Friday, May 08, 2009

Brain pacemaker to lose weight?

The Dr Oz newletter featured a lady named Carol who recently appeared on the Oprah Show. Carol is 5'2" and 287 lbs, and 60 years old. A good looking woman of size who looks young for her age and healthy. Like many people of size, she had tried every diet in the book (apparently her highest weight was 490 lbs). She had also had weight loss surgery -- twice. She had a Vertical Banded Gastroplasty and later, she revised to a gastric bypass.

You'd think she'd figured out that weight loss surgery doesn't work for many people to keep the weight off in the long run and maybe found something healthy like HAES (Health at Every Size) just to stay healthy especially since a clinical study found over a period of 2 years than people on the HAES program without a focus on weight loss, reduced their health risks much better than dieting. REF: Non-dieters more successful at boosting health than dieters, study finds

But there seems no end to people's desperation to lose weight in a society which constantly conveys the message of "never too rich, never too thin". Despite the fact that tried and true surgery like gastric bypass had not worked to make her slim, Carol decided to try - yet more- surgery. Only this time the surgery she picked is an experimental brain surgery! An invasive procedure about which the article observed:

"Before this procedure becomes widely available, Dr. Whiting says he and his colleagues have to prove it's effective and safe."

Carol is only the second person in the USA who has had this surgery which is a variation of surgery sometimes done to relieve the symptoms of Parkinson's Disease. The three hour surgery is done while the person is awake. "The brain feels no pain" says Dr Oz.

About this surgery, Dr Don Whiting, one of the inventors states:

"Everybody knows people who have had heart pacemakers to have their heart work better," he says. "This is like a brain pacemaker that we hope changes the electric signals and the chemicals into the brain to give you a better metabolism."

So far changing the brain chemicals even in a more well known setting like Parkinson's, has not been real successful. And we don't really know where the appetite center is or whether the brain totally controls it. Obesity researchers like Dr Rudy Leibel from years of study, seem to feel that appetite is a complex feeling which is controlled by several structures including the thyroid gland, the pituitary gland and more.

What everyone seems to constantly forget, is that if humans only ate when they were hungry, most would not be overweight! We have free will to choose to eat when we want to and eating is a pleasure to be enjoyed at celebrations, at social events and more. And that is very unlike animals in which the appetite is controlled solely by instinct. So why do researchers use animals like rats to make "rules" for human appetite anyway? (Other than it sells to the media and brings in research funding)

So if we are eating when we are not hungry and appetite has been observed by scientists to be controlled by several places in the body, why use a reconfigured Parkinson's surgery to help a person lose weight?

Because they CAN and because there will always be people who are so desperate that they will take amazing risks with their bodies and money can be made.

This new surgery implants two electrodes deep into the brain. The leads are run around the head and neck to the chest and connect to two small pacemakers which are turned on when the brain heals (about 3 months). The pacemakers (unlike heart pacemakers) are putting out electrical current all the time.

Treating Parkinson's is a bit different scenario. The brain chemicals are already disarrayed and the person is experiencing difficult symptoms, sometimes not controllable by medication.

But to pour electric current into a healthy brain on a theory that it might stop the appetite, seems insanity to me. Has anyone asked questions like whether the constant flow of current will damage the brain? Might cause a disarray of brain chemicals which could lead to Parkinson's and more? Might damage other things like memory, cognitive abilities or ? It is said that epilepsy which causes a short surge of electric current (and natural electric current - not from batteries!) in the brain can cause brain damage. I have to wonder what a constant flow of current will do in a year, 2 years or more.

I am thinking of actress and former Mousekateer, Annette Funicello who had the same brain surgery as Michael J. Fox - she had it to stop the shaking she was getting with Multiple Sclerosis and went from a fairly functional person, partially dependent on a wheelchair but still able to walk a bit, to a person who is totally wheelchair dependent, has lost bladder control, has lost the ability to speak and more. If you haven't seen her in a while, that's why.

It seems really questionable to do this type of surgery to a lady who is totally healthy, and only fat. But then, she, believing in the myth, gave her permission. She looks like an intelligent lady (and young for her age) but what drives a person to be this desperate, I wonder. Was it the constant battering of the TV telling us that fat will kill us in 3 years? Or maybe the constant verbal abuse fat people get from many members of the medical profession.

I cannot forget when a friend was in the hospital - the stoma on her WLS had totally closed and she was vomiting even her own saliva. A surgeon naturally realized she needed to have her WLS undone as her stoma would not stay open despite years of endoscopies etc. While she was waiting to be wheeled into the OR, a partner of the surgeon came into her room, a slim slip of a woman. She said to my friend, rather scornfully, "You realize when you get this undone, you will gain 100 lbs!" My friend had already regained all her weight and then some. Imagine how cruel to tell that to a sick person. By the way, the proposed weight gain never happened - my friend gained all of 10 lbs when she had her WLS undone.

Carol who volunteered for the brain surgery, appeared on the Oprah Show. She had had the current turned on for 9 weeks (2 months) and had lost 11 lbs (which is around 5.5 lbs a month or slightly over 1 lb a week). She told Oprah that she had been making better food choices and going to the gym and "could do things she hadn't done in a long time".

It sounds like this loss was a function of her cognitive brain rather than the pacemakers but what will her prognosis be? I have heard of some pretty nasty side effects with the gastric pacer which only put an electrode on the stomach (not the brain).

Most of all, I wonder when we will start using those brains that now surgeons want to mess with and realize that there is no magic bullet - only bullets which kill and disable.