maryanderson
For the past couple of years, my PCP has recommended that I have weight-loss surgery (WLS), specifically gastric bypass, and it's taken that long to wrap my mind around it and do the research I needed to conclude that WLS is the only realistic shot I have to substantially improve my health and quality of life over the long-term.
I have several comorbidities, including obstructive sleep apnea, hiatal hernia, GERD, asthma, depression (not primarily caused by obesity but certainly exacerbated by it), and recent degenerative joint problems (knees and hips). I have been doing less and less in daily life. I avoid being seen by others as much as possible and have become almost phobic about eating in front of others. In any given group of people, especially at work, I have been unable to shake feelings of inferiority based on my size, whether people are judging me for it or not (I always imagine that they are). For that matter, I believe WLS will be helpful for my career, especially as I age. (I wish the discrimination did not exist, but it does, and I am concerned about the impact on my job security, not to mention prospects for financial and other advancement.)
My father, now 76, has been morbidly obese for most of his adult life. When I was growing up, it embarrassed me (as did his alcoholism, although he's been sober now for almost 20 years, thank God). Now I have come to understand that I have that condition as well and that, for me, it is a disease. That understanding comes partially from some of the great research on the topic and from New York Times science writer Gina Kolata, whose book, Rethinking Thin: The New Science of Weight Loss, had a huge impact on me.
Also see "Rationale for the Surgical Treatment of Morbid Obesity", which is in complete agreement with the NIH consensus guidelines for treatment. So this is very much an evidence-based decision. WLS is fast becoming the standard of care for people who meet the insurance criteria.
Given my history with diets, the long persistence of this problem, a distressing recent gain (that put me into a new category), the fact that I already have comorbidities, the fact that my doctor has already recommended it, and what I know about the long-term efficacy of various approaches for people like me, it appears that WLS would be the only effective treatment.
Having no dependents, it didn't used to seem as crucial. Now, it tears me up to think about having finally met my significant other, Rick, and to have a much shorter time with him than I might have.
Someone who hasn't been in my place might find it extremely difficult to understand all the factors that contribute to obesity as a chronic disease, not to mention the tremendous odds (for someone who has reached my BMI) against achieving substantial, long-term weight loss through willpower alone.
Put another way, if this were cancer, which treatment makes more sense: one that gives me a 5-percent shot, or one that gives me a 50 percent to 70 percent shot?
Mind you, weight-loss surgery is not something I particularly want. Nor does it obviate the lifestyle changes; in fact, it makes them even more necessary. However, WLS is probably the only approach that gives someone like me a fighting chance over the long term. (This is what the science shows, folks.)
I have come to believe that the risks of not having the surgery now outweigh the risks of having it, and I will take every possible precaution. Anyone who thinks this is the "easy way out" does not know the facts and has no clue about what is required to do this -- including strict lifelong dietary and exercise requirements. I admire those few who have been able to lose a great deal of weight by conventional means and to keep it off permanently, and if I could have done that, I would have succeeded by now. I have tried many things, the weight always returns, and this is truly a last resort.
Several friends also have had WLS of various kinds, and their experiences and support have been extremely helpful. After further research and recommendations, I attended the complimentary seminar on October 6 with Dr. Joseph Afram of George Washington University Hospital here in D.C. The paperwork went through, I was approved on the first try (as soon as my insurance carrier received my thyroid test results and psych evaluation), and I am scheduled for Open RNY on January 15, 2008.
I believe that the gastric bypass is the best option for me. I understand what radical changes it will require, and I am ready. I think. Food has been my most faithful (albeit harmful) companion for most of my life, and I am ready to say goodbye to it as a dominant force in my life. I feel that I need the WLS as a tool to help me do that and as the most effective treatment for my condition. I am 51 years old, in generally good health apart from the comorbidities listed above, and I think now is the time. Now that I know what I know, I wish I had taken these steps sooner in my life.
