Episode 122 Transcript

Welcome to the Fierce Fatty Podcast. I'm your host, Victoria Welsby and this is episode 122. Today, we're talking about “Stories From Weight Loss Surgery Patients 8 Years Post Op”.

I'm Victoria Welsby TEDx speaker, Best Selling Author, and fat activist. I have transformed my life from hating my body with desperately low self esteem to being a courageous and confident fierce fatty who loves every inch of this jelly. Society teaches us living in a fat body is bad. But what if we spent less time, money, and energy on the pursuit of thinness and instead focused on the things that actually matter? Like if pineapple on pizza should be outlawed? Or if the mullet was the greatest haircut of the 20th century? So how do you stop negative beliefs about your fat body controlling your life? It's the Fierce Fatty Podcast Let's begin.

Unknown Speaker 1:19

Hello, welcome to this episode off the podcast. How are ya? How's life you feeling? Good? I'm feeling good. So today, I'm not going to be regaling you with stories of dates and pimple popping. up today, I feel like oh, God, what are they going to be talking about today? No, none of that stuff. Because I haven't been on any date. So very sad, very sad. Reminder to write a review for the podcast on Apple podcasts, I think is the only place that you can do it. Write a review for for the podcast, and I will be eternally grateful. And the reason why I'm asking you to do this, if you want to don't have to, if you don't want to, is because the more reviews are more

Unknown Speaker 2:16

likely. Other people will see the show. Because other people are saying hey, it's gone. It's gone God, or whatever it is that you think about

Unknown Speaker 2:28

the show, hopefully that you think it's good. Anyway, so if you can do that on Apple podcasts, that'd be great. I just be so happy if someone reached out to me and said, How do you do review and I was like, well, Firefox, like I didn't tell you how to do it. Last episode, I was just like, write a review. And so people might have been like, Where the fuck are you talking about Vinny? And that is where you do it. Other podcast platforms, I don't think have the option to write a review but Apple podcast does. So alrighty. The inspiration I for today's episode is from. I'm in a Facebook group called fat studies. And Deb God, who I've mentioned on the show before, incredible fan activist. She posted a link to an article. This is a comment that she posted with it. Here's a tiny bit of testimony, seven people in Norway eight years out for the surgeons and researchers who are unaware of the long term realities of starvation and lack of solutions after the honeymoon period of weight loss surgery. The people here also speak to the self blame for the lack of loose solutions. Showing that even when one's body fits in better training as a fat person to blame your self for the neglect and abuse of the medical system remains untouched. It's so cool that these people imagine that because they gave quote informed consent. They then they must have brought their miseries on themselves when informed consent without data is impossible. Love that informed consent without data is impossible. And so Deb is linking to an article called untold stories of living with a bariatric body, long term experiences of weight loss surgery, written by Anita Berg who is faculty of Nursing and Health Sciences, not University, Norway and this was released released September 2019. I wanted to make this episode sharing more stories about, quote, weight loss and quote surgery because I put in quotes because more often than not people don't lose weight from weight loss surgery. So I wanted to have this as a companion piece to it. Episode 50 which is called What about weight loss surgery and you can find that easily by going to face batty.com forward slash 050 for that episode, so, can't believe that like seven episodes ago was when I first started collecting this stuff on weight loss surgery. And so that's a really good episode if I do is eyes. Oh, Mazel Tov, with tons of research around the surgeries the stomach amputation and skirt stomach squeezing surgeries and and this is the bio the synopsis for that episode. Does weight loss surgery make you thin? What percentage of people? Is it successful for other side effects worth it? And what are they exactly. And so this episode, that episode is going to be talking about this surgery, including mention of suicide attempt, and no mention of calories or pounds or anything, I guess we're talking about the reality of living with a body that's gone through this surgery and so that can be kind of difficult to hear about. Because other times it's not fun. And now just an FYI, I'm sharing these experiences, which are talking about the negative experiences. And I just want to point out that there will be people who've had surgery to amputate or squeezer stomach who come out, they lose those away, they have no side effects. And they're like, this was the best decision of my life. My life is great now that okay, so that does happen. But what doesn't happen is people don't get this information when they are looking to if this surgery is good, right? Because all of the because of the you know, the massive injury industry behind it. If you Google like side effects of weight loss surgery, or weight loss or weight loss or weight loss surgery stories, you're not going to get this information, you're going to get sanitize, sterilized,

Unknown Speaker 7:21

hyper positive evidence and stories of people who are likely to change my life. So it's important to have this information out there to show the other side of weight loss surgery. And the other side being that heads nod, it's not a, it's not a great thing to do if you have the choice, if you have the choice, because I know some people don't have the choice to not have surgery because healthcare has been denied to them, unless they do it. Also, sometimes the chance of living in a smaller body. And all of the awful side effects out ways doesn't outweigh the let me say that, again. The living in a living in a fat body in this society is violent, right. And so sometimes people will pursue weight loss at great cost, because it is so difficult to live in this society as someone who is very fat. And on top of that, also for people who have different marginalized identities on top of having a bigger body. And so I I don't want to say anyone who's had or is thinking about or is planning to have this surgery is is not intelligent, is not you know, they haven't thought about it a lot and is not is doing something bad and wrong, because the reality is actually complex. You know, it's really complex. But we also want to get out stories of the realities of weight loss surgery, because like I said, you Google it, you'll see you know, happy thin people running through fields having puppies, saying that weight loss surgery was the best thing ever and they've never had any terrible side effects and blah, blah blah, which is true for

Unknown Speaker 9:45

some people. I do that. Because who knows? And the reality for others is death and the reality for most. So let me read this, this posed to you changes that I made after my previous episode about weight loss surgery, weights talks about weight loss surgery facts. Okay, so weight loss surgery facts. So what are the outcomes? Will it extend your life 4.6% of people who have weight loss surgery die within a year, and that's 7.5% for men 6.4 will die by four years, and 15.8 by eight years. Three out of 1000 people die within 30 days of the surgery. There's an increased mortality risk of time seven in year one, and 250% to 363% by year four. Would it make you thin and healthy. Two years after the surgery 46% have regained weight. And by four years 63% of people have gained weight. We don't have good data. Past that, because people stopped measurement measuring sound familiar, something that weight loss companies do year five afterwards is a little time when weight comes back on. There are no randomized, controlled, controlled clinical trials that have shown any long term improvements to actual health or that lives are saved or extended. The complications 20 to 25% of gastric bypass patients develop life threatening complications. 89% of patients have had at least one adverse event 1/3 of them severe 56 of 56% of bariatric patients have had 62 Different gastro gastro intestinal complications and abnormalities. There's a double the risk of substance abuse issues. And four times increase in death by suicide, the cost of the surgery, most insurance companies won't pay for the procedure, which costs 15 to $25,000, which is one of the most lucrative specialities for doctors. Of course, there are some countries in the world that will pay for it. And so we're talking about North America here. So will weight loss surgery make you thin make you healthy? Is it worth the risks? I don't know. I I'm not able to answer that answer that for people. But looking at looking at that information is not something that I personally would choose for myself. But also I want to recognize my privilege here as a white person. As someone who is able bodied as someone who is a medium fat person, my experience of fatness is laden with privilege. And so that's a decision that I have made, because the pain that I'm feeling in regards to living in a fat body doesn't outweigh the risks of death and adverse health, side effects for surgery. That probably won't make me smaller, long term temporarily it probably will. Okay, so let's look at this in this article. And what I'm going to do is I'm going to be reading new people's exploring answers that's collected by an eater Berg and the article explores long term experiences after going undergoing bariatric surgery, which is shortened to BS, which allow girls bariatric surgery is this with individual interviews now, there are different types of bariatric surgery, and it needs it doesn't say what, what Norway has done in regards to their bariatric surgery. The way that Anita talks about it, it's like there there is one standardized surgery and so if it's just one standardize where it's stomach amputation, that is that sounds like what it is because she's saying it's irreversible, which amputation is whereas a bypass or squeezing, that could be reversible, great risk, you know, but still, and so

Unknown Speaker 14:30

that's something to keep in mind is we don't know exactly what type of bariatric surgery also we have. So the participants were four men and three women between the ages of 35 to 61. When at the time of the interview, and all of them self reported to have lost weight and kept that weight off. So at the time of the surgery, they said, are you okay with us talking, you know, people contacting you to talk about your experience. And then again, in follow up interviews, as they confirmed they were and they had a number of follow up interviews with a Anita who tried her best to be impartial, and just kind of probe and ask questions about their experiences. Of course, it's impossible to be impartial. Because we all have biases, and agendas and all that type of stuff. So, here as well, we've got seven experiences, and it's sis people. We don't know anything about any other of their identities apart from there's a no on, you know, they were married, and they have kids and things like that. But we don't know. You know, are these are white people? Are these these these bipoc people? Are they trans people? You know, presumably not because she says men and women. So I mean, white supremacy is is, is all around in this type of stuff. And so I'm transphobia. And notice how often those stories are not shared. Also, on the other hand, it's hard to get people to talk about this stuff. Especially long, long time out. People, what we see is we've got a lot of studies from people who are a year out of their surgery, 18 months out two years, three years, those people more often other people who were spoken to, or, and or are the ones who want to talk about their experiences, because presumably they're at that point where they've lost weight. People who are longer term, they either have put the weight back on and or they are also seeing the negative side effects really manifest in their life. And as we can see in in the stuff that we're going to be talking about here, you'll see that the stories, a lot of times they're blaming themselves for those outcomes, versus being like, well, the surgery, the surgery was something that's, you know, unethical, not well researched, forced upon me as the only options of that person. And therefore, and I wasn't told about all of the consequences, and therefore the consequences are not my fault. And they're not my fault anyway, even if I did consensually go into the surgery. Yeah, so it's complicated, right? And there's lots of different variables at play. And, yeah, so what I need to start with is talking about all that type of, she doesn't mention the stuff that I just mentioned, but talking about like, who the people are, and how she interviewed them using certain techniques and, and she continues, this is quote from her the experiences of living with a bariatric body fell into three main themes. One, the bariatric body in daily life, to being a dignified patient and three, shame and unknown problems. So the first thing that that we go into here is dumping syndrome and in here, we'll explain what that is. So this is this is I'm going to be doing reading from the article Okay, so are you comfortable, I will begin they'll put participants relate related the non and by the way, the Oh words, I'm going to change them, so you don't have to hear them. So I'm just going to change the words to fat. The participants related their nonfat life to the presence of the bariatric body, and specifically to dumping syndrome DS, thus, eight years after their surgery, all the participants still have problems identifying what they could tolerate. Lin who succeeded very well, in her sustained weight loss pinpointed this continuous challenge on a daily life. One day I can eat eggs, and the next day I react on eggs and eater asks, Are you still trying to figure it out? Yes, I have to every day. I have to figure it out. The effort

Unknown Speaker 19:24

of sorting out what to eat is experienced as energy consuming and uncertain science, says Lynn these are pseudonyms by the way. So DS dumping syndrome is an is an intended effect of surgery. Let me repeat that again. dumping syndrome is an intended effect of surgery and kicks in as an instant bodily reaction when the wrong kind of food or an Send too much food or in the wrong combination is eaten and is valued positively as a barrier to overconsumption. This bodily reflex reflex causes rapid gastric gastric emptying by vomiting, and sometimes diarrhea, and is often accompanied by sweating, dizziness and irregular heartbeats. The consequences of eating the wrong food in the wrong quantity and timing is causing an urgent need for a timeout in the bathroom and puts them out of action for several hours. So it's I find it very interesting. It's that DSX is an intended effect, right that that is there to punish the bad fat people for eating too much food, eating food at the wrong time, or eating food that they will react with. And as we saw from Lynn story, that one day she can eat eggs and next day she can't eat an egg. And so people are struggling to know how to eat because their body is just all over the place. Okay, continuing DS was a well known and expected effect that was essentially viewed positively. problems occurred when participants were unconscious, or when other circumstances such as activity, stress or illness interfered with this issues not understood prior to surgery. Roger explains his three safe cars to avoid DS coffee at work, sushi at restaurants, and beer instead of dinner. This is a quote from Roger. It is challenging to find the middle way, no days are the same and then it becomes difficult. Or I often refrain from the whole meal. I have to cut the nine o'clock meal at work so I won't be sick. But then it becomes wrong because they say you should eat every third hour. I take comfort in drinking or comfort is not the right word. I replace food with alcohol because then I'm in control. So after I become single, I gave up dinner and took a beer instead. I know how much I can drink before getting ill. But I can be sick from one meatball and a spoon of gravy. I was tired of gambling with eating a couple of beers work well and stop the hunger. And then the ball just started to roll cries silently. I needed alcohol more than food. Food was too complicated. So summarize, this is a neater speaking so summarized food is still a big issue in your life after BS. Bariatric Surgery. Yes, because food plays a major role in everyday life. Coming home after work trying to participate in social settings is difficult. I have withdrawn socially Yeah. It goes in kaput goes in coffee at work. And in the weekends with no plans. It is easy to resort to the beer but so that echoes the double the risk of substance abuse issues. I read recently that substance abuse is is not the right way to say that. But they didn't say what was the what is the right way. So just wanted to point that out. There might be a better way to say that instead of substance abuse. Okay, so let's move on. The next section is and so there's more stories, but I'm not going to be reading all of them. Next section is crumbling bodies.

Unknown Speaker 24:08

Okay, so here's a quote. Initially, it gets better. You get rid of the many problems you had before surgery, but after a while, I realized that you receive too little information in advance. Bariatric Surgery was quite new in Norway, then I see it now afterwards, I would not have done the operation again. I'd rather be locked up in a prison cell with locked Jaws because you're very plagued afterwards. I need to asks What problems have led you to such a conclusion. One of the things easy to pinpoint is the lacking absorption of vitamins and minerals and the hormones freaking out all the ways. You eat nutrition supplements for hundreds of pounds each month, but you cannot compensate. Nine days ago I was at my GP and I think it really he sums up how the doctor sees it. And then he read from a letter that he'd received from her from his doctor received reading to me from a letter he received the previous day, quote, blood samples taking it for for show very low levels of vitamin D, maybe you should increase the dose of a telfa. That's what its doctor is saying. So when the doctor does not know what to do, yes, because he asks you if you can double the dose, yes, because I'm on the highest dose he can prescribe and bone density measurements. They say that in three to five years I have I have osteoporosis, osteoporosis, if it does not turn, no. And vitamin D is important for taking calcium. I've never had any dental problems, but now my teeth are breaking like crackers. So when it eventually gets empty in the calcium, calcium reservoirs are as it was reservoirs. I do not do not know what to do. So we need to relate experiencing crumbling bodies and rapid dropping capacity to cope with everyday life made participants draw parallels to aged bodies. As Roger summarized as similar experience. My body is breaking down faster than I am aging. The decomposition of the body begins before you die. In some, the Yes, led to smaller and more capable bodies, but also disrupted bodies undesirably interfering with daily life. Okay, so the next part is called being a dignified patient. Dude, he's asleep next to me, and he's doing little. Let's see if you can hear him. Nice stop now. Maybe you woke up because he heard me say his name. Okay, so being a dignified patient. The feeling of responsibility is prominent in participants stories about undergoing surgery intertwined with their stories of compliance and making their new body's function as intended in daily life. Quote, I think that you have to know what you're getting yourself into. Of course, you're not guaranteed that it will be 100% Fine. But at least I think that I have to do my best to make it as good as possible. Because I hope and I suppose they've done this, then it's up to me, you cannot go back. So you will accept quite a lot. You have to take it up on your own self. And it's hard to say anything. It's a bit embarrassing to tell because it actually means I haven't done my job or paid enough attention to the preoperative training. So talking about how this person is talking about how they have to be a good patient now post op, and if they have complications, and it's their fault because they weren't a good patient. And he just says the participants have an underlying feeling of responsibility entangled with blaming themselves for their need for and choice to undergo the surgery as well as for problems experienced after BS. Okay, shame and unknown problems. And he just says, even eight years after undergoing BS, all the participants exercise caution in talking about their surgery if they are not 100% comfortable with the interlock, you interlocutors, interlocutors interlocutors This is from the dictionary, a person who takes part in a dialogue or conversation. So why did the wonder of use long word of God interlocutors, okay, so

Unknown Speaker 28:54

if they're not 100% comfortable with it interlocutors, and they still have not taught people they interact with daily about it, due to the feeling that surgery is a defeat and an abnormal way of losing weight, quote, imagine losing a pound a day. It's not your achievement. I'm not proud. It was no hard effort to get on the operating table either. And I laid myself there voluntarily. And I know very well that I was too fond of chocolate. Therefore, it was self inflicted to get there because I failed. I was unable to do anything about my weight problem myself. So I'm not announcing Hi, my name is Hannah, and I have bariatric surgery. Laughing. If I'm asked, I will tell but I feel ashamed. On the web, for example, if anyone asks for some experiences, it is not certain. I'm the first to help out. Because then in a way, I'm revealing myself. Nothing. I'm a bit embarrassed by the fact that I was so big that it was irrelevant. I think it's more notable to lose weight by yourself. And now, I just want to really like this quote from Hannah. How much shame and blame is in there? And fat phobic beliefs? Right? Okay, so I'm not proud. And she isn't she's saying I'm not proud because I didn't do anything difficult when actually, she did do something incredibly difficult. And she says I was just lying on the operating table. It has no, there was no hard efforts. But actually, I imagine for Hannah to be at that point where she chose to have surgery, there was a lot of struggle that she went through, you know, and I mean, Jesus, having a tooth out, or getting a felon is difficult. I've got four fillings in the next next Friday. Oh, looks good. And so it's really diminishing, she's really diminishing the hardships that it took and saying I was no efforts, you know? That, you know, it's it's hyperbole, it's, she's really Yeah, docking herself. And then she says, I like myself there voluntarily and I know very well that I was too fond of chocolate. This is what you'll see often is people say, you know, I blame myself I know it's my problem because I ate too much food. And it's, that's a fat phobic assumption, right? There's a fat phobic belief coming to the forefront, which is this very black and white thinking of I eat chocolate, therefore, I am fat. And I am to blame for my body size. Now, do we know what causes fatness? Yes, yes and no. Yes. And it's in the hundreds, hundreds of different reasons. And do we know why people may eat more chocolate than they think is okay. So someone says I just eat chocolate day and night. From the moment I wake up to the moment I go to bed. Wally is chocolate because I am greedy. What that tells me is they are probably responding to a ton of restriction that they probably are going in waves of being like, I should be good. Okay, tomorrow, I'm going to be good. Tomorrow. Just eats you know, diet food or doesn't eat enough food or, and then you know, continues that for as long as they can, as long as they can before their body is like flogging something. And then they will go to the thing that is nice that they enjoy chocolate that they've denied themselves. And it you know, puts chocolate or whatever it is on a pedestal is this sinful thing that I can't stop thinking about? Because there's something wrong with me? Versus okay. I'm wondering why I'm having these big feelings around chocolate. I wonder why I tend to go towards it. And I wonder why I feel out of control? What

Unknown Speaker 33:53

is going on here? What is the reality? is Am I being influenced by diet culture by fat phobia? Is it that I'm just an inherently bad person and I when I want to as soon as I was born, or you know, my first words was chocolate, because I am an inherently addicted person to chocolate and I am bad and out of control. Is that the reality? No. I mean, are we pretty cool. Someone's was word was chocolate. But I mean it's it's, you know, this is not created in a vacuum and if someone does eat a lot of chocolate, is that does that mean that they're bad? Does that mean that they're unhealthy? You know, and and then we go into okay, well what is health? Who knows what Hannah was experiencing because it she didn't talk about it here. But she says I got so big that it was relevant is what her words are to have bariatric surgery but But it seems very simplified to say it's Hannah's fault that she was, I don't know, if she still is fat, because she ate too much chocolate. And it, it probably feels good in some ways to be able to pinpoint it and blame it on yourself. Right? It probably does feel like it's it. I know, I know, I caused this to myself because I did this thing. That probably feels better than actually, I don't know why I'm fat. Actually, health is really complicated. Actually, maybe I don't have control. Maybe if I stopped eating chocolate, I would still be fat. And that doesn't feel good for a lot of people. Because it's nicer to think, Okay, I just need to stop this behavior. And then I'll get the result that I want. Yeah, so So anyway, I'm just, you know, reading Hannah's thing. It's just she says, I feel ashamed. And I don't think I mean, I personally, I don't think people should feel ashamed for having bariatric surgery because, I mean, same way I don't think that people should feel ashamed for for, for having fat phobic beliefs, unless they are, you know, actively, like being a fat fo you know, but I don't think people should be ashamed for being a product of society. I don't think people should feel ashamed for doing things to try and fit in, try and live a longer life, because that's what they've been told. So I don't think people need to feel shame. And I don't think that losing weight quote, naturally on a diet or losing weight with surgery. One is morally superior. One is harder or less hard. I mean, it's you know, different circumstances right. But to me surgery sounds really fucking hard. Even if it's laparoscopic, you know, keyhole surgery. I had my gallbladder out. That fucking hurt. Like fuck, because they have to, like blow your stomach and not blow it up, you know, inflate it with air, so they got the space to do things. That motherfucker you wouldn't have been air in your abdomen cavity would be so painful. And that's just my experience. Other people might be like, What are you talking about? But yeah. Okay, so continuing, dismissed and personalized problems. As described above, above, several of the interview interviewees experienced unknown problems and crumbling bodies experiencing issues in different degrees and combinations such as poor short term memory, emotional intimate stability, cold intolerance, low energy and bad teeth. All of these issues were not experienced before surgery, for example, bury a former angler now living on a disability pension due to previous heart problems, still likes to go fishing but he has problems with his fingers. They get stiff, and he loses feeling in the feeling in them in cold weather. These problems were restricting his activities as a leisure fisherman in Norway. So he went to his GP. This is a quote from from Barry Barry boughs. I froze so much, so I thought the doctor might be able to investigate a little. And he says, Did the GP think it had to do with the operation? Now? Did she think you were just whining then? Hell, I don't know. My blood pressure was too low.

Unknown Speaker 38:59

Once I was told it was because I was too calm and balanced. That's what she told me once. Continuing in numerating, these problems participants often referred to the mandatory pre operative program, and the fact that they were encouraged to get in touch if problems occurred. John described his only call to them. Quote, at the hospital, we were told that side effects were hardly any to speak of, and we would receive good follow up for 10 years, and they had specialists. They followed us at 910 11 months, something like that. And then we're gonna pan on our shoulder when we left. The responsibility was given to the GPS because because they had so much to do, operating on new patients. I tried to call them once to ask if they knew of others with dental problems. There was no one who was bothered with teeth after these operations. Never heard of it. End of discussion. If other issues came up as when Roger was referred for acute psychiatric treatment following a suicide attempt, participants were reminded of their unconventional treatment and their responsibility for their own destiny. Quote, I was at the hospital a while ago, I have had several suicidal suicide attempts. They did not know what gastric bypass was, what is it? What is it? Once they had to use Google? Then I thought, What the hell have I done I've been so far down that I've wanted to kill myself. In reflecting upon the responsibility of undergoing BS discussed by all the participants, Roger is the only one to pinpoint the surgeries effect on the body as a system when reflecting on his or her experience. Quote, bariatric surgery is like playing with nature, the body is, is as it is for a reason it is created in a certain way. Doesn't have to be God, but it's not meant to be redesigned, the body should be kept the way it is, don't mess with it, you're gonna get into trouble. I know all about it. And in my situation now, alcoholic was several suicide attempts behind him. I have nothing to hold back. I just want people to know what they're doing. Choosing surgery, do not mess with your body. They claim the body to be the world's finest machinery. And then the doctors cut out half of the cogwheels it has to break down morphing. Okay, so wrapping this up discussion section here, and he says bariatric surgery expands beyond the boundaries of the body and into daily life. In a short time surgery alters the physical body and functions as intended enabling weight loss and normal weight normal equipment I'm getting I'm putting quotation no more weight. In the long term. Surgical alterations also affect the body beyond the digestive system by irreversible processes that we can enter body structures, an empty its reservoirs, establishing a vulnerability to unforeseen, unknown unacknowledged and not yet curable health problems. The resulting vulnerability requires continuous attention to avoid problems and cope in everyday life. Living individuals individual lives in different contexts bariatric bodies may for some replace fat related problems due to regained health and avoiding fat stigma, while for others it may not. Responsibility for health was a fundamental theme in the narratives from choosing surgery, striving to comply with treatment and coping with problems after surgery. Still, eight years later, the participants were cautious about discussing discussing their form of fatness, Bs and post BS problems, fearing stigma and worsening of their situation. Talking about it will reveal their spoiled identity as a morally weak and irresponsible confirming them as morally weak and irresponsible confirming them as abnormal because they have undergone elective surgery for a condition understood to be self inflicted. Their internalized shame and self stigma, stigma stigma, stigma ties ation results in efforts to non disclose a non help seeking in retrospect by wanting and consenting to be us. The participants experienced unforeseen effects of treatment, some common and some individual, but all unexplainable and addressable. When the consent was informed, it's difficult to determine in hindsight with the knowledge available, whether the consent was informed is difficult to determine in hindsight, with the knowledge available in 2008.

Unknown Speaker 43:58

Undergoing irreversible elective surgery makes it difficult to speak out when informed consent was given, especially when doing so is disapproved by bariatric clinics, the participants of this trying to solve the problems they experience on their own. The long term follow up program was cut due to costs and reprioritization ins. Okay, so here is the conclusion. Another little bit of rereading conclusion. There's stuff above it but then here we go living with Bs in the long run bariatric surgery by the way, in case you've forgotten, maybe experience is demanding both due to the continual consciousness of the object of body and the strong feeling of responsibility to comply with the new body to avoid problems after surgery. Bariatric bodies constitute a vulnerability both physiologically and psychologically and not least to prejudices towards fatness and be us. speaking out about problems after surgery is difficult when experiencing unknown On unacknowledged problems, the study highlights the need for in depth studies on patients experiences of living with bariatric bodies in everyday life to broaden the understanding of the effects of BS. Providing individual outcomes BS may be perceived as an experimental treatment. Individual and contextual parameters of success guides were the BS functions as a positive biographical disruption, or just another event in the biographical flow reinforcing an already difficult life. The patient's success parameters is adjusted by time and life context, depending on daily experiences of living with a body interfering with life, reinforcing both the positive and negative effects of BS. This study confirms a widespread illusion of the body as a controllable unit separable from the lot from life in contemporary society. In addition to documenting the experiences of BS this study reminds us of two potential pitfalls in medical sociology. First, the risk of presenting patients experiences as universal as potentially legitimate legitimizing medical intervention with insecure effects and the patient's responsibility for treatment outcomes. Second, the need for in depth longitudinal quality qualitative studies in order to understand the long term experiences of treatment, finally, sociological knowledge should not be not forget to include the body as a social phenomenon in the analysis, and not merely study narratives of the body as a biomedical phenomenon. So we don't have a lot of information about patients experiences in regards to them speaking, you know, we don't we don't have a lot of of studies to show actual data. Long term. There's another piece, and that's a problem, right? That is a problem. And we need to, we need to look at stuff like data, like, Okay, let's look at, you know, hundreds 1000s of patients, and let's look at the data and let's look at when they died, let's look at what diseases they appeared after, after surgery. Let's, I mean, this is impossible, right? It's impossible. Not that stuff. But it's impossible to separate, then why why why did they die? Why? What effect did oppression have on them? What effect did not being able to go to the doctor because of shame because of lack of access? What effect did that have on health? What affects do poor medical interventions? When people do go to the doctors? What affects the lack of nutrients for year over year over year? Yeah, you know, so we to pull that all apart? If we can have that data? I mean, that's why we we don't we don't, you know, we don't have that data. We have this piece which is called patient experiences of outcomes of bariatric surgery, a systematic review, and qualitative qualitative qualitative synthesis from Karen Kuhlman, Fiona kitchen, Jane Blaise Lee and Amanda Owen Smith, which is an overview of all of the research that we have

Unknown Speaker 49:00

at this stage, and I'm just going to pull out some quotes very quickly. And this is. So again, looking at this, and so this is a review of what we've got so far, in regards to experiences. Now, something to think about what this stuff is. When was the one with the paid people interviewed? Who were they interviewed by? Because like, so if they're interviewed, and we've got this information in the study, right, we've got this information, okay. And most of the people are being interviewed eight months, one to five years, 18 months, 12 months, two to five years, five to six years, two to nine years. So the longest hair we have is 10 years and so there was a study here which was psychosocial social experiences following gastric bypass and it was C six months to 10 years out, and that was of 33 people, how many of those were 10? years out? Was it just one people? Was it all 33? People? You know, we we don't we don't have that right there, we could look into each study to find out. But you know, just like an overview, most of the people in this is looking at the all of the studies that this paper is looking at, are people who are short term. Also, who is doing the interviews, what methods are they using, because because of everything that we just spoke about the shame of, of the realities of living after surgery, if it's people from the team that did the procedure, I guess it would be more likely that they say, yeah, no, everything's great. Yeah, it's good, because good, versus a non, someone who's not biased in that way. So that's something to think about as well. The the quotes from this article, there's two things that two things that I've noticed is I've got medical issues now and it sucks. And the other one is, I'm thin now. And therefore, I'm in a privileged group. And life is easier because of that. So there's a lot of people who are not a lot this like, you know, don't want like 10 different quotes of people who say, I'm happy now, because people will talk to me, because I can get a day because people were not stigmatizing me because of my size. Which is, is that I mean, and that's great for that. That's great, right? We don't want anyone to have to experience those things. Is the solution to living in a fat phobic world to have surgery? Or is it to tackle the problem at the root of the problem? But here's the other thing. When is that going to happen? You know, you know, what is like changing people's belief systems and society and all the different ways that manufactured fatphobia manifests in the world that's going to take there's going to be beyond our lifetimes, right? And so are we saying to people, the best way to go about it is to change society not to go and have surgery. And some people are like, I, I can't wait for that to happen, because my life is shit right now. And I'm going to do anything I can to not to make it not shit. And that's valid. You know, what? I mean? Would you want to be waiting around your whole life for society to change, and, you know, society is going to change in our lifetimes. But you know, all the systemic things of, of, you know, when we look at things like, oh, women are going to be paid equally within the next 100 years. It's just those things. systemic things take a longer time. But the way that, you know, we think about, you know, sexism, even the way that we think about and we talk about women and gender roles, and patriarchy in the last 10 years is night and day, right. And so, there will be a lot of changes, then we have seen a lot of changes already

Unknown Speaker 53:58

in attitudes, and it will also take a long time to change a lot of things too. So, so that's the big things I noticed with these quotes is the that my life is better because I'm thinner. But again, remember, these people are a lot, most of them are not long term. And so we have data up until year five, if I remember or three or something, year, three, good data to show weight loss. And you know, 63% of people have put weight back on by year three. And so this stuff is kind of anecdotal, right? When they say I'm thin now and it's kind of like, oh, no, how long are you going to be thin for maybe forever, you know, and Okay, so we've got the, it's great to not be in a in a marginalized group. Because people treat me better, which is good for them and also that's That's fucked up for that is true. Yeah, it is true. And the health outcomes really fucking suck. And so let me give you some, some of the quotes of the health outcomes really fucking suck things. And these are short ones. Okay, so quote, you just have to find out how much you actually can eat and what you can tolerate. It has been some challenge navigating such as a labyrinth, female Denmark, quote, I must admit that I'm quite scared and often think what if my weight increases again? It's the worst case like a nightmare. I've spoken to others who've told me that they've put on weight after two years, I get really anxious when they tell me this participant, Norway. It's funny how I know was was it? No, it was Norway. Yeah, it was normally I'm gonna say hang on why we got all these Nordic countries. That just happens to be anyway, whatever. I must admit that I'm an and I don't know if I mentioned previously, in the paper that we were just reading. In Norway, Norway were given away at an if they still are free bariatric surgery. And so they were pushing a lot of people through to get that done. I don't know if they still are. And so that might be why we have more people from Norway, maybe from Nordic countries. I don't know if their neighbors are doing similar things. Anyway, continuing on my side notes. I must say, we didn't get one. Right after surgery, there is a part of you that thinks I'm cured, I'm automatically going to lose weight. But the surgery alone only works by itself for the first several months, maybe a year. But then you have to take over, you have to establish your new habits and your new patterns. And that can be rough because you're confronting a lot of issues that you've never confronted before. Female USA quote, It feels like I have a rock in the machinery which makes me disabled in my daily life. Life. I'm struggling with low blood pressure. Occasionally I See Stars and nearly faint when I work. Female Norway. The women emphasized how their blood values and vitamin levels have changed dramatically after surgery. They constantly struggled with iron deficiency, low hemoglobin percentage and B 12. Deficiency. While these levels were previously regarded as normal in terms of medical standards, they were far below the acceptable level accepted level after the surgery. author's words. So the authors from one of the papers. So there you have it, there you have it. And yeah, people's experiences and you know, I've not had surgery like this. So I know, I have nothing to say in regards to my experience, because I have no experience. Yeah, and again, I want to point out, just to make it really clear, that if you have had are thinking of having or no, you definitely are going to have bariatric surgery, it doesn't mean that you are a bad person, it doesn't mean that you are not intelligent, it doesn't mean the I think that you're an idiot or something, you know, I think it's complicated. And there's many reasons why someone would choose to do it. And I also hope that we can continue sharing more information, as more information has been collected, and gathered to show the long term effects and to show the reality is and, you know, one of these quotes here saying,

Unknown Speaker 58:59

you know, it only works for the first year or so and then you have to take over and you have to change your lifestyle and, and that kind of like gave me the chills of the shudders of the, you know, when you go on a diet and what really made me it's like, really made me say what the fuck was when I was on Weight Watchers and I lost a lot of weight and I was just like, I can keep this up, I can keep this up. And then when I've lost weight, then I can go back to eating food. And when I lost weight I said to the leader, you know, can I start eating food now? And she was like, No, you have to eat like this for the rest of your life. And that was a holy shit. Of now I know you have to decide had to be engaged in disordered eating or an eating disorder for the rest of your life to in the hopes of maintaining thinness, not even a guarantee of it in the hopes of maintaining thinness. And, and it's the same with this, like, you're choosing to have a disordered relationship with food for the rest of your life, sometimes irreversibly. Knowing that you, you know, like that one guy was saying he can't eat a meatball and a spoon of gravy without throwing up. And so you just have to have beer. That's what he's what that's what he's doing. So yeah, and I think some people are able to recover in regards to get back to eating in a way that feels more quote, normal, you know, like, not disordered. You know, I do know, people who've had surgery who are able to become intuitive eaters afterwards. And I do you know, people who've had surgery who haven't had bad side effects. And even so regret it. And I know people who have had surgery and don't regret it. Yeah, so I think the thing in here is, is the more experiences we hear the better because one person's outcome is going to be you know, totally unique to them. And we can never guarantee okay, this is what's going to happen. And if we know that, okay, in the hopes of become thin, I'm risking dying. I'm risking shitting my pants every single day. One of the one of the things that I didn't read out was a guy who was saying, Well, I go between having diarrhea and having constipation. And on the days when I when I when I when I know it's a diarrhea day, I can't leave the Hay House. And when it's a constipation day, I also can't leave the house because the pain is too immense. And if I do go out I have to take with me like emergency food in case I faint because of lack of sugar. You know, like this other person saying that they were fainting. And so it's like living life in it being very difficult, very difficult. And as someone who lives with with IBS, I mean, they fucking sucks. Just the IBS stuff, it's sucks and so I can't imagine also then having a meatball and some gravy and immediately throwing up and not being able to eat being like, Okay, well I can't have breakfast like that one guy was saying can't have breakfast because then I'm going to be sick at work. Okay, so I'll just not have breakfast and then but I need to eat food and yeah, it must be really difficult to to keep up with that and to get enough food into you and then spend so much on that guy. One of the one of the guys were saying that he couldn't afford to the vitamins. He couldn't get the vitamins in in Denmark because they stopped being produced the vitamins that this the surgeons told him to use. And so we had to have them imported from the UK and that's why they met he mentioned that pounds cost hundreds of pounds, hundreds of pounds is a lot. So in us it's like let's see hundreds as a 300 Hundreds 100 pound to us. Okay, so you know that's 400 $400 a month on on vitamins and minerals. Okay, well

Unknown Speaker 1:03:59

if you want to know more about this, you want to look at the stats and hear all of the all of that type of stuff, go back to the other episode, which is episode 50 If you want to get to get links to all of the things that I share today, this is episode 122. So you go to fears fatty.com forward slash 122. And you'll get all the links for everything that I've mentioned today and a link to the old episode or to the Instagram post and these two studies. Yeah, okay, well, I hope you have a nice psycho. Nice rest of your day and I'll see you in the next episode. Okay, bye. See you later crocodiles. This work and want to know when the doors open to fears fatty Academy, which is my signature program, where I teach all about how to overcome your fat phobic beliefs and learn to love your fat body, then go to fit Use fatty.com forward slash waitlist again that is fierce fatty.com forward slash waitlist to get your name on the waitlist for when first fatty Academy my signature program opens.