BMI of 21 getting gastric sleeve... thoughts?

[higher 966]

It's kind of funny that the forum mod literally called the OP a troll and then came back later to admonish everyone for using the word troll. This forum cracks me up.

[LisaMergs 2,857]

Let's please keep this conversation civil. It's against forum rules to call other members names etc. Let's just be NICE. if you don't have anything nice to say, don't say it here.

Alex- and this is one of the reasons I've been mostly dormant for the last couple of weeks- and I know others have, as well.

This forum, from my understanding was for people legitimately considering weight-loss surgery or had had weight-loss surgery due to obesity. How any of us got to that state makes no mind. This young lady, and I'm assuming it is a woman, is not obese--whether or not she has an actual eating disorder or is just trying to fill time in her day still doesn't belong here. I think the prudent thing you could've done is reached out to her privately, perhaps suggesting another forum

for people with eating disorders that don't require weight-loss surgery. Alex you know as well as the rest of us who have gone through or going through this how difficult it is. Having a person come on like this quite frankly is not only ridiculous but a slap in the face to those of us who have truly struggled at our highest weights where our life was in jeopardy due to comorbidities and such. This person does need help just in a different way and in a different venue.

Calling out the members on this forum for even having to question her or who want to try and understand her as her story grows more odd by each and every post she makes seems below the standards you set forth not only for behavior but for the reason of this forum. Alex you're the face of this community, and so many of us appreciate the fact that you established it, but allowing people to come in here and basically taunt us with their nonsensical post and comments is below the belt.

The fact that you reinstated her under her original identity here is quite a sad fact.

Now to the original poster, I happen to live in Chicago. I happened to have graduated from one of the top universities in the Midwestern states right here in Evanston Illinois. I'd be happy to meet with you and take you to see some of my colleagues and prior professors who might be able to give you the help you need. And if you'd prefer to do it in Michigan, I have a summer home there, plenty of friends and colleagues in that state as well.

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[LipstickLady 25,682]

I read this thread yesterday and had chosen not to comment when I saw Alex had banned the OP. I was disappointed when I logged on this morning and saw the thread still going and still more disappointed when I saw Alex’s post admonishing everyone to support the OP. And yes, taking the ENTIRE thread into consideration, I do consider it an admonishment. So my post here is directed more toward Alex and not the original poster.

First let me start by saying, you have created a wonderful forum where literally thousands from around the world have been able to come and do research, receive inspiration from others’ stories and get their own questions answered by those who have been there and done that. I commend you for that. This site has been a valuable resource for me and your personal success story an inspiration as well. I typically find your posts thoughtful, informative and understanding. Which is why the turn of this thread has concerned me.

So often on this site (and seems to be more prevalent by the day), the idea of “support” has come to mean condoning and even so much as encouraging poor and potentially dangerous decision making. And often the ones who dole out the “tough love” that isn’t what a poster wants to hear are sadly vilified as not being supportive when in actuality they are often the ones most concerned with other’s health and understand that sometimes the harsh reality is what someone really needs to support their long term health goals. Support should never be equated with “enabling”.

To recap: the OP is currently at a healthy/normal BMI for her height, wants to get a lower weight within the healthy/normal BMI range and admits she has Binge Eating Disorder (BED) and will be getting a VSG as a cure for her BED.

Vertical Sleeve Gastrectomy nor any other weight loss surgery is NOT an approved, safe, effective treatment let alone cure for BED. I’m including a link below where even for obese patients with BED, the author is cautioning patients to not consider VSG as a treatment for BED. The author correctly asserts that WLS is helping to treat the obesity – a SYMPTOM in this case of BED, and is NOT treating the actual eating disorder.

https://www.eatingdisorderhope.com/information/binge-eating-disorder/binge-eating-disorder-bariatric-surgery-or-the-sleeve

Binge eating disorder is a legitimate and very serious psychological disorder that has a tremendous negative impact on the lives of those suffering with it. There are several approved safe and effective treatments for managing BED while the patient continues to be in appropriate psychological treatment to get to the root cause that triggered the disorder and help them discover better ways of handling those trigger rather than binging. And yes, I am familiar with those treatments because I was member on a team of scientists and others researching, developing, and testing in many clinical trials to prove safety as well as efficacy, and eventually obtaining approval for one of those treatments.

I reiterate that WLS is NOT considered a treatment/cure for any eating disorder. As most of us on here realize, it is not a CURE for anything. The surgery is merely a tool to help get the obesity under control while we address the mental aspects that led to the obesity. The reason WLS surgery is an appropriate tool for this is because the further complications that the obesity leads to (sleep apnea, high blood pressure, diabetes etc) can and often will short our lives significantly thus making the need to get the obesity dealt with worth the associated risks/potential complications of a major surgery. Again, the WLS is treating the symptom – obesity – not the cause whether that cause be BED, emotional eating or any other issue that leads to a poor relationship with food. Even with WLS, for long term success and maintenance the cause ultimately has to be dealt with as well.

The OP stated she has “tried everything” for her BED yet didn’t mention a single treatment specifically. Based on all of her posts, she appears to be of the thinking the surgery alone will cure her. Honestly I spent a lot of today trying to find sources or any studies of WLS in healthy BMI patients with regard to eating disorders. You know what? I couldn’t find a single one. All studies I found regarding WLS and eating disorders – were on obese patients. Because the studies recognized that the WLS really was only treating the obesity and the studies all seemed to conclude the same thing with regard to eating disorders – WLS showed temporary effect on the eating disorder itself but that long term, the eating disorder needed appropriate treatment on its own – WLS is NOT a cure for an eating disorder.

Using steak as an example (since the OP mentioned that as a food she binges on), WLS will reduce the amount you can eat in one sitting but it won’t stop you from eating 3 oz of steak every hour, 24 hours a day.

Now to the Original Poster. You have clearly already made up your mind to have the surgery. In fact your initial post you said you were ADAMANT about going through with the surgery – so I’m not really sure why you posted asking for others thoughts when you said up front your mind was made up. So I won’t try to talk you out of surgery. I hope you do come to realize though that surgery is not treating your actual medical disorder and that you see a reputable doctor specializing in binge eating disorder and seek appropriate treatment for the BED otherwise, I feel you will be very disappointed with your longer term results.

apologies for the VERY long post above, but this has bothered me all day and I felt these things needed to be said.

Excellent post! @@Alex Brecher

[LipstickLady 25,682]

Let's please keep this conversation civil. It's against forum rules to call other members names etc. Let's just be NICE. if you don't have anything nice to say, don't say it here.

Alex- and this is one of the reasons I've been mostly dormant for the last couple of weeks- and I know others have, as well.

This forum, from my understanding was for people legitimately considering weight-loss surgery or had had weight-loss surgery due to obesity. How any of us got to that state makes no mind. This young lady, and I'm assuming it is a woman, is not obese--whether or not she has an actual eating disorder or is just trying to fill time in her day still doesn't belong here. I think the prudent thing you could've done is reached out to her privately, perhaps suggesting another forum

for people with eating disorders that don't require weight-loss surgery. Alex you know as well as the rest of us who have gone through or going through this how difficult it is. Having a person come on like this quite frankly is not only ridiculous but a slap in the face to those of us who have truly struggled at our highest weights where our life was in jeopardy due to comorbidities and such. This person does need help just in a different way and in a different venue.

Calling out the members on this forum for even having to question her or who want to try and understand her as her story grows more odd by each and every post she makes seems below the standards you set forth not only for behavior but for the reason of this forum. Alex you're the face of this community, and so many of us appreciate the fact that you established it, but allowing people to come in here and basically taunt us with their nonsensical post and comments is below the belt.

The fact that you reinstated her under her original identity here is quite a sad fact.

Now to the original poster, I happen to live in Chicago. I happened to have graduated from one of the top universities in the Midwestern states right here in Evanston Illinois. I'd be happy to meet with you and take you to see some of my colleagues and prior professors who might be able to give you the help you need. And if you'd prefer to do it in Michigan, I have a summer home there, plenty of friends and colleagues in that state as well.

Sent from my iPhone using the BariatricPal App

And another. @@Alex Brecher

[Alex Brecher 10,516]

And another. @@Alex Brecher

Is there an echo in here?

[LipstickLady 25,682]

Maybe?

Possibly!

Yup.

[Alex Brecher 10,516]

I initially banned the OP because I thought she wasn't real person and just someone trying to garner attention and cause trouble. After having a private conversation I realized she was a real person and unbanned her. I don't agree with her stance and don't condone getting surgery when one has an eating disorder. I don't ban members for that, though. I keep these forums open to everyone and we don't discriminate. You can (politely) explain your stance why you feel she's making a big mistake but there's no need to call any member names. That was the only point I was attempting to make.

[LisaMergs 2,857]

I initially banned the OP because I thought she wasn't real person and just someone trying to garner attention and cause trouble. After having a private conversation I realized she was a real person and unbanned her. I don't agree with her stance and don't condone getting surgery when one has an eating disorder. I don't ban members for that, though. I keep these forums open to everyone and we don't discriminate. You can (politely) explain your stance why you feel she's making a big mistake but there's no need to call any member names. That was the only point I was attempting to make.

And some of the most diabolical individuals in history easily passed as "real", "normal", people. A good liar can fake anything. That is a fact. When you read her posts and how each become progressively more odd, more fantastical, it is a red flag.

I stand by my original comment to you- gently guide her to some place more suited to her needs. Which seem to be on a psychological plane more than anything else.

I must say, at one point, I almost thought it was so absurdly constructed that it was a person doing research on forums of any kind, or perhaps particularly WLS related to see how a "fat" or previously "fat" person would react to a thin person's perception of body image. ...... Then I went back to my original thought that this person was just bored and looking for attention.

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[Havasumoma 250]

I don't see why you should or would care what other people think about your decision. It is a matter for you and your healthcare providers to decide. We have neither adequate information nor experience.

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[chycky 671]

I can appreciate that Alex, but I would add that it didn't come across like that and it would have been good for you to share background.

I support freedom in forum and less policing. But, pasting in multiple website forums, being a constituent of another health crisis and not one that is the subject of forum (ED or anorexia or bullemia not wls obesity), and posting commentary that demonstrated an urgent psychological crisis ---to me, seem like someone that should have been directed elsewhere and not welcomed to continue radical discussions.

It is almost like spam for a product that no one should want or is unsafe. I would also worry about how reputable users or physicians would view the site as a support tool in seeing a topic and poster lobbying for 21bmi wls.

You are balancing a lot and I guess I prefer you being more open than restrictive, I think we deserved your most recent clarification as soon as this person reappeared.

[Anna Nim 196]

Get help. VGS is NOT what you need. Period.

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[Veronivt 10]

Free school counseling is not enough for an eating disorder. Use the money you were gonna spend on surgery to get a good psychologist that deals with binge eating disorder. It just seems like youre looking for a quick fix and this is not the way. You'll end up trying to do something else next year when you figure out that surgery does not fix an eating disorder. They're not cutting out your brain and that's where your impulse to eat is coming from. Take your own advice and "stop being lazy" and put in the work to fix your head not your stomach.

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[Inner Surfer Girl 12,015]

I would agree that counseling through your school may not be enough, but it is a good place to start, especially if you need help finding someone who specializes in eating disorders. I would think most college counselors would have a line on the resources available to you in your area.

[111 118]

If you're adamant about having WLS, try looking into less invasive surgeries like the balloon or even Aspire Assist. The balloon restricts how much you eat and is adjustable, much like the lap band you had. Aspire Assist is sort of like medical bulimia but a little different. You eat the normal amount of food and then partially empty your stomach contents in the toilet. In order for it to work properly, you have to chew your food to applesauce consistency. Chewing your food promotes mindful eating, which is a big thing for BED.

On that note, I have to say that I echo everyone else on this thread and say that what you need is to see a good psychologist specializing in eating disorders. This will be an ongoing process. You may even have to see the psychologist for many years. Fixing an eating disorder is not an overnight thing or even a few weeks thing. I really hope you do the right thing and not go for WLS. Good luck to you!

[Clementine Sky 708]

again, my goal is not to lose weight from a vsg. I want to reduce the size of my stomach so that I can have more control over my portions. My endoscopy results from years back show that my stomach is much larger than the size of an average person's stomach. which is the reason why I am able to eat such large volumes of food.

I am planning on gaining at least 30 pounds before my surgery because otherwise it would be extremely unhealthy for me to lose weight at my current weight right now. Reading other peoples posts losing 30 pounds seemed like nothing for the first few months...

Do you have a good therapist? Have you talked this through with a professional who works with people with eating disorders?

to be honest i went through therapy couple years back but it did not help. I have not talked this through with a professional who specifically deals with eating disorders.

but trust me, i did EVERYTHING that i could think of doing to try to solve my eating problem with no avail. Saying that the vsg is my choice of last resort is an understatement.

This is like someone with a type of cancer that has a high survival rate if proper medical treatment is obtained claiming they did everything possible to no avail ------- except consult an oncologist and undergo proper medical treatment.

You need to pursue ongoing, dedicated treatment with a professional who specializes in treating eating disorders, and genuinely be receptive to it. Many people with eating disorders have benefitted significantly from cognitive behavioral therapy, but it's not instantaneous. It requires patience and resolve. There are also medications that have been helpful. Research has shown that dysfunction of the serotonin system or dopamine system in the brain may be associated with binge eating disorders. It has more to do with your brain and your habits than the size of your stomach.

The VSG will not be curative to an eating disorder. One of my friends / colleagues had WLS right after she graduated from college, and now at 30 is far larger than she was before it. She'd always used eating as her coping mechanism for stress, joy, and loneliness, and that didn't change after her surgery. While working on her PhD and dealing with a heartbreak she put back on all weight she lost, and considerably more. It actually became somewhat of an embarrassing issue at work for her because she was absent-mindedly eating food that belonged to other people from the staff kitchen, and got caught. You really only have a tight restriction immediately after surgery when your stomach is still healing. After that, there are many ways you can maneuver around the restriction and consume ample calories to stall out weight loss, or substantially gain. Calorie-laden liquids like Frappacinos will slide right down, as will ice cream, frozen yogurt, Desserts, and many other fattening foods. Drinking while eating can allow many people to consume more food. It's a form of self-sabotage, but you've demonstrated that you're already prone to this behavior. Even when you do have a tighter restriction, what you eat is as important as how much you eat. There's a bariatric surgeon on YouTube named Dr. Matthew Weiner, and he's made several videos discussing why people regain weight post WLS, and he emphasizes that point.

I definitely think having the lap band removed is necessary, but definitely do not think the VSG would be beneficial for you. At the very least, why not at least wait a while? Has your mom put a time limit on how long the funds will be available for you to use? You could make an honest effort to undergo appropriate treatment for your eating disorder, and if you still want WLS in two years reconsider it then.