Sunday, April 20, 2008

Weight Loss Surgery vs. Diet and Exercise

Everyone who is thinking about weight loss surgery has heard it:

Have you considered going back on Jenny Craig/Weight Watchers/Atkins/South Beach? That's worked for you before.

Or maybe it's:

You just haven't found the right diet for you. Have you tried South Beach/The Blood Diet/Jenny Craig/Weight Watchers? How about seeing a nutritionist?

First of all, did those other diets really "work" if you gained all the weight back? That's not my definition of working.

Secondly, if all those other diets didn't work, why will this new one be any different? We know scientifically what happens when people go on diets and we know scientifically why it doesn't work. Each new diet that comes along is just a twist on an old formula that has been proven not to work.

We know that yet there is still this resistance to weight loss surgery as a way to lose weight. The idea that diet and exercise is the "right way" to lose weight is so deeply imbedded in our culture that any other way is treated with suspicion no matter what science says.

Only about 2% of all people who chose diet and exercise to lose weight are able to successfully lose weight and keep it off for more than a few years. We know that and we've know that for years. We also know the success rate is is much higher for people who have weight loss surgery. Somewhere from 42 to 76% of people who have WLS lose a significant amount of weight and keep it off.

Let's do the math. 2% vs. 42 to 76% So WLS is 21 to 38 times more effective than dieting and exercise.

It's not perfect. The average weight loss is only about 50% of excess weight and some people do gain it back. But compared to diet and exercise alone, WLS is a miracle cure.

Too bad it's not as socially acceptable as all those ways that don't work.

Wednesday, April 16, 2008

What's happening to my plan?

I have to say that my Lap Band journey is not going as planned.

I was supposed to have my consult with my surgeon tomorrow. At that point, I would get weighed and would start the process to lose 10% of my excess weight and get my pre-surgery tests done. Unfortunately, with my insurance excluding WLS, the surgeon's office called to cancel my appointment!

Their reasoning is logical. First, I'd have to pay for the consult out of pocket and they charge $500 for it. Second, if you change insurance in the middle of the process, it causes problems. So they suggested I wait until Aug. 1st when my new insurance would kick in.

There are two problems with that:

1) If I wait until Aug. to start, I will not be ready by Oct. which is when I want to have the surgery. Instead, I would end up having surgery right around the holidays -- a time when I want to be at 100% and not recovering from surgery. There is also a chance that the pre-op requirements couldn't be completed until Jan. or Feb. and that's just too late in our yearly software cycle to be taking a vacation from work.

2) My surgeon hasn't got a contract with United Heathcare! That will increase my costs dramatically. In fact, they will be high enough that I might as well self-pay.

So I feel like I am starting all over, especially if I end up changing surgeons. It's so FRUSTRATING.

Friday, April 11, 2008

I'm the Candy (Wo)Man

I had my nutritional consult yesterday. I was a bit leery because a) I could probably teach a class on nutrition and b) when I made the appointment, the registered dietician I picked was kind of a butthead. She was convinced I'd be late for my appointment and wanted me to do a "dry run" by driving to her office a few days before. Because San Mateo is so huge and easy to get lost in. Not.

Anyway, the actual appointment was fun. The dietician shares office space with a dermatologist of all things. But they had People magazine in the lobby and I actually learned me some stuff during the appointment. Like that I'd gotten confused and was taking the wrong kind of calcium supplements.

Of course, the recommendations were what I expected. Eat less sweets. Exercise more. Don't drink stuff with calories. Have snacks that are higher in protein because they "stick" longer.

The only bad part is that the skinny, tiny dietician clearly had no clue about obesity. She told me that if I stopped drinking Vitamin Water and drank regular water or Crystal Light, I'd lose about 12 pounds in a year. Except I started drinking stuff with calories about six months ago and I have seen absolutely no change in my weight. Plus I've been there before and I know that my body will get those calories one way or another and, if I cut out sweet drinks, I'll just eat something else instead.

I don't think she understands about things like not feeling satiety and being hungry every 1-2 hours. I don't think she understands that if you yo-yo diet, your body learns to hold on to calories and gets upset with you when you lose weight. I think the shrink got it so I was surprised that the dietician didn't.

Still, I was excited to get started on some of the recommendations, particularly as a lot of them are in line with my life after-band, and because my surgeon requires weight loss prior to scheduling surgery. So I drove right back to work where I promptly ate .... a candy bar. Oops. It was good though. I enjoyed every bite!

Today I tried some of the recommendations -- I had yogurt and two cheese sticks instead of yogurt and a banana for my afternoon snack. It didn't stick any longer than my regular snack though. Plus the Crystal Light "on the go" gives me heartburn while the Vitamin Water doesn't. I think maybe I'll try something like watering down the Vitamin Water. I still have an awful lot of it in the fridge. I did tell Mr. Mac not to buy any more but it will take at least two weeks to finish up what I've got.

I've also decided to start working out even if it means I lose weight before I see the surgeon and start on the "Three Month Multi-disciplinary Program" officially. I just can't wait any longer.

Sunday, April 6, 2008

Still Crazy After All These Years

I did my psych eval on Thurs. This is part of what my surgeon requires in order to prepare for the surgery. We talked for a while about my life and I was pretty honest. I told her all about the crazies in my family-- the addicts, the suicides, being molested. Maybe I shouldn't have, but I think knowing what I came from makes me seem saner. Plus I don't have anything to hide.

After we talked about my family history and the realities of lap band surgery, I took one of those true/false "Quality of Life" tests. There were lots of questions about whether I follow sports teams, how often I see my friends and family and what my job was like. Sometimes those questionnaires have a lot of questions about religion, but this one didn't.

I think I came off as someone who does have support in my life and manageable stress. I do think the questionnaire needs updating -- there was nothing in there about keeping in touch with people via the texting or email and nothing about online support groups! Pfft to them.

Now I wait to see what the report looks like, I guess. Hopefully the doctor will say I'm a good candidate for the surgery.

In the meantime, my insurance company is being a pill again and I'm scheduled for a nutritional analysis this week.