Will Surgery Help?

I have been doing a lot of thinking about my upcoming breast reduction surgery and the possibility of having a lap band afterwards. I see the benefit of the reduction although I worry I won't wake up from the anesthesia.

The lap band is another story. I've been reading some articles about how bariatric surgery won't solve all my problems. Yes, I would lose some of my weight, enough so that my blood pressure and other risk factors would go down. I've often wondered, though, what about the emotional baggage I'm carrying around in the first place?

I am an emotional eater. I've been working hard on it and I think I've come a long way. Last year at this time, I was sending TB out on nightly trips to Wawa for a pint of ice cream or a bag of candy. I put the brakes on that but I've substituted. Instead of ice cream, I have a bowl of Cinnamon Toast Crunch or some cheddar cheese and grapes. I'm eating so much better I was sure the pounds would start melting away, especially when I began exercising again.

Well...they haven't. I weigh about the same now as I did last year when I was eating all that ice cream. I tell myself, yeah, but if you werestill eating Ben & Jerry's you'd probably have gained at least 25 lbs. I bet that's true but it's still discouraging.

So...if I had this lap band, everything would miraculously change, right? Obviously I would be very limited in how much I could eat. Obviously I'd start losing a lot of weight, right? I read an article a couple of days ago about a woman in Britain who had a gastric bypass and lost a lot of weight. Soon after, though, she was back to eating the same unhealthy stuff she'd eaten before the surgery. Sure, she was suffering the consequences but she just couldn't seem to live without the junk. She isn't an isolated case I bet.

You have to be in your right mind for it to work. I mean, I could have this surgery but if I don't have a healthy substitute for my comfort food then it won't help me that much will it?

I read an article called Weight Loss Surgery...the End or the Start? and there were several points made that addressed the worries I have.

Bariatric surgery - including several kinds of operations that reduce the size of the stomach and may also change the way food is digested - can be a great weight-loss tool, but patients still need to deal with the behavior and emotions that made them heavy in the first place.

"The psychological thing is that they have to come to grips with the fact that they've chosen a complete change in lifestyle," said Gus Slotman, who does gastric-bypass surgery at Our Lady of Lourdes Medical Center, in Camden. "I tell them they're like recovering alcoholics. They're always going to have that fat person in their head." ...

While the dramatic weight losses and substantial risks associated with the surgery get much of the attention, it's also important to think about the psyche and emotions before and after shrinking the stomach, say surgeons and psychologists. Yes, they note, the operation creates a tiny stomach that makes patients feel painfully full after eating more than a couple ounces of food, and yes, it seems to depress their appetites.

But most of us know that we don't eat just because we're hungry or stop eating when we're full, and that radically changing the way our bodies look and feel is bound to have emotional repercussions. ...

Mann and other surgeons want patients to realize that losing weight won't solve all their problems. Many are depressed - often at least partly because of their weight and the social isolation it can cause - but sometimes their problems go deeper.

"There is a sub-segment of this population where their life is so messed up and dysfunctional that you can help them lose 100 pounds and you're really not helping them," Mann said. "This is not going to make somebody's life great if they're otherwise miserable. It will make their life better if weight is the central issue."

Surgeons and others who work with the patients say that many patients whose weight levels off early don't follow doctors' orders. Unfortunately, to succeed in the long run, patients have to do what they were unable to do before surgery: eat small amounts of food - up to about 1,200 calories a day - and exercise. That's a huge behavioral change for people for whom food has been comfort, celebration and fun, and who often have little interest in exercise. ...

After the weight starts dropping off, patients often feel ecstatic. Their other medical problems generally improve quickly. They have more energy and endurance.

But, therapists and patients said, they need to understand that losing weight can upset the balance of all their relationships. Stories are common of couples who got divorced after one partner had surgery. Patients often become more assertive, and not everyone likes that.

A patient told Cathy Reto, a psychologist who works with a bariatric-surgery program in San Diego, a story that Reto thought was especially insightful in explaining how people and relationships change after the surgery.

"I liked you better when you were fat," one of the patient's acquaintances told her.

"I probably liked you better when I was fat," the patient replied.

This isn't to say I'm turned off the surgery now. However, I think I do need to figure out what's going on in my head for it to be a successful procedure. Lots of "food" for my thoughts...