Tuesday, July 08, 2008

Teens, weight loss and obesity surgery

Clyde was an ordinary teen. When he was in 7th grade, he was intelligent, talented and liked video games far more than exercise. He lived the American lifestyle. In his family, there aren't many veggies available and a lot of fast food and pizza. He tried the swim team but it didn't appeal and he felt a bit odd in a bathing suit because he was about 15 lbs overweight. And back then, the obesity hype for kids had just started.

When reflecting on High School at the end of his 8th grade year, he told me, "The kids in school are MEAN!" I didn't ask details but assumed that, like all kids who are not the "ideal" size, he had taken his share of teasing and nasty comments. He had, already at that young age, learned to dress in cover up clothing.

Today Clyde is a senior in High School and he is relatively slim.

Is this a success story? I wonder. Because how he did it was NOT through eating 5-9 portions of veggies a day, avoiding fast food and junk food, and trying to do 60-90 minutes of cardio daily. He, instead, continued to live the American lifestyle with some modifications.

He drinks a lot of tea (caffeine speeds up the heart and makes it easier to lose weight and by cutting the calories - it may also, in the long run, be a factor in Parkinson's disease as are all stimulants - see the book, PROZAC BACKLASH for one).

And he smokes cigarettes.

If he went to the doctor, the doctor would probably be pleased at his BMI but at what cost did he attain his "ideal weight"?

Does he know the proven dangers of smoking i.e. hardens the arteries, strains the heart, and shortens lifespan as much as 15 years? Yes he does. "I know it's dangerous," he told me a bit sadly, "but it's hard to stop."

He does not receive any support from his parents. They want him to stop smoking but do not help him to accept himself at his natural size. And they don't understand that when you are a teen in school, the pressure is 1000 times what it is in life and right now, there is a lot of pressure and heat given to all of those who are overweight regardless of age.

The sad thing is most kids will keep within the "normal zone" if they eat healthy, avoid foods like potato chips and fast food which are extremely calorically dense and not particularly nourishing and if they exercise 1-2 hours a day. However, most kids are not really enthusiastic about this type of program and do not often get a good example of a healthy lifestyle at home.

Clyde is not alone. Statistics tell us that more teens are starting to smoke now, than in the 1960's before the dangers of smoking were known.

In considering kids like Clyde, is it really hard to understand that teens simply do not care if they are doing something unhealthy to keep thin because that is most important in the narrow minded society of High School?

Starting with Junior High School, "bulimia clubs" are flourishing, use of "uppers" are common and an alarming percentage of kids are already dieting or more extremely cutting calories. Very often it's the models in the magazines who are blamed, totally ignoring the heat overweight kids get from parents, teachers and the medical profession.

And now, with the encouragement of our wonderful news media and the surgeons who stand to profit, teens who are very overweight, have discovered Weight Loss Surgery.

As recent as a decade ago, the thought of doing something like a gastric bypass on anyone under 18 was considered unethical - inducing vitamin deficiencies in a body which has not yet matured, partially disabling a healthy digestive tract was considered bad medicine but now it's considered good medicine, the surgeons reciting the song of how the teen "was in danger" of a variety of ailments, many of which are non issues or not caused by obesity.

The "Today Show" recently, featured a teen, around 256 lbs who got a gastric bypass. In her before photos she was shown running around a field playing with a dog and smiling. A year later, she had lost 100 lbs and was of "socially acceptable size". But now she was not smiling. Even when the doctor told her she was a success, one saw only a hint of a smile on her face.

"I have to eat very differently now" she told the Today Show, "there are many foods which no longer go down right." She concluded, "It's not an easy road."

The rationale for giving this 17 year old a surgery which cut her stomach into two pieces and her bowel into 3 pieces, rearranging them in a very unnatural manner, a surgery which some studies show to pose a risk of serious complications in 40 percent of patients, by the 8 year point, complications like bowel obstruction, ulcer, pancreatitis and more... the rationale for doing this on the young lady was she had "sleep apnea", "high blood pressure" and "was in danger of going blind" (they never told us what endangered her).

Sleep apnea is a fairly new diagnosis. I don't doubt that some extremely large folks may have breathing problems, but I think the diagnosis of "sleep apnea" in everyone with a BMI over 35, may be way exaggerated.

I had an overweight friend diagnosed of that. She was given a C-PAP machine and found it way too noisy so she gave it back and went on and she was just fine without intervention. I think we CAN stop breathing for a few seconds without a problem and probably many people who are not fat might be doing that also.

So that left the "high blood pressure" (which can be easily regulated by medication) as their sole rationale for ruining this young lady's digestive tract for life, giving her lifetime problems which may really be biting her at the age of 30 when she would be in the prime of life had she not had the surgery, even if she was very overweight.

Sober faced, the young girl told the Today Show that it was "so nice to not worry about future health problems." How ironic that the procedure she had is, indeed, going to give her a new set of health problems which she might have never had to worry about.

It's time that the media and also adults stop pressuring our children. If they want to help them, they should encourage exercise (to be healthy) and eating veggies and healthy foods and most important, help them to understand that health and beauty is not about size. But when even our medical profession starts condoning unhealthy ways of getting thinner, things are out of control in my opinion.

On the Today Show, the resident doctor obviously approved of this young girl's gastric bypass. "Today's obese children are in the unique position of really having a shortened lifespan," she told the viewers.

With all due respect, the only reason that might be true is because society is pressuring teens to the extent that they are doing unhealthy things to lose weight, like smoking or gastric bypasses. That's a no brainer, isn't it? Apparently not to many folks.


Tiana said...

Please correct me if that was not your intention, but ... are you saying that sleep apnea isn't a real problem?? I hope not, since I know people who have it and it really IS dangerous. And: THIN PEOPLE GET IT, TOO. That's what needs to be pointed out more often. Ironically, one of its side effects appears to be weight gain! Seriously. For some reason doctors never know that although you only have to ask a few patients and they'll confirm it, including magical weight loss after treatment. So it's not an entirely bad idea to test fat people for it IF they have symptoms. Not because their fatness might be causing it, but since it might be causing their fatness ...

As for the general message of this post? I totally agree with that. I was just a little freaked out by the suggestion that "we CAN stop breathing for a few seconds without a problem" because that sounds scary and I daresay that we can't. Not on a regular basis.

SueW said...

I didn't say that sleep apnea isn't a problem - I am questioning whether it isn't way over diagnosed now.. seems everyone with a BMI over 35 has sleep apnea. I just don't buy it. Also syncro swimmers hold their breath for close to a minute at a time several times during a routine and at practice - are THEY in serious danger?

Harpy said...

I reckon sleep apnoea is a bit overdiagnosed, too, and the assumption that all fat folks have it is just as annoying as any other assumption about fat. And I have sleep apnoea. treated very well with CPAP, and about a week after I'd started on CPAP I actually started feeling human again. It runs in my family, fat and thin relatives have it, we all seem to have inherited a poorly-constructed upper respiratory system that is easily obstructed upon relaxation (sleep). So it wouldn't matter if I had every ounce of fat liposuctioned off me, I'd still have sleep apnoea.

The diagnosis SHOULD be that the patient has to have a considerable amount of apnoeas when asleep, has a blood oxygen level that remains below a certain threshold for much of the sleep time, tends not to have much or any Stage 3 and 4 deep sleep, and generally has significant sleep disturbance that impacts their life in negative ways. (Feeling very sleepy in the afternoons despite thinking you got a good 8 hours sleep, "microsleeps" where you nod off for just a second which can be very dangerous if you are operating a vehicle etc, depression, lack of energy, etc etc.)

If someone stops breathing for a few seconds only a few times a night, that's not really going to impact their health, but especially if a person is fat, doctors like to diagnose sleep apnoea and prescribe CPAP treatment. Ack!! Doing this, putting someone on CPAP therapy when they don't really need it, can CREATE an apnoea problem where there was none - Central Sleep Apnoea, where you don't snore but you stop breathing while asleep - because the your carbon dioxide levels go down, reducing your reflex to breathe.

A bit less than 50% of all people with sleep apnoea are considered "obese", there are lots of slimmer people with it and making it into a "fatties' disease" doesn't help with diagnosis in the fat or thin, just like diabetes or any other condition that's become associated with being fat.

And a note for anyone with sleep apnoea that's been recommended to try CPAP; don't just go with any machine and mask outfit that your insurance provider or doctor hands you or tells you to get. There are lots and lots of machines and masks out there, some are quite noisy, some masks rub people the wrong way, etc. Insist on trying out all the different appliances. My clinic tried to get me to go with a traditional mask that goes over your whole nose, but I found it extremely uncomfortable and asked to try "nasal pillows" instead, which I found to be fantastic. And look online for CPAP machine sellers, you may be albe to get a machine and mask for cheaper than your insurance's medical appliance seller! Also online are some great sleep apnoea support forums, where you can find a lot of great hints on how to make everything more comfortable and so on. (Avoid the weight loss talk sections of course!)

Sorry this comment got so long! :)

Gerry said...

I have tried to find evidence of sleep apnea actually causing a death for years now. To date I have not heard of ONE sleep apnea death. I think that sleep apnea is a scare tactic and is a scam designed to sell CPAP machines and more importantly, WEIGHT LOSS SURGERY and is really a NON ISSUE.

AnnieMcPhee said...

Gerry you beat me to it. I'm glad you've been researching it because I have sleep apnea (and always did, even when I was skinny) but, uh, there was no name for it (so far as I knew) nor any concern about it until recently. All of a sudden people were in danger of their LIVES from sleep apnea, and all I can think is, "Why don't they ever, EVER, point out a single person who died of sleep apnea?" Never once have I seen a case mentioned - only the claim that it can kill you.

It can interfere with your sleep a bit so that you're tired, but I've found over the years that sleeping a bit longer pretty much takes care of that. (When I can, insomniac that I am ;) ) Also, since sleep is so hard for me to come by, a machine over my face would pretty much guarantee I never slept again - and being extremely exhausted is the surest way I know to end up with a night of many apnea bouts. It can be uncomfortable and unpleasant, but deadly? I doubt it. Though when you get the sleep paralysis with it you're sure you're going to die. Ack!

Until I start seeing some hard facts, some genuine (and frankly, considering the hysteria it's going to have to be pretty widespread) real-life deaths, I'm going to conclude, as you have, that it's nothing more than a scare tactic, that the "dangers" are either nonexistent or grossly exaggerated. We ought to have bodies piled up by the tens of thousands - it shouldn't be hard to come up with a thousand or so if it's so deadly. Or a hundred. Or ten. I won't hold my breath waiting, though ;)

Great post - I'm not sure what you mean by "most" when you say most kids would stay in a normal weight range if they did a, b and c, considering that adults who do a, b and c don't get or stay thin if they're normally fat, though.

I'm glad Clyde didn't have surgery - at least if he stops smoking and pounding caffeine the damage will likely be pretty reversible, but with WLS not so much. That poor girl you talked about - how tragic.

Tiana said...

Okay, then I misunderstood you a little! :)

@ Gerry: Just because you don't die from it, not getting enough deep sleep is a non issue? I don't think so. There are many conditions that won't kill anyone, but they're unpleasant and sometimes very painful nonetheless, so it's a good thing if treatment is available.

Brigid Keely said...

Hullo, folks. My tall, slender father has sleep apnea and he stops breathing multiple times a night for a minute or longer. It's eerie. It ends with this huge gasping rattling inhale and noisy exhale and he sleeps normally for awhile and then goes dead silent again. The problem with sleep apnea isn't that you'll suffocate in your sleep, it's that you aren't getting enough rest, you're tired through the day, and you're taxing your heart.

He has a cpap machine he doesn't use, and claims that his apnea improved when he went on anti depressents. I (short and very fat) have sleep apnea, and remember being a lot more alert and well rested when I was on anti depressents years ago. I'm going in for a sleep study soon to get my own cpap machine or whatevs so that I'll stop being exhausted all the time. And by "exhausted all the time" I mean "craving sleeping periods of 12+ hours a day every day with naps in between and never feeling fully awake or alert ever."

There's this common misconception that apnea is caused by being fat, like you're so immensely fat that the fat lines your throat and closes off your breathing passageway. From what I've read and heard from other doctors, though, it's a problem with the BRAIN, and the apnea/fat link is actually more along the lines of "you're too tired to be physically active and thus gain weight" as opposed to "you're too fat and thus develop apnea."

It is a serious problem. It can be deadly. Even when it isn't it involves a poorer quality of life, when untreated. But it can totally be treated with methods other than weight loss surgery.

Anonymous said...

Once again they're claiming playing video games, leads to obesity. I suppose it's not like Nintendo and other companies, have been trying to make their games more full body interactive hmm?

I do mean outside of the reprehensible Wii Fit. Alot of Wii games can work the cardio, especially the Rayman Raving Rabbid games, they require alot of Wiimote/Nunchuck flinging.

I'm tired of this idea that if a child isn't exercising 24/7, like a hampster running on a wheel, it's the video games fault. I understand it's a new technology, and the past generation is wary of new technology. However, if he was into another non-video game hobby, would they be so quick to admonish that?

Sorry, it just sent me on a rant being a gamer myself. A gamer who also doesn't like exercise. Oh, I forgot not liking exercise now is verboten. You have to pretend it's fun, that you like being active until sheer exhaustion. Please.

The problem is they're just not letting kids be kids anymore.

unashamed said...

I think I may have sleep apnea but I blame my chronic sinus problems more than my weight.