Sleeve For My Asperger Son?

[Jillyr 1]

Hello,

I have searched everywhere for information about suceess stories on the topic of Asperger adults and WLS surgery. My son is 23-years old. He has mild Aspergers. You wouldn't know it but it is there. His weight is out of control and he wants the VSG that I had. I watch him eat and he practically swallows his food whole. I mean he crams food into his mouth, chews twice, and swallows the whole lot in one gulp. My husband thinks he will never learn to chew and swallow small amounts at a time. I explained that you don't have a choice. The other benefit for my son having the surgery would be that he simply will not be able to eat large quantities and this will cut down on foods that make his Aspergers worse. There are studies that show glutin can make symptoms worse. My son eats poptarts, donuts, pizza, giant shakes, quadruple patty burgers, etc. If I had to guess, I would say 4,000 to 6,000 calories per day. He also suffers from depression. He is on medication for that.

BTW, Aspergers is in the Autism family.

I see that children have this surgery all the time. I just read about an 11-year old having the VSG. The reason I mention this is because one can liken an Asperger's person to child-like behavior.

I am sending my son to an information seminar about WLS at an american facility. Just so he can really hear and undersand the procedure. I talk to him all the time about how careful you have to be with chewing and swallowing. If I were to help him, I would take him to Dr. Aceves. If I stay out of it, I watch him get larger and larger and more and more miserable. He has stretch marks all over his body.

Keep in mind, my husband thought I was off my rocker when I had the surgery myself. He thinks my son will blame me forever if I help him get teh surgery. My husband is appauled that I even present VSG as an option. I do not present this option to my son, only to my husband. My son asks me about it all the time and I reply "it isn't easy, kiddo, you have to be really careful."

Any thoughts?

[Brooklyn732 7]

My opinion is that this is NOT the thing for you son right now. The sleeve is a tool for weight loss. It is NOT the answer to weight loss. I can tell that you are a very concerned parent who wants the best for her child, but the sleeve will not help your son if he doesn't get control of his eating habits. If he binge eats the way you describe, he could do severe damage to his sleeve and to his health. Do you think he could do the all liquid diet? Why don't you try having him do a "pre-op" or "post-op" diet for a few weeks and see if he can handle that. If he shows that he can handle it then maybe you should look into it further. But him getting sleeved without resolving the food behaviors will result in failure.

This is just my opinion.

I wish you and your son the best of luck!!

[BlackBerryJuice 349]

I think you need to get a couple of consults from both bariatric surgeons and psychiatrists (ideally those who work with bariatric patients), it's not something that you alone can decide, because it could turn out to be a disaster. I remember one of Dr. Aceves' coordinators told me a story about a patient of theirs who got a pass to go to the mall with another pt the day after his VSG and ate an ENTIRE BIG MAC while he was there. His sleeve burst and Dr. Aceves had to perform open abdominal surgery on him to clean everything up and ensure he didn't die from sepsis. Obviously, this person had some sort of unadressed mental health issues to go and do something like that - and without the psych evals that happen if you go through insurance, he slipped through the cracks. You have to consult doctors who are experienced with Aspergers AND WLS to make sure something like that doesn't happen with your son. And if you go to Dr. Aceves for the actual procedure, I'd absolutely notify him of your son's condition so he's aware that your son may be in need of special care post-op.

[juliarh 35]

Hi Jilly -- I have a son with Asperger's too, and it's mild. He's in college right now and my mom (who lives near his school) reports he's gained weight. He tends to have my body type, and eats in reaction to emotional upset, etc. SOOOO, I'm hoping that he can get his eating under control before he ends up like me. The thing is, as I'm sure you are aware, like all people with Asperger's, he has no self-reflection -- he thinks he's fine. He also thinks he's fine when he doesn't shower, but that's another story.

BUT to your question -- as you know, people with Asperger's learn very quickly from non-social feedback -- in other words, negative stimulation goes miles -- which makes me think that the VSG would be perfect (rather than RNY) because it gives IMMEDIATE feedback that you've eaten too much -- you literally get sick. Now it will probably be more traumatic for him than it was for you because he won't be able to process what's happening to him as well as you did. But it could be a very positive thing for him.

I've got a couple of questions -- if he's mildly Asperger's, is he self-sufficient?? I mean, does he have a job, etc?? The reason I ask is because at some point, he can and should make this decision on his own. I know that if you determine that you can present him with the information, you could do it in a very logical, scientific way -- one that would grab his attention -- making sure you include that it takes more than the surgery to be successful.

I don't know if this was helpful or not, but I know how you feel and I worry about my son's weight as well -- he's not obese yet, but he's definitely overweight. But I can see him getting there in the next 5 years or so. . . I hope this helped -- hugs, Julie

[Jillyr 1]

Hi Jilly -- I have a son with Asperger's too, and it's mild. He's in college right now and my mom (who lives near his school) reports he's gained weight. He tends to have my body type, and eats in reaction to emotional upset, etc. SOOOO, I'm hoping that he can get his eating under control before he ends up like me. The thing is, as I'm sure you are aware, like all people with Asperger's, he has no self-reflection -- he thinks he's fine. He also thinks he's fine when he doesn't shower, but that's another story. Yes, he comes downstairs just about every morning and as he his heading out the door, my husband or I holler "have you brushed your teeth?!" Nine times out of ten he goes back upstairs saying "what's the big deal?" So, yes, I can see that you totally get it!

BUT to your question -- as you know, people with Asperger's learn very quickly from non-social feedback -- in other words, negative stimulation goes miles -- which makes me think that the VSG would be perfect (rather than RNY) because it gives IMMEDIATE feedback that you've eaten too much -- you literally get sick. Now it will probably be more traumatic for him than it was for you because he won't be able to process what's happening to him as well as you did. That is very true about Aspies. They do not understand "hot" unless they touch it and get burned.

I've got a couple of questions -- if he's mildly Asperger's, is he self-sufficient?? I mean, does he have a job, etc?? Yes. He has been working at Ralphs Grocery Store as a checker for five years. The reason I ask is because at some point, he can and should make this decision on his own. He is the one who wants the surgery. I would have never even brought it up as an option. He found out I had the surgery and he told me today that it is unfair that I am giving him a hard time about having it done. I know that if you determine that you can present him with the information, you could do it in a very logical, scientific way -- one that would grab his attention -- making sure you include that it takes more than the surgery to be successful. Today, he and I went out to lunch and he brought it up. I told him to give it a try . . . the way you have to eat. I told him to take a bite of his food and chew, chew, chew until it is the consistency of baby food. He did it and said, what's the big deal? But, then came the deal killer. I told him he won't be able to drink carbinated sodas anymore. He was VERY upset about that. He lives on Diet Coke. If you know Aspies, you know they have their comfort issues. He told me he cannot live without having his soda. I also told him he cannot eat and drink liquids together. I told him there are lots of rules. He got upset with me and told me I was just trying to talk him out of it. I told him he could learn to live without diet soda and switch to tea or somethihng. It is true that we cannot have soda, right? I'm not sure if that is a permanent thing or a temorary thing.

I don't know if this was helpful or not, but I know how you feel and I worry about my son's weight as well -- he's not obese yet, but he's definitely overweight. But I can see him getting there in the next 5 years or so. . . I hope this helped -- hugs, Julie This helped so much, thank you! He needs some kind of intervention but I am very concerned that VSG might be too drastic. I am going to look into the liquid medical diet plans on line. If you have additinal thoughts, please let me know. If there are any Aspie's out there who had the VSG, pleeeeeeease chime in.

Thank you so much! Good luck with your son.

[Jillyr 1]

My opinion is that this is NOT the thing for you son right now. The sleeve is a tool for weight loss. It is NOT the answer to weight loss. Yes, this is indeed a good point. I can tell that you are a very concerned parent who wants the best for her child, but the sleeve will not help your son if he doesn't get control of his eating habits. If he binge eats the way you describe, he could do severe damage to his sleeve and to his health. This is my husband's concern also. One thing about Aspies (at least my son, for sure), they are very rule-oriented. My son does not think outside the box. If you say the stomache only hold four ounces, he will freak out if he thinks he consumed 4.1. Do you think he could do the all liquid diet? I think that is a good idea. I will look into that now. Why don't you try having him do a "pre-op" or "post-op" diet for a few weeks and see if he can handle that. If he shows that he can handle it then maybe you should look into it further. But him getting sleeved without resolving the food behaviors will result in failure. I definitely do not want that.

This is just my opinion. Thank you so much! I sincerely appreciate you taking the time to let me know your thoughts.

I wish you and your son the best of luck!! I can tell that you do. Thank you!

[Jillyr 1]

I think you need to get a couple of consults from both bariatric surgeons and psychiatrists (ideally those who work with bariatric patients), it's not something that you alone can decide, because it could turn out to be a disaster. I agree. That is good advice. I remember one of Dr. Aceves' coordinators told me a story about a patient of theirs who got a pass to go to the mall with another pt the day after his VSG and ate an ENTIRE BIG MAC while he was there. WHAT!?! OMG, how is that possible? His sleeve burst and Dr. Aceves had to perform open abdominal surgery on him to clean everything up and ensure he didn't die from sepsis. Obviously, this person had some sort of unadressed mental health issues to go and do something like that - and without the psych evals that happen if you go through insurance, he slipped through the cracks. Wow! You have to consult doctors who are experienced with Aspergers AND WLS to make sure something like that doesn't happen with your son. I totally agree. I am looking for help but it seems the WLS folks don't understand Aspies and the Aspie folks don't understand WLS. I am looking though. I appreciate you pointing this out. And if you go to Dr. Aceves for the actual procedure, I'd absolutely notify him of your son's condition so he's aware that your son may be in need of special care post-op. I definitely will. Thank you!!

[pumpkin07 32]

Perhaps another consideration for him could be gastric plication since it is reversible but still has restriction. Asking the doctor for suggestions is your best bet. Perhaps the sleeve is too drastic.

[latido 178]

Sensory issues are the reason I am scheduled for surgery. I narrowed my food choices down to a few foods that my body was unhappy about. Having the option to prepare healthier choices in advance with less possibility for being hungry is the win-win choice for me. It sounds to me like your son *is* an excellent candidate, albeit for non-traditional reasons. I can consult with you privately on this issue.

[latido 178]

@@Jillyr How is he doing? I am ten days post-op. My need for routine has disciplined me into a speedy recovery.

[Madam Reverie 2,958]

Ever considered the gastric balloon? Non invasive. Takes 30 minutes. Lasts 6 months. Seriously restricts intake. Will kick start sizeable weight loss.

I'd consider it a serious option - almost like a 'try before you buy' scenario.

If your son could handle that (given his condition) and stick to the rules, then maybe invasive surgery might be the next step in consultation with psyche's, etc.?

As it stands, I'd be wanting to see if he could firstly handle not being able to eat as much and then secondly, adhering to the rules.

Just a thought...

Best of luck

[latido 178]

Not to incite anything here, but autism is not a condition. It is a different perspective on thoughts and information. Majority of autistics today have higher intellect than their peers, so let's look for the positive reasons why he can succeed on this surgery, rather than listen to psych's who may not understand the complex and intertwined reasons why autistics have narrow/unwise food choices.

[Madam Reverie 2,958]

I get your viewpoint and understand the core tenet that it is a different way of thinking... However and not wanting to be a pedant;

'Autism is a lifelong developmental disability that affects how a person communicates with, and relates to, other people. It also affects how they make sense of the world around them.

It is a spectrum condition, which means that, while all people with autism share certain difficulties, their condition will affect them in different ways.'

Source: http://www.autism.org.uk/about-autism/autism-and-asperger-syndrome-an-introduction/what-is-autism.aspx

Whatever way you cut it, it is a condition and it does, in relation to having an invasive surgical procedure, require careful holistic management to ensure that the optimum weight loss solution for the respective individual, with their unique requirements, is found.

[latido 178]

The only disabling condition is the human one.

Thank you for understanding. As stated earlier, my autism contributed to my success, making me an excellent candidate for the surgery. My extreme discipline (which stems from a need for routine) is neurological, and not swayed by emotion. A definite win-win.

[Madam Reverie 2,958]

That's good to hear. Truly. I just hope that this little fella's personal requirements are taken into account and the right choice is made for him.

Not all surgical procedures are one-size-fits-all - thankfully!