by talkingmountain » Thu Jan 11, 2018 2:12 pm
As someone who's undergone gastric bypass AND who is in the uncommon position of having tried "McDougalling" multiple times prior to surgery, I felt it important to respond to some of the thoughts in this thread.
First, re the original post, I agree that it is a shame that the medical establishment in general still fails to recognize that there are "treatments" that may be as effective as bariatric surgery. There are hopeful signs that this is changing. With Medicare's 2016(?) approval for Dr. Ornish's "intensive cardiac rehabilitation" program, I think that we will see insurance companies start to cover lifestyle interventions, assuming Ornish is able to publish studies that document good success in the years to come.
I can also tell you that like many others, I wanted nothing more than to go to the McDougall 10-day or any other similar live-in program. I felt it was my best chance at getting away from hyperpalatable foods long enough to lessen their hold on me. Needless to say my insurance wouldn't cover it. Despite despite trying for several years, I couldn't save up the approximately $9,000 it would take to do that. I totally believe it would have been "worth" the money, but saving that amount wasn't possible.
Now to respond to some of the other thoughts expressed in this thread.
1. Taking the "easy way out." Let me tell you that, assuming you go to a reputable bariatric surgery program and are asking insurance to cover it, there is nothing "easy" about the preparation, recovery, or long-term maintenance. NOTHING.
You will first have to document that you've been trying dietary methods for many months. You can't just say it; you have to prove you've been on Weight Watchers or something (all of which cost boucoups $$).
You will then endure months of paperwork, interviews, psyche evaluations, training classes, etc. You will part with a lot of money before and after the surgery. You will get to "enjoy" a 10- to 30-day liquid fast before the surgery. Afterwards you will have gas pains that you think will kill you.
Once you are able to start eating "regular" food again, one bite of food that you "shouldn't" have can make you so sick you wish you could die. Going out to eat will never be fun again, because of the exhaustive list of things you have to avoid.
Beginning about 1 to 1.5 yrs after the surgery, you will have to be just as vigilant as before about what and how often and how much you eat. And for the rest of your life, any time you try a new food you will have to be prepared that it could make you ill.
And during all that, you will be reminded (rightfully so) by the staff and your family and friends that you could die, or be saddled with serious lifelong health problems, if you pursue this path. You will be reminded (rightfully so) almost daily that the path you are pursuing is no guarantee of success. At best you will end up losing 70-80% of your excess weight; at worst you could end up where you started. (I am the rarity in the bariatric surgery world, having has lost 100% of my excess weight; I attribute that to the fact that I follow a plant-centric rather than the meat- & dairy-centric diet prescribed by most bariatric surgeons).
And this is assuming everything goes "perfectly." If you end up with a serious complication (as I did, despite being very low risk), be prepared for missing even more weeks of work, $$thousands in hospital bills, painful tests, and lots of other fun things.
I'm sure there are people out there who've elected bariatric surgery because they thought it would be "easier" than dieting; but I guarantee you they are in for a very unpleasant surprise.
It was heartening to see that some of the posters on this thread "get" how strong the call of addiction is, and that food is, for some, an addiction. "Try to quit smoking in a smoking lounge" -- @Werner1950, that's a good analogy!
2. There's a common misconception that bariatric surgery is a "cure" for obesity. It is not. It is merely a tool. It also is a tool of (or should be) last resort.
For people with a food addiction, or an inability to sense fullness, bariatric surgery can be an incredibly valuable and effective tool because when you eat high fat, high sugar foods you will (if you are "lucky") experience immediate and terrible pain (called "dumping syndrome").
And for people who are so sick and in such physical or emotional pain that adopting a diet of any sort requires more energy than they can muster, it is a way to get the weight off fast enough to give them the energy & hope they need to adopt a healthy lifestyle.
Of course, only IF they are willing to do the work. For the rest of their lives.
Think of the "tool" of bariatric surgery like this. For someone who is addicted to heroin, methadone can be a life-saving tool to kick, or at least control, their habit. For someone who is addicted to alcohol, Antabuse can help them experience an immediate negative reaction that helps retrain their brain to associate alcohol with immediate pain. For someone who is addicted to food, bariatric surgery can serve to help them avoid addictive ("hyperpalatable" to use Dr. Kessler's term) foods long enough to break the addiction habit. In all 3 cases, the addiction is always lurking in the background, ready to roar into life if you start stoking its fire.
3. There really are people who have trouble sticking to the McDougall way, even though they believe in it wholeheartedly and try their darndest. I know because I am one. It's not a shortcoming of the diet; there is nothing more satisfying and healthy than Dr. McDougalls starch-based way of eating. It is by far the only diet I've ever had even a modicum of success at (Wt Watchers 7+ attempts, all fails; Nutrisystem, Jenny Craig, The Zone, Atkins, MediFast, Fuhrman, 7th Day Adventist... you name it I failed at it).
I'm sure there will be ignorant people on this board who tell me I just didn't try hard enough, but I am determined to ignore the haters. My family and doctor and therapist and I know all know the effort I put in and I'll draw consolation from that if needed.
The bottom line is, sometimes it's not "either/or." Sometimes it's "both." Some of Dr. McDougall's "100%-adherent" patients still need a statin to get their cholesterol into the ideal range, or a small amount of insulin to keep their diabetes at bay. Some chronic overeaters may need both the McDougall diet and bariatric surgery to adopt a healthy diet.
For me, gastric bypass has been the tool that has enabled me to finally adopt and stick to a whole-foods, no-oil, plant-centric diet for 2 years now. And that success has given me the confidence that I can go even further to improve my diet without falling into the "all-or-nothing" perfectionist trap that has tripped me up so many times. Not to mention given me the energy to implement those changes.