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Gastro Doctor and her thoughts on WLS



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I have a bunch of ulcers in my esophagus and it is per-cancerous. It is called a Barrett's Esophagus. I informed my gastro doctor about weight loss surgery and of course, I can't be touched at this time. They are going to scope me again on July 17th

She does not want me to do WLS and wants me to really consider it. She would like me to try a monitored WL program first. She told me that they really move things around in your body and that it will not be the same. She has also said that she has seen people in her practice that have had the surgery that did not lose the weight. I specifically asked her if they had bypass surgery and she said yes.

Is it possible to have bypass surgery and not lose weight and be the same size as before the surgery?

I have to be honest that I have considered not doing the surgery. I keep thinking, that bypass surgery is a tool, which it is. So my thoughts were, if this surgery is a tool, then I need to learn how to eat properly, change my habits and lose the weight without the surgery. Since I found out about my esophagus, I have put cokes down. And that is a big step for me.

Thoughts?

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You're always going to find people that can't get past the stigma of WLS. Even somewhat intelligent people like doctors.

Yes, it's a tool. Just like I need a hammer to pound a nail into the wall to hang a picture as opposed to using my hand, WLS was the correct tool I needed to make the job work for me. Just like the hammer is the correct tool to pound the nail.

I pounded that nail with my hand for 30 years, but just couldn't quite get the job done. Now I am 15 pounds away from goal, and now I at least have fighting chance of keeping it off this time with the tool I know I needed. If you use it the way it's intended, you will get the results you want. Like getting that picture of your new healthy, slimmer self hung on your wall by using a hammer ;)

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Your doctor's information about WLS outcomes does not reflect the statistics, but it is true that some WLS patients stop losing weight long before they reach their goal weight. Sometimes this is because they are unable to follow the post-bariatric diet and do not continue to exercise. Even though capacity is much diminished after surgery, it is possible to consume too many calories by snacking and grazing and/or choosing calorie dense foods. And some have health issues that slow weight loss.

I don't know if your diagnosis precludes WLS, but if it doesn't, you should do a little more reading and soul searching before writing off the possibility. Since you believe you can stick to a diet, you might be a good candidate for WLS. Most people find it much easier to lose a significant amount of weight with the surgery than without it. It is also the case that WLS patients are more likely to maintain a large percentage of their weight loss than dieters who did not have the surgery.

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As others have said, yes, it is absolutely possible not to lose all the weight, and to re-gain, if you aren't willing or able to commit to the post-op eating plan. That said, the vast majority of people find it much easier to comply with a strict diet after surgery than they did before -- that's one of the big reasons that weight loss statistics are so much more impressive for surgery than they are for any other option or method.

Since you have Barrett's Esophagus, it seems like bypass would be a good option for you, as it can resolve acid reflux for many people. Or so I have heard,, I am not a medical professional! But you have "Gastric Sleeve" listed on your profile for your surgery and you are posting in the gastric sleeve forum, is that a mistake? Gastric sleeve isn't usually an option for people with Barrett's since it can often make reflux worse. I'm not trying to be unwelcoming, I'm just hoping you are where you want to be on this forum :)

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my first thought is that the sleeve should not be considered as a top option for you due to your current issues

my understanding is that bypass will often reduce GERD/reflux and so that might be the option to consider

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oh and one more thing, if you have never tried a medically managed weight loss program (like one your doctor is suggesting) then it surely would not hurt to try. If it succeeds, then great! If not, surgery is always still an option. No need to rush into a decision.

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Yes, there are people who regain all or most of their weight back after surgery. Ask them, and you'll generally find people who've deviated from the basic principles of the post-op lifestyle, whether it's an unhealthy diet or lack of exercise.

But for those who use WLS as a tool to affect a change in their life, it's a powerful way to get healthier.

Yes, it would be ideal if we could all just change our diet and exercise habits and lose without surgery. So many of us have tried and failed on that path. Or succeeded, but only temporarily.

Your GI doc is woefully misinformed about that.

She is correct that a sleeve would be a mistake for you. The concern is that if the Barrett's were to progress to cancer, those who've undergone a sleeve won't have enough stomach left over to have surgery and hook things back up. Those with bypass have a reserve stomach ready to help with that.

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I have a bunch of ulcers in my esophagus and it is per-cancerous. It is called a Barrett's Esophagus. I informed my gastro doctor about weight loss surgery and of course, I can't be touched at this time. They are going to scope me again on July 17th

She does not want me to do WLS and wants me to really consider it. She would like me to try a monitored WL program first. She told me that they really move things around in your body and that it will not be the same. She has also said that she has seen people in her practice that have had the surgery that did not lose the weight. I specifically asked her if they had bypass surgery and she said yes.

Is it possible to have bypass surgery and not lose weight and be the same size as before the surgery?

I have to be honest that I have considered not doing the surgery. I keep thinking, that bypass surgery is a tool, which it is. So my thoughts were, if this surgery is a tool, then I need to learn how to eat properly, change my habits and lose the weight without the surgery. Since I found out about my esophagus, I have put cokes down. And that is a big step for me.

Thoughts?

Just food for thought... If you have precancerous ulcers they could be in your stomach and if you bypass your stomach there's no way to do a scope to make sure you don't have anything in there nor will you ever get any Cancer there. I would seriously consider what she is saying and talk about it with all of your doctors.

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