Misleading study finds that gastric bypass is a good idea?

Most people only read the first paragraph of a news article and the media takes advantage of that fact, assuming most folks will not read the rest of the article and only a very small percentage will research the article.  Therefore, the news media can inform the public of anything they want to sell, pretty much assuring that their disinformation will hit the target audience.

The first paragraph of a recent Reuters news service article reads: 

"Ten years after gastric-bypass weight-loss surgery, patients in a recent study had managed to keep off much of the weight they'd lost."

That sounds impressive but even reading the rest of the article raises rather large doubts - for example they were only able to contact a little more than half the original patients who got RNY between 1985 and 2004.  The cohort was 1087 patients and they were able to contact 651 of them.  That raises the big question of how hard did they try to contact the cohort - did they, for example, check and see which ones had died?  (Obituaries are public domain and easily searchable on the internet).

And despite the impressive sounding first paragraph, 10 years after an invasive surgery which is known to cause malnutrition etc, patients contacted had only kept off 25% of their excess weight.  That is, if the excess weight was 100 lbs, then at the 10 year point, they only were 25 lbs lighter than when they had the surgery - hardly worth an invasive surgery which has a higher mortality rate than open heart surgery.

Another questionable thing, is, this was a contact by phone - in other words, the patients they did contact, self reported the results and it's common knowledge that patients when self reporting, especially after elective surgical procedures, can be extremely inaccurate or leave out very pertinent facts - like for example, it appears non of the patients were asked if they had metabolic bone disease, a common repercussion of gastric bypass surgery.

At the time of their surgeries, 59% had high blood pressure... but 10 years later, that percentage had only gone down a few points i.e. 47% still had high blood pressure, a risk factor for many things including stroke.

It appears that many surgeons are, for some reason, not learning the newer procedures like gastric sleeve which are safer than gastric bypass.

And one might question whether surgery is any longer a viable option since newer research suggests that the appetite centers are in the brain and not in the GI tract.  It should be noted that Dr Nowzaradan of TLC TV fame, admitted in an honest moment, that 5 years after a gastric bypass the surgery is no longer effective as far as weight loss.

Sadly most folks who read the Reuters article will only read the first paragraph and thus be impressed, perhaps making a life changing decision which while a questionable treatment for obesity, might endanger their health for life.

Sick Gastric bypass patient - not so rare

Malissa Jones of the UK first made the news in 2008 when she became the youngest person to have a gastric bypass in her country. At the time, she weighed over 400 lbs and by her own admission, had a taste for candy and not the greatest food choices. (She told the news, she's consumed 10 chocolate bars in a day!). Typical teenager but with her genetics this type of teen eating did not work. So she had become very obese. Malissa complained about being teased and bullied in school but she apparently had some health problems also. She had trouble breathing and when she was 15, she went to the ER with chest pains which is why the NHS decided to do a gastric bypass on her when she was 17 years old. Typically they don't do bariatric surgery on anyone younger than 18 years old

Her surgery did not initially go easily for her. She was in intensive care for 36 hours but she did survive and began to enjoy her honeymoon year.

In February 2009, she was again interviewed. In a blog which reprinted a news article, now no longer available, it was reported that she had lost over 200 lbs and said that this surgery had saved her life. She weighed around 196 lbs and took a size 14, a great improvement over the size 28 she used to take. She talked about night clubbing and discovering a whole new world. "I've had a lot more boyfriends because I feel much more attractive and confident.", she told the news reporter. She mentioned that she was saving up to have the loose skin removed in a private surgery (it was not covered by the NHS).

But sadly, Camelot wasn't going to last for her.

By December 2009, apparently been unable to save up for the $40K surgery she required (Lower body lift, tummy tuck etc) to remove 28 lbs of loose skin which remained after her quick weight loss, she was not a very happy camper. Life continued on a downward trend, when she became pregnant at the age of 20 but they had to take the baby prematurely because they feared that carrying fullterm might be too risky for Malissa. Henry, a little boy did not survive.

Malissa recently made the news again. She now has been diagnosed anorexic - she weighs only 112 lbs (she's 5'8") and is unable to eat more than 300 calories a day. The news stated she was afraid to eat but she said in addition to being terrified of regaining, she suffers pain and sick stomachs when she tries to eat more food.

There are a number of gastric bypass patients I've met like this - who are unable to eat a couple of years after surgery. This inability to eat is sometimes combined with a phobia of food in general as is the case with Malissa.

One might ask why NHS doesn't give her a reversal and perhaps they have done that, but a reversal won't help the fear of food she has developed since her surgery. Again the NHS is worried for her life. She's much too young to die but this time around there is no surgery which can save her life except intensive psychotherapy.

This is not as unusual a case as providers would like us to think it is. I've actually, met quite a few patients who suffer from something similar to Malissa.

And in a 2001 news article, clinical psychologist and eating disorders expert, JoAnn Mann,RN, told the Fresno Bee,

***"I've seen massive infection, I've seen people hospitalized for malnutrition. I've seen people obsessed with food. I've seen people unable to stop vomiting. I've seen people develop massive eating disorders, I've seen people who are terrified of gaining weight. Terrified. It runs their lives." ***

Dr Jen Berman,a Los Angeles psychotherapist and an expert on eating disorders, has counseled many gastric bypass patients over the years. She told the news media that some patients have developed eating disorders and are afraid that if they eat too much, they will be sick.

***"I have seen people become terrified of food. They feel like their body is out of their control because they lose the weight so fast. I have seen people develop terrible phobias of gaining weight or losing weight." (IBID)***

SO Malissa Jones isn't alone in her food fears, but her road back to health will be a long lonely one, and much harder to trod than it would be had she remained overweight.

Definitely a case (one of many) when the cure is far worse than the original disorder.

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?

Obese children - what is abuse?

If we would listen to the media, we would put our kids on a diet, at the first sign of any fat we see. Unfortunately, our medical providers might agree with dieting our kids and look smilingly upon the parents for doing this. Weight Watchers has special programs where a kid can attend meetings for free with a member parent and get the same treatment which would include weekly weigh-ins and sometimes includes fat phobic advice.

How sad that today so many parents regard healthy kids with a bit of fat on their bodies (or even a lot of fat on their bodies) as our forefathers regarded lepers or severely disabled.

I am reminded of a comment made by Jerry Lewis in trying to raise more money for the Muscular Dystrophy Association at the 11th hour of the telethon.

"Would you like to be saddled with a crippled child?" he asked his audience by way of telling them if not, they should give more money. I wonder if today's parents would ask "would you like to be saddled with a fat child?"

And of course, the ultimate we are seeing more and more often is weight loss surgery for kids at a time when they NEED all their vitamins and nutrients. Sometimes kids get a lap band which at least allows normal digestion but also, sometimes kids are given gastric bypass which causes a lifelong illness of their digestive system.

One doctor opined that these surgeries may have an impact on children's health in adulthood. Understatement of the year.

One news interviewer asked a young person who had had a Lap band placed, if she was exercising now and the parents said she was joined up with a gym but when the parents were asked if she had exercised before she got the lap band, they both said "well... no"

Often I have seen that parents and doctors do NOT seem to be emphasizing healthy food choices for kids, only LESS Food and to be slim. I have two teenage grandkids who began smoking to control their weight. Most people DO begin smoking for that reason.

Having sat on the phone with a 48 year old woman who got weight loss surgery in her early 20's, mostly because of parental pressure and having her, now, ill in bed from the repercussions, weep bitterly and tell me how her mother didn't love her because she was fat, I think the physical repercussions of weight loss surgery, liposuction and dieting for any young girl, are nothing compared to the psychological trauma she may face later on.

And as the Swedish Obesity Study has shown us, weight loss surgery patients after 10 years, had only kept off an average of 16 percent of their original body weight.

We should really question this business of dieting our overweight kids - is it a type of abuse where the parents, albeit well meaning, might induce physical and psychological trauma for life? This might well end up in the wasting of a life and all because of a bit of extra bodyfat. A girl who is not using her talents because she is so busy with the hard work of dealing with stomach surgery to maintain a weight that is acceptable to a society which values not much more in a woman than the way she looks.

Read this and weep, for our children are suffering.... Will the insanity ever stop?

NOTE: for an update of Brooke Bates, please read blog of June 16, 2008.

The Childhood Obesity Hysteria only makes our kids unhealthier

On a show in October, Tyra Banks, host of "America's top models" featured two children with eating disorders. One of them, started in when she was five, eating paper to avoid eating food.

"I would eat a little bit of breakfast, a bite or two at lunch and a bite of each thing that my mom gave me at dinner and then the rest was paper," Justine Galleger, now 14-years-old, told Tyra. "I had a little baby fat on me and I saw other kids being teased, and figured if I didn't put on weight then I wouldn't be made fun of."

During her period of fullblown anorexia, Justine only weighed 32 lbs.

Another child Tyra had on the show chews food, then spits it out to avoid gaining weight.
Tyra who has gotten in the news lately, by allowing herself to gain up to 161 lbs which puts her in the low part of the "normal BMI range", has been trying to bring a message to the public which they need to hear ... our obsession with size and "childhood obesity" is very badly affecting our kids... for anyone who thinks these kids described above are exceptions, keep in mind that many of the kids I know personally, even those as young as 9 years old, are totally calorie conscious, can detail how many calories and how much fat is in most foods (they read labels of most of what they eat), consider being fat as horrible, ugly and negative, consume large amounts of green tea and/or water and chew gum to avoid eating and try to exercise off any food "indescretions". Since most of them do not eat healthy, I suspect that they, regardless of what they weigh, may be poorly nourished. They drink little to no milk, they take no multi vitamins and they don't eat much in the way of veggies but they all eat a lot of fast food and junk food.

In school, most teachers who taught in the 1980's and are still teaching now, have commented that the attention span of the kids, is markedly less now than it was 20 years ago when they were better nourished and not so fat phobic.

We can hope that Tyra gets through to the public where others have not.