Unshelved by Bill Barnes and Gene Ambaum
comic strip overdue media

Friday, August 06, 2004

Thinking about a gastric bypass?

And no, I'm not. But I have a co-worker who recently went through it. She seems happy, and pointed me to her doctors, at Bluegrass Bariatric. When I first heard about it, I kind of went off. I mean, I know she researched it (she changed insurance almost 2 years ago in anticipation, for example) and you have to be fairly stringently evaluated. And yes, she was 110 lbs over whatever they're calling an ideal weight these days/had a BMI of 40, but she didn't seem so, and I still think a lot of it has to do with psychology. But dieting did not work for her, and she's lost 23 lbs in a month. Of course, she's also already suffered an infection and had to go to the emergency room to make sure a stricture--something that usually happens about 4 months into it, rather than in the first few weeks, was opened.

I fit the criteria, but I just can't see it for me; the 1 in 100 or 200 people who die is a problem for me (and yes, you can say 1%, but that's how it translates, and I wouldn't want to be a statistic). Granted, I have a fear of surgery, especially anaesthesia (I still have impacted wisdom teeth because of that), but it is quite major surgery. But also, there's a lot to be considered in terms of how your lifestyle changes. Because of the particular type she had (a Roux-en-Y), she doesn't actually feel hungry, because her stomach was actually cut and most is no longer attached. It is reversible, which I didn't know. I like the idea of a lap band, if you do have to do it--and I recognise that there are some people, especially those who weigh 400 lbs, etc, where it may well be worth the risk. Ironically, whereas only one of our two health plans at work covers bariatric surgery, it doesn't cover the lap band, which is less invasive, less expensive, and has fewer side effects. But I like the idea of things being adjustable or reversible; after all, the idea is to increase longevity, so a lot can change. But I still have my doubts. I found this very informative article on some of the downsides, which echoes my concern over long-term efficacy and the lack of definitive studies on overall effects.

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