ll gladly continue to do all that hard work to maintain it.
GB isn’t really a “tool” to me, it’s a crutch. Eventually you are going to have your full stomach back and unless you really make an effort to do more than eat less, you are going to end up just like my friends that weigh as much now as they did before surgery.
Also, I won’t get into how unfair it is that GB patients get free, or HIGHLY REDUCED cost reconstructive surgery to remove loose skin. But Ben’s sister who lost over 100 pounds “the hard way” can’t. And my friend Amy who lost over 100 pounds “the hard way” has quotes of THOUSANDS of dollars to have it done. It’s not fair AT ALL.
ANYWAY, I can totally understand Caitie’s point of view because without that crutch, it’s HARD. HARDER. You know that and that’s why you had the surgery. It’s great that you’ve lost the weight you have and I hope that you eventually reach your goal but just try to be understanding of the people that have to work harder than you while not getting the same results you are.
@Anna: Anna, I’m assuming different insurance companies have different policies, but with mine, their requirement is that the patient in question must have had at least two yeast infections caused by loose skin. There isn’t a clause stating that the loose skin must be a result of gastric bypass surgery specifically. I honestly had no idea that other insurance companies out there restrict the surgeries just to post-op patients. That really sucks.
And believe me, I am understanding. That’s why I’m not comparing weight loss methods here. Rather, I’m pointing out to those opposed and those *considering* the surgery alike that it isn’t just a walk in the park.
Anna, extremely well said and I agree 100%
GB is absolutely not the easiest way out. Most people I know who have had it actually had to work TWICE as hard because of the intolerance to a lot of food and the problems that come with it.
The decision to go for GB is a work-out in itself!
I’ve actually thought about it a couple of times before I found an alternative way. Right now I’ve lost 35lbs with the Cambridge Weight Plan. It’s all about the shakes and the bars and yes it is a low calorie diet (and you can go to a very low calorie diet as well). You have a consultant you meet once a week where you also weigh yourself.
Wow… I knew some of that stuff about GB since I know a few people who have had it done… But I really had no clue about the extent you have to go to just to make sure that you stay healthy, etc.
Whether or not GB is a “crutch” or “the easy way out” you deserve congratulations for how far you’ve come!
I won’t pile anything on you, Jenn. You know my experiences somewhat watching a gastric bypass and resulting surgeries destroy my wife’s life.
I do want to say that the programs that do these surgeries lie their asses off about complications and that far too many Americans are using gastric bypass as the latest fad diet. I hope they realize there can be devastating problems down the line.
Anna has pretty much said everything I wanted to say when I read this, but I’d like to add the following.
Even though losing weight “the old fashioned way” has taken longer and been harder in a lot of ways, I have no regrets. Even though we had similar starting weights, I have far less loose skin on my arms (and I’m assuming the rest of the body as well, although I can’t know for sure). When I am having a particularly physically active day, I have no problems taking in the calories and the macronutrients I need to support my body. Better yet, there are so many things I can do now that I couldn’t do 3 years ago – full push ups, run for 20 minutes straight, stuff like that.
Here here well said
Weightloss surgery is a lifechanging decision and not just the ‘after ‘effects.
you have to monitor your food/intake for the rest of your life- not easy.Just because ome uneducated moron makes a throw away comment means nothing.From reading your posts about your surgery it seems a pretty severe way to go about losing weight! you were very brave to undertake it in my book, me myself oh well I just ended up with MS and lost over 120lbs in six months..dead easy !!
This whole argument is interesting to me.
I really have to say that I think gastric bypass is the easy way out. If it wasn’t, why would you do it? If it isn’t, why not put that hard hard effort into traditional methods of losing weight?
Lets say I want to build muscle. With steroids, I could do it faster. Without, I could do the same thing with more work. Sure, there would be guidelines to using steroids to make them work (I’d still have to freaking work out)… but it doesn’t mean it’s not an easier, faster way of gaining muscle. If not… why use them!
Here is a quick description of gastric bypass surgery:
Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss.
Now, any person with common sense wanting to lose wait would form a very, very reasonable conclusion from reading this that, “Hey, I can lose weight easier”.
Now, this is not to say we aren’t happy you are losing weight and feeling great about your body. But most people I don’t think will feel it’s an “achievement” deserving merit of tradition methods – and for good reason.
While I do not believe that GB is “easy” in any sense, I do believe it is easiER than losing weight “the old-fashioned way”. I do not think of GB as sitting around watching TV while your body just magically burns away calories and fat. However, with GB your stomach physically CANNOT fit as much food as it could before. You either have to stop eating when you get full or throw up the remainder. While the latter does not sound fun in the least (and believe it or not it can happen while losing weight the other way too) either of those choices will result in less food intake which equals – TADA! – less calories consumed. When your stomach is its normal (or even larger) size, you must discipline yourself to stop eating at a certain point, even if you aren’t full. That is a choice that does NOT guarantee less calories, because one can always say “fuck it” and stuff.
Again, I don’t believe GB to be EASY, but I do believe it to be easier. I have lost 65 lbs now on my own without surgery, diet pills, bars/shakes/etc. Over time my stomach has shrunk a bit ON ITS OWN because I was not taking in as much food. I now eat less, which was the goal! I did not have a doctor chop off a piece of my stomach and reroute the piping, I disciplined myself to STOP EATING at a certain point and to say NO to sugary and fattening foods. While vomiting and pain doesn’t sound fun, those options WILL lead to less calories – and therefor weightloss – regardless, while I and others like me have had to make the concious CHOICE every single day to say NO MORE. There is nothing physically stopping me from continuing. And because you have done some of that part, Jenn (for 30 lbs I believe?) you KNOW how hard it is. So imagine continuing it not only for another 100 lbs, but for the rest of your life.