- Joined
- Jan 26, 2020
My understanding is that, whenever someone is put under general anesthesia, there's a chance they won't wake up. Certain factors, like weight or age, increase this risk. At a certain point, like with my 104-year-old great grandmother, or a 600 pound hamplanet, a doctor will decide that the risk of the patient dying on the table outweighs the potential benefit that the surgery would provide. Different doctors draw this line in different places, either because they're very good, or just unscrupulous. I don't think this is super relevant to Lou, however, because we've seen how fucking inert he is when it comes to his health. Obviously, he's eaten himself into a state where 60% of his blood has retired to become butter, and shows no inclination to make the changes to his diet that would allow him to survive into his fifties. He fired his dietician (for an absolutely MAGNIFICENT reason), and is without a primary care physician. He let a giant hole rot into his foot because it helped him get pitybuxx on the Internet. Now, imagine you're a doctor. Do you want to stake your success rate and conscience in Lou's ability to do the things you tell him, pre- and post-op, to ensure his safety?Bariatric surgery isn't a last-ditch effort for the super-obese. Or at least not exclusively. It's a medical weight loss tool, especially used for folks who have struggled through numerous weight loss cycles without success. The process around qualifying for the surgery is intense, involving months of supervised/directed diet and exercise, nutrition discussions, and a psych eval. But it requires work, long term, to make it all stick.
The surgeries are a lot safer now than they maybe have been in the past, and some surgeons and hospitals are able to boast 99.9% success rates (success here being defined as "no catastrophic complications post-surgery"). The greatest risk involved in the surgery is honestly the patient's weight and size, which is one of the reasons why larger patients get told they have to lose weight before they can qualify for the surgery.
There are several reasons that Lou's doc probably recommended this to him (although they really should have just referred him to a weight loss clinic to start with):
1. his BMI is over 40 and has been for years (criteria is BMI 40 stand-alone or 35 with co-morbidities like diabetes)
2. bariatric surgery can put diabetes in remission
3. his lifestyle is not helping his size, so maybe...?
But as you pointed out, if Lou were to even undergo the surgery, he would be his own worst enemy in the matter. He wouldn't commit to the necessary changes, and would fuck it all up in the end.
<Richard Beltzer voice>: Yeah, that'll happen.