Six Months Out - Full Body Picture

Sunday, December 11, 2011

Why Not Diet? Why WLS?

I hear a lot of people talking about WLS as if it were the "easy way out" or "cheating" on weight loss. Comments about massive weight loss always seem to include "Well, did s/he lose the weight on their own or through surgery?"

I'm here to tell you that WLS is NOT the easy way out. First, it's expensive. I was a self-pay (thank you, Dear Husband) and it cost us $12,500, which is not pocket change. Add to that the medical problems I was having and that I had to have a filter installed before and removed after the WLS, with the attendant deductibles, and it probably cost closer to $20k out of pocket, before insurance paid anything. 

Second, if your insurance DOES cover WLS, and many do not, then you do a ton of hoop-jumping before surgery is approved. I've heard anywhere from six months to a year of supervised dieting under the care of a doctor, plus many insurance companies require high BMI (Body Mass Index) numbers. Some insurance will only cover surgery if your BMI is over 50. Others do allow coverage if you are under 50, but only if you have a certain amount of co-morbidities. Co-morbidities include things like diabetes, sleep apnea, high blood pressure, heart know, all those conditions that make it dangerous to have surgery.

Third, having any surgery IS dangerous. WLS has its own dangers and it's a great idea to research like crazy about your surgeon and your facility before you have surgery. I still plan to post about my doctor, who is an amazing surgeon! I had the best references for him, but still had worries about whether I would survive the surgery because of my co-morbidities. Mine included sleep apnea, borderline diabetes, asthma, DVTs and two pulmonary emboli. The DVTs and emboli are why I had to have a filter surgically installed/removed. And, the filter did catch two clots, so it was a necessary evil.

Fourth, WLS does not make you magically lose weight. I'm sure that we all wish that it did. What WLS gives you is a tool that allows you to not feel hungry as much. What you do with that tool is up to you. YOU are responsible for what goes into your mouth. YOU are responsible for exercising. YOU are responsible for following the plan that your doctor gives you.

MY doctor told me that I must do the following: I MUST take a multi-vitamin every day for the rest of my life. I do not have the option to not take it because my tummy will not hold the volume of food it held before, so I don't get a lot of veggies in me.  I MUST eat 70 grams of protein per day. This is a tall order, because many foods don't have protein at all. I eat a lot of chicken, tuna, cheese, and protein bars/shakes these days. I also MUST drink at least 64 oz of water per day. And, drinks with caffeine do not count because caffeine hinders absorption of water. I had a serious diet coke addiction pre-op, so this one is a biggie for me. My surgeon also says NO carbonated drinks. I hope he doesn't read this, because I still have a diet caffeine free coke sometimes.

Fifth, WLS still requires that you make good food choices. Once I get in my water and my protein, I can still screw things up. If I choose to eat cake, candy, ice cream, etc., I can eat them. They are called "slider foods" because they just go right through my sleeve and don't leave me feeling full. I could eat them all day long and then say that WLS didn't work for me. But, I'd be lying. The truth would be that I didn't work the WLS.

That's the fallacy, that WLS works for us. No, it doesn't. It gives us the ability to handle eating like a normal person. But, it doesn't handle the mental aspect.  I'm not on a diet now, any more than most people are on any given day. I'm commited to a life style change. I want to eat like a normal person. I want to look like a normal person, so I want to do what normal people do. Normal weight people eat what they want, when they want it. That's what I want.

So, I'm doing what the surgeon said and I'm refusing to believe that any food is inherently good or bad. Food is either "protein" or "not protein" for me. If I still need protein for the day, then I eat protein when I'm hungry. If I'm hungry and I don't need protein, I have what I want. Usually that means I eat some kind of vegetable. But, sometimes I eat an ice cream (Skinny Cow usually) or a sugar free pudding.

So far, my life style change has worked for me. I had WLS on August 30, 2011 and, as of today, I've lost 65 pounds, 13 pre-op and 52 post-op. To get this far I've had to cut calories. I get under 1,000 a day, but I'm so full that more won't fit, normally. I've also had to up my exercise levels and to stay on top of the water and protein daily.

I WILL lose the rest of my weight, but I have a long road ahead of me. There are plenty of people who have had WLS, lost their weight and then regained. WLS requires that we be vigilant for the rest of our lives and do what normal weight people (NWP) do. When they see that they've put on a pound or two, they restrict their eating and lose that pound or two.

But, NWP eat food. They don't ignore food completely and end up in the hospital with dehydration and malnutrition. Both of these are risks for WLS patients. Once we've had surgery, the danger of developing eating disorders is higher, as is the danger of cross-over addictions. WLS patients in particular have to watch that we don't replace food with alcohol (the ultimate slider!), with drugs, with smoking, or develop eating disorders like the chew and spit technique I talked about in the last post. I have been told that is called "cupping". EWWW

Anyway, sorry for writing a book, but this is why I chose not to diet anymore. I've done all the well-known diets and lost a few pounds, then gained them back in a hurry. WLS has given me a tool to use to actually take this weight off and keep it off. I think I'm going to add my Weight Loss Ticker to the page so that you can see where I came from and where I'm going.

One last point about WLS and dieting, once the initial spurt of weight loss is over, WE must keep going on the changes. The honeymoon period for weight loss after surgery is roughly a year, depending on the surgery. I probably won't lose all my weight in that first year and I'm predicting that my weight loss will slow way down the closer I get to that year mark, because that's what I hear from those who have gone before me.

I'm sure that's what happens to lots of WLS patients as they get further out from surgery. They get discouraged and don't stick to the plan when the weight loss slows down from that initial surge, and they stop being so diligent about their plan. Then they regain a few pounds, and a few pounds more, and so on. So, traditional dieting and WLS have a lot in common at that point. Add in that WLS patients are typically people who have had difficulty with "dieting" in the past and you can see that it's a double-whammy.

So, every time you hear that story about "Someone" who had WLS and regained all their weight, factor in all of the above. The WLS didn't fail. The person who regained the weight failed to use their tool to its maximum potential. That doesn't mean that every WLS patient will fail, but it does mean that we patients have to be vigilant.

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