Tuesday, January 01, 2013

Life saving weight loss surgery claims another

Since it's January, there is a big push by those selling weight loss and also for weight loss surgery.  TV is showing a lot of programs on weight loss, and weight loss surgery.

When they advertise weight loss surgery by giving case histories, there is a small (well, maybe not so small) problem.  Many patients die from the surgery which is supposed to induce an artificial case of anorexia so the patient either cannot eat much or as in the more invasive procedures like gastric bypass, cannot eat much and doesn't digest much of what they do eat.

One patient who had been followed since being featured on the first show in 2010, was a Haitian lady named Dominique Lanoise.  Lanoise weighed in the 600 lbs range and was bed bound.  From what is known about her, she was slim when younger and ended up having 6 children - she apparently gained after pregnancy.

She was a charming lady, who though bedbound, would sway to the music in her bed.  The documentary showed her eating large amounts of food, rejecting the diet food (they put her on a 700 calorie diet in order to reduce her for surgery) and kidding with her daughters who adored their mother.

Dominique was convinced that a gastric bypass would save her life and be a quick fix for her obesity problems which she felt was out of her control, so she searched until she found a surgeon willing to operate on her, at her current weight.

She lost weight after surgery and was transferred to a rehab facility but two weeks later, she checked herself out and returned home.  A couple of months later, she died, apparently from a heart attack which WLS afficionados assured us was "unrelated" to the surgery.

However, the nutrient shortage from the gastric bypass can raise the risk for heart attack significantly, because the heart is starved from essential nutrients, including protein.  That seems the "elephant in the room" when one researches Dominque's story - certainly those providing weight loss surgery do not want to admit that this "life saving surgery" actually hastened her to an early death.   

Another TLC patient, Donald, also had weight loss surgery.  He was also around 600 or 700 lbs.  Donald did try to move after surgery and do what the doctors told him to do.  Patients are told that unless they make lifestyle changes (like dieting, counting calories and exercise), the surgery will not work for them. Ironically, those same changes will work for weight loss without invasive surgery.

But then, suddenly and mysteriously, Donald went into a coma and emerged with Guillan Barre or "French Polio" - which put him into a wheelchair.  Disease after gastric bypass is common but again providers tell us it's unrelated to denying the body of proteins, fats and vitamins.  Last seen, Donald was getting around in a wheelchair and rapidly regaining weight although trying to exercise it off - another myth one sees on TV - exercise doesn't take much weight off us - how well I know about that one. It does make us healthier but it's not really good for weight loss.

That some are still selling a surgery which hasn't been done for years on non obese patients, a surgery which the inventor thereof dropped in 1980 because of the high complication rate, truly amazes me.

There seems a conspiracy of silence among patients as well as providers.  Patients who regain and live, are reluctant to tell about their surgeries  because both the public and their doctors blame them for their gain.  Patients who have become ill from the surgery and live long enough to be reversed and get back normal digestion, are often reluctant to talk about their bad experiences because new ops and providers can get mean to those who talk too negatively about weight loss surgery.

Patients are so sold on this surgery that until they get really ill, they refuse to admit that it has a high complication rate and a higher recidivism rate.  When I began to research it in 1999, I was shocked that many studies were on line and told the truth openly, but patients were not reading the studies and only listening to new ops who were excited and seemingly successful.  Even successful patients who have suffered difficult complications and talk about them in blogs, have taken a lot of criticism from "the community".

So people continue to jump on the table for a surgery which sounds like the ultimate cure because many do not encounter the "other side", i.e. the dark side especially if they do not have internet access or know where to look.

Informed consent information on all surgeries can be found at:

In conclusion, a friend of mine who weighs over 500 lbs but has refused weight loss surgery, says she's outlived 48 of her friends who had weight loss surgery.      


Unknown said...

I am first of all thrilled that you publicly claim a person who weighs over 500 pounds a friend. That is one of the stigmas of being overweight, that you are not "worthy of friends", especially people who aren't morbidly obese! Even when you have friends in public, you will most times find thin people with thin friends, and fat people with fat friends. That is because the thin people (most at least from what I have found), treat you like a freak of nature who has done this to yourself,not worthy of their time, nor attention.

Secondly, I am surprised, (or maybe I missed this), that you have not mentioned that they are now calling weight loss surgery a CURE for diabetes. I nearly flipped, when I saw this on of all sites, Dr. Mercola. I get it that Dr. Oz, though still respected, (unbelievably), sells himself out, but Dr. Mercola, the most radical of all naturalists? A CURE for diabetes???? What efficacy studies are they talking about, because the last time I read, the diabetes almost always comes back, regardless of the weight lost.

Finally, you are correct about people who have reversed the surgery are reluctant to talk about it, not because of the bad experiences, but because they again are considered of lower human value than people who would never need such a surgery. You are also incorrect in the fact that normal digestion comes back. Maybe with a lap band, but certainly not with the "gold standard", a Roux en y". You still suffer from malabsorption. Just not as bad. My digestive system will never be the same, and the surgery induced neuropathy gets worse each year. Soon, I won't be able to walk, and I DO NOT have diabetes, and never did have it.

Five Hundred Pound Peep said...

I refuse to get weight loss surgery and I am near 500lbs. What makes me horrified is I suffer from medical problems that it would seem doctors would never push this surgery for, including digestive problems [now diagnosed as severe IBS technically] but includes projectile vomiting and days of bowel pain that necessitates medication] With my food allergies and other problems what would be left to eat? I will never do WLS, and I am probably what they consider one of the prime candidates...

1. Everything I know about nutrition, adds up to WLS being bad news, and I agree the lack of protein leads to some of these folks having heart attacks so soon after.

2. No decent answers to questions like, "I have serious blood sugar problems now, how will this NOT happen with weight loss surgery"?

3. No good answers related to my own personal difficulties with endocrine and hormonal illness. I know from times of severe illness when my caloric intake has dropped to lows either from my digestive problems for a week or infections for a longer period of time that no weight has been loss. So why would this work?

4. I believe I have MALABSORPTION PROBLEMS NOW. I go anemic all the time, low Vit D to the point of having to take 50,000 units once a week, low B vitamins-from B12 to B3 and other various problems in that arena never having had weight loss surgery.

5. I know so many people who have died from this surgery either on the table or the FIRST year after, I am horrified. This includes a 30 something year old woman at 300lbs who died right on the table, a friend who was near 500lbs and needed a respirator for days right after and then died only some months after, losing only 60-80lbs, but having other health problems include heart ones grow worse and worse, another supersized man in this case dying only a few months later, who had multiple complications and several others including the most severe diabetic I ever have known, who required amputations AFTER having had weight loss surgery.

I won't do it, I've had enough suffering in this life, That is what I tell the doctors, and I do think there are legions as to the silent of the real results. A few of the healthier types, may lose a first 100 or 150lbs if they are supersized but the regains are intense.

I've had enough digestive problems in life to know its not something you want to mess with.

I saw this woman who only weighed probably around 260lbs who was otherwise healthy and active get this surgery, and saw her mixing a powder with her coffee to just get it down. I shook my head. So much suffering.

Fat people deserve better then this. Now I am not one of those size acceptance idealogues who denies that weight can affect health, but we need something better. It's like they sat down and thought of the most suffering and torture they could bring to fat people and came up with this. Yeah I said it. Wonder what the doctors would think of that?

And it makes big big money.

Think about this tens of thousands of dollars for WLS--what's the average cost, 60,000? half the price of a house, and we don't even have centers that any fat people can afford to go to for help with their weight outside of ones like Duke for the extremely wealthy?

Ponder that one a bit.....

Lady LeFeu said...

Hi all
I am a two times weight loss surgery patient. I had the band 5 years ago that did not work for me and I had that removed 2 years ago and a sleeve performed. I am now 52kgs lighter. I was Diabetic on medication and with a fatty liver, polycystic ovaries and metabolic disorder. My deck of cards were stacked against me. I was killing myself with my weight. As a mother of 4 active boys I needed to ensure I would be around for my kids and grandkids.

I am off the medication and my liver has returned to normal. I no longer have back ache or hip pain and feel amazing. I did completely change my lifestyle in the final year of my band and joined a gym started running and have continued doing both.
So yes the surgery helped but it was a tool, how I used it was up to me. I didnt view it as a "cure" either. Yes I agree its not all plain sailing I did lose a lot of hair due to malabsorbtion at the very beginning. I have to watch what I eat to ensure I have a balanced diet. I do suffer from dumping syndrome which can be very very painful and 2 of the other 8 people I personally know who had the surgery are the same.
However if you ask any one of them if they would do it again they would answer with a resounding yes.
It isnt for everyone I agree and I would never push anyone towards it. Mine was a long journey to prepare myself Psychologically to a huge change in my lifestyle and to change my relationship with food.
My kids now have a mother who cycles with them and will go on fair rides instead of standing at the side watching. I swim and we run marathons together.
I have no idea what the future holds like I say I am 2 years in but I am a qualified PT now and my whole family are fitter and more active. What I do know is my fatty liver isnt being flogged trying to produce enough insulin, my joints are not struggling to keep me upright, my heart isnt racing at the thought of a flight of stairs. How can that be a negative.

SueW said...

To Lady LeFeu, Your message is very wise but I guess I'm wondering why you felt you needed surgery at all when it was the changes in your life you made that took off the weight and fixed your liver etc. You did admit that even WITH all the work you are putting in (and yes, as Dr Terry Simpson says, "success with WLS is 10 percent the surgery and 90 percent the patient"), you still have malabsorption issues and a worry about what the future may hold as you are yet an early patient. You also have to deal with dumping syndrome which you described as "very painful".

That most folks who have had WLS say they'd do it again is understandable - to admit one may have made a poor choice in a surgery which "cripples the digestive system" as Dr Fox, a WLS surgeon puts it, and is not reversible, is hard to do because surgery is a forever choice. I've seen many folks who are very sorry they had the surgery but it takes them getting very ill from it to be able to admit it.

We don't know the long term on the sleeve - it's much less invasive than the gastric bypass but I suspect protein deficiency and other things usually digested in the stomach which are no longer digested there, might be a long term problem. It's a risk that many, understandably, don't want to take.

I also noticed that you are a runner who does marathons - this in addition to your lifestyle changes is what took off the weight rather than having changes done to your digestive tract. There actually is a treatment in which the person gets hypnotized and is told they have had weight loss surgery which can be quite effective. Running burns a lot of calories, true but as you age, you will no longer be able to do workouts like that and will have to depend solely on what you eat to keep off the weight.

If there are no more immediate issues with the sleeve (am surprised to hear that "dumping" is an issue - I didn't know this), the long term of any gastrectomy includes malabsorption, esophagal issues and more. None of which are fun but all of which tend to encourage the eating of things which "go down" easily like cake and ice cream and which are very caloric.

As I mentioned, they don't know the long term on the gastric sleeve since it's such a new procedure and as you found out with the adjustable lap band which was the miracle procedure of the early 2000's, it can have a dark side in the long run. Keep up the hard work and keep up the good nutrition - health trumps thin, any day of the week. Also when you have to quit running (that tends to tear up the hip joints - as an orthopedist told me - her most prevalent hip replacement clients are 40 year old runners), understand you will have to log your food or you WILL regain. Counting "points" is easier than calories, trust me in this.

This is exactly why this surgery is generally not recommended. Because of the issues in the long run of any modification of the digestive system. One of the patient members of my WLS listserve had a plain stapling... that didn't take out most of the stomach as is done in the "sleeve" but just called for stapling across the stomach... she was found deceased, having choked to death (esophageal issues)... yes, even with that non invasive surgery.

I am on calorie restriction alone (Weight Watchers ) to control my severe GERD and it does work well to do that however, even WITH a normal stomach and FULL absorption, I find it's a lot of work to make sure on that amount which is not that restrictive like 1400-1500 calories a day, to get in the protein and other nutrients I need. So even calorie restriction alone is not a walk in the park. I can only imagine that it seems to make things harder, adding the issues of a modified stomach to the mix and dealing with that. I wish you the best in the future with your surgery.