Several years ago, I started reading a blog about food written by a particular woman. It had nothing to do with dieting or weight loss. She was writing reviews of various restaurants and snacks that she tried. As time went by, she stopped that blog and started another. The new one was about her life married to a man in her husband's particular profession (which is hardly rare, but relatively uncommon and wives with such husbands have unique challenges). I mention that I started reading her blogs with these topics because now she has changed to writing about having weight loss surgery. I generally do not read blogs about people who are having, have had or are contemplating WLS, but I already have a "relationship" with this writer and an interest in her life.
I've said before that I think people who have weight loss surgery are essentially putting a biological gun to their heads in order to lose weight. I still believe this is true. I also said that they are likely braver than me for having the courage not only to endure the pain of surgery, but also to force themselves into this position. That also remains true. However, I have changed my thinking about the value of such surgery as I've learned more and more that it can be an incredibly destructive force in some people's lives and a sizable number of people (somewhere in the vicinity of 1/3) end up regaining the weight they lose and more.
It seems likely that it metabolically damages people in a manner which is more severe than extreme dieting (under 1000 calories). I once read someone say that they believed WLS would one day be considered as poor an answer to weight problems as extreme lobotomies were to mental illness. Yes, it can fix a problem, but it creates many others. People can die from WLS complications and their food issues are not fixed if they don't change their relationship with food forever as a result of that surgery. I continue to believe that psychology, not biology, is the main driving force in weight problems whether they be related to overeating or under-eating.
That is not to say that I believe some women do not ultimately benefit from WLS. Clearly, some adapt to the lifestyle change, never stretch their reduced size stomach and it becomes a catalyst for lifestyle changes that they couldn't manage pre-surgery. That being said, such adaptation would have been possible without surgery. The surgery just makes it harder to overeat initially because you vomit if you eat too much and feel full quickly. When you try to eat less without surgery, the only thing stopping you is hunger and psychological issues. Both of these are potent forces that are hard to ignore when you have the biological capacity to fully sate yourself. I don't underestimate the value of a biological stopper for people who can't find their way to eating less. However, the price to me has always seemed too high.
The woman whose blog I've followed through various permutations has presented me with a lot of personal challenge in terms of taxing my self-restraint. I have wanted to say, "don't do it, there is another way," but I realize that there may not be another way for her. I also know that everyone has to make their own choices and, yes, mistakes in life. I've been allowed to make my own and have made plenty. I have refrained from commenting unless I can be honestly supportive in line with my views.
I wish her well, but I feel that the odds are stacked against her given that she has always been a much bigger consumer of junk food than I ever was (because I never ate that much of it). She eats out a lot. I believe that the binge before the restriction habit among people who are attempting to lose weight is always a bad sign and she went crazy the weeks before surgery and gained 17 lbs. before going on the pre-op diet that she had to endure. She eats poorly, and has already overeaten and thrown up several times with barely a week and a half of time between her and the surgery. I think that, while the pouch is small, she will be restricted and lose a lot of weight. Ultimately though, I think she'll return to old patterns with a heap of metabolic damage on top of it and be worse off in the long run. I hope I'm wrong. I'd love to be wrong.