Question:
My surgeon says I have too loose 50 lbs. has anyone else heard of this?

My surgeon wants me to loose at least 50 lbs. He says that I wouldn't fit in the mri machine ,that the weight limit is 300 lbs. I weigh about 390.Has anyone else heard of this.I would appreciate any input.    — Patricia Stephenson (posted on May 18, 2005)


May 18, 2005
It sounds like the doctor is holding you to the limitations of the machinery and equipment at the hospital he plans to use. Can you find another doctor, or will this doctor allow you to go to a hospital that has larger equipment? The hospital I was in had equipment specifically designed for large patients such as wider wheelchairs, sturdy beds, larger sized gurneys, etc. Even the hospital gowns were large enough for us bariatric patients. It was the first time a hospital gown covered me entirely!
   — Shayna T.

May 18, 2005
Ask your doc if there is a place that has a open MRIm You should not have any problem
   — Betty G.

May 18, 2005
My suggestion is to look for another surgeon who doesnt require the weight loss due to "equipment issues". If the hospital your current doc works at isnt equipt well enough now to offer you as a patient the necessary tests for your life-saving surgery, then how will they be during and after the procedure? Also at the same time, since you are seeking a new doc anyways, I would look for one who has experience and is skilled in working with high BMI patients. Those docs already have the necessary equipment to deal with bariatric patients and most even understand that its not that easy to lose 50# just because they would like us to be smaller. They have the skill to operate no matter if we are 100 pounds overweight or 300 pounds overweight. Just make sure you check out all aspects and go with who you feel most comfortable and not just the closest. Although I noticed you are in Marietta...you have an excellent DS doc right in your own city. I would beg that you call Dr. Dennis Smith Jr. and at least go to a consultation with him. He does all the surgeries - RNY, DS, and LapBand. That is a definate plus because he wont be biased on one surgery over the other and give you false information. He will most likely offer you what is your best option for your current health situation and for your long-term success. His site info can be found on (www)(dot)advancedobesitysurgery (dot) com I personally travel 3 hours (6 hrs roundtrip)to Chicago for my surgeon and all my followups and I am glad I did. And I have no regrets. =) Good luck on your journey to better health.
   — ImANewDee

May 18, 2005
been there, and its not just a weight requirement on the machine.the MRI report can read...poor imageing due to large body habitis....meaning i was to dame fat for the test and they couldnt get a conculisve report.now that i have lost 92lbs...im having another MRI to see what really going on. you other option is a sit-down MRI..but the "large body habitis" can cone into play there also. All the Best! Tracey
   — traceybubbles

May 18, 2005
See if you can find a "stand up" MRI. My mom is claustrophobic and could not take going through the tunnel so they had her go to a special facility that had a stand up MRI where it's like a little room. Ask your doctor if he knows where one of those are.
   — Kara J.

May 18, 2005
I have never heard of having to lose 50lbs before surgery, but i have heard of 10-20lbs. My surgeon only requires me to be on a 10 day liquid diet, which will probably cause some weight loss.
   — lovejj01

May 18, 2005
Find a new surgeon,one who is equipped to handle someone of your size. A MRI isnt a normal pre op test, whats it needed for? You can ask on the georgia state message board too, for futher info.
   — bob-haller

May 19, 2005
Yes, most definitely and I hear it all the time. You are in the super obese category and with that comes a fatty liver. With a fatty liver it makes it much more difficult for a surgeon to maneuver around and actually perform the surgery. Also, it makes the complication rate less and recovery much much easier. It could also be that your surgeon you decided on wants to know you are going to dedicate yourself after surgery. It will be work in the end. I struggle with maintenance daily. I was at 287 the day of surgery and my surgeon had told me as well to lose weight prior to surgery. So yes it is VERY normal for a surgeon to require this. Good luck darlin and I wish you much luck in your journey. YOU CAN DO IT girlie!!!!! Hugs..Erika
   — Egyptianeyesdiva

May 19, 2005
I would say look for a new surgeon. We can get so sucked into wanting this surgery so bad we forget that we have options and it is our body and we can choose a Dr. who meets out needs. Not just jump on the first doctor you see.
   — **willow**

May 19, 2005

   — [Deactivated Member]

May 19, 2005
Thank you Diana Cox! that was put so well that I'd like to save it to forward to every person who has to deal with this!
   — **willow**

May 19, 2005
Yes I have heard of some surgeons and insurance companies requiring some patients to lose some weight before doing surgery. I am just grateful mine doesn't. I weighed 300 when I applied but when I went to weigh in, I weighed 287 and don't know how. But yes I have heard of it and I hope this helps.
   — Angelfirewithwings

May 19, 2005
Diana, I would LOVE to see your documented information!!! I disagree and honestly don't believe everything you just stated. There IS documented information and I hope YOU do your research and your surgeon before you start giving out medical advice to a preop. My boss' best friend is a liver Transplant surgeon at Baylor and wholly agrees with the fatty liver FACTS. My two cents!
   — Egyptianeyesdiva

May 19, 2005
Let me just tell you that I wish now that I had been required to lose some weight before my proximal RNY. My preop weight was 368 lbs. I lost 120, regain has been about 10-15 lbs and there I stay. My lowest weight was 247. At 6' tall I would have liked to have at least gotten below 200. Perhaps I should have asked more questions, discussed Distal vs Proximal. Not sure my surgeon does distal surgeries. But one thing is certain in my mind losing some weight would not have hurt me in any case. I also would have benefited from learning and applying some of the eating habits/diet required post-op. If you do not choose to look for another dr, do not look at required weight loss as a totally negative requirement.
   — SARose61

May 19, 2005
I am not Diana Cox, but I do know what my own research has shown me about the liver. Here is what I copied from the American Liver Foundation's website: "Obese patients with fatty liver will have reduction or loss of excess fat in liver cells, as well as in other cells in the body, if substantial weight loss can be achieved." -- Basically it is saying that substantial weight loss will reduce a fatty liver, is 10-15 pounds substantial when, like me, you need to lose 100+ pounds as a pre-op? My surgeon does not require weight loss before surgery nor does he put you on a diet of any kind pre-op. I was put on a liquid diet by my PCP prior to surgery with the blessing of my surgeon, but it was NOT a surgical requirement. You can read more about non-alcoholic fatty liver disease at the American Liver Foundations website http://www.liverfoundation.org/db-select/articles/CatNonAlcy/1/1/ascend/Validated Also read this from the hepatitis central under the title of Fatty Liver and Nonalcoholic Steatohepatitis: "Cirrhosis, due presumably to nonalcoholic steatohepatitis, may be found unexpectedly in up to 6% of patients undergoing gastric bypass surgery for morbid obesity. Most surgeons do not view the discovery of subclinical cirrhosis at surgery to be a contraindication to proceeding with gastric bypass surgery despite a reported perioperative mortality rate of 4% in this group of patients." This is website http://hepatitis-central.com/hcv/liver/surgery/risk.html My other reference is http://www.americansurgical.info/abstracts/2005/28.cgi where it states: "Surgically induced weight loss results in significant improvement of NAFLD and of the metabolic syndrome." From http://www.gastro.com/html/liverdisease/fatty_liver.shtml it reads: "To find out for certain whether a patient has fatty liver requires that a sample of liver tissue be obtained (biopsy). Images of the liver obtained by an ultrasound test or by a computed tomography (CT) scan can suggest the presence of a fatty liver." And lastly, from http://www.findarticles.com/p/articles/mi_m3225/is_12_69/ai_n6158102 (which did not include patients who had WLS, but their findings are significant since the person asking the question is a pre-op): "The authors conclude that even though weight reduction is considered an effective therapy for nonalcoholic fatty liver, few data support or refute this recommendation. They add that there is a need for randomized controlled trials to determine whether weight reduction in these patients is beneficial."
   — Shayna T.

May 20, 2005
Some doctors require that you lose weight before surgery to decrease the size of the liver. The liver sits on top of your stomach and it is more difficult to do the surgery if it is large. It will make surgery safer for you. Mona
   — monymony

May 21, 2005
I would just like to say if we could loose 50 pounds on our own we would not be hqving surgery in the first polace...I think you should check out more surgeons and get more opinions..Just my opinion..have a nice day...
   — mystic0619

May 21, 2005
I think the previous posters have made very good points. But to play devil's advocate, there are circumstances under which I don't think this is a bad requirement. <P> Chances are, your diet history fits into one of three categories. First, maybe you have a diet history of busting your butt to lose weight only to regain it. Second, you have a history of busting your butt and honestly couldn't lose the weight no matter how hard you tried. By that I mean, full compliance with a good plan but no weight loss, not inability to stick with a good diet 'n exercise plan for any length of time. Or,third, you have a history of never really dieting and exercising long enough to see what's involved. Based on questions I see here, I have the impression WLS patients come from all three groups. equirements of a prior diet history. <P>If you belong to Group 1 (can lose it, but can't keep it off), you can meet the 50-lb loss requirement. Why? Because unlike every other failed diet you did before, you'll have surgery here to keep you from regaining that weight, and to help you lose a whole lot more.<P>If you're in group 2, then this requirement is total B.S. because you'll never be able to meet it, and so it's time to get a new doc.<P>If you're in group 3, this isn't an unreasonable requirement. Plenty of people regain as post-ops because the same habits they could never reign in as pre-ops return, and it's easy to "eat around" any WLS surgery in the long run. Having some real dieting skills to blend with your WLS helps fight that. <P>Just another perspective. I just don't see this as an outrageous thing to require (unless you're in group 2, which I believe very few people are). This is a life-saving operation being offered here. To me, this seems a small price to pay for getting yourself on the road out of Morbid Obesity, and makes you a more active participant in the process than those who "last-supper" their way into significannt pre-op gain.
   — Suzy C.

May 21, 2005
I think, if I were you, I would just do what your dr has asked. He is the one who is doing the surgery. My doctor has also asked that I take off some weight (I weigh 415) before surgery. And for all of you people who are saying get another dr, get another dr..... let me tell you a story about a lady that I met at my dr appt the other day... As I sat there, trying to read a magazine (I couldnt I was too excited about seeing my WLS dr for the 1st time) a really pretty lady came in. I asked her after a few, if she was there to see my dr, and if she knew if the appt took a long time. She said that it was her 1st time, and that she was from OK. She stated that she was sent to see my dr as a last resort. She said that her dr had NO requirements, and that he took her right in for surgery. He did not do her surgery correctly, and she couldnt eat anything without throwing up. THis went on for a year and a half! Finally when they realized that something was wrong, her esophagus was damaged. She cant swallow anything and keep it down any more. She eats out of a tube from her arm, and was going to my dr to see if he could save her life!!!! DO WHAT YOUR DR SAYS!!! Dont take other peoples word for it. If you dont trust your dr to be able to do the surgery, then change your dr. Whatever the case...please listen to your dr!
   — bawana




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