Why am I getting bariatric surgery?
I want to explain my reasoning, because it’s probably slightly deeper and more complex than most people imagine, unless they know me pretty well, in which case it might be simply baffling. A run-down:
- I love my round body. I am dreading losing a lot of weight in terms of what it will do to my body, especially because I will not be left with a perfect skinny person body, but rather a bunch of skin. I have spent months trying to come to terms with that but I haven’t yet.
- However, the dread I have about losing my round body is more than balanced by my long-term health considerations.
- I’m pre-diabetic and at extremely high risk for diabetes. My dad is diabetic and I’ve seen what it does to people long-term. People know about problems with feet, which he has, but people sometimes lose sight of the long-term effects it has on the brain. And I like my brain even more than I like my round body.
- Also, I like staying in shape. Biking is my favorite way to do that.
- Last summer, I realized that I simply couldn’t go biking in the summer heat. I felt like a prisoner all summer, cooped up inside the house and getting less and less fit. Thank goodness for swimming, but I’d really prefer to bike.
- Post-bariatric surgery patients complain about being cold, not hot. I’d rather be cold, because then I can wear one of my hand-knit sweaters outside while biking.
- Even when bariatric surgery patients don’t end up losing very much weight, which is rare, they’re almost always cured of diabetes.
- I also have arthritis and bad hips and bad knees in my family. Chances are that I’d need more surgeries, sooner, if I stay at my current weight than if I lose 100 pounds. Also, doctors don’t treat overweight people well.
- Indeed, if I didn’t have bariatric surgery now, I might find myself doing it in 20 years when I’ve had two knee replacements. Why wait?
- The surgery is laparoscopic, very safe, and I think the lifestyle changes are major but achievable.
Long story short, it’s a quality of life issue for me. I want to be one of those active grandmas that takes their grandchildren (or anyone’s grandchildren who will have me) to the zoo, and then bikes home. I don’t want to be defeated by global warming, nor do I want to be forced to move to Maine.
Now that I’ve explained myself, I’ll quickly mention what I find fascinating about the whole experience. Namely, all the reasons I’ve been given, and all the pushback in general, that this is a bad idea. They come down to three categories, which I plan to tackle in turn:
- Shaming tactics
- Financial incentives
- Bad medical information
mathbabe 
A well-balanced and wise decision.
However, keep in mind that surgery is but half the story.
Changing aspects of lifestyle and habits is harder, much harder.
But a determined mind like yours should be able to cope with that as well.
All the luck and success.
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My wife and I both have had sleeve gastrectomies. Her about 15 months before me.
One thing I found interesting about that is she ran into a fair amount of people who reacted to it by trying to tell her it was a bad idea. While I ran into indifference.
Small sample size and plenty of confounding variables but I felt like it was because she’s a woman and people were more likely to think she was acting simply for reasons of vanity (which, even if she were, so what few would have reacted so openly to breast augmentation).
Whereas it was actually me for whom such a case was stronger. I was very healthy fat person. No joint pain, no hints of diabetes, high blood pressure, and my cholesterol was good. My doctor ran extra tests saying it would help with insurance if they could find something other than just BMI. I too was fine with being fat but knew eventually I was going to have problems that prevented me from doing things I really wanted to do and would rather avoid it at 40 than try to fix it at 55. Nobody else could know all of that but unlike with my wife just seemed to assume I had reasons they need not concern themselves with.
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Super interesting, Alex, especially since the rate of such surgeries are much higher for women.
Do you have a theory as to why?
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No real evidence but I just saw it as evidence that people feel more free to comment on the personal choices of women, and to assume they’re acting without much forethought.
But it could just be our personalities are such that my is more pre-emptively rebuffing people.
When my wife was going through her rapid weight loss phase she constantly had people at work, including strangers, come up to her and mention her weight loss.
Whereas I literally went six months and nearly 100 pounds down with not one person at work mentioning it. Then a person from another office visited who walked right by me without recognizing me and then said something. That triggered an avalanche of other people finally feeling ok to say something.
Part of it is definitely personality, but my sense of things is that it is largely a gendered response.
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I lost a lot of fat pretty quickly. It’s true that you get cold. The other big problem I had — also as a swimmer — is that at some point you start to sink. Swimming becomes a whole different enterprise.
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I simply cannot imagine sinking. I cannot swim underwater for more than a couple of feet right now, I keep bobbing up to the surface!
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Thanks for explaining the background. It was very interesting to me as someone who was unaware of the wider issues.
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Your reasons sound sensible to me. Good luck with the surgery and recovery.
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Dear Cathy, since I read your book about doing data sciences on 2013 I have been keeping an eye on your work. At the begging of this year I read the weapons of math destruction and I started to admire you. But please, do not bring your grandchildren to the Zoo, it is not enough to stand against oppression of man against woman, global north against global south, or white against black, Latin, etc. It is really important to stand against the oppression of humans against animals as well, or at least to don’t teach our kids how funny is to oppress them. 🙂
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Anyone who knows you even a little knows that you’ve made the decision in a calm and rational way. I hope the surgery and immediate aftermath all goes well. As for everything else, I have a lot of confidence that you will follow through as you envision. All the best!
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I wish you great success on your surgery. I understand all of the reasons you have given. Diabetes is also in my family history. If I was employed, I more than likely would have had cosmetic surgery years ago. Now that I am older, I don’t think I will go that route right now. I am just going to limit the type of foods I eat, smaller portions, and exercise. I will be cheering and praying for your success. I know you will be great.
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As a surgeon involved in bariatric surgery, I guarantee that you are doing the right thing. Your life will be changed for the better and your health will be much improved. Sure, there are potential complications as there are with any surgery, but this one is definitely worth the risk. Once you have lost a significant amount of weight, you are correct that you will have a lot of excess skin. But we can fix that as well. So good luck and best wishes for a new , healthier you.
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Getting to know you is a joy and is enlightening. I’m an old codger (79) and my kids and grandkids get a big kick out of my blogging with a Mathbabe.
Best wishes with your surgery and its aftermath. My son bikes to work every day and loves biking up along the East River, named after the wonderful FDR.
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best of luck! you are an awesome writer and political activist. your reasons only need to make sense to you, but courageous to put this into a public forum. when you transform a key element in your life, it transforms your entire life. All the best
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Good luck, Cathy! The only reason I have a right to speak about is it’s better to escape diabetes. Admirers of your work, me included, need you to have as much quality of life as you can, so we can keep listening to what you have to say.
Things will be fine. A friend of mine and his wife had bariatric surgery some years back, and life proceeded fine (even if he eventually “defeated” the surgery with old habits). Have a strong hug from Brazil.
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As an amateur data scientist and former mathematician, I read your book with great interest and found it engrossing and enlightening. Now, whenever I see an algorithm that scores this or that, my first thought is: “OK, where are the biases and what is the possible negative feedback loop here?”.
Congratulations on your decision which I find was made with a clear set of objectives. I wish you the best in your recovery. And by the way, Wolfie is adorable. You scored a cute and smart kid. Good job, Momma.
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I just saw this now — best of luck Cathy. A prominent member of the whimsley household has been through two knee replacements over the last year, and (while they went well) I highly recommend keeping your own knees if possible.
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Thanks, Tom!
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Good luck and keep up the determination to follow it through. It’s the long term consequences that are the problem, and too many people put of facing them until it is too late. As one who gave up smoking and drinking and took up diet and a fitness regime, I know it’s not easy, but as I approach the age of 70 I know I have a far better quality of life than I otherwise would have.
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Thanks Graham!
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Your dad might benefit from reading Richard K. Bernstein’s “The Diabetes Solution.” Bernstein was the first diabetic to buy a glucometer and monitor his blood sugar on a regular basis. I’ve been diabetic for 17 years now and following Bernstein’s advice I suffer from none of the co-morbidities that the medical community considers inevitable. I’ve kept my A1C in the low 5s the whole 17 years. The diet I eat is much like the post bariatric surgery diet. If you follow that diet you will get better whether you have the surgery or not. Wishing you well.
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Good choice. Diabetes sucks. The world needs your sage counsel.
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I find myself in the “pushback” group, and curious to hear your thoughts about the three categories you mention. In particular, here are some references that present a rare perspective in the fat-phobic medical industry. That said, what we do with our bodies is our own business, and undoubtedly your decision was very carefully considered. I hope one day we live in a world where punishing discrimination does not make messing with our body’s incredibly complex energy absorption system an appealing option. Wishing you all the success and sending loads of support.
10-year longitudinal:
Suter, M., J. M. Calmes, A. Paroz, and V. Giusti. “A 10-year Experience with Laparoscopic Gastric Banding for Morbid Obesity: High Long-Term Complication and Failure Rates.” Obesity Surgery 7, no. 16 (2006): 829-835.
14-year longitudinal:
Victorzon, Mikael, and Pekka Tolonen. “Mean fourteen-year, 100% follow-up of laparoscopic adjustable gastric banding for morbid obesity.” Surgery for Obesity and Related Diseases 9, no. 5 (2013): 753-757.
obesity and disease:
Walley, Andrew J., Alexandra IF Blakemore, and Philippe Froguel. “Genetics of obesity and the prediction of risk for health.” Human molecular genetics 15, no. suppl 2 (2006): R124-R130.
other resources:
https://www.figureate.com.au/the-non-diet-approach-research/
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Thanks, and don’t worry, I like nerding out about this stuff!
As for the first two links, it’s well established that lap band surgeries don’t work. It’s super interesting, because it put the lie to the assumption that smaller stomachs would lead to weight loss. Turns out it’s more likely that the cells that line the stomach are hormonally active, and that’s why gastric sleeve and bypass work but banding don’t. I’m getting a sleeve.
As for the third link, I am absolutely aware that being overweight doesn’t necessarily put someone in a high risk category. But being very very overweight tends to, and as for myself I’m also pre-diabetic and likely to get arthritis. So my personal risk profile is very different from a generic “overweight” person.
Thanks again,
Cathy
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