Dr. Terry Simpson - Weight Loss Surgery: A Lighter Look at a Heavy Subject

WEIGHT LOSS SURGERY

A LIGHTER LOOK

AT A HEAVY SUBJECT

WRITTEN BY

TERRY SIMPSON, MD, FACS

Copyright 2004 Terry Simpson. All rights reserved.

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ISBN 1-4120-2283-5

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Contents

Thanks

I could not have completed this book without the help of my editor, Yvonne Gray, and my illustrator, Jim Hunt. My editor had infinite patience (as you can see) and somehow my illustrator just keeps drawing away. Thanks, Von, for not shooting the author.

I dedicate this book to my patients and friends from the Gila River Indian Reservation.

The year that I finished my surgical residency, I went to work for the Indian Health Service in Phoenix where I was assigned to a clinic on the Gila River Indian Reservation. I have continued to maintain a clinic at Hu Hu Kam Memorial Hospital, the hospital that serves the reservation, since 1991.

From the beginning, I felt a kinship with my patients. That is probably because these first patients are my distant cousins. I am of Athabascan heritage (interior Alaska Native). These were the first snowbirds, migrating from our home in Alaska to the Southwest thousands of years ago where for many years they lived a peaceful existence along the banks of the Gila River. Then the white man came and formed reservations. They also brought with them white bread, white sugar, and lots of lard. As a result, this small reservation has the highest incidence of adult-onset diabetes and morbid obesity of any group of people in the world. Their cousins, who live in Northern Mexico, do not enjoy this bounty of dense, fat-laden carbohydrates and do not have problems with obesity or diabetes.

I have learned a lot from these patients. I learned to laugh, and I learned that if you feel no way, that is a good thingbut if you feel some way, then something is wrong. So, for Troy, Tony, Robert, Patricia, and a thousand other patients who have taught me so muchthank you. Just rememberdrink a lot of water. It may be only 117 degrees outside, but it is a dry heat!

Also dedicated to

Part 1
Pre-Op

One
Diet and Exercise

There are alternatives to weight loss surgery. Diet and exercise do work but, instead of developing a new routine and new habits, patients fall back to old habits and regain their lost weight (it never really is lost, is it?). In fact, you cannot dispute that diet and exercise are critical to the success of weight loss surgery. You can go a step further and say that if you follow a reasonable routine of diet and exercise like the ones outlined in this book, you will not need any form of surgery.

The laughing you hear in the background is from my friends who have gone through this before. Okay gang! Quiet down. We might have some righteous skinny person reading this book telling their vertically-challenged friend, See, Dr. Simpson agreesyou just need to blah, blah, blah.

The reason we surgeons do weight loss surgery is because there is a point where patients get tired of the cycleor recidivism. Thats a great word. It means falling back to old habits. The National Institute of Health reports that

95 percent of people who are morbidly obese will regain lost weight within two years.

Ah oh, here come those righteous preachers againthey are going to tell you all about willpower. Let me just list those lines in this book for those who dont wish to contemplate weight loss surgery and want to think about diet and exercise:

(1)You just need to

(2)You just need more willpower.

(3)Try this pill (pick one). God knows what is in some of these pills you can buy without a prescription, and doesnt it make you feel good to know that there are no government regulations about these pills or their claims of being safe and effective?

(4)Do this workout (pick your favorite skinny star who is pawning a tape or DVD of their plastic surgery-reconstructed body doing some workout).

(5)Try this machine. Oh, the infomercialsyou have to love these. There are machines that make you feel like it really isnt exercise! There are machines that are designed to make you lose weight in 30, 45, or 90 days. I have owned a couple of machines and found that they make a great place to hang clothes.

(6)Lose weight while you sleep (for those who slept through the class where you learned about PT Barnum and a sucker born every minute).

(7)Biofeedback (as if food isnt the worlds greatest biofeedback).

(8)Behavior modification (just strap these electrodes on your ).

(9)Try this prescription (to see last years favorite weight loss drug, check the yellow pages under legal firms). Of course, some weight loss drugs work well. Amphetamines and cocaine are two great examplesbut they will kill you faster than obesity.

A multibillion-dollar industry is built around obesity. There is everything from fad diets that make you pass gas or eat roadkill, to pills that contain stimulants like ephedrine that can, and do, kill people. There is a diet for every food groupthe protein diet, the carbohydrate diet, the fat diet, the sugar diet. There is a diet for every food. There is the rice diet, the grapefruit diet, the salami diet, the cabbage soup diet. There are diets that are low in carbohydrates, and diets that are low in protein. Fat is good. No, it is bad.

Confused yet? Even the worlds experts, cannot agree. I loved seeing the late Dr. Atkins and Dr. Ornish go at each other; it was more fun than watching wrestling. There is more arguing about the best diet than there is arguing about whose church to worship in. Then there are those who say that the answer is not food, it is vitamins and supplementsbut not just any vitamin or supplement, you must have the one they are selling (what a shock). Why eat, just take these pills with this powder, mix it with this bottled water or skim milk (blue water) and you are on your way to weight loss. Soyant green is the best for this (for later generations see The Matrix, and what that machine feeds its batteries).