Weight Loss Surgery, Part 3

bench press

We have been exploring the different kinds of surgery designed to help an obese person lose weight by having part of their stomach either removed or shut off, and the other bits reconnected in different ways.

The various weight loss surgery (WLS) procedures each have their advantages and disadvantages. The vertical banded gastroplasty (or stomach stapling) used to be the hot item, even though the American Medical Association characterized it as a “severely dangerous” operation. Plus, the patient could just go ahead and overeat, and stretch the remaining pouch of stomach back to a larger size. The results were not optimal in most cases. Nowadays, some other procedure would probably be recommended as a first choice, most likely either gastric bypass or Lap-Band® surgery. When gastric bypass surgery works, it really works. It also has a fairly high weight regain rate.

Nothing is foolproof, and no matter what procedure is used, there can always be an unforeseen development. Some staple or clip can always come loose. More surgery might be in the cards. Or it might be that a sequence of operations was planned from the beginning. The post-op patient has to be very, very good and adhere to a very strict program for the remainder of his or her life, and who among us can do that?

If the weight loss is extremely successful, the person can look forward to more surgery, to remove the leftover excess skin. Even when the whole program works like a charm, the person apparently develops intolerance to a wide range of foods, and is prone to constipation, faintness, thinning hair, vomiting, flatulence, and a number of other conditions that could be detrimental to a person’s social life. That’s kind of sad, considering that many people undergo this surgery in the hopes of improving their social life.

Nevertheless, many post-op patients are very happy. Visiting a website called Former Fat Dudes!, we learn that playful members of the bariatric community choose such names for themselves as Melting Mama, Recovering Fatty, and Beariatric. A fellow called McNee speaks feelingly of an online discussion group he discovered, which turns out to be therapeutic in itself. He recommends the forum at BariatricTV, calling it “support…for folks who have had or are looking in to weight loss surgery. It’s a small, but growing group of some very great folks.”

At the time when he wrote that, McNee was about one week post-op. He believed that having the surgery would help erase the word “obese” from his medical records and life. McNee is currently two years post-op, and faced with an interesting situation. He aims to set up shop as a nutritional counselor, but fears that potential clients will feel that he lacks credibility. People tend to regard WLS as taking the easy way out, and since he lost his weight through surgery, why should they pay attention to what he says about nutrition? But he is going ahead with it anyway. At McNee’s site, a lady known as Gastric Bypass Barbie commented,

I think you and I share the philosophy that life is to be lived to the fullest. Morbid obesity robbed us of that opportunity; bariatric surgery gave it back.

Some time ago, Dr. Pretlow heard from an obese pediatrician who at the age of 50, after decades of futile effort to control his weight, had finally opted for the extreme solution of bariatric surgery. What else did this professional colleague tell Dr. Pretlow? That he would love it if none of his own patients, or for that matter, any other kids, would end up choosing surgery. He clearly sees it as a last resort.

Dr. Pretlow himself would very much prefer that a residential treatment program be tried first, because food addiction is the issue, and successful recovery from addiction can be achieved without the life-changing side effects that accompany surgery. We need to be looking at things through the Psychological Food Dependence-Addiction Paradigm “lens” to create real change. A lot of the other things that people are worrying about are just distractions. As Dr. Pretlow said,

We are selling the souls of our children in order to obtain funding for mostly useless obesity research, which makes funding food companies happy, namely genetics, metabolism, nutrition, physical activity, population studies, bariatric surgery, and obesity drugs.

Your responses and feedback are welcome!

Source: “Flashback: Go ahead, call me obese. I dare ya,” FormerFatDudes.com, 05/05/10
Source: “Obesity Prediction Not So Ridiculous, Thanks to Food Corporations,” Childhood Obesity News, 01/05/11
Image by Colin Rose, used under its Creative Commons license.

One Response

  1. As you most likely know, children and teens spend more than four hours watching TV and more than seven hours using entertainment media instead of engaging in physical activity. These children are more likely to be overweight than children who walk, run, and play more often.

    Screen-Free Week, formerly known as TV-Turnoff Week, takes place April 18-24, 2011 and provides a good opportunity for parents, teachers, and caregivers to replace screen time with physical activity and healthier living.

    WeCan! (Ways to Enhance Children’s Activity and Nutrition), a science-based national education program from the National Institutes of Health (NIH), helps children ages 8-13 stay at a healthy weight. WeCan! offers several materials to help caregivers and families encourage children to become more active.

    Would you be interested in sharing any of the following materials on your blog?
    Tips for Getting Active
    This tip sheet includes bulleted items you can easily cut, paste, and share on your blog. Ideas include enjoyable ways to encourage physical activity while spending time with children:

    • Walk your children to school,
    • Go for a half-hour walk instead of watching TV,
    • Play with your kids at least 30 minutes per day,
    • Dance to music with your kids, and many more.

    Tips to Reduce Screen Time

    Ideas from this tip sheet include:

    • Set Screen Time Limits: Create a house rule that limits screen time to two hours every day…
    • Talk to Your Family: Explain to your kids that it’s important to sit less and move more…

    Please let me know if you have any questions, and feel welcome to send an email or give me a call.


    American Institutes for Research

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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