You eat anything you want and you still lose weight!

My brother (18 months my junior) is a highly intelligent man. This was proven decades ago, when IQ tests performed while his teachers and parents tried to figure out why he was such a miserable little bugger showed a genius level IQ. I know that sentence sounds unsympathetic to my brother, but we were all miserable - our parents, his teachers, me, and my brother.

When I first talked with him about weight loss surgery, many years later, this highly intelligent and (by then) well-read man said, "Wow! So, you have the surgery, and then you eat anything you want and you still lose weight!"

Well, no. Not really. In fact, nothing like that.

During the 6 years of my weight loss surgery journey, I have (over and over and over again) witnessed bariatric patients who came out of the operating room after surgically successful procedures still wondering why they couldn't eat anything want and still lose weight. Their disappointing weight loss was and is a perpetual puzzle to them because somehow they had not grasped that behavioral change is required for weight loss success.

It's easy to label those patients as stupid or ignorant or deluded, or to blame their bariatric team for failure to properly educate those patients about what would be required of them both pre- and post-op. All of those things could be a factor.

In March 2012, almost 6 years since the start of my own WLS journey, I attended 2 sessions of a required pre-op nutrition and education class. My BMI then made me obese, but not morbidly so. I had gained weight after a complete unfill and was preparing to say goodbye to my beloved band due to medical problems aggravated by my band, planning to revise to vertical sleeve gastrectomy in the same procedure.

The dietitian leading the class was a perky, pretty 20-something girl, adorably pregnant, who had clearly never struggled with her weight before. Her slightly condescending attitude was hard to take, but about halfway through the class I thought I could understand her attitude. She had just named a long list of foods we should not eat after surgery (fried foods, candy, baked goodies, soda, alcohol, salty snacks, etc.) when I heard a woman nearby say bitterly, "I don't know. That seems like an awful lot to give up."

Since I had known the before and after of WLS, I was strongly tempted to respond to her, but I held my tongue (wisely, for once).

I don't know just why so many people think that WLS is magic, that you can eat anything you want and still lose weight, that you don't have to give up a single food or behavior or attitude in order to succeed. Maybe we can blame that attitude on the media, or maybe we can blame it on the deeply-entrenched denial that tends to go along with obesity. But the fact is, you can't eat anything and still lose weight unless you're dying of cancer or AIDs or some other fatal disease, and probably don't want to eat a single bite of anything anyway. And I'd trade dying of cancer for WLS sacrifices and success any old day.