Chapter One
The Authors
WLS Illustrations
WLS Links
How to Order the Book


I used to think that weight loss surgery (WLS) was the last resort for desperate, self-destructive, fat people with no self-control and little self-esteem. I'd heard about all the deaths that resulted from the original intestinal bypass procedure 30 years ago and was convinced that this type of surgery was perpetrated by irresponsible "quacks" on vulnerable, unsuspecting patients. Accepting my weight, I vowed to persevere and be successful despite it. However, I was distraught about my health. My ever-increasing weight was causing worsening diabetes, higher cholesterol, painful arthritis, and intolerable heartburn. I knew I had to do something to control my weight, but what? I'd tried every commercial and "fad diet" known to humankind, shed hundreds of pounds, and regained even more. 

Then I discovered that an old friend had successfully undergone WLS, lost over 100 pounds and was now thin and healthy. When I first heard about his surgery I was horrified, assuming he'd ruined his life for the brass ring of thinness. But, after seeing him doing so well, I began having second thoughts. Each visit to the endocrinologist was accompanied by higher blood sugar readings, meaning that I was closer to needing insulin injections. I fantasized about having the surgery. Then my dentist had WLS and the pounds kept dropping off her. As she became thinner, her personality changed. Where she had always been remote and aloof, she suddenly became bubbly, happy and talkative. As she was filing a cavity during one visit, she told me that the surgery had changed her life and she was sorry hadn't done it years earlier. I was stunned that a physical procedure could have such a profound psychological effect, even before she reached her goal weight.

I called my friend and we spoke for a long time. A lawyer and extremely thorough investigator, he had researched WLS for a long time and learned that it was safe and effective as long as you chose a qualified surgeon and were vigilant about taking your vitamins. I'd been taking daily doses of pills for years, so that was not going to deter me. I couldn't argue with his or my dentist's results. I became very excited about the prospect of having surgery. Perhaps having WLS really was a way to reverse the terrible downhill slide my health was taking.

Even after talking at length to my friend and my dentist, I still wavered, and kept waffling for over a year. I was scared of being cut open, of anesthesia, and especially of pain. I scheduled surgery three times with three different surgeons before I finally took the plunge. One factor that helped me reach my decision was reading the (OBESITY SURGERY SUPPORT GROUP) list on the Internet day after day, month after month, and seeing how many people just like me, many in much worse health than me, had undergone WLS, lived through it, and were extremely happy they'd done it. Finally, I realized if they could do it, so could I. 

I had gastric bypass surgery in January, l999 and have lost 70 pounds, about 60% of my excess weight. Although I'm still overweight, I can do everything I want to do, including run up and down stairs, bend over, get up off the floor, walk for two miles without getting winded and, most important, lift and carry my 2-year-old. My quality of life has been transformed. The best news, however, is that my blood sugar is finally under control with just a small amount of medication.

Once my choice was made, I wanted to learn as much as I could about WLS. I searched the Internet, went to libraries, tried to read medical literature and lay publications. Over and over, I hit dead ends. There was little good quality, information for the layperson about WLS that described the different operations, their pros and cons, and long-term effects. Nothing was available offering advice about selecting a competent surgeon, comprehensive program, or dealing with insurance carriers - often the major hurdle to overcome prior to WLS. This book was written as a result of my experience, to provide a useful resource and fill a void for others complementing WLS. 

My collaborator is Dr. Louis Flancbaum, a general surgeon and nationally recognized authority in bariatric surgery. He is Chief of the Division of Bariatric Surgery at St. Luke's - Roosevelt Hospital Center in New York City and associate professor of clinical surgery at the College of Physicians and Surgeons of Columbia University. Dr Flancbaum, who has performed close to 1,000 bariatric surgical procedures in his ten years in the field, has made numerous national and international presentations and has published over 100 articles and book chapters in scientific journals. His study, with Dr. Patricia Choban, of patient satisfaction after weight loss surgery was widely reported nationally. 

Dr. Flancbaum's skills as a surgeon are formidable--he performs the gastric bypass in an amazing 45 minutes to an hour without sacrificing technique--making it a safer operation, but he is more than just an expert surgeon--he has demonstrated a devotion to the problems of obese people. As he expressed to me, "Society doesn't value morbidly obese people. They're considered almost sub-human in today's culture. When I see what my patients go through I feel a strong sense of empathy for them." Unlike most surgeons, who have little contact with their patients after they leave the operating room, Dr. Flancbaum enjoys getting to know and work with his patients over the long term. Weight loss surgery, unlike most areas of surgery, isn't just a one-shot deal, but takes a long-term commitment by the surgeon and his staff to succeed. Also, unlike other surgical specialties in which the surgeon doesn't get to see the effects of his work, Dr. Flancbaum gets tremendous satisfaction from witnessing the total transformation he makes in the lives of his patients. His extensive knowledge of both gastric bypass surgery and the disease of obesity made him the perfect collaborator. He also has a gift for explaining complicated medical jargon in simple language the layperson can understand, as you will see throughout this book. 

"A Doctor's Guide to Weight Loss Surgery; How to make the decision that could save your life." is a comprehensive reference for individuals considering WLS. We have provided detailed information about the health risks associated with severe obesity and its treatments. The various WLS procedures are described, along with their anticipated outcomes, risks, benefits and complications. Additional chapters offer tips to help guide prospective surgical candidates through the process of selecting a bariatric surgeon and weight loss program and obtaining insurance approval. Finally, a number of personal vignettes have been included to provide a human connection and "moral support". The clinical accounts are fictionalized compilations of patients from Dr. Flancbaum's practice. It is our hope that this book will allow people suffering with clinically severe obesity to make an informed decision about WLS, which can dramatically improve their health and well being. 

Erica Manfred