VSG as a preventive measure?

[doxieville 799]

This question has been rolling around in my head for months. I've mentioned it once, but the thread was more interested in flaming IggyChic than having a real discussion. So here goes:

Do the veterans on here think that the sleeve is a good way to prevent obesity? Let's take away the danger part of it, let's say if it was 100% safe. (Just go with that idea for this question; we all know that no surgery can ever be 100% safe.)

From what I've been reading, I'd say it is NOT a good way to prevent obesity. It seems like the only thing that the sleeve is good for is relearning how and what to eat, and it does a great job of that. But if someone hasn't conquered their issues during the 'restriction stage' then how can this surgery help them in the long run?

I love my sleeve. I am in a 7 week stall and pre-sleeve I would have given up by now and regained the weight. I am so pleased with 4oz and I'm full! I am comforted in knowing that when this stall breaks, the weight will drop off. With that thought, I'm not saying 'screw it, i may as well pig out.' And at 5 months out, I can pig out. I was one of those people who would only eat once a day. Now I can't do that because I get that empty feeling. The sleeve has taught me HOW to eat. So for me, if I weren't conquering my food demons, I think this sleeve would be pretty worthless. I could easily graze on fattening & sugary foods all day and gain weight.

I am not bringing this up to judge people, or to start ANY arguments. In fact, if anyone flames me or this topic, I would ask that the thread gets shut down. I just want honest answers from veterans, and I hope that this is a safe environment to discuss this topic.

Thank you,

Judy

[iggychic 1,405]

Judy I think the stats show that it is a good preventative measure. Yes you can regain and many do, but they tend not to regain at the same level. To do so you have to be a)kinda stupid and really work at it!

Mind you there are plenty of people who do that But they aren't in the majority. (Thank god)

[Katie713 423]

I kind of wondered the same thing - having this surgery at 56 years old, I often wondered how much healthier I would have been for most of my adult life - and yes how much better I would have looked all those years. I thought to myself, "If only"...but then, I snap back to reality and have begun to realize that this was the perfect time for me to begin this chapter because I was READY to change.

I saw on this site, a short video of one of the nieces of a major bariatric surgeon from Mexico - it might have been Dr. Aceves who did the VSG on his niece who was a pre-teen at the time. She grew into a beautiful, young woman who maintainted a healthy weight over all those years and now is a huge proponent of VSG.

To take it one step further, I have a daughter who is 28 and I think she would do well with VSG since she has had weight issues since she was a teenager and I know what she is going through. She has a young son, and I do worry about complications and so I think it would have to be a decision she would make knowing that it is a huge risk. She is very proud of how well I have done and sees me as a role model. This would not be a preventative surgery, it would be to lose the excess weight and hopefully be able to sustain it as she lives her life.

[Butterthebean 8,146]

Judy, people have band to sleeve revisions all the time who have not yet regained all their weight. But the band becomes a problem and they need to remove it...and they know that if they simply remove that and do nothing else the weight will come back on in a hurry due to the change in metabolism. In those cases I'm all for it.

On the other hand, you've got a young 20 something who is 15 pounds overweight and doesn't want to have to fight weight problems in the future so she has WLS...I'm not sure I support that. Because as you say, she still will have to do the same things to keep the weight off in the future regardless of whether or not she has the surgery.

I think the surgery is great for people who already have the weight and are having trouble getting it off. The sleeve gives you a chance to lose it but you have to do the work to keep it off. For people who simply see the weight gain as inevitable, and want to prevent obsesity related problems in the future....I truly believe those people can prevent those issues with the same attention to health and nutrition without having surgery if they commit before the weight gain has gotten out of control....

UNLESS...there are diagnosed, underlying medical conditions which will lead to obesity regardless.....like disorders of the thyroid. Ought these people have WLS as a preventative measure when they know obesity is coming regardless of what they do? I don't know enough about thyroid disorders to know how likely that scenario is, but I'm willing to at least consider the possibility in these cirucumstances.

[iggychic 1,405]

The problem with this is that you actually can't remove the risks from the surgery. They're there and they will increase as we see more and more unprepared people move forward with it. I for one would do anything in my power to stop people from having this surgery as a preventative measure if they didn't have some dang good reasons for it. It's being used on models now to keep themselves stick thin....that's just not right.

I don't think the general guidelines of having been heavy for x period of time and showing an effort to comply (ie six month diet) are a bad thing. I think they should be mandatory for all candidates.

Now that won't make me popular will it LOL

And who is F and why on earth does he follow me about? I think I rejected him in highschool heh heh

[AussieLady 521]

I had quite a lengthy discussion with my surgeon about this. He said that a lesson had been learned from the surgery they used to call stomach stapling. It was found that they weren't making the stomach small enough and it was stretching back to it's original size and people were gaining the weight back on.

Therefore, tests were done to determine the ideal size with which people won't regain the weight. Of course, if you try hard enough, you will. Hence, the Sleeve.

[Catracks 865]

Other than band to sleeve revisions, I would say that it would be like removing your ovaries to prevent cancer before it happens. I see it becoming a trendy thing like those tube feeding diets. There are too many anorexics out there or wanna bees who would love this.

[sirensiren 67]

I had my VSG at a BMI of 31 (obese, but not morbidly so)- I was having joint issues, breathing problems, and I also have Hashimotos.

I am now at a perfect BMI of 20.5 and stable here (have been for 6 months!) and I am so glad I did it. While many may think it's only sound to get it done if you are over a BMI of 35, I was struggling to stay at a BMI of 31, and getting surgery when you are in better shape rather than worse is always ideal for your recovery, not to mention the adjustment is easier on your body and prevents issues like loose skin.

I say this all accepting that I was certainly at the "thinnest" someone should be who gets VSG- there is no reason for someone who is in good shape or only recently gained weight to go to the measure of having restrictive surgery. Though VSG is considerably "safe" and not as invasive as some other surgeries, it shouldn't be taken lightly. I have struggled with my weight and over eating all my life- I still enjoy eating, but not to the extreme extent that it sent me into emotional roller coasters before.

[NtvTxn 1,262]

I really can't imagine having this surgery if I were 25 lbs overweight and wanted to use it as a preventative, that said, I had NO health problems, not one. Everything except my weight was normal and my BP and cholesterol was on the LOW side of normal. All my dad's sisters and his mom were overweight their whole adult lives.....ultimately 325 pounds and above. I do say I did this as a preventive measure, it was a constant battle, a constant diet to maintain 228 lbs. When it came down to it, and if we are being honest, it was vanity that motivated me, but the possible health risks as I get older, did lurk in the dark recesses of my mind. I am hoping it's a win/win.

[clk 3,519]

This is the third or fourth time I've read through this thread and I finally want to post here. It will be long (I mean, even longer than my usual) so I apologize for that but I want to give a lot of detail because I invite conversation about this. I don't know that I have an answer for the OP, except that I think that the PPs are right and women that always want to be ten pounds lighter or anorexics would flock to get the surgery if it were offered as preventative. It's a huge risk and a massive lifestyle change so there's that to consider, too.

Before I go further I'd like to ask that I not get attacked for what I'm going to say. I welcome dialogue but I try very hard to be honest and realistic with myself.

The issue with preventative surgery is that we don't know what would have happened without it.

But I look at my daughter and I see myself. I see my mom. I see my grandmother and I see my sister. Understand, at 250 pounds I was the skinniest woman in my family. I come from a long line of fat ladies!

We do not talk about our bodies in my house in anything but a positive way. When we weigh, we simply state our "numbers" and move along. I put no emphasis, positive or negative, on the scale with my kids or my stepkids. I might want to gnash my teeth when I weigh, but we keep it together and we never, EVER put ourselves down or use words that make it seem that one size or body shape is preferable to another.

I have four stepdaughters (one with full blown anorexia) and two daughters of my own. My five and a half year old is a twin. She is beautiful and smart and as sweet and caring as can be. There is no denying any of this.

But she is also obese.

I do not ever say that to her and nobody else has, either. She has no idea that the way she looks is different. But she is going to start school in the fall and I'm sure she'll notice it soon. My second youngest stepdaughter was six the first time she came home and told me she was fat. If you have daughters or you remember being a young girl, you know what it's like and how girls rank themselves in school by smarts and by looks.

When we did their school physicals the doctor brought Ahava's weight up and I immediately jumped on her and asked her to wait to talk to me separately. We had to have blood drawn for tests - five vials of it! Everything came back normal or borderline, so no issues per the doc. Well, the same thing happened to me (and to my mom) every time they tested me until I got diabetes and they finally said, "Oh, you're insulin resistant." Gee, thanks for that - would have been nice to know what part of my issue is when I started seeing doctors about my weight when I was fifteen!

See, my daughter is not an unhealthy eater. This is the difference between her upbringing and mine. Her favorite Snacks are raw veggies. She does great with moderation and eats a good, balanced diet. Except when she eats a processed bread product, Pasta or rice - then it's like that carb monster wakes up and she insists she needs more food even when I know she's full. I never tell her not to eat more, but we try to divert her choice. Before we realized what an issue this was, the child could eat herself sick on Pasta - literally eating so much that she'd puke. Her body keeps demanding more and so she keeps eating.

I relate. It's EXACTLY what it was like for me prior to surgery.

She's active. She sees that I'm active. She never sees me binge on things (I used to witness my mom eating an entire bag of chips Ahoy or a box of Ding Dongs in a sitting as kid) and she is learning good habits and healthy ways to eat.

But she not only outweighs her twin by nearly twenty pounds (he's built exactly like my husband) she's also in plus size little kid clothes. I either have to buy plus for her or size up and hem.

It's hard for me. I am a cheerleader for her and I never want her to feel less if she's just made this way and cannot help it. But oh, it hurts me to think she might have the same struggles I had as a kid.

Now, in all fairness, she could hit a certain age and sprout up and thin out. We keep thinking it will happen (she's also 90th percentile for height) but it hasn't yet.

But all of that aside, I can see how I might consider this surgery for my daughter if she were still fighting her weight in her late teens or early twenties. I do not want her self worth tied up in her appearance the way it is for so many women (myself included, at times) but I also do not want her to feel bad about herself or make her wait for the inevitable health issues to trouble her first.

So it's a complicated situation and I feel differently about it now than I might have a year ago. I might have scoffed at the idea, but what would be different in my life had I been able to regain some confidence as a sixteen or eighteen year old girl instead of waiting another ten years? Don't we all say we wish we had surgery sooner? Haven't a number of us expressed frustration with the strict insurance guidelines that insist your life must be in danger before they'll help you? Where's the line here?

I certainly don't want her to develop diabetes in her twenties the way I did. Now, again, her lifestyle is totally different than mine. As twelve I found that one of the only things I could relate to my mom about was a love of food in massive, hidden quantities. And so began my own binges on boxes of Ho-Hos or Toaster Strudels in the middle of the night. If I can help it, she will never learn those things from me, but I wonder how we'd both feel later on if this is an issue for her despite a healthier lifestyle.

Anyway...enough rambling. I'm thankful for my husband who loved me better than I was able to love myself and who has stayed with me through that journey. He is wonderful with Ahava and is always reassuring her and helping her see that there is so much more to beauty than a size, shape, skin color, whatever. It's harder for me. I do it but I always feel like a hypocrite. I mean, I removed most of an organ to be skinny. Healthier, too, sure, but vanity was a huge part of it.

This probably makes no sense. Ugh...I need to find other ways to work things out for myself! I used to journal but when you have half a dozen kids in the house you learn that you have no privacy, even in the places where you thought you had some!

~Cheri

[JolieBug 82]

Cheri, that makes so much sense to me. I have an 8-year-old son who is also obese. I wouldn't tell him that, but we do have discussions about positive choices. If he is in late teens, early twenties and still following his trend (he is above chart max for height, too, though), I may consider it for him.

I don't want him to be as unhappy with himself as I was in college, settling for love that wasn't, marrying someone I didn't love because I thought he was the best I could do. I want him to be confident in his intelligence and self-worth. As a preventative measure, I won't do it to a child. But I can see it being a possibility for those with family history of obesity related health problems and an upward weight trend.

Jolie

[JolieBug 82]

I also have 3 1/2 year old identical girls. They see my relationship with food, which is much better than what my son saw. They are in perfect health, a little tall, right at the perfect weight. One is two pounds lighter. I don't want them to feel pressured to eat tiny amounts like I do, and it really bothers me that I get nauseous when I eat, so they think it's normal to need to throw up when full.

I think you and I just want to protect our children, but I can see some parents wanting their kid to be popular or pretty and going to extremes (think Toddlers in Tiaras as preteens.)

[courtoomp 107]

What an interesting post.

I can understand the emotional pull to sleeve at risk adolescents and also adults. I lived those tumultuous obese years like everyone here.

But I disagree with preventative sleeving. I am in medical school, and perhaps that education has swayed me. I look at it as cost benefit. Someone mentioned getting the ovaries removed as an analogy. It was a great analogy I think. If a woman has a family history of ovarian cancer she can get her ovaries removed prophylactically and can reduce her cancer risk. But she also will go into early menopause with consequences such as osteoporosis, infertility, etc. But this woman also saves her life. Presumably before having her ovaries removed the woman would have spoken at length with her doctor, researched, made preparations for how to best manage her health after the surgery for years to come.

Similarly, a 30lbs overweight woman may get the sleeve. Just like ovarian cancer there is still a risk of gaining weight with the sleeve. Also, the sleeve comes with risks...surgical risks, Vitamin deficiency, energy level. What worries me about making this option readily accessible is that unlike removing your ovaries (no vanity benefits here!), the sleeve and its associated weight loss will cause ppl to flock in for a quick fix without doing the necessary research to ensure they remain healthy. It's akin to getting your ovaries out to avoid having kids when you could have just take birth control or even had a hysterectomy!

Having said all that, if a patient feels the desire for a preventative sleeve and can pay for it and goes through a regimented and intensive education (I wish there were even stricter requirements than we see now) and therapy, then there should be an avenue for that. And through that education I would hope many preventative sleevers would change their mind bc they get individualized attention from their physician on how to lose weight and maintain a healthy lifestyle. Kind of like going to driving school to learn the rules is preferable to getting in an accident and then having to take a class on safe driving...

Sorry if that was wordy. I had to get it out there.

[Butterthebean 8,146]

This is the third or fourth time I've read through this thread and I finally want to post here. It will be long (I mean' date=' even longer than my usual) so I apologize for that but I want to give a lot of detail because I invite conversation about this. I don't know that I have an answer for the OP, except that I think that the PPs are right and women that always want to be ten pounds lighter or anorexics would flock to get the surgery if it were offered as preventative. It's a huge risk and a massive lifestyle change so there's that to consider, too.

~Cheri[/quote']

2 things....first of all, that was not nearly as long as some of your posts. LOL

And secondly, I get your point about the preventative measures. I too was always the fat kid and it shaped every facet of my upbringing. I'm sure the sleeve could have made my high school years much better and more "normal" if I had been sleeved when I was 14 or 15, but based on what I see now and what we've been talking about on the vets forum, do you think it would have a lasting effect on a teenager or young adult? Meaning....maintenance of course. Would maintenance be easier or more difficult for a 19 year old sleever?

I know we have a few sleevers that young so perhaps one of them will chime in.

[clk 3,519]

Meaning....maintenance of course. Would maintenance be easier or more difficult for a 19 year old sleever?

I think it could go either way. Teenagers are for the most part irresponsible and determined to fit in with their peers. So I could see it being a fight, much the way convincing my fourteen year old stepdaughter that she can't wear those shorts is a fight and that's not even getting into the serious issues kids can have. I also think it would make the binge drinking that many teens and college kids do even more risky.

But at the same time, a few years of ingrained habits vs. a few dozen? Or what if like in my case, the child has a mostly healthy diet and doesn't have those terrible habits yet?

I think that might make success easier.

I think one unintended consequence of having this surgery on a teen, especially a girl, would be the effect on her social circle. I have an anorexic stepdaughter and three other stepdaughters that all have huge body image issues. Even watching their mom struggle on diet after diet and talk about her weight was enough to exacerbate he issues that young girls are already susceptible to having. Watching me lose weight was hard for them! The fact that I wear the same pant size as two of my teenage stepdaughters completely freaks them out - instead of being happy for me or rejoicing that we're all healthy, they see it as some sort of competition and feel they need to be smaller because they're younger or something. It's insane.

So I can see that if one girl in the group starts eating next to nothing, even if the girls are college age and should know better, they're probably going to emulate or develop issues of their own, too.

I'd invite any feedback from younger sleevers about this. I'm not saying I'd do this and I have no idea how my husband would even feel about it (having never been overweight) and I also worry about the implications of even suggesting the surgery to my daughter.

What if she's larger and happy? I don't know, I wasn't but it could happen, right? Would I be reinforcing the idea that our worth, value and vanity has to be tied up in our pant size and the scale? I think I would be, even though I'd be trying to help her.

It's a tremendously complicated issue. And I can't even tell myself that I would have had a happier time as a teen or young adult if I had been thinner; it was just a symptom of my issues that caused additional unhappiness, not the cause of my misery.

~Cheri