Tuesday, April 22, 2008

60 minutes LIES about gastric bypass

Apparently, some surgeons are getting worried about the lap band taking over the top spot in bariatric surgery (why ever would that be? Because it's ten times safer than the gastric bypass and equally effective?).

So the media is blitzing us with gastric bypass propaganda.

The latest was on the TV show, "60 Minutes". This show presented more than misinformation. In some places they out and out -lied!

Here are some of the more outrageous claims:

Claim: that gastric bypass "cured" diabetes. To "prove" this they had 8 newly post op patients on (the longest out post op was 1 year). "How many of you had diabetes before surgery?" the news anchor asked. And they all raised their hands. "How many of you have diabetes now?" she asked and none of them raised their hands. "Wow!" she said, hoping the audience would be just as impressed.

Reality: The few studies which have looked at longer term gastric bypass patients are more sobering. For example, the Swedish Obesity Study which studied patients 10 years post op, found that at that point, only 35 percent of the weight loss surgery patients were "diabetes free". That's a long way from "curing" diabetes especially as they are trying to push gastric bypass on normal weight people with diabetes now. (SOURCE: New England Journal of Medicine: Volume 351:2683-2693 December 23, 2004 Number 26 Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery Lars Sjostrom, M.D., Ph.D et al)

Claim: Then they showed doctors wheeling someone out of surgery and stated that before any weight was lost, in a gastric bypass patient, the blood sugar levels were down to normal.

Reality: This claim is true - the sugar levels immediately do go down in many gastric bypass patients right after surgery but their explanation - something about a gut hormone being affected was bogus. Truth is, anyone who is fasting, has low sugar levels. In fact, many who go on the Weight Watchers program which is a sensible diet (as diets go) also see their sugar levels go down. Mystery solved and nothing really to do with the gastric bypass. The bottom line is that diabetics who have been diagnosed less than 10-14 years ago, can fairly easily get normal sugar levels using diet and exercise, and might not need medication. Diabetics diagnosed more than 10-14 years ago will probably need medication, gastric bypass or not.

They did say that 80 percent (not 100 percent) of the new ops have low sugar levels - those are likely the more recently diagnosed.

Claim: Having finished with diabetes they moved on to cancer. In one of the segments, the news lady asked how many cancers were associated with obesity and the guest, an epidemiologist gave her a laundry list. "I guess it would be easier to ask how many cancers were NOT associated with obesity!" the news anchor says, dramatically.

Reality: In the next sentence, however, the epidemiologist tells us that obesity is a factor in 100,000 deaths from cancer each year. There is really no hard proof for this but if you do the math, deaths from cancer each year according to the CDC, are 550,000 individuals. So what percentage of those deaths, according to the epidemiologist, have a factor of obesity in them? Not even 20 percent... 18 percent. That means that 82 percent of cancer deaths do not have a factor of obesity involved. This would seem to suggest that obesity is not a really "important" factor in cancer, wouldn't it?

It should be mentioned that Glenn Gaesser found in his metastudy of obesity studies that obese people are 40 percent less likely to get cancer than non obese people. (BIG FAT LIES by Glenn Glaesser, CA, 2002) And I have heard from 2 oncologists that fat people are 50 percent more likely to survive cancer than slim people (that's one of those - what is it now - 15 obesity paradoxes?).

Also any study I've ever looked at which named obesity as a factor in cancer in the conclusion of the study, talked about lifestyle (and not obesity) in the body of the study... the conclusion assumed that all people who have unhealthy lifestyles must be obese.

The biggest whopper was yet to come. Neil Hutcher, former president of the ASBMS was asked about early mortality rate with gastric bypass. "Well," he said, "a couple of years ago, it used to be 1 in 100 but now it's about 1 in 1000".

Of course we've heard all kinds of statistics from the ASBMS so I'm not sure where Dr Hutcher was getting his information. Six or seven years ago, the ASBMS claimed the early death statistic on gastric bypass was 1 in 1000 and continued that claim even after no doctor or peer reviewed study stated this! So was Hutcher saying by his statement that 2 or 3 years ago when early gastric bypass deaths were 1 in 100 that the ASBMS was um... misrepresenting the truth when they claimed it was 1 in 1000?

Whatever the case, there is absolutely no foundation in peer reviewed studies that the early death statistics with the gastric bypass are 1 death in 1000 surgeries.

For example, the David Flum Studies of 2003 which is one of the most accurate studies because Flum actually studied 62,000 hospital records of gastric bypass patients, found that 2 in 100 died within 30 days of gastric bypass surgery and another 2-4 percent of patients died during the first year after gastric bypass surgery. (SOURCE: report delivered to the College of surgeons in Oct 21, 2003.[Study title: The Impact of Bariatric Surgery on Patient Survival: A Population-Based Study] )

Most surgeons who had a low death statistic, claimed 1 death in 200 surgeries but that was before the Flum studies.

Moving on, Hutcher said that 1 death in 1000 was about the same risk level as gall bladder surgery. I'm sure gastroenterologists will not love him for this statement which is entirely incorrect! Gall bladder surgery carries a death risk of 1 death every 7000 surgeries and is about the same risk level as the adjustable lap band.

The only good thing I can say about this show is they admitted that patients tend to lose only 30 percent of their weight so "few patients end up thin". This was noticed by some WLS afficionados who were not happy about those percentages.

I'm sorry to say this, but for the news about a risky medical procedure which is rapidly becoming out dated, to be that inaccurate, is more that ethically challenged. It's morally bankrupt because people may go and have this surgery based on the misinformation in that show and many will die or get sick.

Tuesday, April 08, 2008

What are we doing to our teens?

Most teens I talk to, feel they are fat, even though they are not.

Several teens I know personally, started smoking to control their weight.

Somehow we are _not_ getting across the message that smoking has been _proven_ health threatening and are concentrating on giving folks the message that obesity is _extremely_ health threatening even though there is virtually NO scientific evidence that obesity alone is health threatening at all.

How much of a problem are eating disorders among teens and pre-teens? If you look at youtube.com, there are huge numbers of videos which advertise themselves as "thinspiration". These videos either show slim young women squeezing what small amount of fat they have on their bodies in disgust or else, are slide shows of super slim fashion models and actresses. Often the songs which accompany the videos give mixed messages. One song begs "SOS me - rescue me" while another song states that no one notices that her body is falling apart.

One young woman who is 21 years old, and said her latest dieting effort began with her wanting to "get her body back" after having her son, started uploading videos in August 2007. Her first video made while she was smoking a cigarette, had her talking a lot about how she cared for her skin. But in the end of the video, she admitted that she had a problem with eating and also showed us a piece of tape covering a scar she made on herself when she was 16 ("S" for sinner, she said) and how she covered it all the time now. "Smoking is bad" she admitted but then added that she smoked a lot during her 'fasts'.

Another video made in early late 2007 by the same woman, was all text. It told how she had been in a mental hospital because of a suicide attempt. How from the age of 16 and on, she had tried all kinds of drugs in a desperate attempt to lose weight. And how she was going to rehab and get well now (but not take any prescription drugs). "I want to get my son back" she wrote, "he's 3 years old!". Another video showed a visit with a bright eyed 3 year old boy, her son. The video was entitled "I miss my son".

Sadly her rehab didn't work- a recent video talked about her 40 day fast which would end April 11, 2008. Two body shots showed that she had lost quite a bit of weight since she uploaded her first video - she looks like the typical anorexic in those shots. But this fast is not about her eating disorder, she tells us - it's to "gain control". She is allowing herself 1 glass of juice a day and the rest, non calorie drinks like coffee, tea and water. She is continuing this for 40 days, during which she will exercise and get control and save up the money (if she can get a job) to get a pole and start pole dancing. "Weight doesn't matter" she keeps saying adding how she discarded her scale.

One of the comments to this video states:

binges are bad! i was doing well, eating at the most, 300 calories a day, but, then i tried to fast and the binge monster came to me and i ate until i exploded although some people say it wasn't that much food. but all you have to do when you want to binge, is look in the mirror and tell yourself how it will ruin this progress! and then eat an apple or whatever and then wait. tell yourself if you're still hungry in 10 min that you will eat. chances are, you can control your binge better. but you are lucky if you can purge after. it doesn't work for me :(

NOTE: what she suggests in the above quote is a version of what Weight Watchers calls "the 20 minute rule". How much of this comes from our general obsession with dieting and a diet industry which makes a larger profit than even the pharmaceutical companies?

Several feel that anorexia and bulimia are more widespread than we'd like to think. It is usually blamed on fashion models and slim actresses however, most people who are dieting or restricting calories mention health as their first concern. An article in a London newspaper, suggests that there are many internet sites which encourage young women to starve themselves to be very slim:

The UK article suggested that 1 percent of teens have an eating disorder but an estimate from an Australian newspaper stated that 1 in 8 teens has some kind of disordered eating.

What is confusing is that most teens who are restricting (and often over exercising, will not admit it. On the contrary, they say they "eat a lot" while getting slimmer and slimmer. And instead of a cause for concern, slimmer teens are often rewarded with getting more clothing and perks from their family, as well as compliments from their classmates and often, a lack of concern from their medical providers while the fat teen is teased, often not rewarded by the parents and constantly battered by the media as well as medical providers to "lose weight or die". And we wonder why these teens start smoking to "control their weight"? They are following what _we_ are telling them... that _anything_ is more healthy than being overweight!

Ironically, it's the fat teen who is often much more well nourished than those trying to keep what is considered an "ideal weight" (which the CDC has said may be underweight for most people).

And again I ask - will the insanity ever end?