Tuesday, November 25, 2008

a buzz of bogus studies on fat and weight loss surgery

So you are wondering why I have not blogged in a while. Truth being we have been lately inundated with fat and weight loss surgery studies which are obviously flawed. And sometimes it feels like mentioning them is similar to trying to lower the level of the ocean by taking out tea cups full of water.

This morning I saw a study which was questionable enough that I had to report on it. It appeared in the JAMA that is, the Journal of the American Medical Assn, Nov 19 2008. (here I recall the issue of the same magazine - after numerous studies had already suggested smoking was unhealthy - which pictured several doctors on the cover, all smoking cigarettes as an accompaniment to an article about how cigarette smoking was a healthy way to lower stress!).

The Conclusion of this latest study was that women who get pregnant after gastric bypass, have LESS complications in their pregnancies.

First thing to question is it comes from the Rand Corporation, the same group which, a few years ago, announced that one of their studies had suggested that smoking was less dangerous than being fat (this was based on a few thousand people called by telemarketers and asked 8 questions, including height, weight, age, whether they smoked and 6 more about their health). Needless to say, even the diet industry no longer quotes THIS study.

Second, two complications were mentioned - gestational diabetes and high blood pressure (the latter which isn't really a complication of pregnancy anyway).

What is NOT mentioned is that these do not necessarily affect the baby at all (I can attest to that personally knowing a lady who had gestational diabetes and delivered perfect, healthy bright kids).

The researchers, we are told, looked at 75 studies which they selected out of 260 studies. And likely they only selected the ones which gave them the favorable results they wanted.

Some studies I've seen, which suggested the gastric bypass patients tend to have smaller babies and a higher rate of still borns, even if they DO NOT have gestational diabetes or high blood pressure, were likely not selected to be "reviewed".

It's kind of a no brainer that if the mother is not digesting vitamins, it might negatively affect the baby.

Another show called "Extreme bodies" on the Discovery Channel, might have been an infomercial for Dr Rabkin and the Duodenal Switch/Bileo Pancreatic diversion. Ironically, the patients shown in the film were still rather large and Manny Yarborough, the ex Sumo wrestling champ who is up to 750 lbs now (after keeping up his exercise after retiring from the ring for a while) and has decided to NOT have WLS. He states in the end of the film that his friend who died from WLS, told him on his death bed, to "not let them do that to you". So far, he's taken this advice.


wriggles said...

This amazed me when I heard about it.
If indeed the results are correct-although healthier than who, women of the same weight who haven't had GBS?- then as you mentioned, what does that say about 'healthy eating'(noun not adjective)?

Unknown said...

I agree with the basics of your post, but I take issue with something.

As a medical researcher, you know better than to say gestational diabetes doesn't affect the offspring just because you know someone who had GDM and healthy babies. As someone who does research in this particular field, we do know that GDM can affect offspring (often depending on how well blood sugar is controlled during pregnancy). Kids born to moms who had gestational diabetes are more at risk for type 2 diabetes themselves, as well as obesity (if that's as terrible as mainstream media has us believe is another story). These differences show up as early as five years of age, but often not until later in life.

C'mon, just because you have one friend who had *apparently* healthy babies with gestational diabetes is proof of nothing.

Sue Joan said...

Hello Amy, thanks for reading my blog. It's kind of a no brainer that kids born of mothers with gestational diabetes are higher risk for insulin resistance/diabetes as this is hereditary and mothers themselves, whether having gestational diabetes or gastric bypass patients severely calorie restricting such as gastric bypass patients, and therefore not having gestational diabetes, ARE STILL higher risk - same thing. DIABETES IS A GENE and NOT CAUSED by overweight (although overweight and more importantly, lifestyle can bring it on faster). Agreed about obesity but the truth is that ALL people living the American lifestyle are higher risk for obesity - how much is what is genetic but I will remind of the recent study which found that a whopping 65 percent of people at "ideal BMI" weight were found to be obese, bodyfat-percentage-wise and in these so called "normal weight people" the affinity toward the viseral fat (the type which surrounds the organs) was found to be actually more than in those of higher weight (who actually might have higher percentage of muscle tissue). I think we basically agree - are on the same page so to speak.

Other than the higher risk of insulin resistance and diabetes in mothers with GD, there is no real definitive evidence that children of these mothers are under higher risk of birth defects. That's kind of what I was getting at in my blog.

Again, thanks for your comment and for reading my blog.


Sue Joan said...

Wriggles, thanks for your comment. I doubt the study is valid - too many problems with it but I think they were comparing to fat women who have not had RYGB. It's well known that any type of calorie restriction during pregnancy will either undermine the baby OR the mother (leeching nutrients from her body) or both and most RYGB patients eat less than 1000 calories a day.

This is not taking in consideration the fact that RYGB patients cannot digest many nutrients including the so called "micro nutrients" and this might ill effect the baby.

wriggles said...
This comment has been removed by the author.
wriggles said...

Thank you for the clarification Sue.
I suppose in a sense I was echoing part of what you said, to point out what may well be revealing of their underlying attitudes.

All they can see is the potential to bridge the chasm that is the cost/benefit ratio of this kind of surgery. It is in a sense amusing that this possibility undermines healty eating messenges, but at the same time, it's disappointing that they are so blinkered. It makes it hard to trust them.
I wonder if they realise how much respect they are losing from those who just want to know the truth without fear or favour.