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The study that convinced me to have surgery



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"Bariatric Surgery is probably one of the most effective interventions in health care."

- Laurie K. Twells, clinical epidemiologist at Memorial University of Newfoundland [2]

Are you lurking on these forums debating whether or not you should have surgery? Unsure about making a permanent change to your lifestyle and body, or thinking that since you lost x number of lbs before, you can do it again? Heard about all the horror stories of complications and regain? This was me, one year ago. I want to tell you about the study that changed my mind.

This study[1] looked at three groups: 418 patients who sought and underwent Roux-en-Y gastric bypass (surgery group), 417 patients who sought but did not undergo surgery (primarily for insurance reasons) (nonsurgery group 1), and 321 patients who did not seek surgery (nonsurgery group 2). They performed clinical examinations at baseline and at 2 years, 6 years, and 12 years to ascertain the presence of type 2 diabetes, hypertension, and dyslipidemia.

Let me highlight a couple images from their study. These charts graph the amount patients lost as a percentage of total weight (NOT excess weight) at 2, 6, and 12 years relative to their baseline. First, this graph is the individuals who did not seek surgery.

image.thumb.png.ee5629a9900bd127e5fd1e70ec90a105.png

This group lost only 0.9% of their total weight 12 years after the study began. Those empty triangles? Those are people who ended up getting bariatric surgery anyways. Lets look at the second group, people tho sought out surgery but couldn't get it. So at least we are aware that this group is invested in losing weight.

image.thumb.png.29f12baa27f5ccb22c87e332d4d77957.png

This group fared slightly better, as patients lost a mean of 2% of their body weight at 12 years out. This excludes patients who got surgery (they lost an average of 10%). Lets look at patients who did get the surgery.

image.png

Patients lost an average of 26% of their total body weight even after 12 years. I found this difference absolutely remarkable. To reach that average 26% body weight loss without surgery, you would need to be in the top 5-10% of losers. Think about that.

I used to see getting the surgery as an admission of my own personal failure at willpower and dieting. But this study makes it clear that the probability of success for non-surgical options is astoundingly low relative to bariatric surgery. Studies [3], [4], [5] reinforce the positive impact on health that bariatric surgery has on patients who choose to go through with it. Reading these helped put my mind at ease. Bariatric surgery is one of the best decisions I could make for my health.

I encourage you to skim through the studies to see other benefits I didn't outline here. The NYT[2] article is also a great read for seeing why bariatric surgery is so effective. It distills a lot of the studies into facts that you can use to arm yourself when speaking with family and friends who aren't supportive.

Sources:
[1] https://www.nejm.org/doi/full/10.1056/NEJMoa1700459

[2] https://www.nytimes.com/2017/02/13/well/why-weight-loss-surgery-works-when-diets-dont.html

[3] https://link.springer.com/article/10.1007%2Fs11695-012-0718-9

[4] https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21322

[5] https://jamanetwork.com/journals/jamasurgery/fullarticle/2546331#Introduction

Edited by Double_Me

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At my last followup visit with my surgeon I had lost 103% of my excess body weight. He was so impressed. I have lost 53% of my highest recorded weight from 5 yrs ago. I did the diet roller coaster for yrs before having my RNY gastric bypass. WLS works if you do the work! It truly is a lifestyle change.

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Very helpful!

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Lots of people like to make claims about how effective or ineffective surgery is with anecdotes about success or failure stories they’ve experienced in their lives. So it’s great to have some studies with concrete, long term results 😁

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On 9/15/2020 at 10:53 PM, Double_Me said:

"Bariatric Surgery is probably one of the most effective interventions in health care."

- Laurie K. Twells, clinical epidemiologist at Memorial University of Newfoundland [2]

Are you lurking on these forums debating whether or not you should have surgery? Unsure about making a permanent change to your lifestyle and body, or thinking that since you lost x number of lbs before, you can do it again? Heard about all the horror stories of complications and regain? This was me, one year ago. I want to tell you about the study that changed my mind.

This study[1] looked at three groups: 418 patients who sought and underwent Roux-en-Y gastric bypass (surgery group), 417 patients who sought but did not undergo surgery (primarily for insurance reasons) (nonsurgery group 1), and 321 patients who did not seek surgery (nonsurgery group 2). They performed clinical examinations at baseline and at 2 years, 6 years, and 12 years to ascertain the presence of type 2 diabetes, hypertension, and dyslipidemia.

Let me highlight a couple images from their study. These charts graph the amount patients lost as a percentage of total weight (NOT excess weight) at 2, 6, and 12 years relative to their baseline. First, this graph is the individuals who did not seek surgery.

image.thumb.png.ee5629a9900bd127e5fd1e70ec90a105.png

This group lost only 0.9% of their total weight 12 years after the study began. Those empty triangles? Those are people who ended up getting bariatric surgery anyways. Lets look at the second group, people tho sought out surgery but couldn't get it. So at least we are aware that this group is invested in losing weight.

image.thumb.png.29f12baa27f5ccb22c87e332d4d77957.png

This group fared slightly better, as patients lost a mean of 2% of their body weight at 12 years out. This excludes patients who got surgery (they lost an average of 10%). Lets look at patients who did get the surgery.

image.png

Patients lost an average of 26% of their total body weight even after 12 years. I found this difference absolutely remarkable. To reach that average 26% body weight loss without surgery, you would need to be in the top 5-10% of losers. Think about that.

I used to see getting the surgery as an admission of my own personal failure at willpower and dieting. But this study makes it clear that the probability of success for non-surgical options is astoundingly low relative to bariatric surgery. Studies [3], [4], [5] reinforce the positive impact on health that bariatric surgery has on patients who choose to go through with it. Reading these helped put my mind at ease. Bariatric surgery is one of the best decisions I could make for my health.

I encourage you to skim through the studies to see other benefits I didn't outline here. The NYT[2] article is also a great read for seeing why bariatric surgery is so effective. It distills a lot of the studies into facts that you can use to arm yourself when speaking with family and friends who aren't supportive.

Sources:
[1] https://www.nejm.org/doi/full/10.1056/NEJMoa1700459

[2] https://www.nytimes.com/2017/02/13/well/why-weight-loss-surgery-works-when-diets-dont.html

[3] https://link.springer.com/article/10.1007%2Fs11695-012-0718-9

[4] https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21322

[5] https://jamanetwork.com/journals/jamasurgery/fullarticle/2546331#Introduction

This is such a fantastic summary of some really important findings. Thank you very much for posting!

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    • BabySpoons

      Sometimes reading the posts here make me wonder if some people just weren't mentally ready for WLS and needed more time with the bariatric team psychiatrist. Complaining about the limited drink/food choices early on... blah..blah...blah. The living to eat mentality really needs to go and be replaced with eating to live. JS
      · 1 reply
      1. Bypass2Freedom

        We have to remember that everyone moves at their own pace. For some it may be harder to adjust, people may have other factors at play that feed into the unhealthy relationship with food e.g. eating disorders, trauma. I'd hope those who you are referring to address this outside of this forum, with a professional.


        This is a place to feel safe to vent, seek advice, hopefully without judgement.


        Compassion goes a long way :)

    • Theweightisover2024🙌💪

      Question for anyone, how did you get your mind right before surgery? Like as far as eating better foods and just doing better in general? I'm having a really hard time with this. Any help is appreciated 🙏❤️
      · 2 replies
      1. NickelChip

        I had about 6 months between deciding to do surgery and getting scheduled. I came across the book The Pound of Cure by Dr. Matthew Weiner, a bariatric surgeon in Arizona, and started to implement some of the changes he recommended (and lost 13 lbs in the process without ever feeling deprived). The book is very simple, and the focus is on whole, plant based foods, but within reason. It's not an all or nothing approach, or going vegan or something, but focuses on improvement and aiming for getting it right 80-90% of the time. His suggestions are divided into 12 sections that you can tackle over time, perhaps one per month for a year if a person is just trying to improve nutrition and build good habits. They range from things like cutting out artificial sweetener or eating more beans to eating a pound of vegetables per day. I found it really effective pre-surgery and it's an eating style I will be working to get back to as I am further out from surgery and have more capacity. Small changes you can sustain will do the most for building good habits for life.

      2. Theweightisover2024🙌💪

        That sounds awesome. I'll have to check that out thanks!

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