Home > Uncategorized > Updates: TED and bariatric surgery

Updates: TED and bariatric surgery

Readers, I’ve got two announcements today.

First, I’ll be giving a TED talk in April in Vancouver. And yes, for those of you remember, I haven’t always been the biggest fan of such things. But I’ve changed my mind/ sold out/ decided that it might just be great.

As a friend of mine explained to me, sometimes things get so douchey they come out the other side and are super cool. Also, I’m giving a talk in the section called Our Robotic Overlords, so that’s a very good sign.

Second, I’ve decided to undergo bariatric surgery. I’m jumping through the many insurance-qualifying hoops for now but if all goes well it will happen later this year, possibly as soon as July.

And… I’m planning to chronicle my journey on mathbabe. If that kind of thing doesn’t interest you, feel free to never come back, but if that kind of thing does interest you, then buckle up!

I’m not planning to keep myself to the subject of the bariatric surgery; in fact that’s just an excuse to think about a lot more, specifically:

  • the nature of scientific understanding and how it does or does not percolate throughout society as a whole,
  • how money and shame corrupt our understanding of scientific evidence,
  • how bad data and bad technologies and biased academic publishing prevent us from learning optimally,
  • the nature of individual choice, willpower, and control,
  • my historical self-image as a dieter, a fat person, a woman, a feminist, and a thinker,
  • how I gathered evidence and made this decision, and of course
  • the process itself.

So I’m thinking kind of big and I’m going to have fun with it. Please feel free to comment, I’d love your help!

Categories: Uncategorized
  1. March 10, 2017 at 10:50 am

    Did you post a summary of you journey somewhere?

    Like

  2. March 10, 2017 at 10:55 am

    Indeed make sure you get the approval from your insurer for this, and get it a couple times as this is a hotspot. United Healthcare sued in California over this. It was kind of a trick to the approval process in that they covered the evaluations and then later didn’t cover the procedure. If you have Oxford, which is a part of United Healthcare, be extra careful with this approval process.

    http://ducknetweb.blogspot.com/2014/03/united-healthcare-gets-sued-over.html

    http://ducknetweb.blogspot.com/2014/09/lap-band-surgeries-go-full-circle-with.html

    There’s the gastric band out there as well as something new with gastric balloons that are surgically implanted and removed later.

    But hey, if you are a banker’s wife, the insurer has no problem paying $175K for a hammer toe procedure…all is not equal in the insurance world. Even the banker complained about this one, but they had no problem writing out that check.

    http://ducknetweb.blogspot.com/2014/03/17509880-to-fix-hammer-toe-billed-by.html

    Like

  3. March 10, 2017 at 10:55 am

    Bon courage !

    Like

  4. david
    March 10, 2017 at 11:40 am

    Cathy,
    If not too personal, please let us know which type of surgery you will have. I was board certified several years ago in Bariatric Medicine which is the nonsurgical i.e. medical treatment of obesity. It will be very important for you to have a follow up physician that understands the nutritional requirements you will need. At one time, Bariatric surgery was quite dangerous. Today, when done by a properly trained surgeon, the surgical morbidity rate has significantly decreased with overall good outcomes. I look forward to hearing about your journey.
    David

    Like

    • March 10, 2017 at 11:44 am

      Thanks, David! And cool that you’re an expert.

      I’m going for laparoscopic sleeve, and I’m having it done at Columbia Presbyterian, which is considered a “center of excellence” by my insurance, UnitedHealthcare, which I get through my husband’s job as a Columbia professor.

      I’ve talked to people who’ve had the gastric bypass who have real vitamin deficiency issues, even with taking their dailies, so I’m kind of avoiding that, and as I understand it the lap band simply doesn’t work. That leaves the sleeve, which seems to work well, is relatively safe, and causes real (but not extreme) long-term weight loss. I’m not going for thinness, but rather an easier and healthier lifestyle.

      What do you think?

      Like

      • david
        March 10, 2017 at 11:46 am

        I agree with your choice. Good luck!!

        Like

    • March 11, 2017 at 7:07 am

      Is there a source of detailed historical and current data that is available on the web?

      Like

  5. March 10, 2017 at 11:49 am

    “my historical self-image as a dieter, a fat person, a woman, a feminist, and a thinker,”

    Have you considered a lifestyle change instead of a short-term diet (or surgery) that promises to help lose weight? And then when we return to the old lifestyle after the short-term weight loss diet, the weight piles back on.

    I know, I was there.

    Lifestyle change is free. No products, pills, plans, etc. needed.

    I changed my lifestyle, and that included my diet, back in 1982 and my health improved dramatically. That new lifestyle aso didn’t cost as much as my fast-food, soda guzzing, pizza, and beer lifestyle diet.

    During that first year, I lost 50-p0unds from 215 and eventually gained back about 15 where it stayed for decades at around 180.

    I don’t think corporations make profits from lifestyle changes because unlike a short term diet that claims to help lose weight, lifestyle changes are for life.

    Just suggesting.

    Like

  6. March 10, 2017 at 11:50 am

    If I ever write a book about this, there will be a chapter of all the people’s suggestions.

    Liked by 1 person

    • March 12, 2017 at 12:16 pm

      Well I won’t make a suggestion about something I don’t know shit about. I’ll just wish you the best and express my hopes for a positive outcome.

      Like

  7. March 10, 2017 at 11:50 am

    That’s a lot of news in one short post! Good luck with all of it… and the future posting/chronicle looks to be fascinating.

    Like

  8. lindapbrown2013
    March 10, 2017 at 1:38 pm

    Hey, Honey, anything that will make you feel healthy and simplify your life is great ! The women painted by Rubens and Renoir didn’t have the life expectancies we have. A medical adventure not dictated by illness –how cool !

    Liked by 1 person

  9. ed
    March 10, 2017 at 2:30 pm

    What happened with “I’m fat, and beautiful, and healthy”? What has changed?

    Like

  10. Aaron Lercher
    March 10, 2017 at 5:12 pm

    Best of luck with surgery. I admire your ability to make your own path, among other your other admirable qualities.

    Like

  11. Wazmo
    March 10, 2017 at 5:42 pm

    Some comments from someone who has been through one…

    (1) A lot depends on the type of surgery you undergo: the “Gold Standard” is considered the Vertical-banded Gastroplasty with a Roux-en-Y bypass, which tends to produce the best overall results. I underwent this back in 2000 and have kept a significant part of weight off, with the tradeoff of requiring vitamin supplementation. At the time of my surgery I weighed 397 lbs, today I am at 230 lbs. My surgery was an open surgery, today they can now do that laproscopically (my surgeon was also one of the pioneers of the surgery, and was 73 years old at the time of my surgery-he retired a few years later.)

    (2) Men tend to do better than women for some reason-why I have no idea. My sister-in-law states she had weight-loss surgery, and, quite frankly, she doesn’t look like she had any bariactric surgery at all.

    Like

  12. March 10, 2017 at 6:13 pm

    Ben Goldacre who writes for the Guardian under “Bad Science” has done a TED on the lies told in medical research. He is one of the fastest talkers in media and coupled with the cool British sense of humor he is a great presenter. I also have an interview he did with Bob Edwards. I can email you a link to an mp3 file.

    Like

  13. March 10, 2017 at 8:49 pm

    With both the TED talk and the surgery. I have friend who did it last year and he seems to be doing great. I lost fifty pounds coming up on five years now (different method but we’re all different people) and it has made a big difference in how I feel, in how I feel about myself, in the things I can and want to do. I carried that extra fifty pounds around for 30+ years and I’m happy every day that I’m where I’m at right now.

    It did change my self-image. And in another shock to the system, I just finished a round of Invisialign to straighten teeth that had been crooked for 50+ years. How I look to other people is not the deal, it’s that when I look at myself it is no longer a surprise.

    Like

  14. March 11, 2017 at 4:15 am

    Good luck Cathy – miss you on Slate Money so following your blog now and will follow your progress with interest

    Like

  15. dmf
    March 11, 2017 at 11:56 am

    would be good to take a deep dive into the attempts to label eating habits as “addiction” and what, if anything, that means.

    Like

    • March 11, 2017 at 12:05 pm

      yes!!

      Like

      • dmf
        March 11, 2017 at 12:54 pm

        worked in psychiatry for many years and we generally overstate our knowledge of such matters which is minimal, especially in terms of physiology let alone the complications of environmental factors.

        Like

  16. Thomas J. Ruppert M.D.
    March 12, 2017 at 3:24 pm

    As a sixty two year old white male physician of average height and weight, (internist with focus on addictive disorders) I would like to encourage and applaud the openness exhibited by yourself in this process. Bariatric surgery is an aggressive modality to address this matter and I assume that one with your cognitive capacities has both been properly educated by your physician and has self educated to fully comprehend the complexities involved. There are many branches on this decision tree, each bifurcation with difficult pros and cons to balance.
    If I can be allowed a bit of incorrect language this is one ballsy move, thank you for such a display of honesty. Quite a refreshing display of courage actually.

    Of particular value to all in today’s political climate would be an elaboration of insurer “obstacles” that must be overcome in what should be an private decision between yourself and your physician/s. Today’s insurers are motivated by short term quarterly/yearly returns whereas the full value of this intervention would accrue over many decades. In many ways this is the crux of the problem with healthcare financing in general. Your experience should be most enlightening.

    Like

  17. March 13, 2017 at 8:45 pm

    I am a primary care doc. I have seen people have excellent results from bariatric surgery. Avoiding bypass is a good idea. Way to go, Cathy! – Bob Curtis, MD

    Like

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