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The schedule is controlled by the insurance company. I live in a rural area and my doctor/hospital is 2 hours away in another state. They allowed me to attend support groups that were local and scheduled all my medical appointments on the same days (pulmonologist, Endocrinologist, surgeon, dieticians etc. the time frame for mine was 1 year...they were not flexible about that at all. I had my Bypass on 12/11/19 and finally feeling normal. I have not had insulin since the day of surgery.

I had my revision on April 25th. I have more new incisions that it looks like Swiss cheese. I had so much scar tissue from the band that he had no choice. The surgeon had to cut 1/3 of my stomach to clean up the scars. So I ended up with a mini sleeve and RNY.

Why did you have a revision done? Just curious I wonder sometimes if I need to have one done. 17 years out. Sent from my LG-G710 using BariatricPal mobile app

Two years ago when I was banded I told everyone..I was soooooooo happy and still am BUt people are so noisy and tell me, why did you have it blah blah blah I should of said ...hernia operation...even though not true but they have a restrictive diet and they have surgery and HATE talking to everyone My Bitch Sister in law calls me all the time to tell me about her friend who had the gastric bypass and how she looks great and they loose faster blah blah I have a friend who decided not to tell anyone...and people thought he had cancer.... blah blah Bottom line... I am an outgoing person so people feel I will not be hurt by comments :0) tell everyone hernia ..you will thank me in 2 yrs

I am being revised from a sleeve to bypass on the 23rd

Hi, I live in Mesquite, Texas (a 'burb of Dallas). I'm investigating the entire lapband process. I've been referred to Dr. Richard Anderson at the Surgery Center of Dallas. Has anyone used him? Can anyone tell me anything about him? I admit, I'm not thrilled at the concept of "going under the knife," even if it is a minor procedure. Obviously, I'm morbidly obese or I wouldn't be considering this. I'm also disabled, but it has nothing to do with weight -- I have a number of genetic illnesses that make life difficult in the first place. The extra weight only adds to the problems. I'd love to hear some recommendations for doctors in the Dallas area. I've heard about a Dr. Nguyen Wyn in Frisco but haven't been able to find an address or phone number on him. I have 2 srikes against me going in: 1) I'm on Medicare and, while I have several different problems that QUALIFY me completely for lapband, I know Medicare will fight it. As I'm disabled, I don't work and have absolutely NO income outside of Medicare and Social Security Disability (not married; no second income). 2) My longtime gastroenterologist, I discovered recently, wrote in his notes -- ON RECORD -- that I am suing a hospital where I was taken in a coma last year. I was severely mistreated there and actually physically abused. I seriously CONSIDERED suing them for it, but knew I wouldn't have the money or enough witnesses to do anything, so I didn't pursue it. I mentioned to my GI that I *wanted* to sue them, but never that I was doing so. Now, when he refers me to any other doctor and sends copies of is records, the doctors see that and refuse to treat me. They've never come right out and said it, but I've never been turned away from any doctor before, so I feel quite certain that's what's happening. My internist believes I'd be a good candidcate for lapband (I really do *not* want a gastric bypass for so many reasons, some of which are medical), but finding someone who will do it on Medicare is going to be tough. I simply cannot pay for it out of pocket as I do not have that kind of money. ANY ideas, suggestions, names of surgeons (and their phone numbers or ewbsites) would be seriously appreciated. By the way, what's a "fill in" doctor? Thanks! Laura

I hear people saying "He is sick and should be punished." In another thread in this section of LBT, someone writes about the Dr. Phil house (TV show) and the people who are "sick" because of their prejudices. It is easy to single out people who are "sick". If I had cancer, would you want me punished? Just about everybody (except for people who will read this and say that I deserve to die for my attitude) would say no. If I was an alcoholic, would you want me punished? Many would say yes, because I should be able to control myself, BUT, many others would say, "no, it is a sickness and he needs help". I am FAT, do you want me punished? Many would say yes, because I should be able to control myself and do punish me in the form of discrimination, BUT, others would say, "no, it is a sickness and he needs help". If I was a pedophile, would you want me punished? Most people would say yes, because I should be able to control myself, AND, few others would say, "no, it is a sickness and he needs help". Why? Because of the victim? Do we abuse alcohol or eating because we have emotional problems? Does a pedophile abuse children because of an emotional problem? Many if not all pedophiles were abused as children. "Who cares?", I hear. They have to take responsibility. But if you are reading this, you probably have a Lap-Band, but if gastric bypass surgery had not been invented, the same could be said about you (and me). Should we give this(or any) pedophile a medal, or should we coddle him (or her)? NO! Of course not. Should he be separated from society? Of course! But not in a prison where the other inmates are not sick, but in a mental health facility where he should get counseling 8 hours per day, not the one hour per week as he would get in a prison. And these Megan's law are one of the first steps toward all of us losing our freedom. If pedophiles were handled as sick people requiring medical treatment instead of as criminals, we would not have the specter of the government punishing people even after they have finished their sentence. If a person is still sick, they belong in treatment. When a person is no longer sick, they deserve to be free. Treat pedophiles and help them, because they are suffering the same way we suffer. While we are feeding our faces, we are in Heaven, but soon after we return to the Hell of knowing our failure. Do not doubt that many pedophiles go through that same situation. We are sick and they are sick, and it is a medical health problem in each case. All those wishing that I would die of cancer can now respond.

Hi everyone. Here's a bit of my background Lapband done April 2011 Only lost 40 lbs Went in for revision to sleep Nov 5, 2016 And they were only able to take my band out Since it had slipped I needed time to recover. Friday is my surgery, and I decided to go bypass instead of sleeve. I'm very nervous, about dumping and feeling like I'm starving. Plus I'm a very thirsty person and I can chug a bottle of Water lol, so the sipping is going to be a huge adjustment. Anyone else having surgery in January, what day? And what surgery you getting? I'd love to have some fellow BariatricPal friends to embark on this new journey with! Sent from my iPhone using the BariatricPal App

I am going to be getting my band 8/6 so I don't have the first hand experience to share, so I'm only going by my research and my surgeon! The band is the least invasive of the two, yes you will lose the weight much faster with bypass but you have to think about how healthy that really. Please do lots and lots of reading, get as much info as you can. I'd be happy to share my experience with you.

Anyone else on this day?

I agree with the person that said to ask for a referral to have your anatomy looked at. If there is something wrong, that can likely be fixed. I'm Kaiser NorCal, and they generally do not do revisions due to lack of weight loss or regain. Get checked out, but don't count on it. Sent from my iPhone using the BariatricPal App

Girl! I've never imagined myself at this weight EVER! It is an amazing feeling when you can fit into a size 4 coming from a 24! Best satisfaction is when you bump into people that you haven't seen in a year or so, their reactions are priceless! I flaunt my Gastric Bypass! [emoji4][emoji173] Thank you so much! Sent from my LGL164VL using BariatricPal mobile app

I was sleeved on 1/26. I went for a follow up yesterday, and I've lost 15 pounds!! I am extremely happy with the results so far. I was taken off my high blood pressure medicine AND my acid reflux medicine! Very, very awesome things have happened... I was the fifth person in my family to have WLS. All of them had Gastric Bypass, but I had VSG because of my tendency to make kidney stones. My uncle was my surgeon, so I went into surgery not afraid at all. Everything went great- no sickness in the hospital, incisions are looking amazing, support from my family and friends is plentiful... So excited. I am going back to the gym tomorrow. I guess i'll just start with some walking on the treadmill. I will go back to work on Friday... so excited to see my clients I have managed to keep up with my classes, as I am a full time student. Everything is just going so great for me. I am having problems with my Protein intake. The only Protein shake i've found that I can tolerate is the Atkins shakes- more specifically, the Espresso kind! By the way, I don't see how the flavorless Protein powder is flavorless!! I am doing Oikos yogurt, scrambled eggs, the occasional shake, though it's hard to get down, and whatever else protein I can scrounge up. My surgeon also told me I need to drink more liquids, but I feel like I drink constantly! I guess it'll get easier day by day? I'm only 19 years old, by the way. I am hoping to find more people my age around these forums because I feel kind of alone in that sense. I do love everyone, though And just outta curiousity... does anyone else feel like they eat ALL the time? I feel like i'm doing wrong by eating so often, but I guess the portion size is the cause of that?

Hello everyone! It has been a journey for me. Thank GOD for this forum. I've been doing research for sometime and this forum helped me make a VERY wise decision. I started out wanting to be banded, but after reading the forum and seeing others who tried the band not having a high rate of success I began looking for the next best thing (Sleeve). I must admit my doctor pushed gastric bypass as the best solution for my weight problem, but my family and I felt that way to go was a little toooo extreme. Let's be honest, I have a 17yr old and two year old twins (boy and girl), so I need all the nutrients and energy possible to keep up with my crew. :wink1: And the gastric bypass was just not the way to go. I went on youtube and listened to the people who did the gastric bypass and their testimonies were not encouraging. The majoirty said if they could do it again they would NOT have the gastric bypass. The problems that followed were more then what they dealt with when they were morbid obese. But, if you on youtube and type in Vertical Sleeve, you will NOT find 1 person who states they REGRET their decision. Actually, they are estatic about the results and NO ONE complained about having nutritional problems. If you are just are questioning if this surgery is right for you just do your research. I'm excited! I know I made the right decision. PRAISE GOD!!!!:thumbup: I pray who ever begins their journey will come out satisfied and successful! Wheatthin

I am not any kind of expert but I liked the reasoning my doctor had to the bypass vs. sleeve discussion. His take is that he sleeve has far fewer complications - both for the surgeon and the patient. A sleeve can later be converted to a bypass if needed. (In fact, many doctors do a sleeve for the super big folks because it will help them lose weight and make the bypass operation less of a risk.) The fewer things that have to change (rerouting your insides) makes recovery faster and more likely to have a positive outcome. In his experiance, his sleeve patients have as good or better results than the bypass ones. I also agree with everyone else. You need to do what is comfortable for you. I'm in engineering and we are an anal lot. I research stuff to death before I make decisions - especially big ones like WLS.

My scars are not bad, but I also have 2 scars for my port. One from the original surgery, the other from 7 weeks later when I had to have a port revision. Since I am only 3 months post op, they are all still noticeable and dark, but I know they will fade. by the time I am thin enough to show off my tummy, they should be almost non existant. Plus, if you can see them, its just a reminder to me where I've been and where I dont want to go back to

Yea i agree. I believe a revision surgery takes longer so if they opened you up and found out they very well could close you up because they did not allow enough time to do the revision. Or get the scans that they needed ahead of time in order to proceed or whatever. I personally wouldn’t want them to be any less prepared than they could be when they cut me open either.

That's strange. When I was talking to several doctors for a possible revision, not one asked or cared where I was sleeved.

Thanks kids for all the kind words and especially the unfailing support. Last July I found LBT, with no real plan for banding, just curiousity, but not really thinking it was something I'd ever really do. I was sure I'd have to get bypass since my insurance doesn't cover the band, and I was terrified about it. In the beginning I spent hours here, reading stories like my own, and thinking ohhh how great banding could be. I read about the american surgeons, and then got my curiousity piqued about the mexican surgeons and groups. Prior to LBT, going to Mexico for anything had never even crossed my mind. But the more I read here, the more clear it became to me that this was it, this was what I needed to fix the mess I'd made of my body and my health. Mexico just might be something I could actually do! Once I knew I'd found what I'd been looking for I began seeking a way to get it done. That was in the beginning of September. I researched Drs across the USA and Mexico. I researched the different bands, and decided I liked the Midband, and then after a couple of phone conversations, and many emails from previous patients, decided on Obesity Goodbye's package. Once all that was decided; I brainstormed with my husband to gather funding for the procedure and trip. I read posts from others and how they did it without insurance help. How money was borrowed, begged, saved, financed, multiple credit cards maxed etc... Like many others, we put up some from savings, and financed the rest through a medical loan company. We realized my husband couldn't really go as the kids were in school, and he had no vacation time left for the year. I asked my mom to go and she gave a resounding YES! The senior bandsters gave me great packing advice, what to do/not do, what to take/leave at home, what to look for, what to buy/avoid, and what to expect in general while in Tijuana... I do believe Delarla gave me sound advice regarding the donkeys/alcohol/mexicali's... though I can't find it, I remember laughing my ass off... and in the end feeling very prepared and barely nervous about it all. We got to Tijuana on Sept 20 and I was banded on Sept 21. Weight loss successes aside, I'm so very proud of myself for taking this on, and getting it done. I'm very happy about the success with it all, but proud mostly that I actually went through with such a previously unbelievable thing. The rest is just bonus bang. During my research, and initially after banding I wasn't absolutely convinced it would work for me. Every other promising weight loss venture had failed me, and hadn't cost nearly as much, so my mind had a hard time accepting that the band wouldn't fail me too. One year later, I get it. It will work for me if I work with it. If I don't it's gonna sit there waiting patiently until I do. I bought more Vitamins and Protein powder today at walmart. I've still got work to do!

Let me start with saying the band is the MOST invasive surgery, not the least because the complication rate is so high (around 50%) that you could require more surgeries...that is my definition of pretty invasive. I can can post a link to a whole host of those studies if you would like, I had to have my band removed and revised to rny. I chose rny because it is the gold standard been around for decades and proven to work. Sleeve hasn't been around for 10 years yet, so after my mistake of using the band when it was still new...wasn't gonna do that again. Also I developed acid reflux from the band and I knew the sleeve could make it worse and rny often cures it. Also I liked the extra insurance with malabsorption...most sleevers don't dump, the majority of rnyers do with the rny. I liked that it was insurance should I make bad food choice. I don't ever plan have another bariatric surgery. Both sleeve and rny require additional Vitamins. I like the Patches..easy to use and don't know they are there. Having said all this the sleeve is getting close to the 10 year mark and looking like a good alternative to rny. It was my backup if the band had done too much damage and an rny couldn't be done.

First time post here. I'm in the early stages of getting authorized for surgery. Actually attended my first support meeting last night as a prerequisite for surgery. 95% of attendees were Bypass clients, only 3 banded folks. My question is I've been told by my surgeon the banding works better for women than men. Have you found that to be true? Would appreciate hearing from any guys that have been banded to see if it has worked for you. I am hoping to lose 75 pounds. thanks for the info Pocono59

I stumbled upon this excellent article discussing NJ Governor Chris Christie's weight struggle. As a NJ resident, it is a frequent topic when discussing him. I think this Dr. makes an excellent comparison of morbid obesity to heart disease when discussing societal discrimination. Interested to hear others opinions. THE MORBID OBESITY EPIDEMIC AND GOVERNOR CHRISTIE by Mitchell Roslin, MD, FACS As a physician that specializes in the treatment of morbid and severe obesity, the recent exchange between Governor Chris Christie and Dr. Connie Mariano, made me contemplate many of the misunderstood and misappropriated issues and perceptions that surround obesity in our society. Governor Christie decided to appear on The Late Show with David Letterman. To demonstrate his humor and humility, he pulled a doughnut from his pocket and began to eat while Letterman chuckled. The following day, a former White House physician, Dr. Connie Mariano declared that the Governor’s weight was no laughing matter. Furthermore, she stated that he was a ticking time bomb, and if elected president, could die in office. To some, these comments may represent the honest opinion of a famous physician. From my perspective, they demonstrate how unique obesity is over every other medical condition. The difference in our collective perception and beliefs regarding obesity and other chronic medical issues can be shown by comparing the medical history of Governor Christie to that of former Vice President Richard Cheney. d**k Cheney was 59 years old when he was elected, with George W. Bush, to serve as Vice President. As Vice President, he was barely one medical event or disaster away from becoming Commander in Chief. While Dr. Mariano may believe that Christie is a ticking time bomb, Cheney was alive in 2000 because of timely medical care and the incredible advancements made in his lifetime in the management of coronary artery disease. Before, during, and after office, Cheney has been the recipient of virtually every new procedure and technique to treat heart disease. He had his first major heart attack at the age of 37. Prior to becoming Vice President he had four heart attacks, a cardiac arrest and underwent open-heart surgery. While in office, he had multiple angioplasties and stents placed, as well as an implantable defibrillator to treat a potentially fatal arrhythmia. After leaving office, he underwent heart transplantation. While many would not describe Cheney as an empathetic figure, his medical condition was handled with respect and compassion. Despite the multiple cardiac events that occurred, his capacity to serve – based on his medical condition -was rarely questioned. Where it was fair to debate his policies and positions, he was never attacked and/or viewed as being incapable because of the severity of his heart disease. During hurricane Sandy and its aftermath, we all saw Governor Christie climbing through rubble and traveling throughout the state of New Jersey. Appearing with President Obama, he was vibrant and full of energy. Appearing on television regularly, his size could not be missed. However, he never appeared to be limited or impacted by his girth, nor was he hospitalized or treated for any medical issue during this stressful period. The contrast and irony is startling. Christie, who has never had a major medical issue in office, is labeled to be a ticking time bomb. Yet, little attention has been paid to Cheney’s extensive medical condition and complex cardiac history. In fact, you could say that his bomb had already detonated. The difference? Christie’s obesity is not transparent. Everyday, every second, all can see his girth. In contrast, the blockages in Cheney’s heart cannot be seen. While intellectually, we can understand their significance, an angiogram or a map of his circulation is not shown by his side. Much more is also taking place. It is with trepidation and even fear of legal implications that one questions whether someone can or cannot perform their professional tasks secondary to a medical condition. Yet, the implication of Dr. Mariano’s statement is that corporeal weight and body habitus can be implicated in the determining whether someone is qualified for employment. She questioned whether Governor Christie would be able to perform the duties of national office. Thus, on the basis of size, he may not be the right man for the job. If we extrapolate this thought, it would mean that all employers could believe that a person of ideal weight many be better able to work in their establishment than a severely obese individual. Thus, when it comes to obesity, it is acceptable to discriminate. Unfortunately, this is not new news. To protect individuals that have other medical conditions, we have even passed laws such as HIPAA to preserve their privacy. It certainly can be argued that if you are an employer, you would not want to hire someone with a similar cardiac history as Vice President Cheney. Individuals, such as Mr. Cheney, are more likely to miss work time and cost more to employers and tax payers to provide sufficient health care, regarding their dire conditions. That is why, for most positions, your medical record is kept private. In contrast, in the case of morbid obesity, there is no anonymity and a test is not needed to diagnose. It is physically and socially self-evident. Imagine someone of Dr. Mariano’s status commenting on an issue of race, religion, sexual orientation, or even other any other status of adverse medical condition. Her comments would be treated with outrage. It seems that obesity is the last bastion of accepted prejudice. In a world were we have become socially and legally evolved enough to understand and accept all divergent issues, whether they be diverse in ethnic, religious, economic, racial and sexual identifications, obesity still endears itself to cultural stereotyping and profiling. It may be my prejudice, but I think Dr. Mariano was saying much more with her comments: if you are not able to balance your caloric intake, do you have the self-control to balance our budget? Can a person who is morbidly obese be a proper role model to be Commander In Chief? If you do not have the discipline to manage yourself, how can you manage our country? Also if you are not potentially in denial, would you not seek treatment and accept responsibility for creating then solving your own medical problem that would impede you from such? All such simply continues to add to the misperceptions and misappropriations regarding obesity. They also explain why surveys and studies have shown that people would rather be dead than severely obese. No matter how ridiculous this sounds, when you are obese, society looks at you with scorn. You are responsible for your condition. As a result, little compassion is expressed. Besides having a strong family history for heart disease, Vice President Cheney smoked heavily for 20 years prior to his first heart attack. Although, this certainly contributed to his heart disease, his heart disease was viewed as a medical condition, and not equated with character flaws. Obesity is not viewed with such largesse toward any individual. Another unspoken message was that Governor Christie was in denial or should be actively working to lose weight. The truth, in my opinion, is that he struggles everyday and is very much aware of the issue and frustrated by it. It has been my experience that people who are successful and severely obese wonder: ‘how can I succeed in most everything else and still fail this battle?’. So what have we learned about obesity? Is there truth to Dr Mariano’s comments? Is this just another essay that states that no one should be held accountable or have personal responsibility? Severe and morbid obesity combined with a sedentary lifestyle is the biggest medical issue that people, and de facto, our country faces. Despite medical innovation, life expectancy is expected to decline, only seconded to the epidemic of obesity and diabetes. Thus, clearly, someone that is as obese as Governor Christie is at a substantially increased risk of significant heath detriment than someone of similar age, who has a normal body mass. His statement that he is the healthiest fat person is one that I hear commonly. It usually means that he requires no medication for hypertension, diabetes and hypercholesterolemia. Obesity is representative of an energy imbalance. The causes are multifactorial and the impact variable. Not all severely obese individuals are diabetic or prone to heart disease. Those such propensities depends on the distribution of the adipose or fat tissue. Those that have central obesity, especially with fat in their abdominal cavity, are much more likely to have metabolic disease. When the majority of fat resides in the subcutaneous tissues these co-morbidities are less likely. However, their excess adiposity has other consequences. There are only few people that I have cared for that are Governor Christie’s size that do not have sleep apnea. Sleep apnea is a condition that generally results in patients awakening at night to get adequate oxygen, due to the stress on the body of excess weight. The blood vessels in the lungs contract and this puts strain on the heart. As a result, the heart is more likely to have rhythm disturbances. In addition, excess corporeal weight causes undue and substantial wear on joints and the lower extremities. It is a misnomer that Gov. Christie does not care about his physical state or is in denial about such. Besides surgery, there is absolutely no documented or successful treatment option. Laymen watch popular television shows like the Biggest Loser or daytime talk shows and think that weight loss is easy. Unfortunately, the majority of people that lose large sums of weight – regardless of whatever method – suffer cataclysmic recidivism. Intuitively, most believe that we can be trained or be taught to change our behavior and maintain weight loss. However, science contradicts these widely-held beliefs. The body resists weight loss. When caloric intake is curtailed, we respond by becoming more efficient and reducing our metabolic rate. A registry is kept of people that have lost substantial sums of weight and maintained the weight loss for five or more years. On average, to preserve their weight, at the new loss state, they eat less than 1200 calories and exercise more than an hour per day. The story of Dr. Stuart Berger is typical of the weight loss struggle. Dr. Berger was perhaps the first famous television diet doctor. While in medical school at Tufts University, he weighed in excess of 400 pounds. He lost a substantial sum of weight and authored The South Hampton Diet. His diet book was widely-publicized and he became a weight-loss guru. He died from heart disease at the age of 42. At the time of his death, his weight was again 400 pounds. With the development of minimally invasive techniques, bariatric surgery has become safer than virtually any other abdominal or weight-loss operation. Despite these improvements, surgery is a frightening proposition. Family and friends who believe that all that is needed is further education and more willpower discourage many people. This circle also differentiates obesity. In most every other condition when you reach a threshold, treatment is mandatory. In obesity, the desperation of the patients and their desire to seek options determines who gets treated. The differences in how obesity is handled and viewed continue when the decision to pursue treatment occurs. Rather than have a physician decide when a patient is ready or qualifies for a specific procedure, insurance companies require a detailed pre-certification process. This typically includes documentation of a recent diet that is supervised by a physician and includes monthly medical visits. For people like Governor Christie, this means that their life-long struggle is unimportant. Instead, they need to duplicate and relive their frustrations to obtain treatment. Such an approval process exists in no other area of medicine. d**k Cheney did not have to document his gym regimen before one of his many heart surgeries was approved. When proper treatments are met with such difficult fiduciary remuneration, it is not surprising that there are few new remedies. It is estimated that 36% of the American population is now obese. At current growth rates, by the year 2050 the entire population will be obese. Thus it would seem that products that effectively treat obesity would have a large market and a priority for ambitious entrepreneurs. Yet, this is not the case. There has been only one medical device and one pharmaceutical product approved by the FDA in the past ten years. The reasons are multifold. There is no agreement about who should be treated for obesity. There is no agreement as to what constitutes successful or meaningful treatment. Additionally, obtaining insurance reimbursement for obesity treatments is an obstacle. The approval process for surgery is arduous. Less than 30% of insurance plans cover weight-loss pharmaceuticals. In comparison, look at the new products and procedures that were developed for heart disease during d**k Cheney’s life. They include stents, defibrillators, as well as surgical procedures such as coronary artery bypass grafting and cardiac transplantation. All benefited from widespread public acceptance and a clear path for reimbursement. More than 20 years ago, former Surgeon General, Dr. Everett Koop, wrote Shape Up America. He became the first public health figure to recognize the significance of the obesity epidemic. Regardless of the dangers of obesity that have been published since its publication, the emphasis has been placed on education rather than cure. Hence, the epidemic has continued. We must realize that behavioral modification techniques that have not even succeeded in halting the rise in the prevalence of obesity are unlikely to be successful as a treatment for morbid obesity. Stated succinctly, prevention and treatment are different. We prevent bacterial infections by washing hands and avoiding contact with infected sources. We treat people, de rigeur, with surgical debridement and medications such as antibiotics. It is possible that if Vice President Cheney never smoked, he would not have had a heart attack at 37 years of age. However, no one would treat his heart disease by only having him stop smoking and change his diet. While an important component, such efforts would be combined with medications. Yet, in obesity, we still want to believe that the same techniques that are used to prevent weight gain will result in successful treatment. It is time to address the obesity epidemic. Just as we check blood pressure, we need to measure body-mass index. At a young age, those with a mildly elevated BMI need to be referred for treatment. There needs to be reimbursement for these treatments. If initial approaches are not successful, a different approach is warranted. At the end of the line will be surgical procedures. The combination of a mandatory treatment threshold and reimbursement will stimulate the search for better solutions. Coverage should be mandatory. Only with mandatory coverage will insurance companies take preventive efforts seriously. We also need to face that combatting the obesity epidemic will require difficult decisions that will limit personal choice. I am not sure that Mayor Michael Bloomberg’s sugar tax will be successful or the correct approach. But, I highly commend his attempt to bring awareness to this issue. It is naïve to continue to rely on nutritional education. We need to be bold and explore even unpopular options. These may include higher prices for items such as soda and other simple carbohydrates. An emphasis has to be placed on physical fitness. Each week, I see people in their early twenties that are permanently disabled secondary to medical issues caused by morbid obesity. Our society cannot afford for this trend to continue. What about Governor Christie? We should judge him based on his ability to govern and the record he has assembled. Should he ever feel his obesity is interfering with his public duties, effective surgical treatment exists. In all probability he could return to his normal duties in 7 to 10 days. With current surgical techniques, his obesity is far easier to treat than Vice President Cheney’s heart disease. What we also have to realize is that Dr. Mariano was talking about a lot more than the medical implications of obesity. What I heard was a fat man does not appear to be presidential. Additionally, by not addressing his obesity he has character flaws that she does not find acceptable. However, looks can be deceiving. FDR led us through WWII, and The Depression from a wheelchair. What should not be questioned is Christie’s determination and inner strength. As a leader, as a person. Despite constant ridicule and jokes about his weight, he has risen to become a national leader and is being urged to run for president. To survive the discrimination he has faced, he probably has had to perform better than those who merely look the part.

Agree, it sounds like maybe that's the surgeon's preference -- just went to my seminar and the surgeon was very open to either sleeve or bypass, depending on patient's needs/medical issues, etc. It wasn't one is way better than the other -- definitely get a second opinion!

I had one surgeon tell me that I needed bypass not vsg. I wasn't comfortable with that. I found a different surgeon who performed the sleeve. I wasn't too keen on having my intestines messed with and he was a great help and supporter.

If there were no urgent reason for a bypass, or a complicated hernia situation to consider, this would smell like the old bait-and -switch trick. Given that, I would think that the surgeon just simply has more experience with the bypass and is more confident in his/her surgical skills in that regard. Who knows? Maybe you will get a different answer. However, if the second surgeon also feels that a bypass would be a safer procedure and give you better long-term results, then that is probably the way to go. I went to the bariatric clinic expecting a lap-band and ended up with a sleeve.