Talking About Weight Loss Surgery For Men

In this interview I wanted to highlight some of the issues men, in particular gay men, can confront when it comes to weight loss surgery such as gastric band: “Lap Band”, gastric sleeve or bypass such as the Roux en-Y.

Surgical weight loss is a bit of a controversial topic with many people reporting they have been told “it’s cheating” or “why don’t you just eat less”. Obesity and it’s complications is a complex issue. Evidence shows that in some cases surgery is one of the best options for successful weight loss as well as reversal of obesity related issues such as diabetes, sleep apnoea, joint wear and tear and other problems.

I acknowledge that it’s a significant surgery and not for everyone. This video is for anyone who has had surgery or may be considering it.

I’m thrilled to be able to talk about many of the “taboo” subjects rarely addressed.

I hope you find this helpful.

transcript
Todd:               I'm Todd Teddleton. I'm from Atlanta, Georgia.
 Dr George:          Okay. The reason I wanted to talk with you today was that you've had a experience where you're a bigger guy and now you're not as big a guy. Can you tell us a little bit about that?
 Todd:               So I've struggled with weight since I was in college. I would put on some weight, get it off; but it would always kind of come back over time. It's never really impeded my ability to do the things that I wanted to do. I was very active. The type of work that I did in insurance; climbed roofs, carried large ladders, did a lot of manual type work. But over time, the problem I was running into was with my physician. I was taking more and more medication. So it started out with blood pressure issues, one type of blood pressure medication, then another was added on. Then I started taking a statin, and then metformin because all of my numbers were borderline. I saw a problem coming with that sort of issue.
 Dr George:          Yeah. What was the breaking point for you?
 Todd:               The breaking point was I had gotten to the point where I really had started soul searching and realising that if I continue down this path, that even though I liked being a bear - I like being a bigger guy and the guys that like those people - it just wasn't working with my body anymore. My system just could not keep pace with that size.
 Dr George:          So you decided to look at the surgical options?
 Todd:               Yes.
 Dr George:          Which surgery did you choose?
 Todd:               I talked with the physician, I went to a couple of counselling sessions, and I chose the gastric sleeve.
 Dr George:          Okay. Making a decision to get weight loss surgery; it's a very personal one. But everybody has an opinion. Did you have people around you who were like, "That's just cheating," or you know, "Why don't you just try and diet?" Or anything like that? Did you have any of that friction?
 Todd:               I had heard stories of those types of situations occurring, but I didn't really have any negativity towards my journey. My partner enjoys bigger guys, so that was something that was a concern to me, how he would react and feel about it. Yeah.
 Dr George:          Yeah. But he was supportive?
 Todd:               Very, yeah. He was very supportive.
 Dr George:          Did you find the process of getting the operation, did it take you long to recover?
 Todd:               Post surgery?
 Dr George:          Mm-hmm (affirmative). Because it's actually a process.
 Todd:               It is, it is.
 Dr George:          Starting from that liquid diet all the way through to feeling like you're back to your normal self. How long did that process take?
 Todd:               That process was several months. The liquid diet and the counselling sessions with the psychiatrist were really good because they kind of help set a reset for me. Because I needed a reset point, because the surgery by itself, it's just a tool. Once I kind of got into a mode of where I wanted to be and what I wanted to do to get there, several months occurred after surgery before I really felt myself again.
 Dr George:          Yeah. Before you had the operation, did you have moments of sadness where you'd be like, "But I really like having a big breakfast," or, "I'm going to miss this particular food." Did you have any of those sort of-
 Todd:               My initial worry was I've spent a lifetime drinking soft drinks, and then I'm not a real sugar person but I love pasta. My journey was a little bit different because once I made my mind up that this is what I wanted to do, the rest of that just didn't matter to me. I have a buddy that also went through the surgery, and he struggled with missing different sorts of foods. But I never had that feeling personally.
 Dr George:          How long ago did you have the operation?
 Todd:               A year ago.
 Dr George:          Okay. Do you remember what your initial white was?
 Todd:               I was at 277 before I started the liquid.
 Dr George:          Okay. What's your current weight now?
 Todd:               I am at 185.
 Dr George:          That's a big loss.
 Todd:               Yes.
 Dr George:          That's a big loss in a year.
 Dr George:          Apart from the numbers, what are the big physical changes that you've noticed?
 Todd:               Clothes. Obviously they just were hanging off of me and I had to go out and find something different to wear. I ended up needing skinny jeans because I lost a lot of muscle mass in my legs, my arms. That was something that when I've lost weight before, that's never happened. But because your nutrients don't absorb in the same way, that's going to happen. But that's been one effect.
 Todd:               The other thing that I've done is I got a personal trainer and started working out back in December to try to regain. I didn't want to do it immediately because I was so focused on making sure that I was doing the right things with my food and that my weight was stable. I didn't want to throw too many variables into the mix.
 Dr George:          Actually, this just reminds me of something. When we first met, we were talking about something, and I think this is an important thing for anybody who is either considering or getting or had weight loss surgery because it's a mind thing. You mentioned that you had started going to the gym and that you had gained weight.
 Todd:               Yes.
 Dr George:          What did that feel like? What was it like?
 Todd:               It was horrific. It was scary for me, because I had almost 10 months of downward trend or stabilisation where I was controlling every aspect of this process. I felt in control for once in my life, how this was going. I started working out and have a trainer that I meet with three days a week. After about six weeks, I had gained like four or five pounds. Then after a couple of months I was up a total of eight pounds. I told him, I said, "I don't know what to do. I'm really starting to get concerned. I feel a little bit more hungry than normal. I'm still trying to manage the eating small portions because I don't want to overeat and thwart the system." He just looked at me and he said, "It's muscle." I said, "What?" He said, "Yeah, it's muscle." I said, "Yeah, but eight pounds?" He said, "You started here, and now you're lifting this much. You're lifting three times more than you started. It's all muscle."
 Dr George:          Because it's interesting, isn't it? Because people who have never had weight loss surgery don't get that you're trying to drive a four wheel drive with a Prius tank. Do you find that your hunger, that your energy levels go a bit wacky when you're working out?
 Todd:               Yes. There's a lot of management that you have to do, especially when everybody's juggling all these different balls, so the time is limited. I have found that for me, I eat a little bit before I go to the gym, but not enough that makes me kind of sick feeling when you start working out. Then when I'm done, I drink a protein shake that I make at the house. So I just carry that with me. I've also noticed that I can't really drink a lot of that, because if I do, the sugar content and stuff in it will kind of mess with me personally. But then, once I get past that, then just trying to eat up to lunchtime, just some small stuff.
 Dr George:          I've definitely found that my appetite is much higher when I'm working out.
 Todd:               I feel the same way. Like you said, working with the Prius tank and trying to feed a beast, our body. It's kind of hard to do because your body wants to intake more than your stomach's going to allow.
 Dr George:          And your brain's freaking out at the same time going, "I don't want to fuck this up."
 Todd:               Right, right. Yeah, it's like you've got these two sides kind of working against each other because you want this to be successful.
 Dr George:          Yeah. Well on that subject, like was it a success … For me, when my band got filled to the right spot, when I got to the green zone, it was like holy mother fucking god, this is what it's like when you can eat to satisfaction. This is what it's like to actually have a diet that works. Did you have that kind of, what the hell?
 Todd:               Yes. When I would eat before, pasta was a go to for me and there was no amount of pasta. I could just eat a huge plate of food. I'm sure you know in American culture, you get out a plate of food and it's enough for two people. Now, the way I feel is, I can feel that fullness coming on because I'm not eating as fast. Plus, I know about how much it takes now. Because if I overeat, you feel it. It's like kind of backing up. It's not a comfortable feeling. It's not something you want.
 Dr George:          Yeah. How did you go with the initial diet? Are you a weigher? Or do you have, "I must have this many grammes of protein"?
 Todd:               I really just followed the hospital and doctor's recommendation. They gave me a binder that had exactly what I was supposed to do, and I just followed it. That gave me a lot of peace. I measured all my food, because they told you to do that, and how much you should be taking in based on the size of your stomach. Those things I followed. But once I got into a pattern of doing that, I really didn't weigh my food as much and measure it. You can eyeball it, yeah.
 Dr George:          Yeah. Because each surgery has its own kind of little tricks. Say for example, the Roux-en-Y, you can't eat sugary foods otherwise you'll get dumping syndrome. With the gastric band, you have to chew, chew, chew, chew, chew, chew, chew and don't take in liquid calories. With the sleeve, one of the biggest tricks is you can't drink and eat at the same time. What's been the trickiest adjustment that you've had deal with?
 Todd:               I don't really like to have liquid at the table for my meal. Having servers sometimes understand that is a little bit tricky, because you'll say, "I don't want anything to drink." But they're like, "Do you want water?" "No. I don't want water." Sometimes people don't understand that. But I just would rather it not be there. Not really as a temptation. I just don't want to … It's just like someone losing their hand. Obviously they still feel it; it's still there. So the water, if it's sitting there, it's sitting there saying, "Hey, I'd like you to take a sip."
 Dr George:          Absolutely. It's almost unconscious.
 Todd:               It is, it is.
 Dr George:          How do you deal with restaurants? How do you find the experience?
 Todd:               When I first had my weight loss surgery, I asked to eat off the kid's menu. But I found that that was really limiting, and sometimes they didn't want to serve you off the kid's menu, even if I had this little card that the hospital gave me that said that I can do that. But I just got to where I would just order a regular meal and just take half of it or three quarters of it home. So I just eat what I want, take it home, eat the rest of it. I'll make several meals.
 Dr George:          Do you have one of those collapsible Tupperware things?
 Todd:               Yes.
 Dr George:          They're the best.
 Todd:               Yes.
 Dr George:          They're really good. Have you had issues with servers or people that if you only eat half a meal, they're like, "Well what's wrong with it?"
 Todd:               All the time. Yeah, they believe that there's something wrong with the food. Sometimes I explain, and sometimes I just don't.
 Dr George:          Yeah. Do you have little catch phrases? Like mine is, "I just have a small stomach."
 Todd:               Yeah. I've used several different phrases, but it just depends on the situation and who I'm with.
 Dr George:          When you've had a dramatic weight loss, there's fall out. You were talking about how your clothes were baggy on you. In the initial phase of losing weight rapidly, your skin can get equally as baggy. How have you felt about the changes in your body shape?
 Todd:               I made a conscious decision whenever I started this journey to wait at least a year before I made any decisions about what I want to do with my body. The other thing that I made a decision was starting strength training to see what I could get back, gather back in my legs and my arms so that when I decided to get a consultation, because I don't know that I'll do anything, but I would like to talk to someone to see what is possible. If it's something that I would want to do or just leave everything as is.
 Dr George:          Because there is some, the skin can come back a little bit. But yeah, it is what it is really.
 Todd:               Midsection, lower section above my genitals. Those are the areas for me that I have excess.
 Dr George:          Okay, and you'd like to make it a bit smoother?
 Todd:               I would.
 Dr George:          Yeah. On the subject, seeing you brought it up, has your sex changed since you've lost weight?
 Todd:               Well, I've always been really horny, so I don't think it's changed that much. Although, my testosterone level is lower now than it was before, which I didn't really expect that change. But it could just be a function of age, because I'm 52.
 Dr George:          Yeah. But when you change the consistency of the body, you're going to have less body fat and a lot of testosterone's stored in the body fat. So that may be part of it.
 Dr George:          What about the people around you? Have you noticed a change in the people that find you sexually attractive now?
 Todd:               Yeah, definitely. The type of people that are interested in me is different. Just staying relevant, kind of my interest has changed a little bit too. I've noticed I'm a little bit more attracted to different types of people.
 Dr George:          And bear within the American context, it's quite a discreet fetish. But have you noticed that people that you may not have approached previously when you were bigger are suddenly, "Oh, okay. You're interested in me now. Okay, sure. Fine, didn't like me when I was fat, but I'm okay now." Have you had experiences like that?
 Todd:               Definitely. Social apps, you notice it. People that you would have never been approached by before, they'll hit you up just to try to get to know you.
 Dr George:          But what about people within your inner circle; people that are close to you? How have they dealt with the change in the shape of your body?
 Todd:               I think that people within my inner circle have been very supportive, but sometimes shocked at the difference. Because I travel a lot for work, I could be gone for several weeks at a time. Would be home a few days and then gone again, so somebody might not see me for several cycles. So when that would happen, you could see their reaction was kind of shock. It's like, "You have lost a lot of weight." I think in our culture, you can just kind of tell by tone, watching people's expressions [crosstalk 00:00:18:04]-
 Todd:               Exactly. It's not necessarily a positive thing, although they'd want to be supportive and they're not trying to be mean. It's just they're shocked.
 Dr George:          Within the gay culture, it's an interesting one because nobody wants to say AIDS. "Have you got AIDS?" is the primary question. But the other one is, "Have you got cancer," or … Have you had those sort of, "Is your health okay?"
 Todd:               I think that those are the underlying tones when people see a dramatic change. I really do think that a lot of it's out of concern. Friends and people that you know, but they don't want to pry. Yeah.
 Dr George:          When you initially had the surgery, did you keep it personal or were you open about it?
 Todd:               I was open about it to my close friends. I didn't really post anything about my journey on social media, so it wasn't something that I kind of kept a personal log and and really put out there.
 Dr George:          Yeah. Say you ran into Great Aunt Mabel or your old boss 10 years ago and they looked at you now and they said, "Geez, you've lost a lot of weight," how would you respond today?
 Todd:               Today. How would I respond? I would say thank you.
 Dr George:          Because I've had people ask that of me and I say, "I just eat less now." If they continue to pry, I might talk about the band or something like that.
 Dr George:          Because I know that within Facebook, there's a number of groups. There's a men's gastric sleeve group, there's a couple of … The lap band groups are kind of crazy because everybody's talking about ways to cheat the band, which I think is ironic. Have you found a good set of supports for you that if you're looking for information you can go to?
 Todd:               Yeah. The hospital that I used in Atlanta is the university hospital, and they have a really good support group. I go to that once a month. They talk about different recipes, successes, failures, opportunities. It's really good because it's a diverse group of people. There's straight and gay, and married and single, widowed. I like it because it just kind of gives you a really good cross hatch of people.
 Dr George:          Do you find that there are celebrations that are difficult? For me, it's Christmas because there's all of this lovely food and I want to try it all. But it's kind of like I can only … I use a bread and butter plate. That's a meal for me. I can gauge that. But Christmas I find tricky. Do you find like Thanksgiving or something like that is a tricky time where it's a tradition or gorging and it's something-
 Todd:               Excess?
 Dr George:          Yeah.
 Todd:               Yeah. I can see that. For me, I can take little portions of things that give me memory of certain tastes and smells, and it works for me. So just taking those little bits and pieces in a big setting like that at Thanksgiving works.
 Dr George:          Has your taste changed?
 Todd:               Yes.
 Dr George:          Do you have foods that you prefer now?
 Todd:               Yes. I really stayed away from pasta for a long time. As a matter of fact, the nutritionist got onto me about not eating enough carbs., and so she wanted me to integrate some carbs. I was scared to death because that was kind of my go to. But I found that it's not the same as it was. It just doesn't have the same comfort that it used to have.
 Dr George:          I've learned, some people say this, obviously I unconsciously ate, so I will have a couple of mouthfuls of a food and then I'll be like, "Yeah, okay. I'm kind of getting bored of that now." Instead of like, "Oh, I've got to finish it," now it's like, "Oh, I'll just stop." But yeah, is that kind of in your radar as well?
 Todd:               Yeah. I'll see Jason every now and then look at me kind of odd if I've eaten a bite or two, just because it's still kind of shocking to him. "Are you okay?" But I really am. I'm just not into it right that moment, and I'll eat it later.
 Dr George:          Yeah. It's funny, isn't it? It's such a thing.
 Dr George:          If you had somebody come to you today and say, "Look, I'm considering wight loss surgery," what would your recommendations be for that person?
 Todd:               I would recommend that they talk to others that have had it done. Definitely find a system that's solid. I know that there's a lot of different weight loss agencies and places to do this. But I really am lucky to be in a city that I'm in where they have a great support system. Our university medical centre is really good. So I would recommend that they start with talking to friends; anybody that you can talk to that's had it. A support group is good. Get on there and talk to people about their experiences. Don't go on Google and just spend a lot of time reading about people's failures, because I think that it's all up to you. I think that the failure rate of having one of these procedures done is probably pretty low as far as the medical aspect of it. It's what that person does with the tool once they get it, is where the success or failure comes in.
 Dr George:          Absolutely. Any closing thoughts?
 Todd:               Well, I really appreciate you taking the time to talk to me about this. I've not really opened up to anybody.
 Dr George:          People don't talk about this. I think it's important that we acknowledge that this is an option that's available and it's not as scary as what people think. But that it's these points that those little things that you're like, "Did you have that?" that I think we need to share it so we can all understand that it's not just about the numbers. There's so many other aspects to it.
 Todd:               It is, it is. Thank you for taking the time to do this today.
 Dr George:          Thank you.
 Todd:               All right.