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Why Isn't Surgery More Common?



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I know this question might seem strange, and I don't mean it at all in a judgmental or divisive way. But I just wonder - if the majority of people have easy surgery, minimal pain and success, and many insurances seem to cover these surgeries for those who are eligible, why is it that more people don't have it done?

I absolutely understand that not everyone even wants it, and that makes sense. Even for me, for years I viewed surgery as something that was such a big deal that it wasn't even something I would consider. I also thought I could do it on my own. I tried to just make peace with my size and who I was - as a person I have changed my mind and made the decision to do this.

However, I still wonder why only a small percentage of those who are eligible and would be able to have it mostly funded by insurances don't do it?

Why isn't this a surgery we know of more people having or considering?

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Your second paragraph pretty much sums it up. People either give up or think they can do it without surgery.

Your first paragraph I don't think is true. I don't think most people have an easy time of surgery. I know I didn't.

Further, it's a fair bit of work to get approved. Honestly, insurance creates as many obstacles and work as they can because it will cause a certain percentage to quit.

Others are scared of surgery, doctors, hospitals. Some rightly so. I hated going to doctors when I had a problem because it was always my weight.

Further, as you say people are judged for being MO, so it's hard to go though a program to admit you need help. In many of our minds we BELIEVE it is a character flaw to be fat.

And, again, giving up all that food. OMG, A 16oz Prime Rib, loaded baked potato, mushrooms, a good wine, that I will NEVER have as much as I want again! is a tough row to hoe for some people.

Don't forget all the dieting competition. WLS is the enemy product, so it is villainized.

WLS horror stories, I know I read many and had to accept it could happen to me. Many can't.

Boy, I can go on an on, can't I ;)

Tek

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11 minutes ago, The Greater Fool said:

Your second paragraph pretty much sums it up. People either give up or think they can do it without surgery.

Your first paragraph I don't think is true. I don't think most people have an easy time of surgery. I know I didn't.

Further, it's a fair bit of work to get approved. Honestly, insurance creates as many obstacles and work as they can because it will cause a certain percentage to quit.

Others are scared of surgery, doctors, hospitals. Some rightly so. I hated going to doctors when I had a problem because it was always my weight.

Further, as you say people are judged for being MO, so it's hard to go though a program to admit you need help. In many of our minds we BELIEVE it is a character flaw to be fat.

And, again, giving up all that food. OMG, A 16oz Prime Rib, loaded baked potato, mushrooms, a good wine, that I will NEVER have as much as I want again! is a tough row to hoe for some people.

Don't forget all the dieting competition. WLS is the enemy product, so it is villainized.

WLS horror stories, I know I read many and had to accept it could happen to me. Many can't.

Boy, I can go on an on, can't I ;)

Tek

Yep stigma is a huge part of it and a part of the reason it took me as long as it did to decide this is what I needed to do. Only a month out so far, but very glad that I finally did it.

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16 minutes ago, The Greater Fool said:

Your second paragraph pretty much sums it up. People either give up or think they can do it without surgery.

Your first paragraph I don't think is true. I don't think most people have an easy time of surgery. I know I didn't.

Further, it's a fair bit of work to get approved. Honestly, insurance creates as many obstacles and work as they can because it will cause a certain percentage to quit.

Others are scared of surgery, doctors, hospitals. Some rightly so. I hated going to doctors when I had a problem because it was always my weight.

Further, as you say people are judged for being MO, so it's hard to go though a program to admit you need help. In many of our minds we BELIEVE it is a character flaw to be fat.

And, again, giving up all that food. OMG, A 16oz Prime Rib, loaded baked potato, mushrooms, a good wine, that I will NEVER have as much as I want again! is a tough row to hoe for some people.

Don't forget all the dieting competition. WLS is the enemy product, so it is villainized.

WLS horror stories, I know I read many and had to accept it could happen to me. Many can't.

Boy, I can go on an on, can't I ;)

Tek

Thats very true. Those are really all of the reasons I had thought of, and I guess its just a matter of personally getting to the place to be ready for such a change. I know that it took me years!

I guess my anxiety also makes me feel like theres something else I don't know or haven't heard yet that everyone else knows and thats why they have chosen to not have it done! I want to make sure I have all of the facts.

A great big steak with all of the fixings will definitely be one of my last big meals! Thank you!

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Just now, newyorklady20 said:

Thats very true. Those are really all of the reasons I had thought of, and I guess its just a matter of personally getting to the place to be ready for such a change. I know that it took me years!

I guess my anxiety also makes me feel like theres something else I don't know or haven't heard yet that everyone else knows and thats why they have chosen to not have it done! I want to make sure I have all of the facts.

A great big steak with all of the fixings will definitely be one of my last big meals! Thank you!

It was my last 'real' meal.

Haha, look how I talk, like I'm not eating real meals now.

Tek

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I think the main reasons have been nailed by the posts above.

1. Many view being overweight as solely the fault of the person from eating too much or not exercising enough, so the solution is also solely the responsibility of the person. WLS is the "easy way out". Of course, we all know this is not entirely correct and it is a lot of work. But the stigma is hard to get away from.

2. Lots of insurances don't cover it and surgery is expensive.

3. For me, food was a big part of my life (still is). It is a source of comfort and pleasure and wrapped in the fabric of everything we do. So taking that away from our lives, at least in the way that it always was, is hard to comprehend. I miss being able to be able to sit and eat a big meal.

WLS is a big decision that involves a lot of dedication and commitment and giving up our old habits is difficult. I'm glad I did it and I can't wait to get to my goal weight (over half way!), but I have had to change how I go about my daily life.

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1 hour ago, billho said:

For me, food was a big part of my life (still is). It is a source of comfort and pleasure and wrapped in the fabric of everything we do. So taking that away from our lives, at least in the way that it always was, is hard to comprehend. I miss being able to be able to sit and eat a big meal.

This is the exact reason two friends refuse to get WLS. They do not want to miss out on the joy of eating. I was once like them. Today I don't live to eat. I eat to live. It is hard to think that one of your life pleasures will be significantly changed. It is better that they don't get the surgery until they can make peace with it. If not I'm sure they will be miserable and not get the long term health benefits they need.

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5 hours ago, newyorklady20 said:

I know this question might seem strange, and I don't mean it at all in a judgmental or divisive way. But I just wonder - if the majority of people have easy surgery, minimal pain and success, and many insurances seem to cover these surgeries for those who are eligible, why is it that more people don't have it done?

I absolutely understand that not everyone even wants it, and that makes sense. Even for me, for years I viewed surgery as something that was such a big deal that it wasn't even something I would consider. I also thought I could do it on my own. I tried to just make peace with my size and who I was - as a person I have changed my mind and made the decision to do this.

However, I still wonder why only a small percentage of those who are eligible and would be able to have it mostly funded by insurances don't do it?

Why isn't this a surgery we know of more people having or considering?

The number of WLS are trending upward!

https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers

I believe a lot of people do it but in private and you won't hear about it because there is still stigma attached to obesity moral falling or character flaw.

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How many surgeries are performed depends a lot on what insurance companies are covering or not.

Depending on how severe obesity is patients still need to fight for their rights when it comes to proper treatment. In Germany a person with a BMI of 54 is more likely to get surgery fast than someone with a BMI of 41. They don't have to jump through all these silly hoops a lot of the time.

Sometimes the fight to get surgery can take years and is not always successful. Surgery means thousands of Euros and Medical Tourism is not as popular in Europe as it is in the US (at least not yet).

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I thought self acceptance was more important than living with being fat for years. I had my surgery two years ago and have been very happy with my decision.

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43 minutes ago, JessLess said:

I thought self acceptance was more important than living with being fat for years. I had my surgery two years ago and have been very happy with my decision.

I feel the same way! I am very supportive of body positivity and I think everyone should accept and love themselves in any way that they want. I have tried to love and accept myself being so overweight and I just can’t do it. I also don’t want to weigh nothing - just be something that is sensible in between the two.
I almost envy those that can live happily as they are! I am excited to be making big decisions and big moves to hopefully find the same contentment. I’m so glad you found happiness!

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9 hours ago, maslman said:

Yep stigma is a huge part of it and a part of the reason it took me as long as it did to decide this is what I needed to do. Only a month out so far, but very glad that I finally did it.

+1 on stigma

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I started looking into WLS about 15 years ago, but I didn't do it until this year for lots of reasons. First of all, any surgery has some risk to it. WLS is essentially permanent mutilation of one's digestive system and not something to be taken lightly. I've been fortunate to have good health for most of my life, and I hated the thought of putting that at risk just to lose some weight (my family pretty much talked me out of it for this reason). I had heard about dumping syndrome and it sounded horrifying.

At various times over the years, I reconsidered WLS but didn't go through with it, first because of the risk of complications, but also because of the lifelong changes that I would have to make to my diet. No more soda?! Diet soda and flavored seltzer used to be my guiltless pleasure, and WLS mean giving that up. Having to give up all of my favorite foods, like pizza, ice cream, Cookies, cake, bread, Pasta, etc., was also pretty hard to accept. Not being able to take ibuprofen when I have a headache was another concern.

For me, the surgery itself was the easy part -- I just slept while the surgeon did all the work. I didn't have much pain besides some gas pain the first couple of days. But the pre-op diet for two weeks before surgery and then the post-op diet for the first 6 weeks or so after surgery were pretty rough. I'm 3 months out now and adjusting to the post-WLS diet is still no picnic. I used to just eat what I wanted and now I am extremely limited in what I can eat, and I have to think about every bite I take. If WLS were truly as easy as a lot of uninformed people seem to think, and all you have to do is get the surgery and then you magically lose weight permanently, then yeah, everybody would get it. The reality is that surgery is just the beginning of the longest and hardest diet of your life, and even after you go through all of it, you can still regain the weight if you're not careful!

Also, just because insurance covers the surgery doesn't mean it's cheap. I paid $4500 out of pocket for my surgery and related expenses ($4500 is my out of pocket maximum for insurance, so the insurance pays for everything over that this year). Meeting all of the surgery requirements also takes a lot of time and driving to various appointments. I never used to go to the doctor, and now I have to go to follow-ups with my surgeon and get periodic bloodwork, which will be continuing medical expenses for the rest of my life.

It took a lot for me to decide that it was worth dealing with all of these negatives of WLS, but it got to the point where living with super morbid obesity (I started with a BMI over 60) was worse than all of the above. My BMI is just over 40 right now, so if this were my starting weight, I would still qualify for WLS. To be perfectly honest, if I started with a BMI of 40 (as some WLS patients do, and some even lower!), I probably wouldn't have considered WLS, but at the weight that I started, it was pretty obvious that I couldn't do it on my own without surgery.

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