Where The Ball Drops

[Folly 308]

As I've navigated through and reflected on this journey it's become evident to me that the medical community has completely dropped the ball. Prior to my WLS I was required to go to nutrition classes and lose weight. My physical health was adequately monitored. The part that seems absolutely irresponsible to me now is that I was only required to see a social worker for one visit to be deemed ready for surgery. What we're not talking about, not getting real about and continuing to be way too defensive about is the reality that something has gone desperately wrong in a person who eats until they are almost dead and can't move - and still keeps eating. I do not regret the surgery. I'm doing well. Life is good and all but if I had it to do over again I would do it in reverse. For me personally, it went from euphoria to complete emotional meltdown before it got better. People are so eager to hurry, hurry, hurry and take a run at it without really getting to the root of what's wrong. (I'm speaking in generalities here so if what I say doesn't apply to you please do not be offended - if you disagree with me I still love ya.) For me, and everyone I have ever known very well personally who was obese, the weight was the symptom, not the cause.

I truly believe, as I was going through the pre-op process, several months of therapy would have made a world of difference. The 300 pound wall of fat that I surrounded myself with kept me numb and apart - lonely but safe. When it got to 120 lost, 130 lost, 140 lost, etc the emotional pain got so intense it was overwhelming and I just couldn't figure out exactly what was wrong. Depressed, angry at the drop of a hat, fearful, anxious and always, always hurting. Getting up every day and plastering that phony smile on my face every day became harder and harder until I just couldn't do it any longer.

So I finally sought my answers and I'm ok - managed not to return to food but the process has been an ordeal. What I'm getting stuck on is the medical community has a pretty clear picture emerging of long-term success and failure rates of WLS. You can't just cut away part of a person's body and tell them to drink their Protein shakes expecting everything to resolve. Isn't it time to begin recognizing that just living like that in a world that judges and mocks you for it can devastate a person emotionally? Before we even get to what happened that made this behavior less painful than what we were trying to cover up can we at least start acknowledging that ?

The final thought I have is that we have to be very mindful of being smug when one among us struggles or loses their way. I've seen that a lot and I recognize it's really fear of joining them behind the unsupportive behavior and attitudes but it's still ugly. One of the things I like about this site is I rarely see us shooting our own wounded but even here it creeps in sometimes. I've been guilty of it myself. I hope I never make anyone feel bad but if I do, please tell me.

Peace

[Healthy_life2 8,324]

@@Folly

First..I'm not offended... I'm glad you have no regret and you are doing well.

surprised to hear you were not required to have a psyc evaluation as part of the approval process. This was a requirement for the majority of us. You were not given the information or a referral for counseling/therapy in Washington. What is going on with that surgeons office???? I understand why you have feelings about the drop the ball experience you had. This may be the surgeon that you used. My experience was very much the opposite. I can't say enough about St Luke's and the after care programs.

Issues with weight and behaviors were seriously intensified with my WLS. I could no longer ignore the issues. I was forced to address them. Actually dealing with my own crap was the best thing I got out of this process. (Yes the weight loss is great. )

[Jovie62 135]

I have to agree with you. I'm about 7 months post op and while the weight is coming off and I feel so much better I think my anxiety was getting worse. As I explain it to some people I had to basically give up every addiction over night and that is stressful! I used food for so many coping mechanisms that it made me a nervous wreck! I'm getting the help I need now, but it was miserable for awhile. So many mental and physical changes to deal with at once. That being said I wouldn't change a thing!

[Folly 308]

@@Jovie62

I think eventually you get to "it is what it is" and you deal with it. I went through Kaiser, by the way. My process began in California. The pre-op process was 3 months of nutrition classes and an assessment by a LCSW.

[Megdelyn 85]

I agree! Physicians as a whole tend to be dismissive of the mental aspects of our health. Not just bariatric surgeons, although one would think that doctors performing wls would be more in tune with the mental aspect of weight gain and loss.

I'm disappointed with the lack of follow-up care with my surgeon. It's not bad, the center has monthly support groups, required visits with a nutritionist, and a patient coordinator who is available to answer questions. However, I find that the support group is more like a pep rally and doesn't give me much support. And my 3 month f/u was scheduled for 4 months, and I'm told by other patients that I won't even see the doctor. I'm ready to cancel it and wait for my 6 month f/u. Why pay the copay just to get weighed on their scale and tell them I have no questions?

I've looked for support outside the wls community as well. I talk to a therapist and I've gone to oa meetings. It helps a lot.

[VSGAnn2014 12,992]

Well ....

Hmmmm ....

First, my surgeon's program did require a significant psychological assessment -- two hours' worth of paper and pencil tests, an hour-long consultation with a psychologist who works with bariatric patients, and a second results / feedback hour-long review with him.

Second, I did seek psychological help prior to VSG surgery. I started seeing a shrink 2 months pre-op and continue to see him. I plan to continue to see him during Year Two (which I'm now in) and through Year Three. After that, we'll see if I still need that support.

Third, I haven't had the kind of anxiety reactions that the OP described during weight loss or since reaching goal weight, and now that I'm 7 pounds under goal. Those weren't my reactions or responses to weight loss. So clearly everyone doesn't respond in the same ways to WLS and what follows.

Do I think most people would benefit from more therapy? I don't know. But I knew that I would, which is why I went out and secured those resources for myself pre-op.

BTW, it didn't take WLS for me to figure out that I had "issues" around self-care (that happened to be my issue, not necessarily others' issues -- we each have the issues we have, not necessarily the same issues others have).

[Folly 308]

Well ....

Hmmmm ....

First, my surgeon's program did require a significant psychological assessment -- two hours' worth of paper and pencil tests, an hour-long consultation with a psychologist who works with bariatric patients, and a second results / feedback hour-long review with him.

Second, I did seek psychological help prior to VSG surgery. I started seeing a shrink 2 months pre-op and continue to see him. I plan to continue to see him during Year Two (which I'm now in) and through Year Three. After that, we'll see if I still need that support.

Third, I haven't had the kind of anxiety reactions that the OP described during weight loss or since reaching goal weight, and now that I'm 7 pounds under goal. Those weren't my reactions or responses to weight loss. So clearly everyone doesn't respond in the same ways to WLS and what follows.

Do I think most people would benefit from more therapy? I don't know. But I knew that I did, which is why I went out and secured those resources for myself pre-op.

BTW, it didn't take WLS for me to figure out that I had "issues" around self-care (that happened to be my issue, not necessarily others' issues -- we each have the issues we have, not necessarily the same issues others have).

Maybe your not experiencing so much of the negative impact as some is due to having appropriate supports prior to and subsequent to weight loss.

What triggers us is as individual as we are. For you it was self-care. My issue was about long-term sexual assault and violence - being bigger made me feel safer from people.

I can't praise you enough for having the insight to get yourself the proper supports in place and then utilizing them. I wish I had known how desperately I needed to do this prior to jumping in with both feet.