Why it’s not risky to have weight loss surgery

Although I have never personally been overweight, I am an advocate for those who are. It’s not because I watched a family member struggle or have some heart wrenching personal story to share with you. Circumstances ten years ago just lead me to a position working with people who do struggle with weight.

Through that time, I have gotten to know hundreds, if not thousands, of individuals and their personal stories, and why there is so much more to weight loss than “eat less, exercise more.” I’ve helped a lot of people make the scary decision to pursue weight loss surgery, get their habits (and their mind) right on the way there, and I’ve been there that amazing day when they became a literal new person. So much so, I couldn’t even recognize them standing right next to me as I called them into my office for that two month post surgery check up.

I’ve cried with clients, done happy dances with them when the scale hit a certain number, and held the trash can when they needed to vomit because they ate something they shouldn’t have (yea, sucks to do that in your dietitian’s office.) I’ve been the first person to weigh someone after years and years of avoiding the scale. I’ve been the last person to see someone drink a soda before they chucked it in the trash can for good (carbonation isn’t allowed after weight loss surgery if you were wondering.) I’ve also been the first person to find out they’re going for it, for realz. It’s scary, it’s exciting, it’s terrifying, and it’s truly life changing.

Here’s the deal though, I don’t want to hear that “bariatric surgery is high risk” from people who know nothing about it other than that their brother’s coworker’s aunt’s mother in law had that “stomach stapling” procedure back in the 80s and died. Don’t ever take the excitement away from someone by telling them it’s too risky. 

I do get it. I’ve worked with two or three people out of hundreds that had the surgery and it went terribly wrong. They can’t eat food anymore because they had a rare complication. They get to live on a feeding tube for the rest of their life. I’ve gotten to know a couple of individuals who died months later because their health problems before surgery were against them and weight loss surgery didn’t fix it. It sucked. But they were exceptions, more on this later.

But I’ve also seen people get out of wheelchairs, off their diabetes medications, go on vacations again, and live life out of the house again because of this surgery. And that “stomach stapling” or “risky gastro procedure” everyone is so scared of, was actually life saving to someone that used to spend their entire life dieting without success, counting pills, administering injections, and going to doctor visits because their body became a prison.

If you think it’s about eating less and exercising more, think again. Obesity is not a lifestyle choice. If it was, there would be zero obese people in this world trying to lose weight. Everyone would wake up, cherry pick their dream weight and get to it. But if you’re reading this, you probably know that’s not true.

Here are 5 well meaning reasons why I’ve heard weight loss surgery is an unsafe choice and why they are false. If it’s something you’ve been considering but have been convinced it’s a “last ditch effort,” I want to give you some peace of mind to make a rationale choice. I’m not here to tell you to go do it, but I don’t want you to not go do it out of fear, either.

  1. You could die. Obesity itself is the number 2 cause of preventable death (aside from smoking) in the United States today. In this analysis of 13,871 morbidly obese patients from a national registry between January 1996 and January 2006, the risk of death within 60 days following any weight loss procedure was 0.25%, making it a rare event. A main reason for this is because modern day procedures are typically done laparoscopically, meaning only 5 small incisions about one inch in length each are made to perform the procedure rather than a long vertical incision as used to be made. Medicine is always evolving!
  2. It’s a cop out. And you could die. Okay, this is kind of a continuation of the first, but I felt needed more clarification. Bariatric surgery is emerging as a powerful weapon against severe obesity and type 2 diabetes mellitus (T2DM). Numerous studies confirm that weight loss surgery, particularly Roux en y gastric bypass surgery is more effective at bringing those with T2DM into disease remission than those who were undergoing conventional medical therapy. Some studies that back this up include this one, this one, this one, and this one. But there are several more available in case you need more proof. As a reminder, complications of long term, uncontrolled diabetes include: kidney failure, often requiring dialysis, neuropathy leading to toe and/or foot amputations, and heart disease. Not one of these are known complications of weight loss surgery.
  3. You’re going to throw up a lot. Well, yes, if you don’t follow strict dietary guidelines. I get it, this is not a lifestyle for everyone. It requires consuming adequate amounts of nutrition, 5-6 times/day, when you’re barely hungry. It also means you will be preplanning your meals every day, for the rest of your life, including the small details like quantities, calories, and protein grams. You will also need to be picky about what restaurants you choose when and if you decide to eat out in restaurants. Be prepared to eat slower. A lot slower. And chew well. Choose your food wisely. No room for fillers here when your stomach is the size of an egg. So no air swallowing habits either, like chewing gum or soda. Eat the wrong food item and you may be sorry for hours or days following.
  4. You’ll have no energy. Actually, if you’re frame has been carrying an extra 50-100 pounds it’s not supposed to be carrying and all of the sudden, in a very short person of time (say, 4-6 months?), you lose it 50 plus pounds, just like that? Wouldn’t ya think the opposite would be true? Think of it more like this: you’ve been carrying a 75 pounds back pack for a few years and I just took it off. How would that feel? This doesn’t really matter what your starting weight is, either. 75 pounds is 75 pounds.  You will also be forced to eat better with surgery, that’s part of what the surgery is for. Run through the drive through with some friends and a cheeseburger real quick and you’ll be running to puke. It’s just what happens when you’re digestive system is rearranged and shortened. Better diet = more energy.
  5. You’ll just gain it all back, so why bother going through that? Not true. Statically, 20% or 1 in 5 individuals who have weight loss surgery will regain all of the weight lost following surgery. But that also means 80% or 4 in 5 will maintain that loss. Those who do not have surgery? If your body mass index is above 30, the sad and terrible truth is, statistically <1% of individuals will maintain any weight off. I know….

In case you haven’t figured it out by now, I’m a pretty big proponent of weight loss surgery. This may surprise you, but like I said, I’ve worked with lots of people and I know their struggle. I’m also a big proponent of taking control of your own life, whatever that may mean for you…and I’m here to help you on that journey. I’ve got a ton of posts for the non-surgery folk too, so look around!

There are various types of surgeries, but the two most effective and common choices available today are the laparoscopic roux-en-y gastric bypass and the laparoscopic sleeve gastrectomy. If you want to know more about them, I encourage you to talk with your doctor. This post would go on forever if I described them here, but certainly feel free to reach out to me for resources if you want to know what they are.

P.S. If you’re looking for online support with like minded moms striving to live a healthier lifestyle, you may be interested in joining my free online support group here.

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Jillian McMullen, RDN, CSOWM, LDN

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