When Is Weight Loss Surgery the Wrong Choice?

[Alex Brecher 10,512]

I came across this article about a woman who says she regrets her decision to get weight loss surgery 10 years ago. She had the gastric bypass at the age of 22 when her weight was 274 lbs. She lost 146 lbs., and then her life spiraled. She abused drugs, alcohol, and sex, could not hold a job, and even tried to kill herself. She also gained back 100 lbs. Here is the link to the article on Fox News.

After being forced into treatment due to an arrest for driving while intoxicated, this woman was able to make the choice to turn her life around. She finished her college degree, got sober, and got the mental health she needed. She now has lost 100 lbs. through changing her diet and ballroom dancing.

This young woman regrets getting the gastric bypass because she replaced a food addiction with even more destructive addictions.

First and most important, I am glad she has turned her life around!

Now, I have some questions for general discussion. I’d like to get your opinions.

Do you think she may have been too young for gastric bypass? This is a hard question in my opinion. On the one hand, people in their lower 20s do not have much life experience. On the other hand, I was fairly young when I got WLS, and I have never regretted the decision. So, when should a very young adult get WLS?

What do you think about her decision not to have psychotherapy? I think it underscores the importance of appropriate mental help. Maybe it would have prevented her from getting surgery in the first place and instead helped her work through some of the underlying issues. Or, maybe it would have helped prevent her from transferring her food addiction to other addictions.

Now, she is losing weight by making the right food decisions. WLS or not, that is the only way to lose weight. I wonder whether her gastric bypass surgery is helping now. It could be helping with portion restriction and nutrient malabsorption.

So….what are your thoughts on this story?

Here is the link to the article on Fox News.

[KristenLe 5,979]

I think she was a poor candidate for WLS to begin with. I wish more Bariatric Programs required Psych Evals and therapy if issues identified. It is very possible she would have had issues with substance abuse even without the surgery. It is too bad she didn't address her significant mental health issues before surgery. Very sad situation.

[Inner Surfer Girl 12,015]

It sounds like she truly believed the surgery would "solve all her problems".

The results of immaturity, abuse, trauma, addiction, and mental illness is not going be "solved" by anything let alone weight loss surgery.

Without surgery she would have certainly continued to abuse food and still may have turned to alcohol, drugs, and sex anyway.

Blaming the surgery for her issues doesn't sound very healthy to me. What would her life been like without it? You can't compare apples to oranges.

If she was unwilling to seek counseling before bariatric surgery should she have been denied? I don't know. A lot of folks of all ages go into this process blindly. Some actually learn and grow through the process. Some do not. Some people have the capacity for personal growth. Some do not.

If she was a poor candidate for WLS she still might have been able to learn from the experience.

If she had been a great candidate for surgery, she still might have wound up where she is today.

I just don't think there is necessarily cause and effect at work here.

This is much more complex than she or the article seem to acknowledge.

Yes, I think there needs to be many more mental health resources both pre- and post-op for anyone who is obese.

There certainly are not enough affordable mental health resources in the US period.

[VSGAnn2014 12,992]

Putting the blame for this young woman's failure to launch and her subsequent ten years of misery on her weight loss surgery is like blaming the Vietnam War on Elvis Presley's hips.

[CowgirlJane 14,259]

It's a crap shoot in some ways. I am not convinced that psych evaluation actually find the"poor candidate".

[2goldengirl 2,076]

She was a very poor candidate for surgery, and wouldn't have passed any of the evaluators I've worked with.

I think young adults who have been obese throughout their formative years need extra therapy in preparation for WLS. The combination of little life experience with the newfound sexual attention is mind-bending. Additionally, they may have even poorer self-esteem than many of the rest of us. I worry every time I see someone here in their early 20's.

[BigJnav3 174]

only time I can see a weight loss procedure as a wrong choice is of you don't qualify for it.

[Valentina 2,642]

She was a very poor candidate for surgery, and wouldn't have passed any of the evaluators I've worked with.

I think young adults who have been obese throughout their formative years need extra therapy in preparation for WLS. The combination of little life experience with the newfound sexual attention is mind-bending. Additionally, they may have even poorer self-esteem than many of the rest of us. I worry every time I see someone here in their early 20's.

Question: What do you think about the availability of psych eval "templates" online now? Anyone facing an upcoming eval for WLS can go online and review hundreds of questions asked by evaluators all over the country. What are your thoughts???

[2goldengirl 2,076]

A competent, ethical behaviorist doesn't rely solely on any of the standardized tools. The tools themselves are designed to flag responses where the candidate is giving answers they think will show themselves favorably, for one thing.

The other is that (here in CA, anyway, where insurance is paying), an evaluator also includes information from their interview with the candidate. I have worked on cases where the MD reviewing the request for surgery denied it and suggested the candidate re-apply after a period of psychotherapy and a psych re-evaluation.

[Inner Surfer Girl 12,015]

She was a very poor candidate for surgery, and wouldn't have passed any of the evaluators I've worked with.

I think young adults who have been obese throughout their formative years need extra therapy in preparation for WLS. The combination of little life experience with the newfound sexual attention is mind-bending. Additionally, they may have even poorer self-esteem than many of the rest of us. I worry every time I see someone here in their early 20's.

Question: What do you think about the availability of psych eval "templates" online now? Anyone facing an upcoming eval for WLS can go online and review hundreds of questions asked by evaluators all over the country. What are your thoughts???

I think that anytime you are less than candid and honest with anyone on your medical team, your psych eval included, you are only hurting yourself.

[Valentina 2,642]

@ISG: I couldn't agree more. If one isn't completely honest at their evaluation than isn't the evaluation invalid? It easy to give the "desired" answers if you know what they are before hand.

I hope we can just rely on evaluator knowing what's going on and will see "beyond" the rapid answers to "standard" questions and have a "Plan B".

I feel a bit better after 2goldengirl's response.

I just fear that some of the computer savvy generation will be the "what did I do this WLS for?" post ops we hear from way too often. I hope not, but fear so.

Maybe I'm get old and cynical.

Prayers going up for all generations.

[jaxmom 644]

I met a young woman by chance this weekend who overheard me telling someone I had just had Bariatric surgery. She waited till I walked by and said "I had it too, 2 years ago. It changed my life". She was stunning- athletic, healthy and so open. She said she was 22 when she had the surgery and it changed her life. She said she never would have been on vacation in Florida, as the "old her". All of the other girls with her had been with her through her journey and all pulled out pictures of her pre weight loss. In every picture she was on the side looking miserable. It was hard to place the vibrant smiling girl in front of me with those pictures. We all talked for a while and one of the other girls told me she wished her mom would have the surgery- she was worried about her health and she said it was sad... She was 27 and didn't have a single picture of her and her mom. Mom would never be in them. Overall, this generation is very savvy with research and open to discussion- I think if a 22 year old makes this decision they should be encouraged and supported in making a choice that can add years to their lives. My only regret every day is that I didn't do this years ago. I've missed so much. So now, onward!! :)

Sent from my iPhone using the BariatricPal App

I met a young woman by chance this weekend who overheard me telling someone I had just had Bariatric surgery. She waited till I walked by and said "I had it too, 2 years ago. It changed my life". She was stunning- athletic, healthy and so open. She said she was 22 when she had the surgery and it changed her life. She said she never would have been on vacation in Florida, as the "old her". All of the other girls with her had been with her through her journey and all pulled out pictures of her pre weight loss. In every picture she was on the side looking miserable. It was hard to place the vibrant smiling girl in front of me with those pictures. We all talked for a while and one of the other girls told me she wished her mom would have the surgery- she was worried about her health and she said it was sad... She was 27 and didn't have a single picture of her and her mom. Mom would never be in them. Overall, this generation is very savvy with research and open to discussion- I think if a 22 year old makes this decision they should be encouraged and supported in making a choice that can add years to their lives. My only regret every day is that I didn't do this years ago. I've missed so much. So now, onward!! :)

Sent from my iPhone using the BariatricPal App

[Tommy Joe 113]

Alex if I can ask how much weight did you have to lose? I'm 245 and 5 9 and getting the bypass on the 27th through BPMexico. I know I need to lose 70 or 80 pounds . I am using the surgery as a inducement to change my eating permanently. I've lost weight five or six times in my life before , ate healthily, exercised, then quit and got fat again like the young lady did. This time my thoughts are I will take this very serious step and I will have a physical assistance to losing weight as well as my mental determination. Is that correct thinking? Do people needing to lose 70 to 80 also succeed with bypass? Just curious

Edited May 2, 2016 by Tommy Joe

[Cervidae 2,389]

Hearing stories like this always frustrates me. I was 21 when I first started thinking about wls, 23 when I had it, and now I am 24 and 198 pounds down from my highest weight. It's true that we don't have the same amount of life experience as someone 20 or 30 years older. We have, however, had plenty of experience with being fat and seeing just how much it limits us. In some ways, the very obese young who seek out wls have a unique and important perspective. We haven't been living this way for decades, and so have not experienced the decades of routine bodily abuse and psychological damage many older patients have. We don't have the safe, routine life, a stable job yet, or a family, or even a spouse in most cases. We haven't had time to settle into our bad habits and continue it for many years, but have had enough time to see just how damaging obesity is and would continue to be if we don't seek change.

It seems to me that young people who get this surgery are made of two major groups: those who are wiser than their years due to the difficulties we face at this young age, and those who get wls for all the wrong reasons and far before they are actually ready. For those of us who are successful, we are lucky enough to be where so many older wls patients frequently lament they cannot be. How often do you read of or hear a person say "I wish I had done this years ago!"?

Not to mention, I have read MANY stories just like hers from people of all ages. You don't have to be young to be doing this for the wrong reasons, or to think it will solve all your problems, or to pick up a transfer addiction. In fact, of the few people my age who have gone through with this, I've seen a much lower "failure" rate than the rest of the population. I suspect this is because people our age face an entirely new and very difficult beast because we are so young, because we are unstable, and because we must be desperate to risk our lives at such a young age just to be healthy and normal.

I think this has little to do with her age, and a lot to do with the fact that she was just not approaching wls from the correct mindset. She thought it was a fix instead of a tool. It's a sad story, but I highly doubt we won't be hearing more like it. The good news is, more people succeed than fail, so that's always encouraging.

[Tommy Joe 113]

Cervidae you speak with wisdom and I admire you. Maturity and wisdom are found at many ages. You hit it right on its a tool not a fix