Bariatric Surgery

[gdwindowpane]

I'm considering bariatric surgery. In the very beginning stages of research.

I searched the forum and found quite a few threads with posts from those that have had the surgery. Most were from the 2014-2015 time frame.

I'm interested in hearing how you are doing now. Have you kept the weight off? How hard was it psychologically? Would you have made the decision to get surgery if you knew what you know now? How did it affect your flying? Were you grounded for some amount of time post surgery, etc.? How might it affect my BasicMed medical?

Thanks for any information you can provide.

Chris

 

[RyanB]

Can’t provide any info for the questions you asked, but why go through the surgery if you can make simple lifestyle changes to meet the same end result?

Forget trying to ‘diet’ those never work and are only temporary fixes to the underlying problem. Change your lifestyle and be cautious about everything you shovel into your mouth. I know people who were well overweight, not quite obese per say, but ultimately changed their body composition by making a lifestyle change. Look into Intermittent Fasting and/or Keto... both are very effective. Follow this by strength training and conditioning 3 times per week. I guarantee you would be a lot happier with the end result and not have to go under the knife!

 

[tspear]

Chris,

I know two pilots that have done it. One about ten years ago, the other about five years ago. Both have kept off the weight. Both self grounded for about a year, due to perception of not being "themselves". Both have said it was good to focus on health for a while, and get life straightened out before flying again, especially getting used to the eating six/seven times a day of really small meals instead of three large meals.

I have had one aunt and a sister in-law go through it also; but they are not pilots. It took roughly two years for both of them to get to a stable point. For my aunt, she maintained her new weight for close to a decade before cancer got her. For my sister in law, it has been just over two years, so we shall see. In both of these cases, they were trying to lose more than half their body weight. Note: both ladies due to the amount of weight loss had to do it in multiple stages, not a single surgery.

Good luck,

Tim

 

[Rushie]

My niece had a Roux-en-Y at age 23. I think it was a big mistake. But there are different types of surgeries, with different risks and results. If it were me I would only do something reversible, and I would not go to Mexico to get it done cheaply. (My niece didn't but I've read horror stories and I fear it's the in thing for young cash strapped people.) But I can't judge what's right for another individual. A couple studies of long term results show decrease in mortality from diseases such as diabetes and heart disease but an increase in mortality from accidents and suicide, it's not clear why, but the decrease outweighs the increase, something like net 130 lives saved per 10,000 surgeries IIRC. But then your quality of life is better thinner except you need to be vigilant about B12, D, iron and calcium, especially in certain procedures. And maybe protein.

My niece nearly died from a leak and subsequent infection post op. It's been several years now and she does not look much smaller at all. But then she's not much bigger either and if she hadn't done it maybe she would be 500 lbs now instead of "only" 300. So who am I to say it was the wrong thing to do? She loves carbs and sweets and I can't help wonder how much healthier she'd be if she simply dropped all simple carbs instead of mutilating her GI tract. She says she suffers nausea after every meal. But then I doubt she limits her portion size to the tiny bit it's supposed to be.

The surgery, in her case, was NOT the cure for her carb addiction.

A lot to study before you do something irreversible.

 

[DFH65]

My brother and sister both had it and both had various complications. The surgery can be painful and it is not a simple thing. My sister has kept most of the weight off. My brother who was about 550 at the time of surgery is now probably 350 or more so has not kept it all off. I fight it the old fashioned way sometimes more successfully than others.

Personally I wouldn't do it unless you had A LOT of weight (several 100 pounds) to lose and your doctor agrees that your life expectancy is significantly impacted by not having it done.

Even though you have a small stomach you can still put a lot of calories in it.

 

[Checkout_my_Six]

I have the sleeve....best thing I've ever done. I was out of work for two weeks and grounded for bout 3 weeks. I have two other family members who have bypasses with complications....or issues with nutrition (absorption) and or dumping. I don't have any issues. Three years later....I've lost 70% of what I wanted....and the last 30% is a bit of frustration.

I've learned....we just don't need all the calories we think we need.

Git it done....and you'll feel much better.

 

[weilke]

Forget trying to ‘diet’ those never work and are only temporary fixes to the underlying problem. Change your lifestyle and be cautious about everything you shovel into your mouth. I know people who were well overweight, not quite obese per say, but ultimately changed their body composition by making a lifestyle change. Look into Intermittent Fasting and/or Keto... both are very effective.

You say diets never work and then proceed to recommend two diet strategies: keto and intermittent fasting.

 

[gdwindowpane]

@Checkout_my_Six. So its been three years since your procedure. What was your life style like before your procedure and what is it like now? How difficult was it to adjust? I know this will require a drastic change in my life style and worry that the phycological change will outweigh the benefits of the procedure. I don’t want to become a recluce as a result.

 

[weilke]

I'm considering bariatric surgery. In the very beginning stages of research.

I searched the forum and found quite a few threads with posts from those that have had the surgery. Most were from the 2014-2015 time frame.

I'm interested in hearing how you are doing now. Have you kept the weight off? How hard was it psychologically? Would you have made the decision to get surgery if you knew what you know now? How did it affect your flying? Were you grounded for some amount of time post surgery, etc.? How might it affect my BasicMed medical?

Thanks for any information you can provide.

Chris

So far, I have spent all of my career working at 'bariatric centers of excellence' (yes, that's a thing). I have noticed a couple of things:
- there are considerable differences in complication rates between surgeons and in the same surgeon along the trajectory of their career.
- you are never quite out of the weeds for long-term complications like bowel obstructions. Those can come up 10 or 15 years after surgery, whether it was successful or not.
- plenty of obese people walking the planet who did have the surgery. If your diet continues to consist of small portions of carbs, and liquid carb concentrates like soda, you are going to defeat the surgery without much effort.
- sustained weight loss requires more than surgery alone. Unless you are tied in with services like dietary and counseling, your odds of success are going to be limited.


Personally, I have never made it into obese territory, merely overweight. When I noticed that things were going the wrong direction, I made some lifestyle changes, the key one being food discipline. Portion sizes, sweets, sodas, starch servings, choice of breakfast foods etc. all had to change. In addition, I added some regular exercise back into my life. I realize that the exercise side can be difficult if you are further along in the weight gain trajectory, but there are plenty of options even if you are quite heavy. It is a positive reinforcement cycle. As the weight comes off, the exercise gets easier.

So, between my professional and my personal experience, I would say that unless you have already made the required lifestyle changes and are tied in with a dietician and a personal trainer yet your weight is not controlled, I would hold off on going down the surgery path for a while longer.

 

[Checkout_my_Six]

@Checkout_my_Six. So its been three years since your procedure. What was your life style like before your procedure and what is it like now? How difficult was it to adjust? I know this will require a drastic change in my life style and worry that the phycological change will outweigh the benefits of the procedure. I don’t want to become a recluce as a result.

my volume intake is drastically reduced....I eat way less. Was it hard? No, you have no choice once the surgery is done. You will eat less. Loose weight and feel better with more energy.

It is still kinda weird looking at people who can fill a plate and put all that food down. I have the desire, but no ability to eat like I use to. I like it....and have no regrets.

Now if you eat junk food, loaded with carbs.....one could "gain" weight. I try and keep my junk food eating to one or two meals a week. If I further cut calories back and increased exercise I could become an Ethiopian wonder....but.

 

[EppyGA]

I had a friend that had the surgery done. She didn't lose a bit of weight. She just learned how to eat smaller portions more often to make up for it.

Personally, I’ve used low carb. If you seriously want to lose weight you will make the lifestyle change necessary to do it.

 

[Kenny Phillips]

I had a friend that had the surgery done. She didn't lose a bit of weight. She just learned how to eat smaller portions more often to make up for it.

Personally, I’ve used low carb. If you seriously want to lose weight you will make the lifestyle change necessary to do it.

And I will add that it must be a permanent lifestyle change, which may include dumping some of your friends!

 

[Checkout_my_Six]

And I will add that it must be a permanent lifestyle change, which may include dumping some of your friends!

that's always a good thing....regardless.

 

[RyanB]

You say diets never work and then proceed to recommend two diet strategies: keto and intermittent fasting.

No. Diets are something people will get on for a set amount of time to lose weight and then once results happen, they end up going back to their ways prior to starting the diet and it just becomes an endless circle. The two strategies I recommended are diets, yes, but my intent was to incorporate them into a lifestyle change. The reason ‘diets’ fail, is because people don’t have any discipline with what they eat on their own.

Bariatric surgery, as some have stated above, creates side effects and it also leads the patient to believe that because their stomach is now smaller in size, they can still eat whatever they want, just not as much as they could before so they won’t gain any weight—and that’s the entire problem to begin with.

Nobody can lose weight and actually keep it off if they don’t adapt to a new lifestyle. It takes discipline. Surgeries are the wrong approach to take and imo should be illegal. I view it as the lazy mans way out!

 

[Checkout_my_Six]

you're wrong....Ryan.

 

[RyanB]

you're wrong....Ryan.

Nope, I’m not.

I will also bust the myth that people who drink more water will end up losing weight. NOT TRUE!

Fat is not water soluble, so water will not flush out fat. Fat absorbs fat—that’s why the keto diet is so effective.

Contrary to what people believe, that ‘your body is 90% water’ or whatever the saying is. Your body is actually zero percent water!

There is zero pure water in your body (other than that glass you just drunk), but rather it’s liquids—not water. The liquids for example are electrolytes, blood, urine and lymph. So people who think that drinking more water will help in weight loss are wrong and they can also dehydrate themselves because they are flushing out all of their electrolytes by drinking so much water (that is given that the water they are drinking is not electrolyte water). As for me, I may only drink 2 or 3 glasses of water per day. No need to drink this “1/2 your body weight in ounces” stuff.

The only way to lose weight is to be in a caloric deficit. Period.

 

[steingar]

I know two people who have had it done. One did so a couple years ago, one quite recently. Neither are pilots, so no wisdom about that. Both are new men, and neither could loose weight without the surgical intervention due to personality traits.

It is quite clear that the surgery is curative for diabetes.

 

[azure]

It is quite clear that the surgery is curative for diabetes.

How so? Certainly losing weight can contribute to reversing Type II diabetes in many if not most cases, but (a) as others have stated, the effects of the surgery on food intake can be defeated by behavior, and (b) for Type I I really don't see how it could possibly be even helpful, much less curative.

 

[Checkout_my_Six]

now....if surgery would only fix stupid...this world would be a smarter place.

 

[Kenny Phillips]

now....if surgery would only fix stupid...this world would be a smarter place.

I think they used to do that kind of surgery up until 1970; it was called "abottleinfrontofme" or something like that.

 

[Kenny Phillips]

Nope, I’m not.

I will also bust the myth that people who drink more water will end up losing weight. NOT TRUE!

Fat is not water soluble, so water will not flush out fat. Fat absorbs fat—that’s why the keto diet is so effective.

Contrary to what people believe, that ‘your body is 90% water’ or whatever the saying is. Your body is actually zero percent water!

There is zero pure water in your body (other than that glass you just drunk), but rather it’s liquids—not water. The liquids for example are electrolytes, blood, urine and lymph. So people who think that drinking more water will help in weight loss are wrong and they can also dehydrate themselves because they are flushing out all of their electrolytes by drinking so much water (that is given that the water they are drinking is not electrolyte water). As for me, I may only drink 2 or 3 glasses of water per day. No need to drink this “1/2 your body weight in ounces” stuff.

The only way to lose weight is to be in a caloric deficit. Period.

Your body IS about 60% water. That is, you can extract that much water from a human body. Of course it's mixed with other stuff, in the form of blood, urine, lymph, interstitial fluid, etc. I'm pretty sure that most folks realize that it isn't the drinkable stuff!

 

[weilke]

No. Diets are something people will get on for a set amount of time to lose weight and then once results happen, they end up going back to their ways prior to starting the diet and it just becomes an endless circle. The two strategies I recommended are diets, yes, but my intent was to incorporate them into a lifestyle change. The reason ‘diets’ fail, is because people don’t have any discipline with what they eat on their own.

The only reason keto is popular is because you can stuff your face with bacon while still losing weight . And who doesn't like bacon ?
If I am thinking of lifestyle change, I am not thinking of another fad like keto or fasting . I am thinking about changing from fast food tob home cooked, regular meals instead of snacking honesty about portions etc. Intermittent fasting is not going to do a thing if you just make it up on the next day.

Bariatric surgery, as some have stated above, creates side effects and it also leads the patient to believe that because their stomach is now smaller in size, they can still eat whatever they want, just not as much as they could before so they won’t gain any weight—and that’s the entire problem to begin with.

Yyou may not be familiar with the different options of bariatric surgery. With the ''malabsorptive' types, there is not only a restriction in the size of the stomach, you also lose the ability to absorb nutrients. Even with regular meals of your pre-surgery caloric content, you are going to lose weight. (the only way to defeat those surgeries is by deliberately constantly feeding yourselr liquid carbs)

Nobody can lose weight and actually keep it off if they don’t adapt to a new lifestyle. It takes discipline. Surgeries are the wrong approach to take and imo should be illegal. I view it as the lazy mans way out!

You know, that's like your opinion, man.

There is nothing lazy about being a successful post bariatric patient. For it to work it still requires lifestyle changes. For those who are able to stick with the plan, it offers the opportunity to quickly get into a healthy weight range when doing so with caloric restriction and exercise alone would take years. Years they may not have because their type II diabetes is going to cause complications prior to getting there.

I am not opposed to bariatric surgery. I just believe that the lifestyle changes should come first before the surgery option is used. Some bariatric centers don't put much effort into the pre-evaluation. They just go through the motions so the insurance is satisfied. Their interest is to get as many patients on the OR table as possible. Find a dietician, be brutally honest about your intake, start walking/swimming/biking. If you still don't get on a trajectory that will get you to safety in an acceptable time, find the best bariatric surgeon in your area and get it done. If you combine the behavior change with the surgery, you'll see dramatic effects on your health in a short amount of time.

 

[RyanB]

Your body IS about 60% water. That is, you can extract that much water from a human body. Of course it's mixed with other stuff, in the form of blood, urine, lymph, interstitial fluid, etc. I'm pretty sure that most folks realize that it isn't the drinkable stuff!

Yes, but none of those things are water—they’re liquids, as I mentioned in the prior post.

The saying should be ‘your body is 60% liquid’.

Remember, water itself isn’t hydrating, it’s the electrolytes that hydrate.

 

[Kenny Phillips]

Yes, but none of those things are water—they’re liquids, as I mentioned in the prior post.

The saying should be ‘your body is 60% liquid’.

Remember, water itself isn’t hydrating, it’s the electrolytes that hydrate.

No. Your body is 60% WATER. If you count the liquids, it will be more than 60% liquid. And water hydrates (hence the term!!); electrolytes are also necessary, and are found in your food, but if you just took those, and no water, you'd soon die. Of dehydration.

 

[SkyHog]

I’m planning on doing the Gastric Bypass next year. I can’t lose weight and even with exercise and proper eating, I’m gaining weight, not losing it.

I am a very active adult - I ride bikes, run, walk, hike, etc., but I still put on weight every year - over 310 pounds now and probably over 400 by the end of the decade on this path.

Nothing lazy about me. I just underwent back surgery due to a burst disc and 2 slipped discs. Mostly caused by being so active while being overweight.

 

[Rushie]

I know two people who have had it done. One did so a couple years ago, one quite recently. Neither are pilots, so no wisdom about that. Both are new men, and neither could loose weight without the surgical intervention due to personality traits.

It is quite clear that the surgery is curative for diabetes.

Agree that the studies show reduced rates of diabetes, and reduced mortalities from diabetes, but to pick nits, I don't consider this being cured. I consider this managing to keep your blood sugar underneath the curve that defines diabetes. But you still have the underlying disease. Although I grant you that one can consider oneself cured for all practical purposes, assuming one sticks to the new eating plan.

How so? Certainly losing weight can contribute to reversing Type II diabetes in many if not most cases, but (a) as others have stated, the effects of the surgery on food intake can be defeated by behavior, and (b) for Type I I really don't see how it could possibly be even helpful, much less curative.

He is right in that the statistics back up that the rate of type 2 diabetes goes down. You're right about type 1 of course but I'm sure he knows the difference and assumed we all did too and it was not necessary to point that out. But come to think of it he might be wrong about that, maybe there are folks who have no clue what the difference is.

My issue is with the definition of the word "cure". It's not like taking an antibiotic and curing an infection. First of all, the rates would need to be far closer to 100% for it to be a definitive cure, which they are not. The reason is because there is nothing about removing, rearranging, stapling, or installing a balloon that DIRECTLY cures diabetes. The benefit is indirect and the thing that results in the benefit is the reduction of food, especially carbs, and this can be achieved without the surgery. Therefore, the surgery isn't curing anything. It is merely giving you a tool to more easily reduce your food/carbs, which is the real cause of the "cure".

 

[Kenny Phillips]

I’m planning on doing the Gastric Bypass next year. I can’t lose weight and even with exercise and proper eating, I’m gaining weight, not losing it.

I am a very active adult - I ride bikes, run, walk, hike, etc., but I still put on weight every year - over 310 pounds now and probably over 400 by the end of the decade on this path.

Nothing lazy about me. I just underwent back surgery due to a burst disc and 2 slipped discs. Mostly caused by being so active while being overweight.

You cannot be properly eating and exercising and not losing weight, unless you derive energy from the air. What proportion of carbs / fat / protein are your meals?

 

[Checkout_my_Six]

Oh now....lets not get petulant. ...cure schmure.

 

[MarkR]

I agree with Ryan that it is worth looking into intermittent fasting and keto/low-carb as alternatives to surgery. My body does respond to this style of eating - and I can lose weight without hunger.

There are a lot of good resources - dietdoctor.com is a reasonable starting place as is the book ‘Why we get fat’ by Gary Taubes

 

[Rushie]

I’m planning on doing the Gastric Bypass next year. I can’t lose weight and even with exercise and proper eating, I’m gaining weight, not losing it.

I am a very active adult - I ride bikes, run, walk, hike, etc., but I still put on weight every year - over 310 pounds now and probably over 400 by the end of the decade on this path.

Nothing lazy about me. I just underwent back surgery due to a burst disc and 2 slipped discs. Mostly caused by being so active while being overweight.

Yes. I completely disagree with the idea that people who can't lose weight without surgery are somehow lazy, lack willpower, or simply haven't stumbled across the right "diet". Genetics has a lot to do with it, and you cannot control the DNA you were born with. You also cannot completely control your environment.

For some people it's the right answer. I think it might be done too often to the wrong people, and I think people need to be very careful which type procedure they get, but to say bariatric surgery should be illegal? No, not going there.

 

[Checkout_my_Six]

I love all these self proclaimed experts here....

 

[SkyHog]

You cannot be properly eating and exercising and not losing weight, unless you derive energy from the air. What proportion of carbs / fat / protein are your meals?

What causes the issue for me is that after such a busy day of being super active I probably overeat. Eating the right things but too much of it.

It’s not a lack of self discipline it is a matter of not being able to not eat as much because I am miserably hungry otherwise.

So I could do less activity and then eat less, but I still put on weight because I’m doing less stuff. It’s a balancing act that I lose on either way.

Fad diets are a joke. To recommend Keto as an alternative is almost laughable.

 

[MarkR]

It is not a fad diet, it is being extensively studied as treatment for metabolic syndrome, diabetes, and obesity, and you will likely be put on keto or another low carb diet in order to lose weight before surgery.

 

[Rushie]

What causes the issue for me is that after such a busy day of being super active I probably overeat. Eating the right things but too much of it.

It’s not a lack of self discipline it is a matter of not being able to not eat as much because I am miserably hungry otherwise.

So I could do less activity and then eat less, but I still put on weight because I’m doing less stuff. It’s a balancing act that I lose on either way.

Fad diets are a joke. To recommend Keto as an alternative is almost laughable.

Keto actually works very well. I've tried it but it's still a diet. What I mean is, you still need willpower. You aren't hungry and you lose cravings for carbs, but if you SEE a carb, like a beautiful birthday cake, you cave "just this once", and then, like all addictions, you're off and running on a binge.

That is what I mean by environment. We live in a society with far too much bad food all around us, people at work eating it, having it be sentimental parts of family tradition (Christmas cookies, B-day cake) and so on. It would be very easy to stay keto if I never left my house and I had a full time chef prepare meat, seafood and fibrous greens for me all day long. The trouble is we live in the real world.

Keto is: you eat a half stick of butter and you aren't hungry, it will keep you satisfied for hours. You eat a half stick of butter with just a half teaspoon of sugar in it, you will have hunger pangs very soon, not only that, you aren't likely to stop at half a stick, you'll eat a whole stick. You really need to eliminate ALL sweets and carbs from every single bite you eat for it to work.

On the keto diet I felt better than at any other time in my life. I just don't have the money and lifestyle and willpower to keep it up. WIsh I did, it really is the way to go.

 

[Rushie]

It is not a fad diet, it is being extensively studied as treatment for metabolic syndrome, diabetes, and obesity, and you will likely be put on keto or another low carb diet in order to lose weight before surgery.

It was the only treatment for epilepsy before they came up with pharmaceuticals.

 

[weilke]

How so? Certainly losing weight can contribute to reversing Type II diabetes in many if not most cases, but (a) as others have stated, the effects of the surgery on food intake can be defeated by behavior, and (b) for Type I I really don't see how it could possibly be even helpful, much less curative.

The effect of certain bariatric surgery techniques on diabetes goes beyond the reduction in food intake. They divert the food around the portion of the gut that triggers the release of some of the hormones involved in the disease. The effects of Roux-en-Y gastric bypass or a duodenal switch bariatric surgery on type II diabetes is immediate. In some of the series 80-90% of diabetics experience resolution of the disease.
At the same time, these are the most invasive surgical options and they leave the patient with the need for long term vitamin supplementation and nutritional support. For someone threatenend with some of the complications of type II , this can be a worthwhile trade-off. For someone 'just' struggling with weight, it may not be the right option.

Anyone who thinks about doing this needs to be evaluated by a center where you find folks who can look at the individual situation and recommend a plan. This is all a bit more complicated than what can be explained in an internets post

 

[EppyGA]

Back in 98 I bought the Atkins book and read it cover to cover and followed exactly what he suggested. I was working and fairly active due to my work so watching calories did not have to be done. I lost 52 lbs and kept it off for awhile until I got stupid and relapsed. Now twenty years later, at 67, I can still lose going low carb but must also watch the calories since I’m retired and do not get as much exercise. I also realize it will need to be my lifestyle from here on out. I've discovered some great recipes that allow me to still enjoy pizza and pancakes for instance without then carbs.

 

[weilke]

Oh, and drinking water is not a weight loss method. However, consistently replacing soft drinks, sweetened coffee drinks, fruit juice and beer with intake of water instead will significantly affect your calorie and particularly carb intake. It's not the water. Its the reduction of easily absorbed carbs that has an effect on your health.

 

[Checkout_my_Six]

Lets not forget black coffee....

 

[azure]

The effect of certain bariatric surgery techniques on diabetes goes beyond the reduction in food intake. They divert the food around the portion of the gut that triggers the release of some of the hormones involved in the disease. The effects of Roux-en-Y gastric bypass or a duodenal switch bariatric surgery on type III diabetes is immediate. In some of the series 80-90% of diabetics experience resolution of the disease.

Interesting, I didn't know that. Thanks!

BTW, the term "Type III diabetes" isn't very well known, in fact your posts are the first time I've ever encountered it and I had to look it up. It seems to be a new (and, according to Wikipedia, controversial) term for a situation where someone has both Type II diabetes and Alzheimer's Disease - apparently insulin resistance is now a recognized risk or even contributing factor in the development of AD. Is this what you meant? If not, could you please explain?