Another One Takes the Cut

I debated a bit whether to post this, but decided to.   When I started this particular job some year and a half ago I was pleasantly surprised to note that there were plenty of fat people around – safety in numbers, you know?   And I was far from the fattest by any means.    But where you find plenty of fat people, you find Biggest Loser competitions, you find dieters, and you find gastric bypass.  Sometimes despite knowing the fact that you believe the surgery (even in your libertarian heart) ought to be outlawed except for all but the most extreme cases of people who are caught between a rock and a hard place and can’t even get out of bed (though that doesn’t mean the surgery will be a cure) your supervisor insists on spouting off to you about how great she sees other people doing with either diets or surgery.  Even when said supervisor never succeeds in a diet herself; she internalizes every example of someone who has taken the cut or starved themselves thin and goes on and on about how it’s a cure for all “the sugar” and how “good” this or that one is being.   Gag me.

Well this time, the first woman who actually made me feel comfortable here, both because she was very fat and because she is really very nice, has decided since her brief, once-in-a-lifetime romance crumbled, that she too has to undergo bypass.    At first I didn’t get it; my supervisor said, “She’s going for a bypass,” and I thought something was wrong with her heart – I was shocked!  This woman has no trouble walking except for some knee pain from various prior falls in her life, she’s over 50, she eats a fair-seeming amount of so-called healthy food, she doesn’t have any mobility issues, no heart problems, no lung problems – just a very large amount of fat from the waist down.    And so-called pre-diabetes.   You don’t even know she’s fat until she stands up, because her shoulders and face are small; she’s like the fattest-bottomed pear I’ve ever seen, and she looks good to me.   She looks…healthy.  She IS healthy.

My fear is that she will no longer remain healthy after such life-altering surgery.

Against all hope, when she mentioned it to me, I hopefully mentioned “So…are you getting the band?”  (Please please please be getting the band.)   Nope.   “Because on the band you can cheat, and with the bypass it’s just one-time, it’s a done deal, there’s no going back, nothing you can do about it.”   Do people hear themselves when they say things like this?   Has she been informed that it can KILL her?   Has she been informed that it’s supposed to be for *serious* health problems and she doesn’t have any?   And then she gets nothing but encouragement from the people around her.   Now I’m not going to say anything one way or the other except to hope for a good recovery – but there is no real recovery from surgery designed to create within you a disability and malnutrition, is there?

I am afraid she will possibly turn to substances, if indeed she uses food for comfort (who doesn’t?) as so many surgery candidates do.   I am afraid that she will get rickets or any one of those other hideous malnutrition diseases or, God forbid, as happens frequently, they simply cut a little too much, you go bald and shrivel away and die over the course of a year, only they can’t attribute it to the surgery anymore.   I’m afraid she is going to wreck her healthy glow and her cheerful disposition.

Am I afraid that I’ll be one of the fattest women in the place?   No.   I have a feeling she will not even get down to my size before the first year is up and she’s not the only fat person by a longshot.   But I’m uncomfortable with how this surgery has been portrayed in this establishment, how many people have undergone it, and how many are held up as having done so well.   I don’t want her to be an example, do I?    Well, no.    I don’t fucking know how to feel about it because of that, and frankly, I don’t want to keep thinking about it right now.    It’s enough to make a person go on a diet, isn’t it?   (Well, no.)

10 comments on “Another One Takes the Cut

  1. vesta44 says:

    I would refer her to OSSG-gone_wrong on Yahoo groups. If that doesn’t open her eyes and let her know what she’s in for, then those rose-colored glasses she’s wearing will never come off unless/until she gets those complications (and she will, eventually, everyone does, sooner or later, and most of them regret ever having the surgery). I don’t know how many people I’ve seen on that list that say if they knew then (before they had their surgeries) what they know now, they’d tell the doctors, not just no, but “HELL NO!!!!”. Most of them would give anything to go back to being fat and having the health they had when they were fat because it’s so much better than what they have now.
    In fact, one of the threads I’ve been following lately is about a bariatric center that changed its name to New Life (yeah, that new life they promise isn’t a good one, that’s for sure), and how ironic that name change is. Most of them that have had the RNY are looking for reversals because their health has deteriorated so badly – can’t get out of bed, no energy, brittle bones, malnutrition, blindness, nerve damage, hypoglycemia, and the list goes on and on and on. And even when they have the reversal, and their health does improve, it still doesn’t go back to as good as it was before the surgery (one woman is 5′ 8″ and weighs 114 lbs and is not-so-slowly starving to death, her husband hugged her and broke 2 of her ribs). Yeah, that’s not something that the doctors will tell you could (and probably will) happen.

  2. anniemcphee says:

    She’s got her mind made up and is undergoing tests for the surgery already. I know she’s going to regret it – doesn’t almost everyone at some point? But what can I really do? How is it going to be seen if I refer her to such a place, really? I just don’t know. Sigh. What is that other weird malnutrition disease that I only learned about after I found FA – something that starts with an A and it causes gross deformity – I can’t remember now, but I know it only happens in third world countries and people with the surgery.

    I pointed out the **irony** to my supervisor as she glowingly talked of the positive step this woman is taking (gag, puke, barf) in having to be in really excellent health to even GET the surgery – your heart has to be healthy, your organs have to be functioning well, your lungs, everything. When – AHEM – the surgery is supposed to be CURING all the horrific ailments caused by teh FATZ. I said boy, it’s weird you have to be in perfect health to have the surgery when supposedly it’s for people who are sick from teh fatz! She didn’t get it, I don’t think. She has repeatedly asked to have the surgery herself but she isn’t “fat enough” her doctors told her. I said, emphatically, “GOOD!” Plus she’s already got artery disease (genetic), had a heart attack, and she’s in her 60s – what the hell does she want to go having major surgery like that for??? Is she insane??

  3. ndlesdream says:

    Hi all, I’m new to this blog. I actually discovered it from Sandy’s blog Junkfood Science, she mentioned it in one of her articles. I’m so glad to have found other people in the world who actually use their brains when it comes to all this obesity insanity that has taken hold!! I was so scared that I was alone in this world 😦 Hallelujah is all I can say!! Anyway, I do have a comment that pertains specifically to gastric bypass (I promise).
    My aunt had gastric bypass about 5 years ago. She already had some health issues, she was diabetic and suffered from sleep apnea. Her doctors did nothing but paint her lovely rosy pictures of how healthy she’d be and how the surgery was going to take all her other health concerns away. Instead, she is thin-she weighs half of what she used to, she is still diabetic, still has sleep apnea, vomits on an almost daily basis, makes lots of trips to the emergency room, can’t go a whole day without at least a few naps, can’t eat a normal meal (by anyone’s standards!) and is very slowly dying, to be extremely frank.
    I love my aunt, she’s my favorite of all my aunts, my uncle also loves her. He loved her when she weighed over 300lbs., even though he’s always been very slim. He loves her regardless of her “packaging”. He’s sad that she’s so ill, but even he doesn’t see that the surgery was a bad idea, she doesn’t either.
    Although I’m extremely sad for my aunt, what makes me even sadder is that my two cousins (her son and daughter from a previous marriage) followed right along in their mother’s footsteps and had bypasses as well. Now one of them is very sick and the doctors can’t figure out why. But I can. She’s dying, from the massacre that her poor body went through and continues to go through every day. This surgery brings nothing but pain, suffering and eventual death. That’s the truth, that’s the reality. I certainly don’t mean to be so negative, I promise it’s not in my usual nature. But on this subject, there is no positive thing I can say.
    I love my family and I wish to God there was a way I could go back in time and stop them from doing this atrocious thing, but I can’t. What I can do is tell everyone I know just how dangerous these surgeries are, and that’s exactly what I do. I hope all of you do too. Telling the truth isn’t always easy or popular but, in this case, it will literally save lives.

  4. anniemcphee says:

    Welcome ndlesdream – I hope you enjoy your stay here. I feel exactly the same way about this horrible surgery – I just can’t believe such a barbarous act is committed in the name of easing patient suffering and curing ailments. There have been one or two times when I know someone felt they had absolutely no choice, and I do sympathize with them, but even then I do wish it could just be the band, which is at least theoretically reversible. This woman said she didn’t want to bother with adjustments (never considering that those adjustments might be really really important and wouldn’t be possible with the “done deal” she’s so in love with) and blah blah blah. I just don’t know what I can do. It’s so disheartening. Maybe I can send her something anonymously, like a link to OSSG gone wrong as vesta mentioned.

    But anyway hopefully we’ll have more pleasant things to talk about as well as this awful one.

  5. everjoy says:

    Could you please explain why you prefaced “pre-diabetes” with the words “so-called”?

    Thanks in advance.

  6. bigliberty says:

    @everjoy: Because pre-diabetes is a risk factor, and not predictor, of diabetes. For a greater understanding of what risk factors mean, search the term on JunkfoodScience. I believe Annie was expressing the belief that language should be exact, and if something is called “pre-X”, it should be a predictor of X. Just as preheating an oven to 350 F is a predictor of that oven reaching 350 F.

    The people who coined pre-diabetes are the people who directly profit from greater diagnoses of/awareness of diabetes. Which makes the coinage questionable on its face, and under further review quite unreasonable. Yes, even doctors and researchers are biased.

  7. La di Da says:

    I have pernicious anemia. It’s not a fun time. It just seems incredibly freaking stupid to remove your stomach and duodenum from your GI tract and thus lose your ability to absorb vitamin B12 without mega-supplements (which you mightn’t be able to keep down anyway) or having to have injections. Which are a bit painful, frankly. Low B12 causes BRAIN DAMAGE. It damages the myelin sheaths and you end up with what looks like dementia and MS. It is AWFUL that doctors would encourage surgery that can result in this, amongst the long list of other side effects. I’ve heard people who’ve had gastric bypass are often not told they will need extra B12. WTF.

    And that surgery picture looks essentially the same as the surgery people who have stomach cancer have. Only if you go look up patient advice for that, it says the surgery itself has a risk of death, and that you will need to have maximum nutrition all the time – whatever calories you can keep down, basically – in order not to become very ill from wasting. No matter what your starting weight. The difference in advice given is pretty shocking.

  8. bigliberty says:

    And that surgery picture looks essentially the same as the surgery people who have stomach cancer have. Only if you go look up patient advice for that, it says the surgery itself has a risk of death, and that you will need to have maximum nutrition all the time – whatever calories you can keep down, basically – in order not to become very ill from wasting. No matter what your starting weight. The difference in advice given is pretty shocking.

    If I might be so blunt, La Di Da, I would suggest the difference is that stomach surgery for cancer is trying to save the patient, while gastric bypass is trying to make the patient thinner at all costs. Making a fat person thinner by surgering them won’t necessarily (or I’d argue, usually) make them healthier.

    When the object of surgery shifts from promoting optimal health as determined by a definitive foundation of evidence-based research, you move out of the realm of medicine and into the realm of human experimentation/social engineering/eugenics.

  9. anniemcphee says:

    Agreed that the purposes for the surgery are completely different, but when the surgery is so similar, isn’t it bizarre that they give completely different advice to people having it? Wouldn’t it make more sense to offer all the same warnings to people getting the gastric bypass? Warnings that they will be wasting away and being malnourished if they are not extremely careful (and perhaps even if they are) and that the surgery can kill them? (Is it still 2 out of a hundred people who die just from the surgery, though we know it’s more because they cut that off at thirty days?) Anyway, that’s what I took LaDiDa to be saying, and it gives me pause as well.

    The part about B-12 is actually really good – she already takes tons and tons of supplements including B vitamins – I *might* be able to ask if she’s been advised of that part of it, that B12 can’t be absorbed afterwards sometimes even with megasupplements or shots (one reason she didn’t want to have the band was because you had to go back in for adjustments which she says are shots – I didn’t bother explaining that I thought it was a shunt type deal because I know what she’s going to do – she’s going to shrug and say “Well, whatever. I’m doing this one.”) She’s going to say that no matter what I say, actually. I only see her once or twice a week for a few minutes and it isn’t like it’s going to be fostering any good will. Sigh.

    My husband’s idea for anyone going into this surgery is to say, “Well, been nice knowing you,” but, er, yeah, I’m not going to say that of course.

    BL pretty much covered why I said so-called pre-diabetes but there is one more reason. People who aren’t as well-versed (or who have ONLY heard the party line on fat all their lives and never heard anything but) hear “pre-diabetes” and they aren’t skeptical at all – they hear it and say to themselves, “I have diabetes.” This woman is one of those. They only hear the second part of the word and start taking Metformin and dieting, as she’s been doing. By all accounts she’s lost a fair amount of weight already dieting, but it “takes too long” so she’s going the most drastic route possible. I can only imagine how it’s been pushed on her…or, worse, that it hasn’t and she just heard all the glowing reports from friends and asked for it on her own. Either way, she’s healthy and this surgery makes you unhealthy – bad deal all around.

  10. La di Da says:

    Annie McPhee, that’s what I was getting at, yes. “Here fatty, have some great surgery! But we won’t tell you all the dangers of it like we tell the cancer patients who get the same surgery! And if something goes wrong it’s your own fault!” Destroy your body to become societally acceptable, it’s pretty disgusting. There’s probably an element of eugenics to it for some surgeons, I’m sure: to them, if the patient dies, it was just hastening the inevitable early death of a fat person anyway. A mercy, really. Makes me sick!

    And on B12, yeah, if you lose the ability to absorb B12 in the normal way, which is through being bound to intrinsic factor secreted by gastric cells, you also have a lessened ability for the body to store B12 in the liver, as this cycle of B12 absorption from digestion is disrupted. That usually means you need B12 injections more frequently as the hydroxocobalamin from the shot is nearly all excreted within 48 hours. So even if someone with a gastrectomy starts on B12 shots straight away, it’s likely their liver will eventually be depleted of B12.

    And a noted side effect of Metformin is to decrease ability to absorb B12 from the digestive tract. :/ My insulin resistance is now gone – it was caused by an androgen deficiency caused by hypothyroidism. Taking DHEA for it worked; my last lab tests showed I was well within normal ranges. Hormonal imbalances will mess you up. Guess what gastric bypass will also cause!

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