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Bytsi · 09-22-2008, 12:48 PM

Just saw this thread, and I wanted to chime in (if anyone's still interested)...

I work with bariatric patients, pre- and post-op. I do their fitness assessments and then teach them their exercise program (walking pre-op, more extensive including some strength and flexibility post-op). The people I work with must pass a psych assessment (but I don't know the details or how extensive it is).

For at least one month before surgery (sometimes more, if surgery dates change), the patients are on a meal-replacement program (bars and shakes). I've seen them lose 50# in a month following this plan and doing their walking program. BEFORE their surgery.

So... if you know you CAN do this, why would you opt for dangerous surgery? I'm not saying it'd be pleasant to stay on the bars for months on end, but... I wonder if any of the patients have an A-ha moment and say "I can comply with a diet - maybe I should try some kind of diet plan for a while longer and see what happens." Haven't met one yet...

There is also a great deal of resistance to the idea that they will have to exercise to lose and maintain their loss, that exercise has to become a part of their life forever. I can usually tell who's just nodding along, and every once in a while I meet someone who actually seems motivated and learns to enjoy exercise... but that's rare.

I often hear "I've lost weight before (many times), but it always comes back. This time it will stay off because of the surgery." Well, uh, not necessarily. As mentioned in this thread, the relapse rate is pretty high - you CAN stretch out a stomach, even after the bypass... I've met 2 women who had bands put on AFTER they had bypass and restretched their stomachs.

I think WLS can be a helpful tool, but education and support could probably do as much or more for many people (which goes back to doctors not having the time or tools to support or educate). For people with severe comorbidities or lack of mobility, maybe it can be the major jumpstart they need... but without constant vigilance (just like is necessary for ANYONE who's ever had a weight problem), the surgery is just another tool that only works as hard as the person works, and only lasts as long as you continue to work the program.

09-22-2008, 12:48 PM	#37 (permalink)
Bytsi Senior Black Belt Hamster Join Date: Mar 2008 Posts: 6,543	Just saw this thread, and I wanted to chime in (if anyone's still interested)... I work with bariatric patients, pre- and post-op. I do their fitness assessments and then teach them their exercise program (walking pre-op, more extensive including some strength and flexibility post-op). The people I work with must pass a psych assessment (but I don't know the details or how extensive it is). For at least one month before surgery (sometimes more, if surgery dates change), the patients are on a meal-replacement program (bars and shakes). I've seen them lose 50# in a month following this plan and doing their walking program. BEFORE their surgery. So... if you know you CAN do this, why would you opt for dangerous surgery? I'm not saying it'd be pleasant to stay on the bars for months on end, but... I wonder if any of the patients have an A-ha moment and say "I can comply with a diet - maybe I should try some kind of diet plan for a while longer and see what happens." Haven't met one yet... There is also a great deal of resistance to the idea that they will have to exercise to lose and maintain their loss, that exercise has to become a part of their life forever. I can usually tell who's just nodding along, and every once in a while I meet someone who actually seems motivated and learns to enjoy exercise... but that's rare. I often hear "I've lost weight before (many times), but it always comes back. This time it will stay off because of the surgery." Well, uh, not necessarily. As mentioned in this thread, the relapse rate is pretty high - you CAN stretch out a stomach, even after the bypass... I've met 2 women who had bands put on AFTER they had bypass and restretched their stomachs. I think WLS can be a helpful tool, but education and support could probably do as much or more for many people (which goes back to doctors not having the time or tools to support or educate). For people with severe comorbidities or lack of mobility, maybe it can be the major jumpstart they need... but without constant vigilance (just like is necessary for ANYONE who's ever had a weight problem), the surgery is just another tool that only works as hard as the person works, and only lasts as long as you continue to work the program. __________________ Bytsi 2009: The Year of the Hamster My old log (2008) What would Scooby do?