Why You Probably Don’t Need Surgery

Why You Probably Don’t Need Surgery

Last week, I was asked to be a talking head on HuffPost Live, during their interview of Lisa Lampanelli – who is ace. She’s known for her amazing (if a tad…uhhh…blue) put-downs – the only one I could find that wasn’t too filthy to put here was “Donald Trump has disappointed more women than Sex and the City 2” – but I have to say, I find her absolutely hilarious. So it was pretty exciting to be interviewed on the same show where she talked about the 80lbs she’s lost over the last five months.

Here’s a link to the full slot, if you’d like to watch the whole show – but for the short on time, here’s my bit (which my Dad kindly put on YouTube for me):

So, Lisa’s method of weight loss was pretty different to my own. She had gastric sleeve surgery, after having tried other methods of losing weight to no avail, and she looks great. Plus, she’s happy with her decision, and I have no argument with that – it was the right decision for her.

But it got me really thinking about the weight loss surgery question. It’s something I personally can’t really get behind, despite knowing a few people who’ve had successful ops and who’ve lost a lot of weight as a result. But for me… I don’t know. I can’t understand it.

In individual cases, it makes more sense to me – when I’ve spoken to people who’ve had it, for instance, or seen individual success stories, the reasons the surgery was necessary for these people becomes a little more clear. But I have an issue with the pervasiveness of the weight loss surgery ideal as a cultural thing – because it’s selling a lot of people a dream. It seems to me that weight loss surgery perpetuates the idea that once you get past a certain weight, there’s no way back.

My worry, then, is that there are a lot of people out there that are overweight, that have issues with overeating, food addiction, and emotional attachments to foods, who can’t get the surgery – be that because of the enormous waiting lists here in the UK, or issues with insurance and healthcare in the US – who will, as a result, give up on themselves, and spiral into eating more because there is, apparently, ‘no hope.’ Even as a last resort, it’s selling the idea that if you’ve failed at diets in the past, and you can’t get weight loss surgery… You’re “screwed.” You’re “too fat to ever change.”

I’d certainly begun to think that was the case when I first started out.

To qualify for weight loss surgery here in the UK, you have to have a BMI above 40 and be unable to lose the weight through lifestyle changes. When I joined the gym, my BMI was 49.8. I couldn’t walk, so exercise was painful and exhausting, and cooking healthy meals when it was hard to stand up was really difficult – so I was definitely ticking the necessary boxes. But in all honesty, I’m not even sure they’d have let me go forward for the surgery with my BMI that high, because, as the NHS website points out, “the risk of dying shortly after bariatric surgery is around 1 in 200. However, this risk can be as high as 1 in 40 if you have other risk factors such as high blood pressure or a BMI of 50 or above.”

It would’ve been easy to ask for the surgery, get on a waiting list, and continue to eat. But in all honesty, the only thing that stopped me doing that was the fact that I’d had three rounds of surgery on my knees – and the pain of having metalwork put through your shins isn’t something you forget all that easily. So as much as I’d love to say I didn’t ask for surgery because I knew I had the resources within myself, yadda yadda yadda… No. I didn’t ask for the surgery because I was scared it would hurt. That’s it.

But even a couple of weeks after starting out at the gym, trying to walk a little bit and eat a little better, I found my outlook changing.

I don’t think you realise the resources you do have inside yourself until you start to tap into them. Once I’d started, the number on the scales started to drop, and my muscles seemed to be getting stronger by the day. I’ll never forget the first time I got out of bed and didn’t need my crutches to stand up. Bearing in mind I thought that I’d be on crutches forever, that was mind-blowing – but it wasn’t just my physical strength that had improved. Emotionally, I’d managed to find and reinforce the strength I had to not be trapped in that situation forever.

The thing is, dramatic weight loss changes you, inside and out. I wrote in a post on fit psychology a little while ago that:

“Seeing yourself differently because you know you’ve put in months and years of hard work to get there has a very different impact on you than waking up after surgery or extreme, sudden weight loss having been changed by something or someone externally.

Personally, I can completely understand how it’s easy to regain the weight if you suddenly drop 100lbs in a short space of time, because in your head, you’re still the same person. You haven’t learned how to live in a different body, or how to maintain it – and you’re not psychologically prepared for the change in yourself and your identity.”

Source: The Psychology of Getting Fit

There are a lot of reasons people choose to have weight loss surgery – emotional eating, food addiction, inability to exercise or make lifestyle changes – but I, personally, feel like I’d like to get myself some sort of van and a megaphone and pay a visit everyone who’s ever thought that surgery is the only answer. It’s not.

It’s really, really not.

I’m aware that I sound like some sort of irritating TV-evangelist crossed with a super-annoying saleswoman. I get it. It’s preachy, and it’s annoying. But while surgery is the answer for some people – and even then, it still needs to be combined with dramatic lifestyle changes to make it actually work – you can change your life just as dramatically without it. It’ll take a little longer, but you’ll be stronger, happier, and you’ll get to eat meals that weigh more than four ounces for the rest of your life.

I’m not in any way criticising people who do decide to have the surgery, because it depends entirely on personal circumstances, and only you can know what’s the best decision for you. I don’t want to go around pouring scorn on anyone else’s choices, because it’s all about the individual. But it should always be a last resort, because it is completely possible to lose weight in a healthy way, if you just believe in yourself enough.

As Lisa pointed out on the show, “the solution is simple, but it’s not easy” – and I completely agree. It isn’t easy, at first. It takes time. But once you’ve gotten over that learning curve, and you’ve started to take the first steps to realising how strong you actually are, you’ll never look back – so take a moment to give yourself credit for how strong you are, and focus on how strong you could be. You’ll thank yourself later.

14 thoughts on “Why You Probably Don’t Need Surgery”

  • Great post!! As another gastric sleever, it is frustrating to see people thinking surgery is “the only way out” and that there is no hope without it. I have been an emotional eater for years, I had a phase of bulimia, I had binge eating disorder, and I could not lose the weight. Any diet or lifestyle attempt i tried just heightened my binge eating disorder, and I’d consume more calories than on a “non” diet. Once I began recovery for binge eating the weight did start to come off, I lost almost a stone before I had my gastric sleeve operation. In all honesty, I could have lost the weight without the operation. I know this, I knew this going in. But my self esteem, my lack of confidence in myself made me believe that i needed more “help”, something bigger than just my own self will to help me get the weight off and keep it off forever. Knowing that i had invested 6.5k in a procedure that would offer me “extra help” in losing weight has made me more determined to change my lifestyle. I know it’s no fix, and I could have saved the money and pushed myself harder, but investing financially in myself did something to my brain, made me realise I have to make it work this time. Sort of like betting on yourself to win a race. I’d paid out the big bucks, I have to see it through. If I didn’t have that knowledge at the back of my mind then on hard days I might be more tempted to give it all up.
    Surgery is no cure, it’s still bloody hard work, and somedays I wonder if it’s even THAT much of a help. In order for it to work, I still need to eat the right foods, workout til i’m drowning in sweat, and be 100% dedicated to changing my life. Did surgery really help me that much or did it just give me a push in the right direction?? I’m not sure, but I made me choice and I’m happy with it. I’m 50lbs down currently, and still losing, and whether it was the surgery or not that has helped me achieved it, the biggest point is that I have achieved it, and the method isn’t really something that I think about.

  • I know where you’re coming from on seeing the changes that continue to motivate you. In just 2 months I am amazed at how far I have come. I’m not necessarily talking about numbers on the scales, but the improvement in my fitness levels. The fact that if necessary I can run for a bus, I can (and usually do) go upstairs on the bus without thinking, I can spend an hour chasing my friend’s little boy around and not feel like I’m about to die, I can walk up a hill without people wanting to call me an ambulance.
    At no point has it occurred to me to ask my doctor about surgery, because for me it’s not just about weight loss, it’s about ME changing MY life, it’s about giving myself a chance to live past 65 (both my dad and his mum died of heart disease in their early 60s). I knew I had to find it within me to change the pattern I was in. I had to learn new behaviours, and I had to not just lose weight but ‘gain’ health.
    Whenever I have tried before the results on the scales have been sporadic and i’ve lost my motivation fast, this time because I can see improvements and changes in other areas (lost inches, increased fitness) it’s keeping me motivated.

    • Absolutely – the all-round improvements across your whole life are worth a hell of a lot more than that number on the scale. You’re improving your life and making a huge difference to its quality, not just now, but in thirty, fifty years time too 🙂

  • You’t not done it katie, or you Toni, but what i really dislike about the weight loss community is that there seems to be a negative relationship between surgery weigh loss people, and “natural” weight loss people. They seem to have a disliking for each other, and a “my method is better” attitude, rather than just all being supportive of each other trying to develop a healthier lifestyle!

    • I agree – I think there should be a lot more support on both sides, because regardless of where you’re starting from or how you get there, we’re still all aiming for the same thing. I’ve noticed a lot of reluctance on both sides to talk about it – but really, if everyone was as honest about their journey as you’ve been (and I try to be myself) I’m sure everyone would be better off! Thanks for the comment though Hazel – and the previous one – let’s open up that dialogue!

  • First of all, I happened to catch that interview last week – and you were adorable. Thank you for this post. I think you don’t know it – but you meant it for me. (How’s that for ego? lol) Anyway, I’ve had several people close to me go through gastric bypass surgery – and I must admit their rapid weight loss made it soooo tempting for me to try that solution. What gave me pause were the side effects and the alternative addictions they each went through. And now, various years later – they have each gained back most of their weight. It was a really tough road for them…and I worry about going through something that risky when each case it changed what they weighed (albeit dramatically) – but didn’t change the inner demons or actions or addictions causing the weight. Keep doing what you’re doing – your voice is an important one and it makes me want to keep trying to get a grip on this.

    • Thank you so much! The alternative addictions thing is an interesting point – if it’s an emotional issue you’re facing, then surgery alone categorically cannot fix it.

      I’m so glad you liked the post – it means a lot!

  • Katie, an interesting post. I am 54 and like you I put on weight at university and despite various attempts have never been able to take weight off and keep it off. The longest I managed was a year before putting what I’d lost back on plus more and this is a common scenario. Three years ago I had both my hips replaced due to an undiagnosed birth defect, not my weight, so I can relate to pain and having to use crutches. Since my surgery I have put on weight which I really was not expecting. As a consequence, I have spent the last two years researching gastric bands and am close to having one myself. I do not understand this idea that in some way it is ‘cheating’ as some seem to think. The surgeon I have spoken with, the head of the bariatric unit at a leading (Birmingham) NHS hospital, has told me that the band works not just through the physical restriction of your stomach but also because it adjusts hormone levels and the signals sent to the brain in terms of appetite and satiety. He said that in fact that they do not know exactly how all this works. He also said that there is a great deal of evidence that once someone is significantly overweight as I am (BMI 46) it is unlikely that I will lose the weight and, more importantly, keep it off. To me this is the issue – I feel I could possibly eat less and exercise more and then lose weight, but based on 30 years of my experience and various friends’ experiences, I do not feel confident that I would then KEEP IT OFF. This the key point. You are young, you have just lost a significant amount of weight and I congratulate you on that, but you could be me 30 years ago. All the overweight people I have known in my life have more or less been constantly trying to lose weight, thinking about weight, thinking about food. I have spoken to people who have had gastric bands and they tell me that it does involve work, it is hard at times, but that they wish they had done it years ago. I am older than you and want to live to see my 60s, 70s, 80s+.

    • It’s a very difficult call to make – and one that really does have to be up to the individual. As I said, it’s got to be your decision, and if you think it’ll dramatically change your quality of life then it’s something you should do. However, I would say that you shouldn’t limit what you can do because of your friends’ experiences – I’ve failed at losing weight a lot of times, and I don’t know many people who’ve managed to lose it and keep it off through dieting. I guess that’s why people are so interested in how I did it, because it’s not that common – but it’s absolutely not impossible if you go into it as a lifestyle change, rather than a diet. I know Matt’s had a lot of success with the programme working for people even in their 70s, too – so it’s absolutely not impossible, no matter what age you are or what BMI you start from.

      That in mind though, Hazel (who commented above) runs a blog called Pretty Fat – if you do decide to go ahead with the surgery I’d recommend giving it a read, as she’s written some great things about her experience of the gastric sleeve, so do take a look 🙂

  • I tried and failed at dieting for 40 years, since I was in my mid-twentys. I am going to be 65 on my next birthday. Then I found a website called shrinkyourself.com 3 years ago. After doing their interactive program 3 times(yep, 3rd time was the charm) I had my emotional eating under control. Once I had confronted my emotional issues around food, I was able to lose weight without “dieting”. It was a BIG life style change. Now I have managed to go from 340 at my highest weight in 2002 to a current weight of 248. I totally changed my relationship with food. I now have a ‘normal” relationship with food, instead of the dysfunctional one I had for years.
    It is as simple as eating more fruit, veggies and drinking water. I gave up sugar also. It is also one of the hardest things I ever have done because everything had to change. Now I exercise several times a week, including Zumba(which is FUN). I chose better foods but allow a certain amount of “treats” so that I never feel deprived. As you make healthier choices, each choice builds on the previous one until it becomes habit. Portion control is my new best friend.

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