Another study on gastric bypass

Every so often, a new study comes out, presumably "proving" how effective the gastric bypass is.  That's because this surgery is a huge cash cow for the medical field and less and less folks are having it - because of the post op, high complication and death rate (never mentioned in the studies of course). And because at the end of the day, it's not even very effective for weight loss.

This study which appeared in NEJM, was similar to the others.  Sounds very impressive - it was a 12 year observational study they tell us - as the surgery was shown as slightly effective for weight loss and very effective for diabetics.  Let's remember that patients are told if they don't diet and exercise, they won't lose any weight even after an invasive surgery like the gastric bypass but of course, diet and exercise work well without risking one's life to have a gastric bypass, thus the first thing they slip by us, is not distinguishing those who dieted and exercised (which would have caused a weight loss without surgery) from those who didn't.  

If we break down the study, you will see, it's not what it seems to be.  Here's a money quote:

In the study by Adams et al., despite a wide variation in change in body weight across the sample, 360 of 387 patients (93%) in the surgery group maintained at least a 10% weight loss from baseline to year 12, 271 (70%) maintained at least a 20% weight loss, and 155 (40%) maintained at least a 30% weight loss. Only 4 of 387 patients (1%) in the surgery group had regained all their postsurgical weight loss. 

First of all, a 10% weight loss on a 300 lb person is only 30 lbs. But secondly, of course, the high death rate for this surgery (5% in the first month after surgery) is not counted and also even a 30% weight loss is not very impressive. Also, the gastric bypass, more often than not, causes malnutrition which can cause weight loss. (The important parts of the digestive tract are severely undermined or bypassed)  To be fair, they should eliminate all members of the cohort who are suffering from hypoglycemia or malnutrition but of course, they never do that.  

For diabetes, it looks even more impressive:

In the surgery group followed by Adams et al., remission of type 2 diabetes was observed in 66 of 88 patients (75%) at 2 years, in 54 of 87 patients (62%) at 6 years, and in 43 of 84 patients (51%) at 12 years. Of the 62 patients in the surgery group who had initial remission at 2 years and had 12-year follow-up data, 69% remained free of type 2 diabetes at 12 years. Successful remission of type 2 diabetes was strongly predicted by baseline medication status.

But let's look at how they pick the cohort (study participants). Usually, they pick folks who are - what is called - pre diabetic. Which means they don't have diabetes yet, and if and when they come down with diabetes, it's several years before it gets really bad.  Additionally, malnutrition after the gastric bypass helps with this aspect too.  It's well known that starvation or semi starvation will cause diabetes, especially early diabetes, to go into remission.  Bottom line, starvation or semi starvation with a non mutilated digestive tract is safer than that caused by a mutilated digestive tract and causes a better weight loss than invasive outdated surgery.

The study was funded by the diabetes assn and it's a known fact that the funding does influence the results of the study. 

In other words, it's the same old trick - the hope that the public will believe this, rather than do research or question, and rush out to buy the surgery. Because the bottom line is, although they should not even DO this outdated, risky and not real effective surgery anymore, it's a big cash cow.  Buyer beware, especially in a "for profit" medical provider setup.

My 600 lb Life - Laura

This week's, "My 600 lb Life - Where are they Now" featured a lady who lost most of her weight and ended up in the 180's after skin removal surgeries.

Interesting to note was the massive loss and new style of eating, took its toll on her relationship.  Sadly it was a "common law" marriage i.e. they were living together as husband and wife but not legally married (common law marriages are no longer acknowledged as legally binding in most states).

And one might ask "why".  There are hints in the show. First of all, the husband has Multiple Sclerosis, a serious neurological illness which only a few years before TV checked in on the couple, paralyzed him at one point.  The show said Laura had "nursed him" back to health but he obviously was disabled to the point of not being able to work - always a strain on the marriage to begin with.

Second, Laura was very addicted to food and had used food all of her life to "feel better" in the presence of adversity and certainly, having the burden of supporting the couple and other stresses she alluded to (probably connected with her partner), were difficult for her to deal with, without the help of the food which had helped her in the past.  Her weight loss had come to an standstill, so the good doc revised her gastric sleeve to a gastric bypass, which, of course, zapped her strength because of the non digestion of nutrients (we need some 100 micro-nutrients a day and that's in addition to macro-nutrients, most of which cannot be digested by gastric bypass patients since the very important digestive organ, the duodenum, the first several feet of small bowel, is bypassed in this surgery.)

Less than 25% of surgeons still do the bypass because of not only, the short term repercussions, but long term ones as well.  The inventor of the gastric bypass, stopped doing them in the early 90's, pointing out the numerous issues with this surgery.  But of course, the 72 year old doctor "Now" on "My 600 lb Life" is likely not up with the current science and doesn't realize that people who get pretty sick (as Laura DID after her bypass  - she suffered a lot of nausea and most things she ate didn't stay down), may need a takedown immediately.  I'm sure that she felt badly did not help her patience with her husband.

The show put out a note that 85% of bariatric patients end up divorcing their spouses.

Let's hope Laura gets herself to a doctor who is more up with the science of digestion and realizes she badly needs a takedown NOW.

Higher rate heart attack and suicide after gastric bypass

In the gastric bypass, the stomach is very compromised and the duodenum, a vital part of digestion, is bypassed.  This is why it causes nutritional deficiencies in most patients.

Yesterday's broadcast "My 600 lb life", was unsettling, especially in my watching it for the second time.  I'm assuming because the patient died from heart disease, soon after they had stopped following him, they haven't shown this episode much because of the possible negative effects on the audience of prospective surgical patients.

What was interesting to me is that he apparently, had heart disease before surgery because during his excess skin removal surgery, he suffered a total cardiac arrest.  "I actually died on the table," the patient tells the camera, but they were able to resuscitate him.

He called his resuscitation, a miracle but a year or two after these procedures, he had a heart attack while driving a school bus and crashed the school bus.  He was D.O.A. when he got to the hospital. We weren't told how many kids were injured but since he'd had a heart attack a year or two earlier, while driving a shuttle bus, one questions why he was again driving and then, a school bus.  One of many questions with this case.

One question that arises was - was this person who obviously already had heart disease, really a good candidate for a procedure like the gastric bypass which tends to raise the risk of heart disease? 

A study published in the "Archives of Surgery" in 2007, found that gastric bypass actually increased the risk of both heart attack and suicide in post ops.  The study examined the records of 16,683 weight loss surgeries among Pennsylvania residents.  They found a substantial number of excess deaths attributed to both heart disease and suicide.  As post surgery time increased, the researchers continued, so did the death rates with heart disease topping the list.  The bariatric industry basically ignored the study, pointing out that these ailments are higher among the obese anyway.

The Dr on TV requires prospective patients to lose 50 to 100 lbs before surgery which they all diligently do, pointing out that diet and exercise are needed to continue weight loss after surgery, but of course, diet and exercise also work well to effect a weight loss without surgery and often, the patient, anxious for the surgery, loses weight at a faster rate before surgery, than after.

When the gastric bypass was promulgated in the 1960's, it was thought that the stomach controls appetite and thus, mutilating this vital digestive organ, would help the person to control their overeating.

They didn't realize then, that the stomach, although a key player in the digestion of proteins, fats and vitamin B12, does NOT control the appetite centers which we now know, are located in the brain.  Moderns who have the gastric bypass are disappointed that their cravings (which originate in the brain) have not been affected by the surgery.

Interestingly, if we look at the repercussions of the gastric bypass more closely, we see that although the weight loss effects are temporary (according to TV bariatric surgeon, Dr Nowzaradan), the complications not only last much longer but increase in the years after surgery.

Happily, less and less surgeons are doing gastric bypass - hopefully, we will see the end of this invasive but not that effective procedure in the near future.

One doctor told his patients to diet and exercise before surgery and then, when they'd had a substantial weight loss, he told them "Now, go home and continue what you are doing!  You don't need surgery!"

weight loss surgery not really effective, admits top surgeon

It's pretty common knowledge for those who access the Internet, that weight loss surgery is not only ineffective but risky.

But recently, Dr "Now" of "My 600 lb life" admitted on TV that weight loss surgery isn't effective after 5 years, a telling admission for him since he actively, is pursuing clients for his surgery although there is some evidence that he might be doing the safer gastric sleeve, more than the gastric bypass.

Weight loss surgery, all of it, is based on an idea we now know to be false i.e. that the appetite center is in the stomach. 

The appetite center is in the brain which is why weight loss surgery isn't effective unless you diet and exercise which of course, causes a weight loss without surgery!

The inventor of the gastric bypass, Edward Mason, found, in the 1960's, his ulcer surgery patients were losing weight and thought he could do similar surgery on overweight folks with the same results.  Thus began a long era of surgeons quite literally, going to the bank, doing weight loss surgery procedures.  Because there was so little followup, surgeons were neither aware of the high rate of regain nor the alarming number of deaths and/or repercussions.

When one procedure proved ineffective as well as risky, another one came into vogue.  Right now, the gastric sleeve, a surgery which calls for the permanent removal of up to 90% of the stomach is the surgery "du jour".  

Trouble is, the remaining "thumb sized" stomach which results from a sleeve gastrectomy, probably does not digest B12, fats or proteins really well.  And this surgery, although safer than the gastric bypass, is not reversible.

In a society where the medical profession is profit making, abuse is common.  Thankfully, the internet can inform people but sadly, many people either don't have access to the Internet or cannot really utilize their access well enough to do research.

Less than 5% of dieters can keep the weight off and that number who can keep off weight, is only 2% higher among weight loss surgery patients...that is less than 7% of weight loss surgery patients can keep off all of their weight for any amount of time.

Bottom line, if you want to take off weight, you might be best to just do the diet and exercise part and skip the surgery.  (Diet, unless you do it very carefully, has its own set of risks).

Surgery for weight loss

A sad thing for me is when weight loss surgery post ops come back and say "Oh Sue, I wish I'd listened to your warnings".

The warnings I've posted can actually be found on most weight loss surgeons' websites but they aren't in a very prominent place.

Moreover, people want to believe there is a quick way to doing this weight loss thing - so maybe many folks don't look for the small print like 1-2% of gastric bypass patients die within 30 days of surgery or like undermining the delicately balanced system we have for nourishing our bodies with the hundreds of nutrients we need on a daily basis, isn't a very good idea.   As one doctor put in it in a book I read in the 1970's, this type of thing is similar to trying to run our cars on French perfume... how long would they run? Sadly, we often treat our cars better than we treat our bodies! 

The body adapts in a way to various forms of starvation, but of course does not last very well in the long run as it starts to consume protein and macro nutrients from itself, like the brain, the heart, calcium from the bones etc.

It's meant as a short term way to survive a starvation period and not for something in the long term.

I remember when I started studying this stuff in 1990.  I called a medical provider, an intelligent well educated one, and asked him to tell me what he knew about the GI tract. He gave me a short basic explanation.  I asked for more details but he said that was all they got in medical school!

I ended up reading bunches of books and medical journals to get the rest of the information, a research which took more than 10 years of study (not counting the many books etc I read before my specific study on weight loss surgery - I'd been studying weight control since the 1970's and still am studying it).  Sadly, this is not easily available to the public and apparently many medical providers don't have the time or ? to study this in more detail.

Eating healthy and exercising at least 5 days a week (the only thing which strengthens our hearts is cardio exercise or as it was formerly called, "aerobic exercise") is the best way to go.  That's what they say if one studies the subject and I can attest from personal experience, it works.

Eating healthy usually means avoiding fast or fatty foods and eating mostly veggies and some fruits.

Not eating healthy and exercising raises our risks for heart disease, stroke, thrombosis and more.  I've lived through this thing of heart disease and clogged arteries - not in myself but in my hubby who never heard from a medical provider about a heart healthy diet or how important aerobic exercise is. I made him exercise daily but he only did 20 minutes most days.  Never-the-less, that 20 minutes is probably the reason why he's still living albeit required five major surgeries to fix his heart and clear out the clogging from his arteries. 

And all this, while seeing medical providers regularly and paying lots of bucks - where were the warnings he should have gotten?  

And basically, not looking for the quick way out of a weight problem because there is no quick way that is healthy and works.  Terminal cancer patients don't have a weight problem but I suspect most of us would not want to go there.  But having one's stomach and bowels cut up and/or rearranged in a very unnatural manner, as done in surgeries for weight loss, isn't a good idea either.

As Beverly Sills has said "there is no quick road to a place worth going!"

Dominique Lanoise - an American Tragedy

Recently, I watched the Dominique Lanoise story...this was a lady, bed fast from her weight (over 600 lbs). The doctors kept saying about how she "needed" a gastric bypass. How modern physicians could buy into the myth that there is anything lifesaving about a surgery which interferes with the digestion of the many nutrients we need on a daily basis, I will never understand.  Understandably Dominique's life (she was in her 40's when the show was made) would have been cut somewhat short by her weight and inactivity, but it's significant to point out that she died, only a couple of weeks after what the TV show called, the "lifesaving" surgery. 

How sad that ignorance, hers and perhaps the medical providers who had bought into the myths told about this surgery, ended up killing her prematurely. As her daughters, who missed her after she died, said, "even in bed, she sang songs with us and talked to us."  The medical profession denied Dominique's children, the few years they would have had with their mother. How sad. :(

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.

Fit to Fat to Fit on TV?

There is a series on "A & E" TV called "Fit to Fat to Fit".  The show has two protagonists.  One of them is an overweight person (usually quite overweight like over 300 or 400 lbs) and a personal trainer.  The personal trainer is usually very slim and fit and decides to put on some weight so he or she can "understand" how it "feels to be fat" (as the show states).

One of the shows I saw, had a lady who really did usually, watch her weight and was able to gain 40 lbs rather easily. But two of the shows had a male personal trainer who obviously was naturally slim (while eating healthy but having "cheat food" every so often).  When the male personal trainers tried to gain weight, they had to work very hard at it, eating 5000 calories or more a day and even at that, they could not gain much more than 20 or 30 lbs and didn't look overweight at all.  They too, however, at that point, said they now could understand how it felt to be "fat".

What annoys me, especially about the latter two shows, is that everyone I've known who is able to gain large amounts of weight (including me!), has genetic and metabolic issues which TV shows like the A&E programs do not take into consideration at all. Science does acknowledge this. For example, obesity scientist, Dr Rudy Leibel states that 60% or more of our size is genetic and/or physical rather than what we eat.

TV star, Al Roker, who had a gastric bypass, has told his audience that he does count his calories and also does 45 minutes of running several times a week.  He's not the exception - he's the rule.  Surprisingly, a study which included members of NAAFA, a social club for people of size as well as average size people, found that NAAFA members actually consumed considerably less food at meetings and banquets than did those of average size.

But sadly, TV which is the informing source of most folks who do not have the time to read, is telling a fairy tale.  People on TV asked how they got so fat, invariably say they eat too much but their "too much" is often less than the amounts that average size folks eat - those who do not become overweight.

I get very weary of TV shows blaming overweight people for their size.  Surely true that an overweight person can keep to a so called average size but it takes lots of work, including saying "no" to any type of fast food, in addition to counting caloric intake (and I mean writing it down or keeping it in the computer - the latter is made more pleasant by great clients such as "My Fitness Pal" etc).

I feel shows like "Fit to Fat to Fit" do a great deal of damage to folks who do have genetic factors and physical factors contributing to their size.  I know about this on a personal basis.  I was very active as a child and kept slim...until I had a tonsillectomy and right after that, I started gaining quickly despite not changing my level of activity (in fact, after, I was more active after surgery, because I wasn't sick in bed all the time like I was before surgery).

Later on, much later on, like when I was in my 40's, still pondering why I gained weight after my tonsillectomy, I read that 50-60% of kids who had tonsillectomies in the 1950's and 1960's, sustained damage to the pituitary gland which of course, would adversely, affect the metabolism.

So, after blaming myself for so many years for my "weight problem", I realized I had a medical reason why I gain weight so easily and since then, I, ironically, have been able to compensate for my lower metabolism through mild calorie restriction and have managed to lose and keep off 106 lbs since 2010.

Shows like "Fit to Fat to Fit" should be balanced out by a more realistic portrayal of obesity, and the genetic and physical factors involved, instead of intimating that all fat people do nothing but sit on the couch "eating bon bons".  Society as a whole would be better off.  Because the truth makes everyone free.

More Weight Loss Surgery ads on TV disguised as shows

Filmed in High Def and artistic cinematography and certainly scripted (as all "reality TV" is), the show, "My 600 lb life" is certainly watched by many and the producer who is the son of a Houston weight loss surgery surgeon, is definitely going to the bank.  A great improvement on earlier shows like the old series "Big Medicine", artistically speaking, one can be certain these shows have the same effect on the TV audience as the earlier offerings.  After every show on weight loss surgery, more than one weight loss surgery clinic remarked that their phones were "ringing off the hook" with prospective buyers.

  People featured on "My 600 lb life" i.e. the patients, not only do not get compensated for their appearance on the shows, but they also, have to pay for their weight loss surgery and/or skin removal surgeries.  There has been some speculation that the patients get a bit of a discount on the procedures but a couple of thousand bucks off on surgeries which can cost from $15,000.00 and up, isn't much of a financial aid.

This season, a new show has been added.   They call it, "Skin Tight" and is ostensibly about the plastic surgery that weight loss surgery patients (who lose the weight too fast for the skin to respond) often need.  Truly (and as the show portrays), many weight loss surgery patients have so much loose skin that they feel their bodies are more uncomfortable than they were when they were at their starting weight. 

The photography in "Skin Tight" is interesting.  The so called "skin surgeries" are long and very painful, a fact which is (of course) omitted from the show. Most patients I've talked to, describe it as more painful than the original weight loss surgery.  The skin surgeries involve long incisions and long hours under anesthesia and long healing.  But of course, the patients seen on "Skin Tight" all smilingly say it was totally, worth it because they "look so good" now.

However, if you watch the cinematography closely, you will notice that the patients who have undergone "skin surgeries" (most of them, have multiple procedures), are photographed from the front in the before photos and from the side or even covered up in  clothing in the after photos.  So even though the smiling patient says (according to the script) how wonderful life is, I wonder if the long scars and months of pain are really so wonderful.

It bothers me a lot how much of a business, the medical field has become.  Often, more expensive procedures are sold when a less expensive procedure (or no procedure) would do fine.  And often, despite the glowing reports we see on TV, the end result is fraught with problems and/or repercussions. 

There is no doubt in my mind that the public wants these surgical procedures because being of size in our society is considered worse than anything else.  But it seems that surgeons face a rather interesting dilemma.  Either they do invasive surgeries like the gastric bypass  which, albeit causes a large weight loss quickly (mostly muscle - good tissue you don't want to lose), can, in the long run, cause patients,  to suffer, many complications and can even shorten lifespan because of the malnutrition of fats and proteins and the lack of some 100 micro-nutrients a day which no longer can be digested.  Or they do the safer weight loss surgeries like the lap band or the gastric sleeve which do not offer the desired quick weight loss but also do not cause the complications of the more invasive surgeries.  

Surgeons who do the latter, often have to offer their patients diet plans including shakes etc.  But the truth of the matter is, that all weight loss surgery patients will not lose the weight unless they diet and exercise - these two things which, of course, cause a weight loss without surgery.

Best to remember the Buddy Valasco ("Cake Boss") statement, "It's TV, Baby!"

Or to recall a testimony by one of the major TV networks in the 1950's when they were caught cheating on the quiz shows.  Said one of the CEO's, "Well, the people were entertained, we made money and no one was hurt!"  

Unfortunately with today's shows, featuring weight loss surgeries, although the public is entertained, many people are hurt.  A sad thing to sacrifice a human's quality of life and longevity, for entertainment.

Thoughts about the TV show "My 600 lb life"

As I watch the TV show, "My 600 lb life", I see many issues .... Elephants in the room, things left unsaid like, the fact that at least 2 of the patients featured on this show, ended up with severe complications such as neuropathy and guillian barre (which the provider attributed to "obesity" even though it was after the gastric bypass that these folks suffered these complications). One  patient uses a wheelchair now (he could walk before his gastric bypass). Another 2 patients that I know of, died a couple of years after surgery which is before they would have died without surgery.  (The bus driver featured in the first or second season, died about two years after his gastric bypass - he had a massive heart attack while driving a school bus.)

First, it seems many of the patients feel the 'before surgery' diet is temporary but in truth, weight loss surgery does NOT fix a damaged metabolism...that is the patient will have to stay on the 1200-1400 calorie diet for life if they want to keep off the weight... it bothers me that many patients don't seem to understand this and so their weight loss after surgery greatly slows down or in some cases, they gain.

Second, with weight loss surgery, there may be a large initial (after surgery) weight loss as the person cannot eat because there is a healing process going on, but after the surgery is healed, the appetite (which is centered in the brain) comes back strongly.

When weight loss surgery was invented in the 1960's, medicine thought the appetite centers were in the stomach and by making the stomach very small, that would control the appetite... Studies and a greater level of knowledge that we have now, have taught us that the appetite centers are in the brain and the size of the stomach makes little to no difference in how hungry most individuals feel... This means that the entire theory upon which weight loss surgery is based, may be outdated.  So one wonders why some providers still do the invasive procedures like gastric bypass?. Well, surgery is a cash cow for providers, unfortunately... and sadly, many patients who have become ill with gastric bypass or have regained, are made to feel ashamed if they speak out.  One of my friends called this a "conspiracy of silence".  She, a weight loss surgery patient herself, died at the young age of 54.  She had been ill with her surgery and bed-bound for several years before her death.

Do providers know that surgery does little to nothing to control the appetite for most folks?  Unclear... They really might think that the surgery helps... To keep up with all the advances in medicine, a provider would have to spend all his or her free time reading...

Most of all, one cannot gain to a very heavy weight, unless one has some serious physical metabolic issues going on.  And no one seems to acknowledge this, although it can be found in medical literature .... And especially not the provider on the TV show, "My 600 lb life"...who assumes that every one of these patients is really stuffing him/herself. However, a revealing study found that members of NAAFA, a fat acceptance group, actually consumed less food at conventions than their thin cohorts!  It's true that people who get very overweight may overeat at times, but basically, most of them eat like many other Americans who do not become extremely obese... And yet these people are made to feel like they are total pigs when it comes to eating. I can't help wondering why providers don't seem to know more about metabolic issues which can cause obesity... 

I stumbled upon my metabolic issue...after spending a lifetime wondering why, if I ate like most around me, I became very overweight... A goodly percentage of folks who had tonsillectomies in the 1950's and 1960's got pituitary damage after surgery... My tonsillectomy was in 1953 and right after surgery, I began putting on weight...That is, before this procedure, I, being very active, was on the slim side, however, after surgery...eating the same amount and with just as much activity as before, I gained weight...

So in digging through medical literature (for years literally), I found the reason why I gain so easily.  Now why don't providers let us know about this, I'm wondering...like those folks on "My 600 lb life", the provider really takes them to task, when they gain weight...

To defend Dr Nowzardan, it's possible he doesn't know about the latest research...he's 72 years old and this may be one reason why people of this age (over 70) should be retired... I am 71 and yes, I do NOT have the brain power I did when I was, even in my 60's, and trust me, it drives me nutz!  To paraphrase Buddy on "Cake Boss" , one might say with emphasis, "It's the aging process, baby!"

Undoubtedly, some of us, like me and those folks on the TV show, "My 600 lb life" have no set point and thus, we can gain easily up to astronomical weights, without especially overeating, at least not more than most Americans who do not gain so easily...

I've tried to explain all this to providers... And most of them naysay what I am telling them. 

Metabolic differences and pituitary damage from procedures like tonsillectomies,  seems  something which, apparently, is not included in the medical school curriculum...

Sue

Weight Loss surgery and dieting

I have heard many folks sign up for weight loss surgery because they feel they will "never have to diet again".  The next step is they go to a "seminar" held by the surgeon they are thinking of hiring. But the seminars are really mostly selling sessions for the surgery (I can only think of one surgeon who actually gives very informed consent seminars, detailing risks as well as benefits - this does not cut the number of people who go to him - on the contrary, they appreciate the info!).

Today, I met a lady who had had a gastric bypass in Oct 2015 and had recently attended a weight loss group meeting. (and keep in mind, most surgeons are doing the less invasive sleeve now).  She had lost 80 lbs but lamented that no one had noticed her weight loss.  "But I lost it fast," she added.  That prompted me to ask her how and that's when she said she'd had a gastric bypass.  I explained that a fast weight loss like that was mostly muscle and that's why it didn't show a lot of reduction in size.  She looked sad and said that she knew that.  She was NOT told that surgery would not take off that much fat and she'd have to diet to do that - and she'd already been back to the hospital because she had developed ulcers after surgery and couldn't keep anything down so had needed more surgery.   I can't help wondering if, had this lady been informed of the risks, she might have gone a different route.

But the sad thing was she really didn't lose much fat with the surgery despite her inability to eat much and ended up joining the weight loss group, even - with having had the surgery.

I gave her my web site and also, some of the informed consent info she should have had before surgery.  "The advantage of a gastric bypass", I concluded, "is, it is reversible and you should probably consider having it reversed."  She told me her surgeon had told her only the sleeve was reversible (it's not reversible, because they cut off most of your stomach and throw it in the garbage i.e. "send it to pathology" as the surgeons call it). I said, "no, it's the opposite - the gastric bypass is reversible" and I told her how they reversed it., explaining that a reversal would still provide her with some restriction but give her normal digestion back.  Hopefully she will consider having it reversed.  I told her she might have to go to another surgeon to have this done.

Some surgeons send pre ops to my website to obtain informed consent information but obviously this lady's surgeon had neither given her informed consent info nor did he send her to my website.  Because the 80 lbs she lost was mostly muscle, she still was very overweight.

The bottom line with surgery is, it really, isn't that effective for weight loss.  This lady told me she thought it would kill her appetite but it hadn't done this and I explained that this is because they now know, the appetite control center is in the brain, not the stomach (as formerly thought in the 1960's when these surgeries were first conceived of).

As for the gastric bypass, it's very effective at greatly diminishing the ability to digest proteins and fats (and yes, we do need some fats) which is why most surgeons have switched to the sleeve which, albeit invasive, is much less invasive than the older surgeries.

Another interesting thing - when I told this lady who had had the gastric bypass that I knew several 300 lbs gastric bypass patients, she looked shocked - she didn't know that so many had regained the weight, although she was already having trouble with this.

All I can do here is *sigh*.  How I wish everyone would have the informed consent information that they need to really make the best decision for them.  Informed consent after the fact, can be bitter but this lady had several friends, also of size and I'm sure my information helped them in case they were considering surgery.... (the photo is of my friend who died in 2006 from the aftermath of the weight loss surgery she'd had in the 1990's. - she spent her last days, before her untimely death, warning folks to not have weight loss surgery.)

Weight loss balloon - a good or very bad idea?

The news today, announced a "new" device, for losing weight. Basically, the patient swallows a pill which is attached to a long tiny tube catheter device.  When it gets down to the stomach, the medical provider pumps distilled buffered water into the pill through the catheter, which causes it to swell, not leaving much room in the stomach for food.  This is supposed to make the patient feel full and want to eat less.  The water in the device supposedly, leaks out in about 4 months ("if all goes well") and then the deflated pill passes hopefully, through the digestive tract and out through the bowel. As the article stated:

"If all goes as planned, the resulting grapefruit-sized (19-ounce) ball of water fills the stomach and significantly curbs the amount of food someone can eat before feeling satiated."

     This was tested on 30 some patients, who lost an average of 22 lbs.  And has not been approved by the FDA as yet.
     They are advertising it as "non invasive" and non surgical.
     But (and there always is a "but" right?), from where I sit, I can see lots of problems with it - like for example, a non food item like that could cause an gastric obstruction or other problems,  and... what if it doesn't deflate, what if it doesn't "pass out" through bowel, like it's supposed to etc etc.
     And the idea that a full stomach makes us feel like eating less is thought to be somewhat erroneous as we now are pretty certain, the appetite originates in the brain and NOT the stomach.  And that means, even if you have this device in your stomach, you still can be very hungry (and very frustrated if you cannot eat much or the food you ate isn't going down right... another 'elephant in the room' not discussed in the promo).
     One of the patients on my discussion group, had a type of balloon device and he suffered so much with it that he considered the invasive gastric bypass as far more comfortable.
     This device costs anywhere from $6000 to $10,000 bucks and insurance will not cover it.
     As the old saying goes "buyer beware" (and DH added "If it doesn't work, you can't just bring it back to the store!")

Gastric bypass patients should consider reversal!

The good news is most surgeons have stopped doing the gastric bypass by now and have switched to the gastric sleeve which is a much safer procedure and just as effective as the bypass with weight loss (not very effective unless the patient diets and exercises which of course, works very well without surgery).

The bad news is many surgeons are not saying anything to bypass patients like telling them to consider getting their procedures reversed (which would effectually give them a gastric sleeve).  The reason they are not saying anything to the thousands of gastric bypass patients is, that would be like admitting the gastric bypass was a bad idea which it was, big time!  Mason who invented the procedure, stopped doing them in the 1970's because he said the repercussions were too great but he only wrote about this in medical literature.

Surgeons are afraid to tell you the gastric bypass is a bad procedure because of the possible lawsuits they might get (most WLS surgeons are facing up to 5 lawsuits at any given time!).  But if you are a bypass patient, consider getting the reversal procedure - you will still have restriction but will be able to digest vitamins again, hopefully...

We need some 100 micronutrients a day (which cannot be supplemented) plus a bunch of macronutrients like B12 etc which cannot be efficiently supplemented.  None of which the gastric bypass patient can digest.

As one WLS surgeon said, he "buries his mistakes".  Literally.  Dead people don't talk and live gastric bypass patients are afraid to detail the gnarley side effects of this surgery.

In the UK, they force a reversal of the gastric bypass after a couple of years - that's because the govt picks up the tab for all the side effects which kick in long term... if you are a gastric bypass patient, consider getting a reversal.  If you lost weight and kept it off, it wasn't the surgery, it was YOUR WORK and you can continue that without the bad side effects of surgery.

I have digestive problems from a lifelong case of GERD - they are very annoying albeit nothing like bypass patients suffer, but trust me, since I was clinically obese until 2010, digestive problems didn't help in the least, to keep my weight off.  (In 2010, I hit my Weight Watchers goal and lifetime membership - and have kept off 106 lbs ever since, being on program)

We did not become overweight because our digestive systems worked.  Just saying

New old program for WLS patients?

I went to a seminar on Weight Loss this morning - the weight loss surgery surgeon involved, meant well - he wanted to provide his patients with a program to do after surgery - the need of which was witnessed by the fact that most of the folks in the room, either gastric sleeve or lap band post ops,  were still quite overweight (although there were a couple of pre ops in the room also).  The surgeon also, has some problems with midline obesity and this, he says, is the latest thing that is working for him but he'd only lost 15 lbs and still had some 15-20 lbs to lose (which he has all in his waist).  He is a believer in low carbing but like many of my friends, that, alone, had not worked for him.  (Dr Atkins the founder of the low carb diet as we know it, explained in his last book that calories do count and you can gain just as much weight on too much of no carb foods as you can on carbs, a fact which has not been seen much in the media - if at all.  Also Dr Atkins had heart disease, which is again, a fact which has not often been seen in the mass media.).

The so called "protocol" seemed to me, a rehash of other low cal diets  - similar to the old "Dr Simeon program from the 1950's... in the first stage, you cut the calories down drastically (which of course, damages the metabolism) - they have some kind of protein drink you buy (and also you can intake your protein in other types of product which they also sell.  They have 3 stages of this program and in the maintenance stage you can again eat carbohydrates in small quantities. Although sugar is portrayed as the demon in this program - the latest thing in diet plans - apparently aspartame - nutrasweet which is somewhat toxic and far more unhealthy than sugar ever thought of being, is "ok".

The new twist is, this company seems to be targeting physicians (many of whom sadly, know little about weight loss science and regard obesity as a medical problem for which a solution - pills or surgery - can solve and be a cash cow at the same time).

I asked the guy hawking this product - what about maintenance... and he said he would talk about it later.  He dismissed it with "well, when you creep up in weight as 'we all do', you go back on the "protocol" for a week or two and take off (crash off?) the weight."  He gained some popularity in the room when he said that people don't have to exercise with this "protocol".  In fact, he went on to say that even if people were working out a lot, it was advised they did not work out while on the low calorie part of the protocol.

As we all know, yo yo syndrome is the best way to really mess up the metabolism and which causes most folks to be more overweight after repeated attempts at crashing off weight.  But they didn't talk about metabolism, of course.  Also if you weight cycle as small an amount as five or ten pounds several times, it not only raises the risk for heart disease but also causes the individual to end up with a higher percentage of body fat.

Here's how it works... when you lose weight on a very low cal diet, you only lose 30% bodyfat - the rest of what you lose is muscle and bone (tissue you do NOT want to lose).  However when you regain even as little as 5 or 10 lbs, it's all bodyfat (no muscle).  The salesperson telling us about this diet, said "everyone's weight creeps up!"

Bottom line is, this diet is quite pricey - according to the physician's website (which is more honest about the cost than the manufacturer's website)... Start up fees are $279 dollars and when you go off the "protocol" and regain and want to go back on "the protocol" for a couple of weeks, it costs $108 dollars a week.

Consider that this "protocol" is being sold to people who have already invested thousands of dollars in weight loss surgery.  Looking around the room at the people who attended this meeting most of whom had had weight loss surgery, and were still very overweight, it was clear that weight loss surgery often is ineffective for permanent weight loss.

Big Push for Weight Loss surgery

Tom holds photo of his daughter who died shortly after her gastric bypass - parents of patients who die or become sick, suffer very much for years after

In case you haven't noticed, there has been a big push for Weight Loss surgery in the mass media.  A Fox News article announced that "diet and exercise may not be enough to lose weight" and goes on to state that the "only proven effective treatment for obesity in the long term, is surgery."  Proven?  Hardly.  While it's true that about 5% of dieters can keep off the weight, having surgery only increases that percentage by 2% i.e. 7% of bariatric patients can keep their weight off (Mayo Clinic study, Swedish Obesity study and several others).  Hardly worth reconfiguring the digestive tract in a very unnatural manner which will deny the person much of their digestive ability.

On TV, the old "Big Medicine" shows have been regurgitated under the title "My Weight is Killing Me".  This show, although more honest about how surgical patients have to diet and exercise after surgery (which works, by the way, without surgery), still portrays surgery as "the only way" for people who are clinically obese.

Another show, "My 600 lb life" produced by Dr Younan Nowzaradan, MD (a bariatric - weight loss surgery surgeon), portrays patients who are 600 - 700 lbs - all of them "need" surgery, of course, according to the show... and after they slim down with surgery to a "svelte" 400 or 500 lbs, their lives are supposedly saved.  The show seems to ignore that weights of 400 and 500 lbs are still considered clinically obese, only now after surgery, the patient is not digesting some 100 micro-nutrients (like zinc, etc) which we need on a daily basis to stay healthy.  Not withstanding the patient after a gastric bypass is also not digesting well, macronutrients like proteins and fats.

Interestingly enough, a recent show about a lady named Susan, followed her as she lost 150 lbs before surgery and then, after surgery (gastric bypass), very little more weight and very slowly.  One wonders why they didn't just tell her to go home and continue what she was doing instead of mutilating her stomach and bowel... Well, I guess that's a no brainer - the surgeon takes home $5000 bucks (at least) with every surgery.... so if s/he does five surgeries a week - that's one a day with 2 rest days, his/her weekly pay is $250,000.00!  People have done odd things for far less money than this.

Several studies including some 30 year studies on 30,000 people by the Cooper Institute, have found that it's not weight that endangers health but rather lifestyle and that anyone with a healthy lifestyle (i.e. making healthy food choices most of the time and exercising at least 5 days a week for 20 minutes or more) can live a long life even if their weight is in the obese or clinically obese range.

That being said, Dr Rudy Leibel pointed out that obesity is mostly genetic (60% genetic).  Also being from a family where several relatives were or are overweight, I can attest to the fact that most lived long healthy lives - without having their digestive tract surgically altered.

One of my husband's cousins is celebrating her 80th birthday - she has been clinically overweight all of her adult life and totally healthy (well, in her late 70's, she had a hip replacement surgery).

There are some advantages to calorie restriction - for me, my severe GERD goes into remission as long as I mildly calorie restrict but to say "everyone" needs a digestive tract which no longer works well, is not logical...  We did not get overweight because our GI tract worked and so rendering it somewhat non- functional will only add to the original problem... another no brainer.

If you are considering Weight Loss surgery, please visit this website....  (http://obesitysurgery-info.com)  It gives informed consent information about weight loss surgery - you will find it quite different from what you see on TV but then, remember, TV is for entertainment, not for good education!

Gastric bypass on TLC TV show

My dearest friend in life, Trish, who died way too early, from complications of a WLS she had had several years previous.  I still miss her and this blog is dedicated to her.

 

The Long Island Medium is a show on TLC about a lady who supposedly talks to dead people. The following article is not arguing whether or not she really is contacting the dead but rather that this week's show was mostly dedicated to a mother of a gastric bypass patient who died after his surgery... Following are the highlights:

Theresa Caputo, who is the "Long Island Medium" was doing a group reading at a restaurant.

She hesitated for a moment and then asked one of her general questions which tend to encourage people to tell her about their deaths in the family etc.

Theresa said "I want to talk about the young man who passed in a tragedy."

A woman in the back of the room, raised her hand quickly.

Theresa, facing her, said, " Your son has been gone for some time..."

The woman whose name is Elaine, answered: "Eleven years."

Continuing, Elaine added: "LJ was my only child - I waited a lifetime for him - now that he's gone, a piece of me is gone."

Therese, pausing for a moment, said: "Your son says it was difficult for you, his mother, because it was a total freaky thing."  (in retrospect - this was something she probably said because the son had passed from complications of WLS - as sort of a disclaimer. Like all reality shows, I'm sure this show is somewhat scripted and it has been written that Theresa Caputo spends some time with each person to be "read" on the show, before taping the show.)

Elaine described her son as a football star in college, admitting she had saved his jerseys from his participation in the sport.

Elaine then continued with: "I never expected LJ to die...LJ was 6'1" and 443 lbs... he had gastric bypass surgery. Obviously there's a risk with any surgery
but LJ's surgery was supposed to be 'textbook' and after the surgery, he seemed to be ok but then a month later, he started having complications..."

The complications put him back in the hospital and soon he required the necessity of life support machines.  Elaine did not specify what the complications were but the attending physicians all stated they were a result of his gastric bypass surgery.

In July, a month after LJ's surgery, his mother had to make the difficult decision to turn off the life support machines and even now, 11 years later, she said, weeping,  that there isn't a day, every day, that she doesn't re-live that moment.

" I go through it every day... he passed away from complications - it was sepsis" Elaine said adding that
"I kissed his eyes, his hands and his feet.", after he had died.

When the doctor broke the bad news that their son was in cardiac arrest to Elaine and her husband, her husband had a heart attack on the spot.  Although he survived that heart attack, he died 18 months later.

Theresa described Elaine as having a shattered soul...and Elaine agreed with her.

Bottom line, no one really talks about the relatives, the family of gastric bypass patients who pass on, but from the few I've met, they seem broken up about it for years after the fact... perhaps because weight loss surgery is an elective surgery and often their adult progeny are healthy before surgery albeit overweight, (in this case, the son was a star athlete).  Watching a kid die has been said to be the worst thing a parent can witness.

This particular show can probably be seen on Netflix or even somewhere on the web - or wait for the re-runs.  (photo is the blog author in 2009 trying to ask a WLS provider at a Women's Expo about complications of WLS and getting nowhere!)

Questionable studies on obesity and weight loss surgery abound

Yet another eye catching headline hit recently.  "Obesity primes the colon for cancer!", it triumphantly announced.

And what was this "landmark study" you might ask?  They fed mice lard and then tested, and only the ones which were fat, had the "markers" for cancer.  Huh?  Are people supposed to believe this would apply to humans? 

Although we might have our suspicions about some humans, I can safely say we are NOT mice and a mouse GI tract barely resembles a human GI tract, if at all, and also, the mice which got fat, didn't get cancer -they only "had the markers" for cancer which means they might or might not get cancer by the time their short lives are ended.

If that's not questionable enough, try the the following study - the headline on this was about how Weight Loss surgery "cures" diabetes.  This study was on humans however, among those who had had a gastric bypass (which forces starvation for the first couple of years - starvation will always bring blood sugar levels down), barely more than 1/3 of the patients saw a remission, even in the first three years after surgery.

I wouldn't call those results impressive, especially considering that gastric bypass is so invasive.  Among patients who had the sleeve gastrectomy, the popular "surgery du jour" which only reduces the stomach (to the size of a thumb and about twice as long as a thumb), only 25% experienced a remission of their diabetes in the first three years.  Keeping in mind that without a stomach, digestion of fats and proteins is basically, not happening and patients must for the rest of their lives, consume protein drinks which are expensive, not paid by insurance and not good tasting to avoid protein deficiency diseases which have not been seen since the 1800's... they should also take B12 shots at least once a week since a greatly reduced stomach likely no longer digests vitamin B12 which can cause many and varied problems.... this doesn't seem worth the expense and pain of surgery for the small number of remissions of diabetes early on.

In a buyer, seller's society, consumers must be careful of what they buy -to avoid the myths seen on TV etc - and sadly, for post ops who experience one of the many complications, there is little available to support them.

Definitely, "buyer beware!" or...
  If it's too good to be true, it probably isn't...

The Demise of a Great Blog

One of the most honest blogs on WLS (this patient sustained a seizure disorder after her gastric bypass and found 150 other patients who had suffered the same) is apparently closing shop. 

I know the blogger had gotten a lot of pressure from those who wish to cheer-lead the surgery because she had mentioned that several times but it mostly, seems that the more involved she became with providers, the less she seemed to want to blog candidly about what she experienced on the negative side of WLS.  Providers started asking her to speak at their booths, and paid for her trips to conventions... when that started happening, I wondered how long her candid blog would continue - it's difficult - next to impossible, to refuse those types of perks, especially for a young mother whose disability (epilepsy after WLS) kept her from working and that's exactly how those who have had a difficult time with the surgery tend to be silenced - that or settling lawsuits out of court in exchange for the patient's silence about the repercussions from their WLS surgeries. 

I've stuck in so long (since 1999) because I have not had WLS and thus there is nothing they can really offer me to shut up (although I know my name is not spoken with love in many WLS circles).  One patient, Trish Hargis (RIP) called it the "conspiracy of silence". Trish courageously got on "Obesity-help"  which is financed by the WLS industry, as well as wls_uncensored listserve, and talked plainly about what she had experienced but unfortunately, her WLS contributed to her early demise at the age of 54.  I see so many folks go into weight loss surgery without knowing that, at best, with a lot of work on a daily basis and blood work every 6 months etc, the WLS surgery can only offer them a 2% greater chance of keeping their weight off than going at it with a non surgical program like Weight Watchers (Mayo Clinic study early 2000's for one - Swedish Obesity study for another). 

Sorry to see that blog go - it was a good one....

Another one lost

One of the most difficult things with being involved with weight loss surgery patients is when one observes people passing on, way too early.  A couple of years ago, I lost my bestest friend ever (pictured above) - she was a VBG patient which is a stomach stapling only - the surgery worked for her for about 12 years (with a lot of hard work on her part) and then, she got very ill with fibro and lots of other things to the point where in her early 50's, she not only gained weight very easily, eating very little food, but was basically bedfast.  She was a highly intelligent lady and her courage was amazing. She would boldly post about WLS, warning people despite getting numerous "nastigrams" in the mail. We chatted on the phone daily and shared everything with each other.  Then one day her husband called, distraught.  He had come home to find her deceased.  At the age of 54.

I don't understand why folks write nasty emails to people who try to present a realistic view of WLS.  Basically,  it seems, that pre-ops who want to believe the dream and new post ops who have lost a lot of weight and are thrilled at this, seem to feel that people should post nothing negative about WLS least a person might be "denied" this "life saving" surgery. 

Trouble is, in all these years, I've not seen it save any lives - on the contrary.  Cash cow, definitely.. and one WLS surgeon told me laughingly, "I bury my mistakes!"  It's true that dead people don't talk.

Lately, another patient has died, probably earlier than would have, had they not had WLS.  This patient had had the duodenal switch which is a surgery which calls for cutting away 90 percent of the stomach and bypassing most of the small bowel.  They lose weight well but in the long run, it's almost impossible to replace the nutritional deficiencies.  Less than 25% of the surgeons in the USA do the duodenal switch as there are safer procedures available but they don't want to openly diss it either, even if they have stopped doing the procedure because they are worried about lawsuits (and many surgeons have multiple lawsuits pending).

This patient was 57 or 58 years old and had their surgery in year 1999 or 2000 - was very pro surgery and very much angry that I dared to say anything against it.  Was a young person with their life ahead of them and now they are gone like so many other of my WLS friends, died from lack of nutrition, it is thought.

The truth about any WLS is not only do people have to do the same things that non surgical people do to keep off the weight but also, they have to have regular checkups and take a lot of expensive supplements, in other words, work very very hard to keep off the weight, and even then, they might not have a good prognosis.

I have a cousin whose BMI is over 75 - she is 77 years old and going strong.  Had she had WLS, she probably would not have lived to that age.

It's ironic that in this day of super communications, things which should be  communicated, somehow may not be. In other words, if it's too good to be true, it probably isn't.  There is no easy way out and certainly not having surgery to lose weight!

Weight Loss surgery stories or -- ads?

The latest news on Weight Loss surgery reminds us that the media openly admits they don't feel obligated to tell the truth. And often when they report on weight loss surgery, they do sneaky ads.  Weight loss surgery of any kind doesn't really help patients to keep off the weight.  After they have invasive surgery to lose weight, they are told that if they don't diet and exercise, they will not keep off the weight.  But diet and exercise will keep off weight whether someone has had surgery or not.  Medical providers do not give the public "informed consent" for medical procedures.  "If we did tell the public about repercussions," a medical provider friend told me, "they wouldn't have any procedures done!"  As if this is a valid reason for not warning folks what might happen and especially after elective procedures like weight loss surgery.


 Lately in the media, we find a questionable study and a story which emphasizes how a couple keeps off weight - one of them who had a gastric bypass and the other who did it without surgery.

The study looked at se/x after weight loss surgery and declared that it's better after weight loss surgery.  Anyone who knows a significant number of weight loss surgery patients like I do, will ask, "how can this be when erectile dysfunction is very common and especially after gastric bypass?"  Easy answer - the researchers studied women - no men!  The women studied were a couple of years post op - and it was a study in which the cohort were surveyed 1 and 2 years after surgery and reported more reproductive hormones and better se/x!

First of all, the study was financed by Ethicon Endo which makes instruments for weight loss surgery - can we say "conflict of interests"?  Secondly no men were studied - had they looked at men, they would have found a different story, especially longer term like over 3 years.  The news story sounds like weight loss surgery is a great deal, but the truth is more sobering - since men were not studied, the fact that many men get ED after weight loss surgery stays unreported (unless you read the long term weight loss surgery communities).  It should be noted that many patients who regain after weight loss surgeries are encouraged to not attend support meetings and not tell those around them that they have had weight loss surgery. Meanwhile many surgeons parade the slim 2 year post ops at support meetings, giving the impression that "everyone" keeps the weight off.  One longer term post op who cannot eat more than 1200 calories a day without gaining, also came down with epilepsy after a gastric bypass and found 150 more patients with the same repercussion - this patient is considering having brain surgery rather than having the gastric bypass reversed, despite the fact that the seizures are likely from vitamin deficiencies which would be fixed with a reversal.

As for the weight loss story, in a story entitled "No Magic Bullet for keeping off the pounds", a couple, both of whom lost a lot of weight, are interviewed.  The man lost weight without surgery and the story emphasizes how he is having a hard time keeping off the weight.  The lady had a gastric bypass and we are told she's kept her weight at 160 lbs for 3 years.  In this story, if the reader looks at the photos, s/he will see that even with a slight weight gain, the man is not only slimmer than the lady but he is in better shape also.  But if the story is read superficially, the take-away message is that people have a much easier time keeping off the weight with weight loss surgery.  

In  other words,  the story hints that weight loss surgery is "the easy way out".  Any weight loss surgery patient will tell you it's definitely not the easy way out and many patients have regained at the 10 years post op point - even with extremely invasive surgeries like gastric bypasses.  This is a reality which may never get to the public if they confine their reading to news media. 

 I am reminded of the patient who called me up, crying, after her gastric bypass.  "They never told me about the side effects," she told me also adding that her surgeon no longer answered her calls.  And for patients who do keep off the weight, how many of them can no longer eat?

Should it really be "buyer beware" when we are talking about surgery after which 2 percent of patients die and 30 percent have serious repercussions including requiring additional surgery?