Episode 90 Transcript

Read transcript alongside audio.

Welcome to the Fierce Fatty Podcast. I'm your host, Victoria Welsby and this is episode 90. Today, we're talking about will "weight loss" surgery make you thin healthy and live longer.

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 fifth party 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 first fatty podcast Let's begin.

1:21

Hello, fatty how are you? I hope you're good. I'm good, because I'm probably doing nothing right now while you're listening to the show, because I'm taking four weeks off. It is a week three of me taking four weeks off. And that's a lie. I said, I'm taking four weeks, I'm taking four weeks off from the podcast, I'm taking 10 days off from working. So I'm Bella Bella Balaam. Yeah, so this is a replay of a really popular episode, which is all about weight loss surgery, and actually a really, really popular post on Instagram. So if you want to round up all the statistics that I'm saying in this episode in an Instagram post, then just go to my Instagram and one of the very first not one of them will probably be like the 10th, one down by now. And it's a pink picture of a pink garage.

2:24

So just look for a picture of a pink, pink garage, and it says, well weight loss, something blah, blah, blah, well weight loss surgery, and then it has different it's like a Google search thing. And then on the on the following pages has the statistics for you to share in a handy dandy little thingamajig. And people love that because it's a good roundup of everything that's in this episode. So yeah, for anyone's considering any type of weight loss episode then, or if you're just curious, like, when I was young, I used to dream about being big enough to have quote unquote, weight loss surgery, and being like all I'm almost big enough, and you know, then if I have the surgery, then I'll become really thin and everything will be great. And obviously I was a child then and and as an adult, we like okay, well, there are risks.

3:19

But you know, it's probably a good idea because XYZ, well, we're not really told the risks and the outcomes. And you know, what is really mind boggling to me is we don't have the data to show if weight loss surgery actually makes you thin, long term. It's just like diets. It's just like diets. And it basically it shows you know, yes, you'll lose weight initially. And then, well, well well. The longer time passes, weight just keeps going back up. No vo of the people who've had the surgery, if you've had the surgery, and you're fat, it is not your fault. Your body is doing everything he can to get itself back to a weight that it is happiest at. Yeah, and so anyway, we've got all of these like, oh, it's gonna make you thin, it's gonna make you healthy. There's no evidence to show that any weight loss surgery actually increases health or lifespan.

4:31

And in fact, there's evidence to show the opposite. This episode is gonna break that all down and you were probably going to be like, What the fuck? I feel very angry at the end of this and so if that is not feeling good in this, in this episode, there's going to be mentions of the Oh words, suicide rates and brief mention of calories. So if that doesn't feel good for you, then skip on to the next episode, or just go back to a different episode. We'll just go and watch some Netflix or go and do whatever you want. I'm not the boss of you. And if not, if you That does sound like Okay then let's let's get into this juicy episode. Thanks for tuning in today. Miss episode 50 Oh my gosh. Oh my gosh, I did half of 100 I did twice of 25 episodes once a week minimum since October 1 2019. Almost a year it's September here when I'm recording this actually this will come out on October 6. So been a year. I'm so good. I'm so good. Oh my gosh. So this episode we're talking about bariatric surgery. I put it in quotes weight loss surgery. Do you lose weight with surgery? Who knows?

5:53

But someday, now we've done 50 episodes. Thanks for hanging out with me. I want to remind you of some of the juiciest ones. I tell you what, a lot of people love that one. Episode 43 belly hating hurdles, life coaching with betheme That was a really popular one. Will no one ever find me attractive if I'm fat episode 40. Y'all love that. And so if you haven't listened to these episodes, go and go and check them out. You also liked listening to Susie's story Episode 39.

6:28

From ashamed and obsessed to face it. I was like what you were saying I was like, from a shame Trump says that's not good. From a shame from ashamed and obsessed. But I'm afraid people will judge me number 37 How fatphobia stem from racism number 33 That was popular. The lies we tell ourselves so we can get to a place of body love number 31 is fat positivity anti health number 27. I'm just going down my list of all of the things. Am I addicted to food or sugar number 21. I'm just remembering which was like the highest downloads. Number 17 My doctor told me to lose weight for my health concern.

7:10

This was a popular on why Intuitive Eating isn't working for you. Number 14 tell you on the least the least popular one was episode 12 New Year's resolutions that won't make you feel like a bag of poop as a good episode. But I guess like I know, who cares about New Year's resolutions? I'm gonna share that again. New Year this year. And let's see if you like it this year. Five reasons why you hate your fat body number nine. How to deal with dieting friends, number six. And number four, the three biggest fears we have about stopping dieting and loving our body and how to get over them. And of course, every single other episode is incredible. But they are the most popular. Probably because the titles sound more interesting or something who the fuck knows? Or maybe the topics are better? Who the fuck knows? You might know because you're the one listening. You're gonna be tell me it's because of this Victoria. Well, thank you. I appreciate that.

8:10

Okay, so let's get into today's episode. I've been meaning to make this one for a while, but I've been putting off I don't know why I've been putting off. Because it's a big and juicy topic. It's kind of it's kind of I don't I'm not into I'm not into shaming people. And I don't want talking about weight loss surgery. I don't want people to think that if you choose to have surgery that you are a bad person. And, you know, we see a lot we see a lot of celebrities who were fat icons and still are who then have surgery. And a lot of people in the fat positive body positive community are sad about that. And that makes sense. Of course. It's sad to think of someone who you thought was, you know, who likes their body who was a champion for fat people than having surgery.

9:15

Some people feel like it's a betrayal. I personally don't, because it's not any of my business, really, what people do with their bodies. I don't know what's going on with their brain. I don't know what's going on with their life. I do know what it's like to move through the world as a small medium fat. I don't know what it's like to move through the world with ever marginalized identities. So I'm white having to move through the world as a black indigenous person of color. That adds another layer on top of it, to move through the world with someone else. If you have disabilities. If you're trans, it All sorts of things. If you're gender non non conforming, it makes life harder. And so if you can do something to make your life that you perceive or make your life easier, who knows if it will or not, and that isn't an option for you, and that is available for you.

10:23

Then I can understand why people would do that. And so I don't feel betrayed, I just feel compassionate towards them. But, you know, there's probably is a bit in me that it's kind of like, Oh, I wish that they hadn't. Now, in this episode, we're talking about what actually, bariatric surgery is, the different types. I'm not advertising it to you, but I'm not like, Hey, here's the different types. And here's why it's gray. No, just so we were on the same page of we know what we're talking about. And, and, and what not, the outcomes and the risks of the surgery. And the stats around, does it actually make you thin? And why people get the surgery? And we're going to have, I'm going to read a few accounts from people who've had a surgery and what what it's like. And if you're considering the surgery, we'll talk about should you have the surgery? So let's do it. So what about weight loss surgery?

11:26

Now, I wanted to talk about this today, because it's been on my beautiful brain. Do you remember I say, do you remember? Like we've been best friends forever? Do you remember when I was on that BBC documentary Who equalling fat? Well, we don't remember because you don't know. I was on this documentary. And I live in a house with other people who have higher weights. And two of those people in the house had previously had surgery to amputate their stomachs in order to lose weight. Now, one of the people was now a fat positive person. And she had had the surgery years previously wasn't even talked about on the show. But she had that surgery, and she had seen tons of serious consequences.

12:25

Malnutrition, her bones were super weak, and they she would break bones constantly. She had put on all the weight. And I think more from what if my memory serves me now though, is that one person and there was another person who was heavily featured in the show, he had just had their surgery. And he lost lots of weight, because that tends to happen after the surgery temporarily. And he was on the show to espouse the benefits of this surgery and everyone should get it but he was already in the process of putting weight back on because he had it had his surgery, maybe a year prior. But he was not that positive. And he still thought that the surgery was great. And he went around to the country telling people about the surgery.

13:20

So I, I sometimes refer and often refer to the surgery as stomach amputation surgery. That's something that Marilyn Wan who is the author of fat so amazing book. She uses that term and the reason why she uses that term and the reason why I like that term, although it's not actually that accurate is because we want to show or not show how big this is how you are amputating a healthy organ in the pursuit of a smaller body and the reason why it's not actually that accurate not as accurate is because sometimes people amulets to amputate their stomach and sometimes they do other things. And the reason why I say weight loss in quotes weight loss surgery, because as you'll see that actually the outcome for most people is not weight loss.

14:26

So is he called like temporary weight loss surgery where there's a shit ton of terrible side effects. So just so you know, before we get into it that there are different types of, I'll call it I'll call it weight loss surgery, just for the sake of keeping things simple. There's different types of weight loss surgery. So there is the gastric band which is when a like a circle, a band is put around someone's stomach and then it is inflated with with liquid So the the stomach is made smaller. And that is something that you can have the band deflated. So it's not squeezing the stomach. And that is what a lot of people have done after they've seen the side effects of having that gastric band. Another thing is that is the balloon, which is literally having a balloon,

15:24

not one that you probably have at your birthday, but having a balloon in your stomach inflated and so it makes the volume of your stomach again smaller. Now there's also something called the gastric bypass, which is cutting off some stomach sometimes not cutting off stomach from what I've understood, sometimes it's literally just bypassing some of the intestines and so that you're not absorbing as much of the nutrients in that food. Therefore you're getting kind of well less of the food and also your stomach has cut smaller sometimes so that you have a smaller stomach so you can't eat as much. And then the last one which is the called the sleeve which is where like I think about 90% of your stomach is cut off, thrown in the bin thrown in the garbage. And to be never seen again and you're left with they call it a sleeve because it's like a little sleeve like a little pocket. You can also get one which is is like a tiny pouch. So that is just so we know what we're talking about that is what weight loss surgery is.

16:37

Now I want to share with you the most common risks of weight loss surgery and obviously all surgery has risks. There is no surgery that is completely risk free. I don't know maybe there is I don't know but there's risks under it everything. But it has been said that weight loss surgery has the IS is the if not one of the riskiest surgeries for death and complication and also is the most expensive and the most money making for surgeons. So most common risks. Hair loss also leaks. I'll explain more about that in a minute. Gastric bleeding, bowel obstruction, gall stones. I've had gall stones I've had my gallbladder removed. I've had I had gall stones from a from a child. I think it's it's something to do with with my blood. There's different reasons why you get bauxites Anyway, I had gall stones as a kid they fucking suck, I had to have my gallbladder removed, which sucked.

17:42

Anyway, so gallstones suck, dehydration, acid reflux, and a seizure related risks, chronic nausea and vomiting, dilation of the esophagus inability to eat certain foods infection, obstruction of the stomach, weight gain or failure to lose weight. Now the long term side effects are dumping syndrome only tell you what dumping syndrome is in a minute. Low blood sugar malnutrition, vomiting ulcers, bowel obstruction and hernias dumping syndrome. It's basically what it sounds like shitting your pants so the this is all from the Mayo Clinic and the Mayo Clinic says dumping syndrome is a medical condition in which your stomach empties its contents into the first part of your small intestine.

18:34

The duodenum faster than normal dumping syndrome is also known as rapid gastric emptying people with dumping syndrome experience symptoms like nausea and abdominal cramping these symptoms happen because your small intestine cannot absorb nutrients from food that has not been digested properly in the stomach and you basically shut your pants have diarrhea so other side effects you know we were mentioned about the the malabsorption of nutrients so nutrient deficiencies long term in this way are really damaging to the body and is a cause for neurological decline which I didn't know about and premature aging of the body not like the way that you look although I don't know but that doesn't matter anyway. It a lot of people are not aware that the extent that they have to the tablets and the supplements that they need to take to get over this severe lack in food and what that does to your body. And so a lot of people have been told, oh just take a normal multivitamin that the regular Josh blow on the street takes and that is like woefully inadequate to keep people have had the surgery healthy. It's actually The regimen that people need for the rest of their lives can cost hundreds of dollars a month. And if you can't afford to do that, then it's going to have consequences on your health unfortunately.

20:12

Something else that is really interesting is so this stuff here that I'm gonna be talking about is in Christie Harrison's book, anti diet, which is excellent, you should absolutely read it. And something that Christie talks about is that people who have the surgery, they have a doubled, doubled risk of substance abuse problems. And so alcohol or, or drugs, problems, and so these are people who previously didn't have any issues with with any substance abuse. And as well, substance abuse tends to manifest in younger people, so people in their 20s, but it showed that the study that I'm talking about showed that the substance abuse were happening to people in their 40s 50s and 60s, when they previously hadn't drunk alcohol. And now some people say, Oh, that's probably because if you have weight loss surgery, you're clearly addicted to food, big quotation marks on addicted. And so they're swapping one addiction for another. But actually, that is not what they found. Because one, food addiction isn't real.

21:30

Now, food addiction isn't real. Because if you get more access to the thing, food that you that you desire, the food addiction behaviors and feelings decline, whereas with a real addiction, the more access you have to drugs or alcohol, then your symptoms increase, because you just want more and more and more. And so it's not an addiction. Also, studies have shown that the what happens in the brain, just like if you just have a hug from someone, or you see a picture of a cat, like when you have food, you need to have that those feel good hormones and chemicals in your brain need to be stimulated, activated, but not to the extent of something like drugs or alcohol, you know, we need to want to eat right, it's a part of what makes keeps us alive is the desire and the enjoyment around eating. But it's not the same as something that you can actually be addicted to. And as well people say, Oh, you could be addicted to sugar. Same No, you can't, it's because you get more access to it. Those, those feelings of addiction actually decline.

22:45

So, so these people who had the substance abuse issues, post surgery, it's because the because of the size of their stomachs, the alcohol hit their brains at double the rate that it normally would. So if they had two units of alcohol, it would feel in their brain that they had four. And so they were getting this high. And this burrs way more quickly, which in turn caused that addictive type behavior. And as well, because they could only have these teeny tiny stomachs, they couldn't eat food to take away from the effects of the alcohol. And so this is what was found in this study. Other things 4.6% of people who have the surgery are dead within a year. And another study shows that three out of every 1000 People die within 30 days, here's the kicker, here's the kicker, most people regain weight that was lost during after the surgery. So what happens normally, and obviously, every single person is different. So not everyone is going to have bad side effects. Some people are going to be like I had weight loss surgery, it was best thing of my life.

24:02

Now I'm really thin and happy and I've had no side effects and everything's great. You know, there's going to be people who were like that and there's going to be people who are somewhere in the middle and there's going to be people who have died. So this is not kind of like a blanket this is happening to everyone but this is this is what the studies are showing us. So what happens generally is that within 12 to 18 months after the surgery, people have reached their lowest weight and then from there that is when the weight starts coming back on and that is through no fault of their own. It's not because they're just you know, these these people are so greedy that they're just eating all the food is because our bodies want to be at the weight that they have previously been at the setpoint weight.

24:48

And when there's there's this extreme for starvation which is what it is because when you have this surgery you can only tiny amounts of food so you know very low Low calorie consumption, and all these other beautiful nutrients that we need to, to live as human beings. And so our body, exactly what happens when we are on a diet, our body does all the things it does to get you to a place where it's safe and happy because you're in this forced extreme starvation. So

25:22

a quote from this study all of this, I'm going to link in the show notes. By the way, this study is called long term weight regain after gastric bypass a five year prospective study, quote, percent BMI loss was no longer significant after 24 months, and weight regain became significant within 48 months after surgery. So basically, people will lose weight and but then within five years, they've put the weight back on. So two years after the surgery, 46% of people have regained weight. And four years after the surgery, it's 63%. And presuming presumably, year after year, that number goes up and up and up, because there's no reason for it to go down again, right. So chances are you have this weight loss surgery, it's not actually going to make you thin.

26:20

Now I want to share something from junk food science, which is an amazing website. And this is written by Sandy swan. As I said, W A, R C swag. So I'm going to link to this as well. Quote, bariatric surgeries have been described as the as a gold rush in medicine because they're one of the most profitable medical procedures done today. According to Dr. Edward H. Livingston, MD professor of surgery at the University of Texas Southwestern Medical Center in Dallas. Last year, it was $7.8 billion industry and last year was when this was written was 2006 and enjoying exponential growth increasing some 1,100% since 1995. Continuing in the more than 40 years that bariatric surgeries have been performed, there have been no randomized controlled clinical trials that have shown any long term improvements to actual health, or that lives are saved or extended by the surgeries.

27:30

Not any of the dozens of types and variations being performed and certainly none of the new procedures claiming to be better and safer. So the new new procedures that they're talking about here is the lap band stuff. According to quote unquote obesity researcher Dr. earns Berger PhD of Case Western Reserve School of Medicine Cleveland, Ohio, several clinical studies to examine the long term consequences and look for improved life expectancies have been started. But the results were never released. Quote, I think it's because it's bad news. Continuing the ECI report, bariatric surgery for the quote unquote obese noted that the surgeries can produce significant significant initial weight loss. But three years after surgery, the typical patient is still quote unquote obese.

28:24

Most importantly, they concluded that based on the quality and strength of the available evidence, claims have improved quality of life and long term health impacts are less conclusive. The Mayo Clinic reported in 2000. That's 20 to 25% of gastric bypass patients develop life threatening complications. But the recent lap band clinical trials done to earn the FDA FDA approval reported 89% of patients had at least one adverse event 1/3 of them severe complications from lap bands are more likely to require surgery to correct and the band's result in so, so much more vomiting. They are known as surgically induced bulimia among medical professionals. And finally, a recent study by researchers at Virginia Commonwealth University found that 56% of bariatric patients had 62 Different gastrointestinal complications and abnormalities by CT scans.

29:34

So that is from junk food science, great resource for all the science on all fatty stuff. Something from another thing from Christie Harrison's book anti diet is Christy says that this is the most lucrative surgical speciality and costs 15 to 25,000 US dollars per procedure and a lot of insurance companies won't pay for it. lindo bacon, incredible wrote health every size body respect. Linda Bacon says bariatric surgery would be more appropriately labeled high risk disease inducing cosmetic surgery, then and health than a health enhancing procedure.

30:25

Hmm, well, well. Next, a study came out two years ago, remember when it came out about the increased suicide rates of people who've had the surgery. So I'm going to link to this as well, quote from this study. based on their analysis, the estimated suicide rate for bariatric surgery population is 4.1 deaths per 10,000 patients, when compared to the World Health Organization's suicide data for the general population, the investigated, investigators reported a four fold increased risk of death by suicide among patients who underwent weight loss surgery, so you're four times more likely to die by suicide.

31:21

Now, so we know all this, this is, you know, if you have a surgeon who is ethical, they will present to you the realities of what this means now, they're probably not going to say by the way, this is this surgery is 64% chance not going to result in weight loss, long term weight loss, you'll temporarily lose weight, and then you'll put it back on 64% chance of that, they're probably not going to say that, they're probably not going to tell you that you're going to have four times their risk of suicide, because that's a newer study came out a couple of years ago. But hopefully they reveal all of the other things. And but some surgeons, or the medical team supporting them don't really emphasize how much people's lives are changed, and how much they have to spend on care for themselves to make sure that they get enough vitamins and nutrients and all that type of stuff.

32:25

And also, the effect that not being able to eat food has on your life in general, because food is very social food is communities is like spending time with your community, and a way to share love and happy times. And And as well, it could be something which is a great coping strategy for some people. Of course, not every fat person uses food as a coping strategy at all. But if that's taken away, that can be difficult, if your family is having this big, beautiful meal and you can only a couple of things, you know, like if it's Christmas or Thanksgiving or whatever it is, that can be very isolating, not being able to go out and on a night out with your friends or you know, things like that, because you physically can't unless you go out and just had no sip some water, you know, your life is is change in so many ways. And a lot of them are social. And then the how it feels for those who put on weight, which is a majority of people how much shame they must feel. I read a read people's accounts and how they felt like they were the only one that they were so fucked up, that they couldn't control themselves so much that they even surgery couldn't help them because they were so out of control and greedy and bad. But really, your body is doing exactly what it needs to do to keep you alive.

34:07

So something that Lisa Dubray Lisa Dubray is an incredible psychotherapist and clinical social worker says about people who get who go for the surgery. This is what Lisa says. What we know when we look at what research has been done is that a lot of fat people that are interested in pursuing these surgeries have really high rates of internalized weight stigma. There is a study that was done years ago that compared the psychological profiles of fat people going to Weight Watchers and fat people pursuing weight loss surgery. And what they found was that the fat people that were going to Weight Watchers, their psychological profiles were in line with the general public. So about average rates of depression and anxiety and things like that. The fat folks We're pursuing weight loss surgery had cited psychological profiles in line with psychiatric patients meaning significant levels of mood disorders, anxiety, trauma, history, things like that.

35:12

So again, it's not to say that everyone because we can't keep track of everyone, but you know, I think there's a lot of evidence to say that a lot of people that are pursuing an interest in in the surgery are feeling pretty desperate, and dealing with a lot of internalized weight stigma, and that doesn't get treated by the surgery. Another perspective about this is from Caitlin, and Elaine. Caitlin is known as reframe your story, on Instagram, I'm going to link to their account. And Caitlin on on their Instagram shared a picture of the belly with surgical scars. They're just like little, little things little pellets in in their belly. And this is what it goes along with that image.

36:04

This is what my eating disorder looked like five small incisions from my weight loss surgery, there was no part of me that made the decision to have weight loss surgery from a place of self love. It came from deep self hatred and a longing to be accepted. I told myself it didn't have to do with weight loss, it was about my health. I thought I was a ticking time bomb and that if I stayed in this body, it would inevitably lead to health issues. I thought it would be only a matter of time. When the majority of society views your body as part of an epidemic and a strain on society, it makes sense that a person would want to change that.

36:48

So people make the decision to have their stomachs banded, amputated, and rerouted, they are encouraged by doctors and by other professionals to put a permanent physical restriction on themselves. The most sick part of this is that I knew and wanted there to be pain if I ate one bite too many. So I had to face the consequences of living in my body. The true consequence of all of this, and a lifetime of being told my body was wrong, was falling deeper into my eating disorder behaviors. And for that I was praised. People who didn't even really know me would come up and tell me how inspired they were by my weight loss. Regardless of intention, praising my weight loss was praising my eating disorder. So that is from reframe your story on Instagram, Caitlin on delay.

37:46

Now, another account of weight loss surgery because by the way, in case it wasn't obvious, I haven't had any surgery. Myself, although weight weight loss surgery, or bariatric surgery. Hello? How fucking Yes, did I want it? I remember being a teenager watching those, those shows, I think in the USA called like Girls Gone Wild. But it was like the UK version where young young people went to like Ibiza and stuff. And they would they would show the text of the camera. And I remember sitting on the sofa watching that late at night, seeing the girls showing their tits and being like, I'm not thin, like they're my, my tips don't look like this. I can't become thin.

38:39

So I really want to have bariatric surgery. That was like my goal. And I was at that time I was a child. I was probably 15 1617 Something like that. But I was just like, oh, one day when I'm old enough. I'm going to get that and that is going to fix all my problems. So anyway, so I haven't had it but I definitely did dream about having it. Now someone who had it recently and someone that is quite well known is Roxane Gay. Roxane Gay is the author of you might recognize Roxanne from her books, hunger and bad feminist and she has other books too, but they probably the most recognizable. Roxanne wrote a brilliant piece on her decision to have surgery. And what happened on medium?

39:32

Again, I'm going to link to that in the show notes. But let me I'm going to read some quotes from that piece. This is not the whole piece in total and these are just kind of snippets. So Roxanne says I capitulated to a procedure after more than 15 years of resistance and had a sleeve gastrectomy at the UCLA Ronald Reagan Hospital in January 2018. I told only a few people I did not tell my family I felt in equal parts hope, defeat, frustration and disgust. She continues. The truth is that my desire for weight loss has long been about satisfying other people more than myself, finding a way to fit more peacefully into a world that is not at all interested in accommodating a body like mine. And the dominant culture cultural attitude towards fatness is that the fat body is a medical problem a drain on society and aesthetic blight.

40:36

As a fat person, I am supposed to want to lose weight. I'm supposed to be working on the problem of my body. I'm supposed to apply discipline to physical unruliness. I am not supposed to be fine with my body I'm not supposed to to yearn simply for people to let me be to see me accept me and treat me with dignity exactly as I am. She continues. After more than 15 years of refusing it, I made the decision to get weight loss surgery. On an ordinary day. At home in Lafayette, Indiana, a young man yelled at me to move my fat black ass.

41:16

While I was crossing a grocery store parking lot to my car. It was the last straw. I tried to hold my head high shuffled as quickly as I could put my groceries in my car and sat behind the steering wheel. I sat there shaking, wishing I could have been as quick in that moment to put him in his place as I would have been online. I wanted to call someone for comfort. But I was at a silent impasse with the only person to whom I could talk. Instead, I pressed my head against the steering wheel and sobbed when I collected myself I drove home and went to bed. I hoped I might not wake up, but I did. She continues. The dominant narrative around weight loss surgery is that it changes your life and makes everything better. It is a lovely fantasy that by cutting yourself open and having parts of yourself removed. Everything that weighed you down will be lifted. But it is only a fantasy. She continues

42:24

though, the psychologist I saw for my pre surgical evaluation warm to the warned that the first year is really difficult. And many patients end up suffering from depression and regretting the surgery. The second year is better, she said, trying to reassure me after my face fell, and she was right. I am depressed and miserable. I am cold all the time and exhausted because I'm only eating between 12 115 100 calories. I'm filled with regrets because everything has changed. But everything is exactly the same. She continues, I've replaced one set of anxieties with another. I worry I'm eating too much and stretching my new stomach, something I was warned about repeatedly and vigorously. I have brief moments where I allow myself to imagine hiking Runyon Canyon or wearing a fabulous outfit because it is available in my size or going to see a musical without having to make special arrangements. And then I tell myself to get a hold of myself. I tell myself to not want I tell myself that I failed to disbelief discipline my body before and I will probably fail this time too. I tell myself these things because I've carried this weight for almost 30 years. And it is terrifying to face who I could be without it. So that is excerpts from a piece that Roxane Gay wrote on medium and it's called what fullness is so you can find that on medium. Or you can just go to the shownotes where the link is going to be there for you.

43:58

Now, Roxanne is I don't know, Roxanne's exact size, but I know that she I think that she might be a super fat. I know from reading her work that you know, even just reading that piece not being able to fit in to go to a theater without making arrangements beforehand. So I'm presuming that I know. She's not a small fat person. She is a she's a large fat person. She is a super fat she might be in Infini fat, I don't know for sure. But I want to recognize that she's also a woman. She's also a black woman walking through the world with these different intersections and I don't know if she has other other things is really fucking difficult.

44:49

So why wouldn't you take that chance at living a life which, of course you know, a lot of weight loss and places will paint it as this you know, very and roses and you know fairytale and roses and unicorns and all that type of stuff. But, you know, we're intelligent, we know that it's probably going to be hard and all that type of stuff. But I don't know what it's like to be a fatter than I am, to, to be black to be also in the public eye, Roxanne shares in this article about how people constantly make memes of her images of her and, and tweet them at her and she's constantly barrage barraged with people reminding her that her body is not good. And so I It makes total sense to me that Roxanne words electrosurgery, that pressure must be immense that the weight of people's expectations, like she mentioned in this article, she did it for other people, basically, it must be overwhelming, even if there's a almost 5% chance that you will die.

46:07

For a lot of people. They are close to dying right now. But the thing is, the thing that's really heartbreaking is that for most people, this won't make them fit. And I don't think that people know that when they go into the surgery that 64% chance, just after four years. And we don't have the data past that, because there's been 1000s of studies on weight loss surgery, but only a tiny, tiny, teeny tiny fraction are actually usable. Because the rest aren't good science. And so we have hardly any data. And also a big problem when it comes to the science around this stuff. Is that the follow up with patients after a certain amount of years, the patients don't come back for follow up. Now, I don't know for sure. But I can guess why would a patient not come back for follow up? Because they're fat again, they've put weight on. And they've blamed themselves versus blaming a faulty product, weight loss surgery.

47:21

And I know in the States, it's you know, it's for profit. And so it's going to be even more, you know, worse and extreme and, and unethical practices and all that type of stuff. But of course, every country has weight loss surgery, and as well. Talking about weight loss surgery for children. And I want to roundhouse kick kick people in the face who thinks that is appropriate to amputate and healthy organs from a child? Oh, dear God, please, all those people who those children have had it done already, I just want to just go and hug them and tell them that their body is perfect.

48:02

Obviously, I wouldn't do that. Because they'd be like, go away. It's weird. I'm just trying to play on my bike or whatever. But so, weight loss surgery, some people will lose weight and keep it off. We don't really know what percent. What we do know is that most people won't. But imagine if you're thinking as I did, going into diets, well, I'm going to be with diets 95% fail, I'm going to be the 5% because I really want this I'm really desperate to be thin. And so let's pretend that you are that that percent that is able to lose weight. That question, the question that I would want to consider is, but at what cost? I always think about the the unicorns who do lose weight, what their life is like, what they're having to do to maintain that weight loss. How are they eating? How are they relating to food? Are they forcing themselves to move their body bodies in ways that they don't like? What's their mental health? Like? Are they happy? Are they fulfilled? Do they like their body? Do they hate themselves? It's super painful. This stuff is super painful. And it makes absolute sense that people would choose this is your choice. You can do anything that you want to your body, of course, but looking at the statistics around it. It's not actually effective and the amount of side effects.

49:36

Remember that one said 89% of people from the lap band had at least one side effect. And most people had severe side effects. Like you have to make a decision is it worth it for you to be constantly shitting your pants because of the dumping syndrome to be vomiting all the time to not be able to enjoy meals with people in the way that you did before, to have gastro intestinal issues to have a hardcore regimen of tablets that you need to take everyday to try and get the nutrients that you would have got previously from food to have your life change. And you for a lot of people, they can't reverse it.

50:19

Especially you've had if you've had your stomach amputated, that's gone into being that's long gone, you can't grow your stomach back. It's irreversible. Is that worth a one in three chance for you to be smaller, but also have a known side effects? I don't know. I don't know. You know, it's not my place to say you shouldn't do it. I personally wouldn't do it. Because obviously, I think that my body's fine as it is. And I know that if I want to become healthy that there are, you know, if I want to improve health, there are lots of different ways that you can do that without working to try and lose weight, which is ineffective.

50:58

So yeah, so that is weight loss surgery, aka bariatric surgery, aka stomach amputation surgery. I wanted to talk about this. It's kind of like one of those things that's been on my mind for a while. And I don't know if it's if it's obvious me, but I wanted to clearly state that, if you've had this surgery doesn't mean that you're, you're bad or you're not smart, or you're you it's all about vanity or any no like or if you're thinking about it, or if you're going to get it done. This shit is difficult. Living as a fat person is hard. You know? And so a lot of people come back to me, and they're like, Oh, I followed you for a bit. But then I went away because I wanted to do another diet. And guess what, you know, it's failed. And, and I'm like, I get it. I get it. Why not? Have you think that you've got this last chance to be happy? To be healthy, to have a rich and full life? And you think that it might work for you? Why would you not take that? But do you have all the information? Hopefully, this podcast has given you a lot of information that maybe people haven't previously shared.

52:21

So it makes sense that people have it. You're not a bad person, if you have it, you're not a bad person if you're planning on having it. Because shit, life is complicated. But just know that chances are, it won't make you thin and won't make you healthy. It probably won't make you happy. In fact, you're more likely to die by suicide. So yeah, okay, well, thank you for hanging out with me to return. A reminder, I have a free Facebook community. And it's pretty amazing if you if I do say so myself. It's called first party friends.

53:02

Now, to get into first party friends, you have to be a human being a real human being. And if that is you, congrats, you can come on in. So to show that you're a real human being you have to answer the three questions. There's questions, you know, when you join a group and the questions three questions are very simple. If you don't answer the questions, if you ask the questions, and you're like, Fuck you or something. Like why would if someone's asked the questions, we wouldn't let them in that if you you know the, you don't answer them in the right way. Not that you know, so if you don't answer even one of the questions, you don't get it.

53:43

So so if you've requested previously and you haven't got in then that's probably why so you can request again and answer the questions. So we just need to make sure no creepy people come in. Or you know, no, super creepy people. You can be creepy and come in but you know, creepy in the right ways. Not in the creepy creepy ways. Okay, so come and join me hang out with me and first party friends. And thank you for being with me for 50 episodes. Yo, some missing so. Yeah, so thanks for being with me for 50 episodes. And here's to another 50 How about that. How about want another 50 That'll be good one. Okay, all right. I'll see you in episode 51. Have an incredible day. I'll see you later. Crocodile stay face fatty. Bye bye.