View Full Version : Thru-hiking and weight-loss surgery
minnesotasmith
07-06-2005, 16:18
I've been wondering about this one. When someone who is substantially overweight gets one of the various surgical procedures performed that limits how much they can eat, simply living normally will usually see their weight plummet to somewhere around normal. This is a great thing, making them look and feel better, extending their lifespan, etc.
However, if they try to do a thru-hike, their newly-tiny stomachs won't have the room for them to eat as much as a thru-hiker pulling any kind of miles (like over 9 per day, never mind 16-20) normally eats to even come close to maintaining their body weight.
Would a person having had weight-loss surgery that shrinks their available stomach volume mean that a thru-hike is no longer a realistic possibility for them?
Sounds like a good question for an MD.
Hey MNS,
How about an Extreme Makeover!;)
-B
minnesotasmith
07-06-2005, 16:38
Is that most of them won't understand long-distance hiking worth a flip, while the ones that might would only rarely understand gastric surgery and its consequences. I suspect there is more knowledge amongst the people who read this forum on this question than there is at a typical clinic that performs such surgery.
I would think they'd be able to maintain their weight, as much as a "normal" thru-hiker does, by eating more often.
max patch
07-06-2005, 18:18
Would a person having had weight-loss surgery that shrinks their available stomach volume mean that a thru-hike is no longer a realistic possibility for them?
As a practical manner, a thru hike is not a realistic possiblility for someone who is morbidly obese to this extent.
Is that most of them won't understand long-distance hiking worth a flip, while the ones that might would only rarely understand gastric surgery and its consequences. I suspect there is more knowledge amongst the people who read this forum on this question than there is at a typical clinic that performs such surgery.
I disagree. Ask an MD about how you could consume perhaps 3000-4000 calories a day after surgery. Sly makes a good point about eating frequently. Anyway, I hope the surgery isn't necessary. That's a pretty radical solution.
SGT Rock
07-06-2005, 18:25
You would probably have to have a lot of nutrient shakes and put them in a version of a Camel-Bak and constantly sip on it as a form of hydration and calorie intake.
Is that most of them won't understand long-distance hiking worth a flip, while the ones that might would only rarely understand gastric surgery and its consequences. I suspect there is more knowledge amongst the people who read this forum on this question than there is at a typical clinic that performs such surgery.Well, why not ask a few and find out rather than saying they are all dopes so I won't ask. You will be surprised to find that people in the medical profession are all people and have varied interests. I was in the hospital last February and the x-ray tech was a former thru, the anathesiologist was a seciton hiker, and the surgeon knew aobut every shelter and trail town on the AT. He hoped to hike it after his career. He had lots of advice for me.
Don't let prejedices get in the way. Ask. If you meet people who do not know, ask others.
minnesotasmith
07-06-2005, 21:08
"As a practical manner, a thru hike is not a realistic possiblility for someone who is morbidly obese to this extent."
Oh, fah. That's not true at all, if it ever was. I've read several trail journals by people who have lost 100+ pounds while thru-hiking the AT that they needed to. Less than a week ago, I finished reading Robert Rubin's book "On The Beaten Path" about his AT thru-hike, where he went from over 275 pounds down to under 200 pounds. Further, the guidelines on who can reasonably risk one of these surgeries have been relaxed, as the procedures get done more and more, proving their relative safety and usefulness at extending lifespans. That means that people don't have to be as fat as they used to be, to be allowed to get weight-loss surgery.
Yes, there are people who can plausibly consider thru-hiking the AT who would likely find one of these surgeries worth doing.
"As a practical manner, a thru hike is not a realistic possiblility for someone who is morbidly obese to this extent."
Oh, fah. That's not true at all, if it ever was. I've read several trail journals by people who have lost 100+ pounds while thru-hiking the AT that they needed to. Less than a week ago, I finished reading Robert Rubin's book "On The Beaten Path" about his AT thru-hike, where he went from over 275 pounds down to under 200 pounds. Further, the guidelines on who can reasonably risk one of these surgeries have been relaxed, as the procedures get done more and more, proving their relative safety and usefulness at extending lifespans. That means that people don't have to be as fat as they used to be, to be allowed to get weight-loss surgery.
Yes, there are people who can plausibly consider thru-hiking the AT who would likely find one of these surgeries worth doing.Okay, fine. So if you feel so strongly about this, why did you ask the question to begin with?
Nightwalker
07-07-2005, 02:34
Yes, there are people who can plausibly consider thru-hiking the AT who would likely find one of these surgeries worth doing.
Be sure that you know the morbidity stats on this surgeruy before you get it. Even though I sometimes disagree with you, I'd hate to see you die on an operating table.
karen0540
07-07-2005, 03:29
If you have not already had a gastric bypass, why not start hiking first and see how much regular exercise can truly help w/ weight loss? Small day hikes leading up to longer...then eventually thru? I don't think that being "skinny" is nearly as healthy or attractive as just being in good shape...no matter what your weight. I realize that many people have had great results from gastric bypass, but there are also many who regretted having the surgury, and ended up w/ serious, long term health problems afterwards-some have even died. It's a very serious surgury and not a magic bullet for being happy or even in good shape. Just be careful-unless you already had the operation...and if so, how are you doing?:-?
Be sure that you know the morbidity stats on this surgeruy before you get it. Even though I sometimes disagree with you, I'd hate to see you die on an operating table.
Last year the rate was about one in two hundred die on the table. That's not counting the ones that die later from complications.
I like to ask people to consider this. If I put 199 empty guns on the table an one loaded one, would you put one of them to your head and pull the trigger?
As far as the trail is concerned. I had a co-worker that had this operation (and later died) and food went right through him like a bb through a goose. I think if you thru-hiked after this surgery you would be spending a lot of time eating small meals and squatting :banana in the woods.
Not knowing the people involved, I assumed that what was being discussed was someone who had had the procedure sometime in the past, and was now at what they thought was, let's say, their "fighting weight" and wanted to know the effects of the procedure on thru-hike appetite and Calorie consumption.
Y'all took the other approach that someone wanted to have the surgery and hike off the pounds.
Minnesota, are either of these right or are we barkin' at the moon?
:confused:
karen0540
07-07-2005, 03:54
As a general rule of thumb, most people who work in the health care field are extremely knowledgeable about all matters related to health...nutrition, exercise, symptom diagnosis, remedies, prevention, etc. I work in a hospital, and a larger than normal percentage of the employess there are very active people, just by virtue of the work environment and the matters dealt with on a daily basis. There should be no better resourse for answering your questions than the exact people who work in the weight loss clinic and deal w/ the bypass patients on a daily basis. That is their JOB, afterall, and the vast majority of health care providers take their professions very seriously and are extremely dedicated individuals. (with extensive education!) In fact, if one cannot get decent answers to serious questions from the very people responsible for the surgury, why entrust them with your life in the first place? Because that is exactly what you are doing whenever you go under the knife! This forum is a wealth of knowledge, but unless the members answering your posts are MDs, you're really not getting the best advice possible. I don't ask my plumber to diagnose abdominal pain, and I wouldn't ask my doctor to fix my toilet.
Well, why not ask a few and find out rather than saying they are all dopes so I won't ask. You will be surprised to find that people in the medical profession are all people and have varied interests. I was in the hospital last February and the x-ray tech was a former thru, the anathesiologist was a seciton hiker, and the surgeon knew aobut every shelter and trail town on the AT. He hoped to hike it after his career. He had lots of advice for me.
Don't let prejedices get in the way. Ask. If you meet people who do not know, ask others.
SGT Rock
07-07-2005, 13:57
I like to ask people to consider this. If I put 199 empty guns on the table an one loaded one, would you put one of them to your head and pull the trigger?
If I win, do I get to keep the gun?:cool:
Lone Wolf
07-07-2005, 15:02
Weight loss surgery is dumb. Thru-hiking after it would be even dumber.
Footslogger
07-07-2005, 15:10
Weight loss surgery is dumb. Thru-hiking after it would be even dumber.============================
Sounds like an idea for a movie ...oh yeah, they already made one.
'Slogger
Last year the rate was about one in two hundred die on the table. That's not counting the ones that die later from complications.
I like to ask people to consider this. If I put 199 empty guns on the table an one loaded one, would you put one of them to your head and pull the trigger?What's the payoff? One out of two hundred would be good odds if I had a disease that was about to kill me. Not so good odds just to make me look better. Well, look good.
Lone Wolf
07-07-2005, 16:03
Being fat ain't a disease.
whitedove
07-07-2005, 16:45
MS...I don't have an answer to your question but having just done a rotation with a surgeon who performs gastric bypasses....eating smaller amounts would be an option for them. Just as for someone with diabetes or another health problem, shall we say arthritis...they would have to tailor the hike to accomodate their health issues.
Most people who are morbidly obese are not active in the first place because of their weight so thru hiking to lose it wouldn't be a wise option. And it is a disease state in a way, that's why insurance companies are starting to pay to have it done. It leads to as much if not more health problems than cigarettes...diabetes and heart disease being two major complications. And the psychological problems of being overweight most of their lives shouldn't be ignored either.
Ask a surgeon who specializes in these procedures...not all of them are dorks.
The Solemates
07-07-2005, 17:29
If you have not already had a gastric bypass, why not start hiking first and see how much regular exercise can truly help w/ weight loss? Small day hikes leading up to longer...then eventually thru? I don't think that being "skinny" is nearly as healthy or attractive as just being in good shape...no matter what your weight. I realize that many people have had great results from gastric bypass, but there are also many who regretted having the surgury, and ended up w/ serious, long term health problems afterwards-some have even died. It's a very serious surgury and not a magic bullet for being happy or even in good shape. Just be careful-unless you already had the operation...and if so, how are you doing?:-?
this is probably the best advice yet. do the thru, then decide if you want surgery. likely, you will lose so much weight on the thru you wont need it when you are done.
The Solemates
07-07-2005, 17:30
Being fat ain't a disease.
Preach it. I couldnt agree with you more. And to even hint that it is, or that it is all genetics makes me cringe.
justusryans
07-07-2005, 19:00
I thought it would never happen Lone Wolf but I agree with you! No one made a alcoholic drink, no one made a drug addict use, and no one made you eat those twinkie's. We all need to accept responsibility for our own actions. When we screw up we need to say "yup, I screwed up" and then do your best to fix it. You can't go through life avoiding responsibility for our actions. I don't want to come off as callus, however it does no good to place blame except squarely where it belongs.
Being fat ain't a disease.I worded my post poorly. I'd explain what I meant but the purpose of this thread is escping me.
whitedove
07-07-2005, 20:07
Maybe my "in a way" was also worded poorly. I was by no way saying obesity is a disease in and of itself but it "causes" severe health problems and please note the word "morbid" that I used.
orangebug
07-07-2005, 21:13
Given that there are several experts who know just what morbid obesity is, whio defines disease, and who contemplate the payoff of Russian Roulette - this MD would prefer that anyone contemplating either a gastric bypass or hiking with morbid obesity talk with some real world doctors.
Preferably, the consults should include a psychiatrist.
I have a friend who had a stomach reduction. I asked them could they do a long backpacking trip. The answer: It's like a heart attack, before the attack you could have gotten yourself in shape to do it. After the attack, the damage is done and life changes. Not to say its impossible but to say it would be very, very difficult, and a chance that more negative health benifits, rather than positive ones, would be achieved. Hikerwife
cutman11
07-08-2005, 00:06
I am a surgeon with 2 partners who have been performing a version of the gastric bypass weight loss procedure. They have done around 1000 of these over the past 2 years without a major complication or death. The procedure is designed for people who are so overweight that they have significant health risks due to their weight, and therefore what you or I would consider a crazy or silly or stupid thing to do is actually for them less risky than continuing to be morbidly obese with the problems that come with obesity. Yes, it would be better not to be so overweight in the first place, but once in that category, the issue becomes in some respects a matter of life or death.
A little about the procedure: What most of the newer procedures do is partially prevent complete digestion of carbohydrates. If you have this done, and you eat large amounts of carbs, then you get crampy pain and diarrhea. Eventually even the most carb addicted patient's behavior is altered into not eating the things that make them feel pain and get diarrhea. The majority of the stomach is bypassed, so there is no reservoir to pile in a bunch of food at once either. Sugar does not require much digestion, but in these patients a large sugar ingestion is absorbed rapidly, causing blood levels to rise quickly, and the body responds by increasing insulin levels rapidly. The body overdoes it, however, and then the blood sugar levels drop quickly again, usually too low. This causes one to feel bad too. So these patients in effect, are on a surgically caused "Adkins" diet, in which they receive immediate negative feedback for trying to "cheat" on their diet. It doesnt take long to "learn" what to avoid.
Now for the hiking implications: Most of us eat lots of carbs both complex and simple sugars for energy on a hike. But we are also often burning more than we ingest, so we are in "ketosis", using our fat stores (and non essential protein stores) for energy to make up the difference. That is why most thruhikers lose fat (and also muscle from arms more so than legs) during the course of a thru hike. I would think it would be very tough for a bypass patient, as they would not be able to eat many carbs, and if they lost weight too rapidly, would be too weak to hike, as they would just lose more muscle mass and more rapidly than a normal thruhiker. It probably could be done, but would require much more careful selection of foods, and perhaps given the limited trail food selection, may not be possible.
I will try to ask my partners tomorrow if they give their patients specific exercise restrictions following surgery. Im sure most of the patients are so out of shape, that their exercise is restricted by their cardiovascular system (heart) and stamina much more so than because of the surgery. I also would think a gastric bypass patient who had lost most of their excess weight would be in better shape and use up less calories per mile hiked, so they might be better able to handle it.
cutman11
07-08-2005, 00:16
Given that there are several experts who know just what morbid obesity is, whio defines disease, and who contemplate the payoff of Russian Roulette - this MD would prefer that anyone contemplating either a gastric bypass or hiking with morbid obesity talk with some real world doctors.
Preferably, the consults should include a psychiatrist.
Incidentally, the procedure my partners employ involves and extensive medical and psychological screening before surgery. The results, I believe, are more the result of being very selective in choosing patients who will be able to handle the permanent change in their eating habits, and to the extent that many of life's social interactions involve food (example -- Thanksgiving dinner), your LIFE not just your eating habits are permanently changed. There are many many obese patients who are that way because of some underlying deep set psychological trauma/issue. It has been estimated that 30% of women in the morbidly obese category are that way because of sexual abuse at a young age which their mind deals with by becoming so unattractive that they feel "safe" from further abuse. If forced to become thin again, they cant handle it psychologically as they feel vulnerable again to further abuse.
cutman11
07-08-2005, 00:23
Being fat ain't a disease.
Actually, in a sense, it is a disease. And it causes or contributes to the worsening severity of several other diseases of the human body, including high blood pressure, diabetes, and arteriosclerosis. We arent just talking about being 20 or 30 pounds overweight. The folks getting these procedures are 100 to 250 pounds overweight. Many lose HALF of their pre- surgery weight.
cutman11
07-08-2005, 00:26
Is that most of them won't understand long-distance hiking worth a flip, while the ones that might would only rarely understand gastric surgery and its consequences. I suspect there is more knowledge amongst the people who read this forum on this question than there is at a typical clinic that performs such surgery.
Although I would agree with your comments, minnesota, there are some of us who are both: Long distance hikers and surgeons knowledgable about the gastric bypass procedure. I will try my best to answer, or find the answers to these questions and any others any of you may have.
cutman11
07-08-2005, 00:29
"As a practical manner, a thru hike is not a realistic possiblility for someone who is morbidly obese to this extent."
Oh, fah. That's not true at all, if it ever was. I've read several trail journals by people who have lost 100+ pounds while thru-hiking the AT that they needed to. Less than a week ago, I finished reading Robert Rubin's book "On The Beaten Path" about his AT thru-hike, where he went from over 275 pounds down to under 200 pounds. Further, the guidelines on who can reasonably risk one of these surgeries have been relaxed, as the procedures get done more and more, proving their relative safety and usefulness at extending lifespans. That means that people don't have to be as fat as they used to be, to be allowed to get weight-loss surgery.
Yes, there are people who can plausibly consider thru-hiking the AT who would likely find one of these surgeries worth doing.
Yes, there are many who lose much weight on a thru hike. BUT that is not the same as someone who has had the bypass surgery and is forced to lose weight even if they do not walk 10-20 miles each day. They have additional metabolic issues in that they are not able to ingest and digest calories the same way.
cutman11
07-08-2005, 00:33
If you have not already had a gastric bypass, why not start hiking first and see how much regular exercise can truly help w/ weight loss? Small day hikes leading up to longer...then eventually thru? I don't think that being "skinny" is nearly as healthy or attractive as just being in good shape...no matter what your weight. I realize that many people have had great results from gastric bypass, but there are also many who regretted having the surgury, and ended up w/ serious, long term health problems afterwards-some have even died. It's a very serious surgury and not a magic bullet for being happy or even in good shape. Just be careful-unless you already had the operation...and if so, how are you doing?:-?
I agree that on the surface, this sounds good. But the people who get this surgery are so obese, they would not make it up the approach trail and sassafras mountain much less the entire trail. The weight they carry would destroy their knees in short order on the slopes of the AT.
cutman11
07-08-2005, 00:40
As a general rule of thumb, most people who work in the health care field are extremely knowledgeable about all matters related to health...nutrition, exercise, symptom diagnosis, remedies, prevention, etc. I work in a hospital, and a larger than normal percentage of the employess there are very active people, just by virtue of the work environment and the matters dealt with on a daily basis. There should be no better resourse for answering your questions than the exact people who work in the weight loss clinic and deal w/ the bypass patients on a daily basis. That is their JOB, afterall, and the vast majority of health care providers take their professions very seriously and are extremely dedicated individuals. (with extensive education!) In fact, if one cannot get decent answers to serious questions from the very people responsible for the surgury, why entrust them with your life in the first place? Because that is exactly what you are doing whenever you go under the knife! This forum is a wealth of knowledge, but unless the members answering your posts are MDs, you're really not getting the best advice possible. I don't ask my plumber to diagnose abdominal pain, and I wouldn't ask my doctor to fix my toilet.
Thanks for the vote of confidence. And believe it or not, I could fix your toilet too. Just dont ask me to paint your portrait. I can draw a pretty good stick figure tho.
((((((((
O O
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If I win, do I get to keep the gun?:cool:
Sure you can! You got 200 guns I can borrow? :D
SGT Rock
07-08-2005, 10:34
I had a lot of them when I had an Arms Room, but the Army might not like playing that game with their guns.
karen0540
07-08-2005, 14:11
I thought it would never happen Lone Wolf but I agree with you! No one made a alcoholic drink, no one made a drug addict use, and no one made you eat those twinkie's. We all need to accept responsibility for our own actions. When we screw up we need to say "yup, I screwed up" and then do your best to fix it. You can't go through life avoiding responsibility for our actions. I don't want to come off as callus, however it does no good to place blame except squarely where it belongs. EXACTLY!!!!!!! That's the problem w/ our world today, people don't want to take responsibility. It's always someone else's "fault".:(
karen0540
07-08-2005, 14:19
Thanks for the vote of confidence. And believe it or not, I could fix your toilet too. Just dont ask me to paint your portrait. I can draw a pretty good stick figure tho.
((((((((
O O
L
-------
!!!!
"""" ######
## #### #
## ##### #
###### """"
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##### ##### And believe it or not, MY plumber is so good, he could probably fix my abdominal pain, but he charges more by the hour than my doctor, so I go to the MD cuz it's cheaper and my PPO won't approve pay outs to my plumber anymore...:bse
Patrickjd9
07-08-2005, 22:18
this is probably the best advice yet. do the thru, then decide if you want surgery. likely, you will lose so much weight on the thru you wont need it when you are done.
Someone who has the general idea:
http://www.washingtonpost.com/wp-dyn/content/article/2005/07/07/AR2005070701972_pf.html
http://www.thefatmanwalking.com/
Walking Off the Fat, Across the Land
At 400 Pounds, a Californian Set Off for New York. In Arizona, He's at 350.
By Amy Argetsinger
Washington Post Staff Writer
Friday, July 8, 2005; A03
<NITF>PEACH SPRINGS, Ariz. -- This week, his 13th on the road, has been the hardest thus far for Steve Vaught, a 400-pound man trying to walk across America.
On Sunday morning, he found a creek just as the desert heat forced a midday break. But when he woke from a nap and tried to fill his water bottles, the stream had already gone dry. Late that night, he walked right past his scheduled motel stop in Truxton, a flyspeck on historic Route 66 so slight it vanished when the sun went down.
On Monday, out of water in 102-degree heat and miles from any town, he sent a frantic text message to his wife, who called the local police. They drove him to a hotel, where he rested a night and a day, sick with dehydration. On Wednesday he started late and tangled with a scary dude on the desolate highway.
"I'm quitting," he told his wife this week. She said okay.
But within hours he hit the road again, as they always sort of knew he would. For quitting is not so easy when you're 500 miles from home.
This spring, as he neared his 40th birthday, Vaught had an epiphany: If he didn't lose the weight, he would die before 50. But dieting would not work, he decided, and neither would normal exercise. He knew he was the kind of guy who could rationalize his way out of one three-mile walk after another. "My weakness," he said, "is the easy way out."
So Vaught made it hard. On April 10, he left his home in San Diego -- and his wife and two children -- and started walking, alone, to New York.
---article continues---
saimyoji
07-08-2005, 22:43
Well, there you go. I hope he makes it. More importantly, I hope he resolves his issues in the process. While he may end up thin, it sounds like he's gonna need some couch time, in a professional sense. A 75 lb pack? Wish he'd post his gear list.
Currently he's dropping a pound per 10 miles walked, I guess that sounds right for someone that large. He may should have considered a long trail, such as the AT. Hiking on roadways can get difficult in all kinds of ways.
Also, My husband put on over 25lbs after his AT thru, over a period of less than a year. He blamed it on being use to eating all he could while on the trail. Hope this guy doesn't do the same.
Nightwalker
07-11-2005, 00:41
Being fat ain't a disease.
How about being stupid? :D
Nightwalker
07-11-2005, 00:44
Preferably, the consults should include a psychiatrist.Well of course YOU would say that! :D
(Couldn't resist. How ya been, buddy?)
I had a gastric bypass surgery in october of 03. I started my thru attempt in march 04. I only made it half way but it had nothing to do with my stomach. Yes eating smaller portions for sure but also eating more often. My surgery was to necessary due to ulcers, not being overweight. It is true...i am unable to gain weight no matter how much i eat but that was pretty much the case all my life anyway. I rather enjoy my digestive situation now because i'm convinced I can convert calories into energy FASTER now than when I had a stomach. My stomach problems stemmed from my youth and this surgery ended all my problems at once. Thank GOODNESS for modern technology!!! I'll take a second stab (no pun intended) at the trail next spring!