Thursday, January 14, 2016

Thoughts about the TV show "My 600 lb life"

As I watch the TV show, "My 600 lb life", I see many issues .... Elephants in the room, things left unsaid like, the fact that at least 2 of the patients featured on this show, ended up with severe complications such as neuropathy and guillian barre (which the provider attributed to "obesity" even though it was after the gastric bypass that these folks suffered these complications). One  patient uses a wheelchair now (he could walk before his gastric bypass). Another 2 patients that I know of, died a couple of years after surgery which is before they would have died without surgery.  (The bus driver featured in the first or second season, died about two years after his gastric bypass - he had a massive heart attack while driving a school bus.)

First, it seems many of the patients feel the 'before surgery' diet is temporary but in truth, weight loss surgery does NOT fix a damaged metabolism...that is the patient will have to stay on the 1200-1400 calorie diet for life if they want to keep off the weight... it bothers me that many patients don't seem to understand this and so their weight loss after surgery greatly slows down or in some cases, they gain.

Second, with weight loss surgery, there may be a large initial (after surgery) weight loss as the person cannot eat because there is a healing process going on, but after the surgery is healed, the appetite (which is centered in the brain) comes back strongly.

When weight loss surgery was invented in the 1960's, medicine thought the appetite centers were in the stomach and by making the stomach very small, that would control the appetite... Studies and a greater level of knowledge that we have now, have taught us that the appetite centers are in the brain and the size of the stomach makes little to no difference in how hungry most individuals feel... This means that the entire theory upon which weight loss surgery is based, may be outdated.  So one wonders why some providers still do the invasive procedures like gastric bypass?. Well, surgery is a cash cow for providers, unfortunately... and sadly, many patients who have become ill with gastric bypass or have regained, are made to feel ashamed if they speak out.  One of my friends called this a "conspiracy of silence".  She, a weight loss surgery patient herself, died at the young age of 54.  She had been ill with her surgery and bed-bound for several years before her death.

Do providers know that surgery does little to nothing to control the appetite for most folks?  Unclear... They really might think that the surgery helps... To keep up with all the advances in medicine, a provider would have to spend all his or her free time reading...

Most of all, one cannot gain to a very heavy weight, unless one has some serious physical metabolic issues going on.  And no one seems to acknowledge this, although it can be found in medical literature .... And especially not the provider on the TV show, "My 600 lb life"...who assumes that every one of these patients is really stuffing him/herself. However, a revealing study found that members of NAAFA, a fat acceptance group, actually consumed less food at conventions than their thin cohorts!  It's true that people who get very overweight may overeat at times, but basically, most of them eat like many other Americans who do not become extremely obese... And yet these people are made to feel like they are total pigs when it comes to eating. I can't help wondering why providers don't seem to know more about metabolic issues which can cause obesity... 

I stumbled upon my metabolic issue...after spending a lifetime wondering why, if I ate like most around me, I became very overweight... A goodly percentage of folks who had tonsillectomies in the 1950's and 1960's got pituitary damage after surgery... My tonsillectomy was in 1953 and right after surgery, I began putting on weight...That is, before this procedure, I, being very active, was on the slim side, however, after surgery...eating the same amount and with just as much activity as before, I gained weight...

So in digging through medical literature (for years literally), I found the reason why I gain so easily.  Now why don't providers let us know about this, I'm those folks on "My 600 lb life", the provider really takes them to task, when they gain weight...

To defend Dr Nowzardan, it's possible he doesn't know about the latest research...he's 72 years old and this may be one reason why people of this age (over 70) should be retired... I am 71 and yes, I do NOT have the brain power I did when I was, even in my 60's, and trust me, it drives me nutz!  To paraphrase Buddy on "Cake Boss" , one might say with emphasis, "It's the aging process, baby!"

Undoubtedly, some of us, like me and those folks on the TV show, "My 600 lb life" have no set point and thus, we can gain easily up to astronomical weights, without especially overeating, at least not more than most Americans who do not gain so easily...

I've tried to explain all this to providers... And most of them naysay what I am telling them. 

Metabolic differences and pituitary damage from procedures like tonsillectomies,  seems  something which, apparently, is not included in the medical school curriculum...


Saturday, January 02, 2016

Weight Loss surgery and dieting

I have heard many folks sign up for weight loss surgery because they feel they will "never have to diet again".  The next step is they go to a "seminar" held by the surgeon they are thinking of hiring. But the seminars are really mostly selling sessions for the surgery (I can only think of one surgeon who actually gives very informed consent seminars, detailing risks as well as benefits - this does not cut the number of people who go to him - on the contrary, they appreciate the info!).

Today, I met a lady who had had a gastric bypass in Oct 2015 and had recently attended a weight loss group meeting. (and keep in mind, most surgeons are doing the less invasive sleeve now).  She had lost 80 lbs but lamented that no one had noticed her weight loss.  "But I lost it fast," she added.  That prompted me to ask her how and that's when she said she'd had a gastric bypass.  I explained that a fast weight loss like that was mostly muscle and that's why it didn't show a lot of reduction in size.  She looked sad and said that she knew that.  She was NOT told that surgery would not take off that much fat and she'd have to diet to do that - and she'd already been back to the hospital because she had developed ulcers after surgery and couldn't keep anything down so had needed more surgery.   I can't help wondering if, had this lady been informed of the risks, she might have gone a different route.

But the sad thing was she really didn't lose much fat with the surgery despite her inability to eat much and ended up joining the weight loss group, even - with having had the surgery.

I gave her my web site and also, some of the informed consent info she should have had before surgery.  "The advantage of a gastric bypass", I concluded, "is, it is reversible and you should probably consider having it reversed."  She told me her surgeon had told her only the sleeve was reversible (it's not reversible, because they cut off most of your stomach and throw it in the garbage i.e. "send it to pathology" as the surgeons call it). I said, "no, it's the opposite - the gastric bypass is reversible" and I told her how they reversed it., explaining that a reversal would still provide her with some restriction but give her normal digestion back.  Hopefully she will consider having it reversed.  I told her she might have to go to another surgeon to have this done.

Some surgeons send pre ops to my website to obtain informed consent information but obviously this lady's surgeon had neither given her informed consent info nor did he send her to my website.  Because the 80 lbs she lost was mostly muscle, she still was very overweight.

The bottom line with surgery is, it really, isn't that effective for weight loss.  This lady told me she thought it would kill her appetite but it hadn't done this and I explained that this is because they now know, the appetite control center is in the brain, not the stomach (as formerly thought in the 1960's when these surgeries were first conceived of).

As for the gastric bypass, it's very effective at greatly diminishing the ability to digest proteins and fats (and yes, we do need some fats) which is why most surgeons have switched to the sleeve which, albeit invasive, is much less invasive than the older surgeries.

Another interesting thing - when I told this lady who had had the gastric bypass that I knew several 300 lbs gastric bypass patients, she looked shocked - she didn't know that so many had regained the weight, although she was already having trouble with this.

All I can do here is *sigh*.  How I wish everyone would have the informed consent information that they need to really make the best decision for them.  Informed consent after the fact, can be bitter but this lady had several friends, also of size and I'm sure my information helped them in case they were considering surgery.... (the photo is of my friend who died in 2006 from the aftermath of the weight loss surgery she'd had in the 1990's. - she spent her last days, before her untimely death, warning folks to not have weight loss surgery.)

Saturday, November 07, 2015

Weight loss balloon - a good or very bad idea?

The news today, announced a "new" device, for losing weight. Basically, the patient swallows a pill which is attached to a long tiny tube catheter device.  When it gets down to the stomach, the medical provider pumps distilled buffered water into the pill through the catheter, which causes it to swell, not leaving much room in the stomach for food.  This is supposed to make the patient feel full and want to eat less.  The water in the device supposedly, leaks out in about 4 months ("if all goes well") and then the deflated pill passes hopefully, through the digestive tract and out through the bowel. As the article stated:

"If all goes as planned, the resulting grapefruit-sized (19-ounce) ball of water fills the stomach and significantly curbs the amount of food someone can eat before feeling satiated."
     This was tested on 30 some patients, who lost an average of 22 lbs.  And has not been approved by the FDA as yet.
     They are advertising it as "non invasive" and non surgical.
     But (and there always is a "but" right?), from where I sit, I can see lots of problems with it - like for example, a non food item like that could cause an gastric obstruction or other problems,  and... what if it doesn't deflate, what if it doesn't "pass out" through bowel, like it's supposed to etc etc.
     And the idea that a full stomach makes us feel like eating less is thought to be somewhat erroneous as we now are pretty certain, the appetite originates in the brain and NOT the stomach.  And that means, even if you have this device in your stomach, you still can be very hungry (and very frustrated if you cannot eat much or the food you ate isn't going down right... another 'elephant in the room' not discussed in the promo).
     One of the patients on my discussion group, had a type of balloon device and he suffered so much with it that he considered the invasive gastric bypass as far more comfortable.
     This device costs anywhere from $6000 to $10,000 bucks and insurance will not cover it.
     As the old saying goes "buyer beware" (and DH added "If it doesn't work, you can't just bring it back to the store!")

Sunday, September 20, 2015

Gastric bypass patients should consider reversal!

The good news is most surgeons have stopped doing the gastric bypass by now and have switched to the gastric sleeve which is a much safer procedure and just as effective as the bypass with weight loss (not very effective unless the patient diets and exercises which of course, works very well without surgery).

The bad news is many surgeons are not saying anything to bypass patients like telling them to consider getting their procedures reversed (which would effectually give them a gastric sleeve).  The reason they are not saying anything to the thousands of gastric bypass patients is, that would be like admitting the gastric bypass was a bad idea which it was, big time!  Mason who invented the procedure, stopped doing them in the 1970's because he said the repercussions were too great but he only wrote about this in medical literature.

Surgeons are afraid to tell you the gastric bypass is a bad procedure because of the possible lawsuits they might get (most WLS surgeons are facing up to 5 lawsuits at any given time!).  But if you are a bypass patient, consider getting the reversal procedure - you will still have restriction but will be able to digest vitamins again, hopefully...

We need some 100 micronutrients a day (which cannot be supplemented) plus a bunch of macronutrients like B12 etc which cannot be efficiently supplemented.  None of which the gastric bypass patient can digest.

As one WLS surgeon said, he "buries his mistakes".  Literally.  Dead people don't talk and live gastric bypass patients are afraid to detail the gnarley side effects of this surgery.

In the UK, they force a reversal of the gastric bypass after a couple of years - that's because the govt picks up the tab for all the side effects which kick in long term... if you are a gastric bypass patient, consider getting a reversal.  If you lost weight and kept it off, it wasn't the surgery, it was YOUR WORK and you can continue that without the bad side effects of surgery.

I have digestive problems from a lifelong case of GERD - they are very annoying albeit nothing like bypass patients suffer, but trust me, since I was clinically obese until 2010, digestive problems didn't help in the least, to keep my weight off.  (In 2010, I hit my Weight Watchers goal and lifetime membership - and have kept off 106 lbs ever since, being on program)

We did not become overweight because our digestive systems worked.  Just saying

Saturday, July 25, 2015

New old program for WLS patients?

I went to a seminar on Weight Loss this morning - the weight loss surgery surgeon involved, meant well - he wanted to provide his patients with a program to do after surgery - the need of which was witnessed by the fact that most of the folks in the room, either gastric sleeve or lap band post ops,  were still quite overweight (although there were a couple of pre ops in the room also).  The surgeon also, has some problems with midline obesity and this, he says, is the latest thing that is working for him but he'd only lost 15 lbs and still had some 15-20 lbs to lose (which he has all in his waist).  He is a believer in low carbing but like many of my friends, that, alone, had not worked for him.  (Dr Atkins the founder of the low carb diet as we know it, explained in his last book that calories do count and you can gain just as much weight on too much of no carb foods as you can on carbs, a fact which has not been seen much in the media - if at allAlso Dr Atkins had heart disease, which is again, a fact which has not often been seen in the mass media.).

The so called "protocol" seemed to me, a rehash of other low cal diets  - similar to the old "Dr Simeon program from the 1950's... in the first stage, you cut the calories down drastically (which of course, damages the metabolism) - they have some kind of protein drink you buy (and also you can intake your protein in other types of product which they also sell.  They have 3 stages of this program and in the maintenance stage you can again eat carbohydrates in small quantities. Although sugar is portrayed as the demon in this program - the latest thing in diet plans - apparently aspartame - nutrasweet which is somewhat toxic and far more unhealthy than sugar ever thought of being, is "ok".

The new twist is, this company seems to be targeting physicians (many of whom sadly, know little about weight loss science and regard obesity as a medical problem for which a solution - pills or surgery - can solve and be a cash cow at the same time).

I asked the guy hawking this product - what about maintenance... and he said he would talk about it later.  He dismissed it with "well, when you creep up in weight as 'we all do', you go back on the "protocol" for a week or two and take off (crash off?) the weight."  He gained some popularity in the room when he said that people don't have to exercise with this "protocol".  In fact, he went on to say that even if people were working out a lot, it was advised they did not work out while on the low calorie part of the protocol.

As we all know, yo yo syndrome is the best way to really mess up the metabolism and which causes most folks to be more overweight after repeated attempts at crashing off weight.  But they didn't talk about metabolism, of course.  Also if you weight cycle as small an amount as five or ten pounds several times, it not only raises the risk for heart disease but also causes the individual to end up with a higher percentage of body fat.

Here's how it works... when you lose weight on a very low cal diet, you only lose 30% bodyfat - the rest of what you lose is muscle and bone (tissue you do NOT want to lose).  However when you regain even as little as 5 or 10 lbs, it's all bodyfat (no muscle).  The salesperson telling us about this diet, said "everyone's weight creeps up!"

Bottom line is, this diet is quite pricey - according to the physician's website (which is more honest about the cost than the manufacturer's website)... Start up fees are $279 dollars and when you go off the "protocol" and regain and want to go back on "the protocol" for a couple of weeks, it costs $108 dollars a week.

Consider that this "protocol" is being sold to people who have already invested thousands of dollars in weight loss surgery.  Looking around the room at the people who attended this meeting most of whom had had weight loss surgery, and were still very overweight, it was clear that weight loss surgery often is ineffective for permanent weight loss.

Saturday, July 18, 2015

Magic Quick Weight loss? Really?

(Written with tongue firmly held in cheek!

Every so often when I write a blog about weight loss surgery or other types of weight loss, I get comments from folks advertising quick weight loss.  The latest comments I've received came from a couple of people who claim that some individual helped them quickly lose weight! (I looked him up on the web and he, calling himself a doctor (?) goes by a couple of different names apparently), - are you ready for he helped them?  He cast a spell on the individuals and caused a weight loss.  The individuals don't claim large losses, 15 lbs or so but still.

Spells?  Like waving a magic wand or ?  In the 21st century?  Really?  I'm not kidding - these people gave me links to this guy's email (he doesn't have a website) and seemed totally serious.

One individual commented on one of my blogs, the following: 

"All thanks to Dr ---- who helped me loose weight when all effots proved abortive. Am on this blog to help those in need of weight loss get the help you need. Worry no more just contact this great man via (email address on yahoo!) and he will help you with a spell, in less than 1 week after i contacted him i lost 15 pounds and ever since i have been having normal meals no more diets and my shape is perfect. What more can i say than a big thank you "

I left the misspellings in there (emphasis on "spell" is mine). Perhaps English is not this person's first language but I think they could have paid more attention to the built-in spell checker (that's the red line under a word). :)

I frankly didn't believe folks in the 21st century believed in "spells" anymore but I guess I stand corrected.  Someone should tell these folks that the reason they lost weight was all their work and not some web foot muttering some words over them.  Take the credit for your weight loss - it's yours to take.

PS: I'm sure these individuals did not say their "magic" words without a fee.  Makes me think I'm in the wrong business! :)

Thursday, June 18, 2015

Garcinia Cambogia - neither effective nor safe

Weight loss supplements are many and varied.  The idea of just consuming a pill or a drink, appeals more to prospective dieters than counting calories or points and/or exercising.

One supplement I often see advertised, is Garcinia Cambogia, whose advocates are all over blogs like this one.  Whenever I post a blog here, whether about weight loss surgery or some other diet craze, I almost, invaribly, get a comment or two advocating Garcinia Cambogia and so I decided to research it a bit.

In investigating it, I found that there were concerns about how safe it was to use as well as not being effective for what they are pushing it for ... weight loss. The active ingredient in Garcinia Cambogia which supposedly causes weight loss, is hydroxycitric acid, or HCA = this is also included in other weight loss supplements.

In one study, the average weight loss in folks taking Garcinia Cambogia, was 2 lbs and the researchers couldn't really say if it was the lowered calories or the supplement that caused the weight loss, but they concluded it was likely the lower calorie intake of the cohort that caused the weight loss.

Garcinia Cambogia is apparently a tropical fruit which resembles grapefruit - people who have eaten it, say it tastes good but the medical profession does not feel it's a good weight loss supplement. As for the claims of lowering the blood sugar levels in diabetics, this, again, is unproven.

One article advocates a person wishing to lose weight would be better off, buying an exercise DVD than investing in Garcinia Cambogia.  I agree there.  Although convincing people to buy Garcinia Cambogia might be a cash cow for those selling it, it appears to be a waste of time for those wanting to lose weight or control diabetes.