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.

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.

Does Obesity really cause brain damage?

Obesity might cause inflammation in the brain, shouts out the latest headliner coming out of the NPR News.

According to the NPR article:

...some provocative research suggests that a part of the problem might be that obesity could change the area of the brain that helps control appetite and body weight.

The study was published in the Journal of Clinical Investigation and since my trust of media reporting on studies is about zero, I decided to look up the original study to see what it really found.

Not surprising, the study report article differed completely from the news article.

In this study, the researchers found that when rats were fed a diet high in fatty foods, even before they became overweight, there was evidence of inflammation in the rat hypothalamus gland, a gland in the brain which is thought to regulate body temperature and metabolism.

The scientists wondered whether humans reacted similarly, so they MRI-ed the brains of 34 humans and found more evidence of damage to the hypothalamus in the 12 humans who were obese than in those humans of normal weight.

Michael Schwartz, one of the researchers on this rat study was very shocked at the results, he told NPR. Schwartz is the head of the Obesity and Diabetes Center of Excellence at the UW School of Medicine.

I do see some possible issues in the study such as, can it be assumed that normal weight humans did not consume as much fatty food as obese humans?

But unlike the media, the scientists commented that this damage may be a factor in developing obesity and not that obesity caused damage as the NPR article stated. The scientists named their article, "Obesity is associated with hypothalamic damage". The media in their typical fashion of misreporting, headlined their article "Could Obesity Change the brain?".

Actually, I am not surprised that the hypothalamus glands of some overweight people might be damaged but of course, the study never stated that the obesity proceeded the damage - either in the rat study or in the human study.

Interestingly, this study may dovetail another recent study which found that a rather alarming percentage of people developed obesity after their tonsillectomies (which may be due to hypothalamic damage). The scientists in that study stated they did not know what caused this but suggested it might be that swollen tonsils caused difficulty in swallowing before they were surgically removed. I was one of those who packed on the pounds after my tonsillectomy and no, I had no difficulty in swallowing before that surgery! I also was very active, spending most of the day, running around, riding my bicycle etc. However, I was more hungry after my tonsillectomy which could be the effects of a damaged hypothalamus.

The study at the UW seems a landmark study, the first which suggests that damage to the hypothalamus might be a factor in obesity, which is a pretty shocking result as Dr Schwartz suggested however, with the media misreporting the study to something totally different, the public may never know what the real study found!

Obviously, the rat brain is quite different from the human brain. And the scientists admitted they cannot really generalize from how the rats reacted, that humans would react in the same manner but they did suggest more research along this line would be appropriate.

As an aside, it would be nice if, for once, the media would consider accurately reporting about the scientific research instead of totally changing what the study was even about. (the photo is of the Olympic weight lifter and medalist, Cheryl Haworth)

All he did to lose weight was eat less and move more?

An article on CNN covers the weight loss of a man who went (they claim) from almost 500 lbs to "one-der-land". The man, Matt Hoover (who ironically is a namesake of one of the Biggest Loser Contestants of the 2005 season), told CNN his weight loss journey lasted 3 years. Most of the article is detailing "how terrible he looked" as a person of size and the usual. Finally a couple of sentences way down in the article tells how he lost the weight.

Predictably, he "ate less and moved more" that is, the article states:

He ate smaller portions and took daily walks. The first 120 pounds came off.

And in case we didn't understand how the weight melted off when he "just got off the couch", he's quoted:

"When you're that big, you can lose weight pretty quickly," he said.

The article goes on to say that Matt plateaued out at 150 lbs over his goal weight and then, joined Weight Watchers and "lost the rest of the weight"

According to this article, Matt had no health problems (or I'm sure they would have mentioned them) and it was all how "bad he looked" which motivated him.

Hey, if a person wants to lose weight (or not lose weight) that's fine - our bodies are ours to do with them what we want.

What I found very objectionable in this article was the following:

1. The article implies that the only reason Matt got up to 470 lbs was because he ate too much and moved too little in other words, "he sat on the couch, eating bons bons all day so no wonder he was so fat", and this idea is I think, what CNN wants to convey to the readers. But the reality about obesity is that according to Dr Rudy Leibel and the scientists who study this stuff, size is mostly genetic.

2. The article gives the impression that once Matt started eating as a "normal person" i.e. not totally overstuffing himself while sitting on the couch, the weight just "dropped off". And that is so not true! For a person who is genetically/physically obese to lose weight and keep it off takes daily vigilance almost to an obsessive level.

To expand on the second point, while the article implied that Matt just had to "get off the couch" (they never did detail what his exercise program consisted of however), ordinary exercise does not keep off any weight if you've got a certain set of genetics - I can personally attest to that one!.

For example, the Matt Hoover from the "BIGGEST LOSER" (not the same guy as in this story, I'm pretty sure) is described in one article as exercising 25 hours a week (he did regain some, it says from his "Biggest Loser" season but is determined to get it off):

Hoover spends 25 hours a week training for the grueling triathlon, which consists of a 2.4-mile open-water swim, a 112-mile bike ride and a marathon 26.2-mile run.

In my research I have found that societies in which there is no obesity, typically move 25-40 hours a week and eat about 1200-1400 calories a day.

Now that's a lot more than just "getting off the couch" and "eating smaller portions".

This type of article is falsely misleading. To the person of size who thinks that they can exercise an hour or so a day and eat a bit less and the weight will drop off, they will be very disappointed when they can actually gain weight eating normal amounts of food even if they do exercise. (How well I know about that one!)

And for those 85% of society who do not have to fight clinical obesity, articles like this just fuel the flames perpetuating the falsehood that shaming people of size is actually "good for them" because they might get motivated to "eat less and more more" and the "weight will drop off", as it did with Matt Hoover who is not the Biggest Loser contestant in this article.

I know people of size who have awesome achievements, careerwise and life-wise and even are very good looking, and yet, feel themselves failures because even though they already "eat less and move more" the weight just doesn't fall off them like it does on people in the newspaper or on TV. These feelings brought on by articles like this CNN article, filled with falsehoods and misleading statements, can lead people to drastic measures including unhealthy diets or even surgery to cripple their digestive system (what Dr Fobi, WLS surgeon calls the gastric bypass) or worse.

In a world which needs more love, isn't it time we enjoy people for who they are and just accept that in a country like ours where food is in easy access, people are going to come in all sizes and so what? What if we were all the same size - it would be pretty boring! (look at manikins for example). :)

Note: the photo included with this blog is Olympic athlete, Cheryl Haworth who won an Olympic medal in Weight Lifting. Like all elite athletes, she trains hard for several hours a day and watches what she eats. She also weighs over 300 lbs. People do come in all sizes and just because someone is a person of size, doesn't mean they lie on the couch all day, eating bons bons.

Like one of the TV reality show stars quipped when someone called him on a misrepresentation in a so called "reality show".

Well, you cannot believe everything you see on TV!

Push for weight loss surgery even if you have a lower BMI follows study about obesity

A new study of 1.5 million people suggests that obesity, even overweight, shortens your lifespan. So says the study - obese people are 44% more likely to die earlier than those in the so called ideal BMI range.

The findings and size of the new study, which was conducted by researchers at the National Cancer Institute and published in the New England Journal of Medicine, should settle the debate over the relationship between excess weight and the risk of early death

So says Ali Mokdad, Ph.D., a professor of global health at the University of Washington, in Seattle.

According to one report on a local TV station:

The latest research was launched after a controversial 2005 study by the Centers for Disease Control and Prevention that concluded being overweight didn't raise the risk of death; that report included smokers and those with pre-existing illnesses.

The CDC study was actually a re-examining of existent data and an admission that the wrong conclusions had been drawn. It was only controversial among those advocating diets!

In 2005, the CDC reassessed their data, stated one news article in the Seattle Times, and found that 112,000 people (not 300,000 people) had died from obesity related diseases however, they also added that since people with BMIs in the overweight zone (BMI 25-29) live longer than those in the "normal ranges", one had to subtract 86,000 from the 112,000 and that leaves 26,000 people who die from obesity related disease... less than who die from gunshot accidents!

The new study doesn't settle anything because it made the same mistake pointed out by Dr Stephen Blair, PhD, head of the Cooper Institute.

Seems the folks at the Cooper Institute took 30,000 people and found when they added exercise habits to the equation, that fat people who exercise regularly had no greater risk of sickness or death than slim people who exercise - and people who do not exercise regularly, had the same risk, regardless of size - about 44% greater than the exercisers.

I'm sure the pundits are banking on the fact that the public either has a short memory or else, hasn't seen the Cooper Institute studies.

However, some reports on the new study included the remarks of the lead researcher on the Cooper Institute studies, Stephen Blair, PhD:

University of South Carolina obesity researcher Steven Blair said the results were consistent with other studies and the "massive effort" was commendable. But he said there wasn't enough information available about fitness level or physical activity. A proponent of the "fit and fat" theory, Blair said his research has shown that obese people who are tested and deemed fit did not face increased risks of dying.

"If we want to get to the bottom of the health hazards of overweight and obesity, we have to have better data on physical activity," Blair said. "Until we do that, there's uncertainty of how important BMI is as an important predictor of mortality."

Seemingly coincidental to the release of this new study which looks impressive to the unquestioning eye of the public, the Allergan company has petitioned the FDA to lower the weight limit for obtaining the lap band obesity surgery. Right now, only people who are at a BMI of 40 or higher, or 35 with co-morbidities can have their insurance pay for a lap band. Allergan would like to see that minimum weight lowered to a BMI of 35 or 30 with co-morbidities.

Even CNN remarked on the fact that the head of the FDA committee petitioned to lower this weight requirement, owns stock in the Allergan Company! Not only did she not recuse herself (which she should have done!) but the FDA voted that it was "OK" for her to be on this committee as long as she didn't vote!

The lap band is a much safer surgery than the gastric bypass. It's a band placed around the top of the stomach which can be tightened or loosened and is supposed to limit how much a person can eat and thus cause a weight loss. Of course, what it limits (when it's not swollen i.e. some band patients complain of their stomach swelling shut in the morning) are the good bulky foods like veggies. Milkshakes, ice cream and cake go down beautifully. Although unlike the gastric bypass which is greatly troubled by long term vitamin deficiencies in many patients, the lap band is not without its own set of repercussions. A certain percentage of patients experience the band growing into the stomach, thus requiring removal and/or a gastrectomy. Mostly what I hear lap band patients complain about is discomfort and difficulty in keeping off the weight. The difficulty in keeping off the weight complaint, one hears from gastric bypass patients also.

What science really says is, if you cannot keep off the weight, it's healthier to not lose it in the first place as "weight cycling" or "yo yo dieting" raises the risks for heart attacks significantly.

About 5% of the public born with the obesity gene (according to obesity researcher, Rudy Leibel, size is 40-60% genetically determined) can lose and keep off the weight (7% with weight loss surgery according to the Hebrew U Study for one).

For the rest, it is strongly recommended that they consider following the "Health at Every Size" guidelines - Linda Bacon's book on this is excellent!

A clinical study at USC found that those following the Health at Every Size, guidelines without a focus on weight loss - ended up healthier than those who dieted - this study is highly respected and the cohort was followed for two years. Linda Bacon was one of the researchers and the other researcher was Julie Stern who is a member of the Weight Watchers scientific committee. Undoubtedly, Stern is not opposed to dieting and yet confirmed the results of this study which headlined "Non-dieters more successful at boosting health than dieters, study finds".

Isn't it time to "stop the insanity" and focus on real health which is determined by healthy food choices about 80% of the time and regular aerobic exercise?

Weight Loss surgery safer than being fat?

Is Weight Loss surgery really, safer than being fat? That's the conclusion of a Weight Loss surgery surgeon from Baylor, at least.

In a video on the ABC website from "Good Morning America" this surgeon who is head of the Baylor Weight Loss surgery unit, does give that impression. In the video, he not only advocates ALL WLS for not only clinically obese, but also for "lower weights" i.e. for people with a BMI of 30 and over. While not openly misrepresenting, one could easily get the wrong impression of WLS from this video.

For example:

When asked about the risks, he brushed the question off with a "it depends" and changed the subject. Later he focused on the difference between having open surgery and lap surgery, giving the impression that that's the only concern about weight loss surgery which is so not true.

He also, said the surgeries done today are less risky than done 10 years ago. That's true but only of the lap band. The RNY - gastric bypass is basically the same risk (it hasn't changed). And today's RNY with transsection of the stomach, may actually be more risky than the older loop gastricbypass which left a larger pouch and did not cut the stomach into two pieces.

It makes a difference which procedure is done - the death risk with the lap band is 1 in 5000 or less. (One study in Australia found no deaths in 10,000 patients). The death risk with the gastric bypass is 2% within 30 days of procedure and 4-9% within the first year (According to the David Flum studies of 62,000 patient records)

They have no data as to weight maintenance over 10 years post op (1 study of 100 patients went 12-15 years post op) but that 10 year post op data they have suggests that most patients after gastric bypass have an average BMI of 35 and that was the same with all procedures. In the small study of 12-15 year post op gastric bypass patients, 68% suffered involuntary vomiting, 68% had suffered a plugged stoma so it was not complication free at all.

Many are frightened into surgery by thinking they are under less risk having surgery than remaining fat however, there is no evidence that this is true.

Even the release form for gastric bypass (which is given to prospective patients so it's not "anti WLS") warns about this:

****Keep In Mind: Slender individuals have adult diabetes. Slender individuals have heart attacks. Slender individuals develop arthritis and have joint problems. Slender individuals have strokes and develop cancer. If obese individuals have these problems more commonly than the slender, it is because the same bad health habits just don't happen to cause obesity in some individuals "fortunate" enough to be slender no matter what they eat. They may be slender but they could very likely die just as early in life as someone who is overweight.****

Kaiser Permanante Release form

(I know many slim people who have type II diabetes)

One doctor interviewed for "Self Magazine" stated:

*** "Because it's risky, it's only appropriate for a tiny fraction of people with obesity—the sickest 1 to 2 percent. The idea that all obese people should get [WLS] surgery is insane."
Lee Kaplan, M.D., director of the Massachusetts General Hospital Weight Center in Boston in "Self MAGAZINE: 'The Miracle Weight Loss that isn't' AUG 2008 ***

I am reminded of a quote from one of the patients featured on the show about weight loss surgery, "Big Medicine" (which disappeared rather suddenly from the scene and so far has not gone into re-runs). The show filmed him being sent home and them bringing a gurney which was too small etc etc. He later wrote that this was all staged and he had never been sent home from the hospital (I think the idea of this drama was to emphasize how insurance sometimes did not pay for WLS). When people on the forum expressed surprise that a so called reality show had staged a scene, he wrote back "Well, you don't believe everything you see on TV, do you?"

Especially when it comes to risky surgery, prospective patients are encouraged to research the studies or to consult a gastroenterologist first... (someone who does not stand to profit by a decision in favor of surgery).

Biggest loser premier shows lowest rating ever

An article on the Philly burbs tells how the show, "The Biggest Loser" suffered a significant loss in the ratings - 25% down. The article asks in the conclusion, "is it because Americans are tired of being reminded how obese they are?"

No, I don't think that's it at all. I think it's because of those former contestants who have spoken out about the sadistic methods of training used in the show, the long hours of workouts and the psychological abuse contestants get. The last one to "sing" who said she got an eating disorder after being on the ranch, might have signed the death nell for the show.

That and the fact that Ryan Benson, the winner of the first season has admitted he's regained to a higher weight than his original weight (not withstanding his open admission on his "myspace website" about how he clinched his win using techniques of dehydration he learned, back in his days as a High School wrestler - and how he gained 30 lbs the week after the big win).

Or maybe it was Erik Chopin appearing on the Oprah Show, almost back to his original weight. The Biggest Loser tried to do damage control by having trainer Bob, visit Erik and Erik admitting it was just all his fault. Bob extracted a promise from Erik to be back to a better weight by the finale but that never materialized. Maybe some of the viewers were looking for that event and didn't "forget about it" as the show producers likely hoped.

Perhaps it was the couple who appeared on Carnie's quiz show who got married but both admitted quite a bit of regain.

Or the contestant who told the press that the week before the finale, she had lived on diet jello all week.

There is also, a growing number of personal trainers who are very much against the way the "loser" contestants are treated by Jillian and Bob - they say it gives folks the wrong idea about personal training in general. And there have been articles in industry magazines which were critical of the personal training on the show. Likely some of this filtered down to their clients.

The show has received enough "bad publicity" to spoil the magic image of the weight somehow magically falling off the contestants.

Everyone knows if you starve and work out many hours a day, you will lose weight but that isn't even healthy, and rapid re-gain is likely. No magic in that at all. On the contrary...

gastric sleeve story

If you look at this blog, you will see the glowing report from a new op on the gastric sleeve. She didn't want the gastric bypass (admits she was 'barely qualified' for WLS by US standards) because she felt it was "too drastic". But although things are rearranged in the gastric bypass, nothing is taken out of the body.

Not true of the sleeve - this drastic surgery calls for the removal of 90 percent or more of the stomach, creating a Frankensteinian pouch which holds only a couple of ounces of food.

The new op goes on to credit her normal weight to the sleeve and the reduction of ghrelin in her blood not realizing that her lack of hunger now, is simply that her stomach is going through a healing process. Human appetite is NOT controlled by one hormone, scientists will tell us and I would ask, how many people are fat because they only eat when hungry anyway?

That ghrelin has anything to do with appetite is merely a theory however, there is a body of evidence suggesting that those with less ghrelin in the system also have less growth hormone and this can cause premature aging. That, they don't tell you in WLS seminars.

Back to the new op, she runs a couple of hours a day and has done a triathlon or two. Since she is working out like those on the "Biggest Loser" she has lost weight like they do. But when she's all healed and finds her lack of a stomach to be more of a liability than an asset, like when eating healthy food like veggies with bulk is difficult which makes many tend toward foods which go down more comfortably like milkshakes, then she will likely leave her glowing testimonials up and not warn newbies of the other side of the story which she has regrettably discovered - all too late.

Some of us call this the "conspiracy of silence", the lack of negative information about weight loss surgery which leads 200,000 people a year to get cut without really knowing what the repercussions might be.

Sadly, the sleeve is viewed as less invasive than the gastric bypass and this is so not true. Since most folks know someone who has had a gastric bypass with a bad result (the least of which was regain), many are now choosing the new guy on the block, the sleeve, as the weight loss surgery panacea.

Still looking for the easy way out. But like the perfect solution, the easy way out doesn't exist and grabbing of something which is being sold like used cars, might make things a lot worse.

CAVEAT EMPTOR.

Remember even the surgeons admit, and most older op WLS patients will tell you that....

"Success with weight loss surgery is 10 percent the surgery, 90 percent the patient" (Dr Terry Simpson, MD and WLS surgeon)

New study obese children more likely to die earlier

An article in the news recently, shouted that being obese as a child doubled the risk of premature death (i.e. death before the age of 55).

This was based on a study appearing in the New England Journal of Medicine in the Feb 10, 2010 issue and is online as the full text version, accessible without a subscription.

The news reporting on this study ranged from total misreporting -one source gave the deaths which "counted" as 559 deaths - cohort was 4857 people born from 1945 to 1984 - other sources were more accurate about the 166 deaths in the cohort which "counted". The cohort came from the Gila River Reservation in Arizona.

However, for some reason, (I could speculate on this but I won't) the researchers included deaths from alcholism/drug use and infectious disease in the deaths from which they figured that those who were obese as kids were two times likely to die prematurely of.

The breakdown on the causes of death in the 166 who died prematurely, (which is still a low number) out of the 4857 member cohort was as follows - according to the study article:

A total of 166 deaths were from endogenous causes: 59 were attributed to alcoholic liver disease, 22 to cardiovascular disease, 21 to infections, 12 to cancer, 10 to diabetes or diabetic nephropathy, 9 to acute alcoholic poisoning or drug overdose, and 33 to other causes

Several things should be taken in consideration here. The deaths from those causes which may have an obesity factor in them is only 44 individuals out of the 4857 member cohort i.e. diabetes, cancer and cardiovascular disease. Infections, alcholism, drug poisoning and "other" have no established relationship to obesity at all.

So as you can see, two times as many in a small group like 44 is not very many. And in fact, had they considered, for example, which of the 44 rode bicycles as kids, they might have found a highly significant relationship between early bicycle riding and premature death!

I am always reminded of something Science News editor Stephen Milloy quipped some time ago:

"But who needs data when you can spoon-feed junk science to a gullible media?"

Postscript: 166 premature deaths out of 4857 individuals may be a lower figure than in those who do not live on the (Native American) reservation which might suggest that reservation living might be less stressful than living elsewhere (something I've long suspected since working in a Pima Indian mission several years ago).

Also, anecdotally, I've known several who died premature deaths but none of these were obese - several were smokers however (including my own slim father who died several years before my obese mother and mother's death was a suicide). My husband's cousin was married to a person who had no risk factors at all not even smoking i.e. he ate healthy, exercised daily and was very lean. 15 years younger than she is, he died several years ago, a premature death (heart attack). She who has a high BMI, just celebrated her 74th birthday.

Obesity causes cancer - more "BIG FAT LIES"!

A radio show from the BBC recently featured a metastudy which concluded that obesity "causes" cancer. The researchers opined that 100,000 cases a year can be linked to obesity. According to the Washington Post:

This study, from scientists at the University of Manchester, analyzed 141 articles involving 282,137 cancer cases and 20 different types of malignancies to determine the cancer risk associated with a 5 kilogram-per-meter-squared increase in BMI, roughly the increase that would bump a person from middle-normal weight into overweight.

141 articles isn't that many of course, not withstanding that they can pick and choose which articles to include and also, probably did not have a real accurate measure of BMI from the studies anyway.

It should be noted that over 1.6 million new cases of cancer are diagnosed in the USA every year, so even if their figures were correct that would only be 6 percent of cancers (according to WEBMD.COM) which can be linked to obesity - 94 percent of which can NOT be linked to obesity. The researchers on the program admitted that lifestyle factors like sedentary lifestyle and poor food choices were a player and briefly mentioned "the link between tobacco and cancer" but did not give any figures.

WebMD states that these figures linking obesity and cancer, were "estimated" from existent data (what the junkfoodscience.blogspot.com calls a "data dredge" study.).

So how does excess fat "cause" cancer? The researchers didn't have an answer for that but opined that fat tissue, produces estrogen. What they didn't tell us is that fat tissue produces the type of estrogen our bodies can use but when we flood our bodies with synthetic pharmaceutical estrogen, this raises the risk of breast cancer FAR MORE than 6 percent.

For example the HERS study on 11,000 women, a double blind study found a 26 percent higher incidence of breast cancer in those in the cohort, on low dose birth control medications. 26 percent OBSERVED in a double blind study which was stopped midterm. Not a tiny 6 percent from "estimated" figures.

Synthetic estrogen was put on the FDA list of carcinogens in 2005.

Finally, it should also be noted that researcher, Dr. Glen Gaesser stated in his book, "BIG FAT LIES" (CA, 2002) that he found in his metastudy of all the obesity research in the previous 20 years, that obese people seemed to get cancer significantly LESS often than non obese people. 40 percent less cancer in the obese, than normal weight people, concluded Gaesser.

Dr Linda Bacon, respected scientist and author of "HEALTH AT EVERY SIZE", was also on the BBC program and started to directly refute the findings with cited studies. As soon as they found she could do this, she was rudely interrupted (twice!). Before they cut her off, she pointed out that for example in a group of 23 studies, only 4 had suggested a significant link between obesity and cancer so she asked how these researchers could conclude from a small percentage like that, that obesity "causes" cancer. They evaded her question, of course.

I wrote the BBC a comment accusing them of dishonesty in news reporting and challenged them to have Dr Bacon on again to tell the REALITY of what the studies on obesity and cancer REALLY show. Perhaps some of you might want to do same.

Until we demand more honesty out of the news services, we won't get it. Fat activist Marilyn Wann was on the same program. Here's the link:

BBC radio program on the so-called "obesity link" to cancer

answering rebuttal to gastric bypass post

The following is to answer a comment - this was in two parts and had a lot of quotes in it so would be hard to read and brings up some points which I have answered (and so has Junkfoodscience blog answered) in other blogs but should be answered again to clarify things :

Mikalra who wrote the comment states he/she has no interest in the bariatric industry but since he/she does not identify him/herself I have no way of verifying this. Mikalra (M:) writes:

A study of 10 year post op gastric bypass patients found that 34 percent of those who started with BMI 50 or over, had regained all or most of their weight.
The abstract is here: "The failure rate when all patients are followed for at least 10 years was 20.4% for morbidly obese patients and 34.9% for super obese patients" -- which means, of course, that ~80% of morbidly obese and ~65% of superobese patients were successful.

No that doesn't mean this at all. And they do not define "success". FYI, success with bariatric surgery means keeping off 50 percent of the originally lost weight which still leaves many patients severely or morbidly obese (this is 50 lbs kept off for most patients), but as the Swedish Obesity Study found at the 10 year post op point, patients only tended to keep off an average of 16 percent of the original bodyweight and were, in fact, still High BMI. SOURCE: New England Journal of Medicine: Volume 351:2683-2693 December 23, 2004 Number 26 Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery Lars Sjostrom, M.D., Ph.D et al


Secondly, the 35 percent was for BMI 50 which is the average BMI at which folks get a gastric bypass. Exactly why this study concerned the ASBS and they approved some revision procedures (which later turned out to be unsuccessful and temporary and painful i.e. the -through the mouth- stomaphyx and rose procedures)

Third, success is also staying healthy and estimates of acquired co-morbidities from gastric bypass have ranged from 20 percent in the 5 year duration Mayo Clinic study in 2003 to 40 percent in Dr Livingston's study of 800 of his own patients over a 10 year period post op, and can include epilepsy, reactive hyperglycemia and islet cell death, gastroparesis, osteoporosis and auto immune disorder.

As Dr Terry Simpson has stated:

***The RNY trades one disease for another: it trades obesity for malabsorption. By re-arranging your guts you sometimes have severe side effects, and can have long-term problems such as iron deficiency anemia, calcium deficiency leading to osteoporosis. (Dr Terry Simpson, MD, WLS surgeon)

The other study you quoted "long term mortality after gastric bypass" is not an accurate one for many reasons (epidemiological, not randomized etc) and also compared gastric bypass patients against fat people as obtained from driver's license weights only most fat people very much under state their weight on the drivers license so matching weights this way, one is going to be comparing the patients actual start weight with much HIGHER BMI people. Finally, if I remember correctly, the study mostly just followed for 7 years and did NOT take in consideration the 5-9 percent who die within a year of surgery (started following 1-2 years after surgery). I have written about this study in another blog - you may want to look that up.

And no we do NOT have "several" longevity studies on gastric bypass - we only have a couple which you have mostly managed to obtain and those are not real accurate.

Mikalra further wrote:

So yes, there were certainly some risks from gastric bypass, as with any medical procedure -- but overall, it's clear, the health benefits to these very obese patients outweighed the risk.

This is NOT clear at all and why many surgeons are advocating the lap band now which is a much less risky procedure which delivers the same weight loss retention benefits.

Mikalra further wrote:

Moreover, this study included people who had undergone surgery as much as 25 years ago, when the technique was much more experimental; it's reasonable to think that both the techniques, and any counseling or warning signs that need to be followed for optimal patient safety, will have improved by now.

The gastric bypass has not basically changed at all except now they are cutting the stomach into two pieces so it's much harder to reverse than the ones done 25 years ago were. Also 25 years ago, less of the stomach was bypassed which made it a bit safer than now. As Dr Ernsberger has pointed out:

"All of the operations, old and new, are based on an incorrect assumption: that the stomach is no more than a passive sac for receiving food. In fact, it is a critical digestive organ and cannot be cut away or bypassed without compromising the digestive process."

Paul Ernsberger, PhD, Department of Nutrition,
Case Western Reserve School of Medicine, 10900 Euclid Ave., Cleveland, OH 44106-4906

Mikalra concluded:

I am personally very concerned about the obesity epidemic. I would like to see a lot more of this epidemic controlled through support for healthy lifestyles in children, but for patients who have already become obese, this is clearly an option that should be seriously considered, based on personal values and risk factor profile, as it provides very substantial health benefits for most very obese patients.

First of all, news flash, "controlling children's diet" doesn't work. No matter HOW you do it. We know that putting kids on a regular diet does nothing more than injure their metabolism, making them more likely to get fatter when adults. It also injures their self images. But even a less invasive approach such as a friend of mine used... not having things like candy, potato chips et al around, building exercise in their son's daily life and limiting high fat foods does not work. In the case I am thinking of, this individual who kept reasonably slim during his childhood years, as soon as he left home, starting eating all the foods his family never had around and has been clinically obese for the last 20 years or more (he's 40 now).

Secondly, if the gastric bypass introduces NEW comorbidities, what good is it? Are those comorbidities lesser than what they experienced as being fat? In the opinion of several patients I know, they felt healthier BEFORE their gastric bypass than now.

And if the suicide rate among gastric bypass patients is 58 percent greater than among fat people, we must question whether the after surgery quality of life is all that good.

You watch the ads. I see the other side. Countless people who write to me, alone and isolated in their homes, underweight, living in fear or many more, very overweight but also very ill. You cannot make a judgment however well meaning you are, about this surgery until you have seen the entire story.

One super sized friend of mine (over 500 lbs) who is in her 50's (and her slim husband is the one who has had heart problems by the way- not her) has told me that she has OUTLIVED 48 of her fat friends who had weight loss surgery.

Here is just one poem which expresses the pain that some long term patients feel, the pain which never gets to TV or the ads:

(reprinted with permission of the patient)

Sent: Wednesday, August 21, 2002 3:13 PM
Subject: if only...


> oh, sue, I just found your site re: RNY GBP
> if only...
> if only the tears would stop
> if only I knew then half of what i know now
> if only I knew how to turn back the clock
> if only I had not trusted so blindly
> if only I had my life and my love of life back
> if only doctors understood and respected the value of living vs. the lack of value in existing
> if only the effects of malnutrition and slowly starving to death were not so bizarre that people assume and treat me as if I were terrifyingly contagious
> if only I knew someone who could/would reverse, not merely modify, this hell in which I exist
> if only I could hide from that emaciated creature who peeks at me in such a terrified manner when I glance at her reflection
> if only I had not learned so much about medical "error" and the resulting retaliation from the medical world if you dare to whisper those words
> if only I didn't have to hide from the world out of shame and fear
> if only I didn't know so much about PTSD as I do now
> if only I could ever trust another medical care provider
> if only I didn't spend every moment wishing I could die or regretting I did not
> if only I knew how to protect others from the incompetent/unethical animal who did this to me
> if only
> if only
> if only

Fatter babies caused by estrogens in the air?

A recent Newsweek article opines that the chemicals in the air, namely the so called "phytoestrogens" may be causing today's babies to be more overweight than before.

They quote an impressive sounding statistic:

In 2006 scientists at the Harvard School of Public Health reported that the prevalence of obesity in infants under 6 months had risen 73 percent since 1980.

Pointing out that if more fast food and less exercise could explain the higher prevalence of adult obesity, it was more difficult to explain an increased incidence of obesity in a population (like babies) who don't attend movies, and don't eat fast food and were always "couch potatoes". Must be the chemicals in the air, concludes Newsweek...

I looked up the study - apparently the researcher, Matthew Gillman, MD, is also a pediatrician.

He never even mentioned chemicals in the air as a possible reason for fatter babies but rather concluded after studying "120,000 children younger than 6 years old at 14 Harvard Vanguard Medical Associates practices in eastern Massachusetts from 1980 through 2001" that solving the problem of increased baby weight might lie in:

"Avoiding smoking and excessive weight gain during pregnancy, preventing gestational diabetes, and promoting breastfeeding, all of which researchers have shown to be associated with reductions in childhood overweight."

(remember how a recent article blamed breastfeeding for _increased_ size in infants?)

While I understand that Newsweek must come up with eye catching stories almost on a daily basis which must be difficult, I think the public should realize that stories like this one are just that - eye catching - and not necessarily based on any good science.

One thing which struck me is the entire article is based on the "73 percent increase" in "infant obesity" however, is that really as impressive (or alarming) as it sounds? Probably not. For example, the study found that the incidence of overweight children had "jumped 59 percent" but then the actual numbers on overweight kids, were in 1980: 6.3 percent and in 2001: 10 percent. And this means that in 2001, 90 percent of the children were not overweight, even according to our inflated weight charts which have set the line for "overweight" to much less than it was in 1980.

Less than 3 percent more kids were found to be "overweight" in 2001, not exactly anywhere close to a significantly higher figure even with much more fast food and much less activity!

We should always be on the lookout for statistics which may sound alarming but in reality, are not.

Unfortunately I could not find the actual percentages of overweight babies but I suspect it's not that significantly higher either...

The Newsweek article goes on to cite a string of mouse and rat studies which seem to prove their "chemicals in the air = obesity" theory.

And all to the conclusion that we just might be innocent victims of weight gain, like the caged rats and mice (which also were very "under-exercised" and had a much greater exposure to food than their cousins in natural surroundings), and the fact that we burn 800 calories a day less than did our grandparents and that most of us are consuming high calorie fast foods several times a week, has nothing to do with our being somewhat larger than our grandparents. Nope, it's all the chemicals in the air!

(Forgetting of course, that the phyto-estrogens in the air have not particularly increased since the 1980's - on the contrary, with all the "green" hysteria, there are actually less pollutants like this in the air. I know, details, details... :)

While articles like this are entertaining reading (Americans love to be alarmed), we should not take them too seriously. All news media should carry a warning "for entertainment only - any resemblance to facts is purely coincidental"!

New Scientist Magazine and gastric bypass

In the Sept 2nd issue of the "New Scientist" Magazine, they have an article about gastric bypass.

The article presents the surgery in a very positive light, mentioning virtually no serious repercussions (like reactive hypoglycemia, epilepsy, B12 deficiency leading to pernicious anemia or iron deficiency anemia, ulcer, bowel obstruction etc), advocating it as a "cure" for diabetes as well as obesity:

Clearly these drastic procedures will cut your calorie intake, but here's the strange thing: the operation is much more successful than anyone could have expected. Even though they can't eat as much, people who have undergone surgery are not constantly ravenous, in stark contrast to those dieting through will power alone. It seems the gut normally secretes hormones that make us feel hungry or full, and bypass surgery ramps up production of the ones that make us feel full.

This article also includes long, pseudo scientific explanations of why this surgery "cures" diabetes and makes you feel full - they attribute it to changing gut hormones (of course, they don't say how this occurs and not surprising, they only mention a rat study or two as documentation for their claims).

I say, not surprising, because they really do not know _what_ controls appetite nor exactly what those gut hormones do. And also, the temporary lack of hunger in new ops is easily explained by the sudden difficulty in eating (food can get stuck etc) and the massive healing going on inside after the small bowel and stomach have been cut into pieces and put together in a very different manner from what nature intended.

And interestingly enough, human studies have tended to show that these surgeries are not particularly successful as for maintaining weight loss on the long run. For example:

• A study of 10 year post op gastric bypass patients found that 34 percent of those who started with BMI 50 or over, had regained all or most of their weight (REF: Annals of Surgery. 244(5):734-740, November 2006. Christou, Nicolas V. MD, PhD; Look, Didier MD; MacLean, Lloyd D. MD, PhD)


• The Swedish Obesity study found that at the 10 year point, the average BMI was 35 evidencing a significant lack of weight loss retention. (REF: New England Journal of Medicine: Volume 351:2683-2693 December 23, 2004 Number 26 Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery Lars Sjostrom, M.D., Ph.D et al)


• the Hebrew University study found that only 7 percent of gastric bypass patients had kept all their weight off- and that 25 percent of patients had regained all their weight back (or more). (REF: Dept. of Surgery C, Soroka Medical Center, Beer Sheba (Israel study) Harefuah 1993 Feb 15;124(4):185-7, 248 (article is in Hebrew))

But worse yet, a new human study found erratic blood sugar levels in most of the patients studied (clinical study) which caused them to be _ravenously hungry_ soon after meals - this study directly disproving the claim that the gastric bypass somehow changes the gut hormones to kill the appetite.

A clinical study of 63 gastric bypass patients by Mitchell Roslin and associates, has disproven this theory when it found that not only did 80 percent of the gastric bypass patients in their study suffer a RAVENOUS appetite soon after meals, but also experienced the almost uncontrollable urge to eat which did for many result in weight regain after the first year (the study went for 4 years). The researchers also found that 80 percent of the patients also had undiagnosed "glucose abnormalities" including "high blood sugar" or "low blood sugar" or both. Dr. Roslin reported on this study at the 2009 ASMBS convention, suggesting that the gastric bypass may cause a heightened insulin response due to the rapid emptying of the pouch into the small bowel.(ref: Roslin M, et al "Abnormal glucose tolerance testing following gastric bypass" Surg Obesity Related Dis 2009; 5(3 Suppl): Abstract PL-205.)

The so called "cure for diabetes" also attributed to the elusive gut hormones by this article, has only been called a "cure" in the media. Any studies which suggested that weight loss surgery got the blood sugar levels down to normal in diabetics, called it a "remission" and what long term studies we have seen (for example, the Swedish Obesity study), found that at the 10 year post op point, only 36 percent of diabetics were still "diabetes free".

Additionally, as observed in a friend of mine who was diagnosed diabetes, 16 years ago - six weeks on the Weight Watchers Momentum program reduced his sugar levels to normal also even though he only had lost 12 lbs of weight and still was significantly obese.

Any gastric bypass patient will tell you that this surgery is NOT the "easy way out" but in fact not only takes a lot of work to maintain weight loss but also to make sure one gets vitamins, supplements, B12 shots and iron infusions (which patients need as time goes on) and close medical followup required. Gastric bypass has been observed to cause some alarming repercussions in many patients over 6 or 7 years post op.

In fact even a significant number of newly operated gastric bypass patients suffer repercussions:

In a radiologists' study, they looked at 72 gastric bypass patients and found by CT scanning, that 41 of the 72 patients i.e. 56 percent) had some 62 "abnormalities" in their digestive tract. The "abnormalities" included leaks, hernia, spleen and kidney damage, hematoma, bowel obstruction and distended excluded stomach. (REF: Diagnostic Imaging - September 2, 2004)

And if healthy food choices, slight calorie restriction combined with exercise, can reduce sugar levels even in a diabetic diagnosed many years ago, one would wonder why a person should even consider getting one's digestive system permanently surgically changed.

Articles like this one in the "New Scientist" do a lot of harm in misleading people to make permanent changes in their organ systems, a move which many find does NOT work real well for them but can give them a whole new set of co-morbidities and a lot of grief.

the obese only have themselves to blame?

Suppose a cancer patient walks into to the doctor and/or oncologist or hospital and before they treat her or maybe instead of treating her, they all say "but you only have yourself to blame!"? Never would happen, right? Even though the American Cancer Society has stated that cancer is 85 percent lifestyle caused!

However with obesity, Dr Rudy Leibel has stated that it is only 40-60 percent lifestyle caused and yet, the obese person going for medical treatment hears it all the time that they "only have themselves to blame".

One of the most ignorant articles I have read in a while (and that's saying something considering how ignorant the media is) was written by someone in the UK named Amanda Platell.



(Photo caption - "self delusion is an obese person's greatest problem" says Amanda)

She writes:

But my mother cooked simple, cheap food for us every night, packed our lunches (sandwiches, a carrot and an apple... is that too hard?) and none of her three children ever had an ounce of fat on them.We swam, ran, climbed trees, played football. We ate healthily and lived healthily.

Well, excuuuuse me Amanda but MY mother cooked healthy, packed our lunches with no sweets and we swam, rode bicycles, climbed trees and played sports and we still were fat, all of us!



And according to the unpublished Russell Williams study, in which he asked 6 catering services which had catered both the NAAFA conventions as well as many other conventions, which group had consumed more food, the answers would have surprised Amanda and others. Three of the caterers said that the fat folks in NAAFA consumed exactly the same amount of food as those of the general population and three of the caterers stated that the folks in NAAFA consumed less food than consumed by other conventions.

It's time for those of us with genes which tend to render us fat, stop taking the nonsense and ignorance from such as Amanda and for that matter, consider stopping taking their advice to disable our digestive tracts also. Instead, we need to embrace our beautiful bodies whatever size they are, live on a healthy program like HAES (read Dr Bacon's book "HEALTH AT EVERY SIZE" if you have not yet read it) and educate the general public about genetics and size and obesity.

See http://healthread.net/obesity.htm

Because if we do not tell society the truth, no one else will and articles like Amanda's will continue to misinform the public. The Amanda's of our society never hesitate to speak out, as we can see.

dying from a surgery which might not work anyway

The doctor gently told the family to dis-robe and remove their jewelry. They were standing outside a modern facility and were told that they would be released but first were to be allowed to take a shower so they would be presentable to their loved ones. The people wondered if this doctor could be trusted because he worked with their jailers but surely since he was a doctor, he had their best interest in mind. Most of all, they WANTED to trust him. So they suppressed their fears and doubts. Showering would be nice, they thought since, they had not had this luxury during their time there. After taking off their clothing, they filed into the what looked like a community shower. They might have had hopes of "getting their lives back" because this is what they were told by those who led them into the building. Somehow one thinks they might have been in denial about things because their jailers were not really into saving their lives. But people will believe what they WANT to believe and they wanted to believe the nightmare would end with their shower. Standing in front of the shower head, they looked forward to living normally again. But no water came out of the shower head. Instead a deadly gas filled the air tight building. Their "release" was only by death. This was Nazi Germany.

And the kindly doctor who led them into the "shower" to their death, was on hand to sign the death certificates and report that he had further "taken care of the Jewish problem".

In 2006, Ray, a very large person, blogged for a year how he felt a radical type of weight loss surgery was going to "magically" save his life. To their credit, several bariatric surgeons refused to operate on him. He weighed close to 500 lbs and was still mobile (he drove a truck) but was in kidney failure from diabetes and required dialysis three times a week. One of the surgeons who refused him was Dr Baltazar of Spain who tried to explain to Ray that he didn't have a prayer of surviving weight loss surgery. But Ray bought the hype he had heard on some of the discussion groups and TV. He truly believed that Weight loss surgery would somehow make him slim and "normal". He did not speak well of those doctors who refused to operate on him and finally, he found someone who WOULD operate. Because insurance did not pay, Ray's grandma went to her savings to come up with the $50,000 for Ray's surgery. Ray's last letter before surgery, expressed hope that he would "get his life back" after surgery and he went into the hospital, confident and optimistic.

But after surgery, several other organs joined his failing kidneys and went into failure. He was awake, awake enough to realize that what those doctors who refused him surgery had warned about, was happening. His surgery was not going to save his life. On the contrary. People who went to see him, described him as very depressed before he died about 3 weeks after his weight loss surgery.

Ray may not have had the life he wanted before surgery (dialysis isn't everyone's first choice of a fun thing to do) but he _had_ a life. He drove his truck, he held his nieces and nephews, he saw his Grandma, he still could get around. Instead of giving Ray his life back, the bariatric surgery had denied him of the life he had.

TV just showed another similar case. Renee Williams was a pretty lady who at 29 years old, looked young. She had been bedfast for 4 years, partially due to a crushed leg from a car accident. And she had gained weight to 900 lbs. She video blogged and said she wanted to "get her life back" and do more things with her two kids. Like Ray, she had contacted many surgeons who refused to operate on her because she was too big a risk. But finally she found a surgeon who agreed to do a gastric bypass on her. After her bypass, he came out smiling at her family. "The surgery went well," he told them. Visiting Renee after she woke up, this surgeon said to her "and you will soon be skinny". And in the next 3 weeks, she lost 60 lbs. But then one night she had a sudden heart attack. The surgery HAD been too much for her. Her older daughter said tearfully that her mother had been her best friend.

"I know I have 100 percent chance of dying in the next year," Renee told her video blog.

But seems with the gastric bypass, Renee didn't even have a year to live but only weeks.

And Manual Uribe who refused the offer of a gastric bypass, and only a hundred lbs or so less than Renee, is still living albeit still bedfast. (It's a no brainer that walking is a lot more than being slimmer - many muscles must be developed before that even should be attempted.)

Somehow, I feel Renee's life was wasted and that she was given false promises because this drastic invasive surgery is not even that effective on larger people. One of the few studies we have which looked at many patients 10 years post op, found that 34 percent of them with a BMI over 50 regained all or most of the weight they lost.

We to date, have no data on weight loss 20 years after gastric bypass despite the fact that gastric bypasses have been done for 40 years. Why is that, some wonder. Dr Paul Ernsberger, associate professor of nutrition at Case Western Medical school, opined:

"A number of trials have been started, and the final results have never been reported. We have to ask, you know, why haven't we seen the final results? I think it's because it's bad news." (Dr Ernsberger on "The Donahue Show")

When these very large people showed hesitation about the surgery, this surgeon (now under lawsuit for the death of another patient) paraded a woman who had had a gastric bypass and lost 400 lbs. "It's the best decision I ever made in my life," this patient who works for the surgeon as a "liaison" said, enthusiastically. But that woman is only two years post op. We should remember that 6 months after Big Pete Herida appeared on Oprah and said how losing 600 lbs with his gastricbypass had "saved his life", Herida died of congestive heart failure.

And then there is another lady I know who weighs in excess of 500 lbs who is in her 50's and not real mobile. She says she's _outlived_ 48 of her friends who had Weight Loss surgery. One never hears about that on TV.

There is some evidence that losing a lot of weight even slowly, may be more of a strain on the heart than NOT losing it.

What really upset me was the misrepresentations going on.

"If Renee survives this surgery, she will lose 700 lbs" stated Renee's surgeon to the TV cameras.

None of the very large folks I know, have lost more than 400 or 500 lbs with gastric bypass (many have lost less) and most of them regain a significant amount of weight (if they live) within 4 or 5 years.

"Renee only had a year to live" was another thing we heard a lot on the TV show and no one can predict that at all. Surely it's not real healthy to be in bed weighing 900 lbs but who really can predict the lifespan of anyone. Telling her that seemed more like a misrepresentation in order to scare her into surgery.

And the worst thing was the spin they put on the show "If Renee had been accepted for surgery earlier, things would have been different. She called many doctors and begged them to help her."

This seems to suggest that those surgeons who were ethical enough to NOT operate on her were somehow guilty of her death.

"The show has inspired many to call for help - to not wait until it is 'too late' like Renee did. " the show told us detailing two other patients, both of whom got bypasses but are still in bed.

It's way past time to realize that what we hear on TV may not, and probably IS NOT the truth. TV makes only a commitment to entertain, not to tell the truth.

During the trials after the game show scans in the 1950's, one of the producers shrugged his shoulders when confronted with their lies, giving contestants the answers etc (there is a movie called "QUIZ SHOW" which details this famous case). "Well," said the producer, "no one was hurt. The contestants won money and the people were entertained."

Now with today's spin, giving people false hopes about surgery which may not even help them (and may cause their death), can we really say anymore that "no one is being hurt"?

The new non surgical WLS which isn't - non surgical!

You have probably seen by now, the media hype. "New WLS - no cutting needed".

Transoral Gastroplasty the so called TOGA procedure, has already been hawked in the media as the latest and greatest.

What the TOGA is, is that they stick a bunch of flexible staplers down your esophagus and pleat part of the inside of your stomach (with staples) into a small pouch:

The TOGA System (Satiety, Inc), a set of transoral endoscopically guided staplers, was used to create a stapled restrictive pouch (similar to other restrictive pouches) along the lesser curve of the stomach.

The news media lost no time in hawking this as the latest and greatest WLS with no cutting:

Unlike other bariatric procedures, the TOGA does not require any incisions. That translates into quicker recover times, shortened hospital stays, and a decreased risk of complications.

Decreased risk of complications? Well, partially true. That is, decreased risk of complications from incisions like hernia and wound healing. We won't talk about complications which may arise from stapling the interior soft tissue of the stomach and of course, other complications which generally arise from WLS.

Other sites have called this procedure 'non surgical'. Again the term may be misleading - that just means there is no incision. But it certainly IS surgery. For example, if a surgeon does a vaginal hysterectomy would that be "non surgery" just because there was no incision?

Below is the best description I could find of it - Medscape news (requires free membership in Medscape to read this)

http://www.medscape.com/viewarticle/555586

There were no complications; all but 2 instances of procedure-related adverse effects (nausea, vomiting, pain, dysphagia, pharyngitis) resolved within 5 days and none were serious. The most recent follow-up visits (endoscopy at 3 or 6 months) showed persistent full or partial stapled sleeves in all patients. Weight loss averaged 17.5 lb at 1 month and 24.7 lb at 3 months after treatment (excessive weight loss [EWL], 14.9% and 20.5% at the respective time points). At 6 months, average weight loss was 31.1 lb and EWL was 24.9% for 6 patients followed up so far.

According to Dr. Scott, "Gaps between staple lines [negatively] affected weight loss. The gaps were dependent on stomach anatomy. As we gained more experience with the instruments and the procedure, we made adjustments, and weight loss increased."

... Dr. Scott reports a financial relationship with Satiety, Inc. Dr. Zundel reports financial relationships with Ethicon and Inamed.

One is left with many questions about this procedure. First of that, that's soft tissue inside the stomach and also has a lot of important digestive cells, much softer than rather than the outside of the stomach which is stapled. Secondly the Rose and Stomaphyx procedures which are used to revise gastric bypass patients who have experienced regain, apparently have a problem with the tacks (Stomaphyx) or sutures (Rose) coming out. The Stomaphyx has been all but dropped because the tacks came out pretty soon. (The two patients I know personally who had it say not only was it ineffective in helping them to lose weight again but had a painful aftermath). In doing the Rose procedure, surgeons tell patients the sutures are only guaranteed for a year after surgery.

And a major issue ... the Vertical Banded Gastroplasty which is more permanent than the TOGA but similar in concept, was EXTREMELY ineffective for keeping weight off.

I have known one patient who kept off her weight for 9 years but after that, it started piling on as she became increasingly ill with autoimmune disorder and a host of other things (which many of her medical team DID attribute to repercussions of her WLS). At the 22 year point when this patient had to have her pouch amputated because her stoma stayed shut and she could not even swallow saliva, she was 15 lbs heavier than she had been on the day of her WLS, 22 years ago.

Typical of these patients are things like losing all their teeth, gastroparesis and atrophic gastritis and more.

(see: http://obesitysurgery-info.com/post-gastrectomy-symptoms.htm )

It's true that the VBG was safer than the gastric bypass (which is why Mason invented it- he wrote) and many of those patients are still around at the 25 year point but I have not met one long termer VBG who is a happy camper. On the contrary.... and every one of them has regained all the weight.

Of course, this TOGA procedure has no silastic band and no stoma. But even after a few months they found (by their own admission): "partially stapled sleeves". In other words, the staples seem to last less time than the sutures....

What damage does this do to the patient's stomach, I wonder....

Studying history is helpful here. The vertical banded gastroplasty which seemed much more permanent was neither effective in the long run nor complication free. For instance here is a patient case history with endoscopic photos:

http://obesitysurgery-info.com/vbg_patricia.htm

And even the horizontal gastroplasty which was extremely ineffective as far as weight loss, had its own set of long term complications which interestingly enough resemble the VBG long term. Here is a case history of a 30 year post op horizontal gastroplasty patient. NOTE: although she is very ill, she has been told that any type of take down or reversal will destroy her stomach and put her under risks of dying on the table:

http://obesitysurgery-info.com/savage.htm

NOTE: both these courageous patients have requested of me that I include their real names AND their photos because they very much wish to warn those considering similar surgery....

The weight loss seems typical of what we have seen with other gastroplasties. Even in the medscape article, the average loss per week by the 6th month was 5 lbs per month or approx 1 lb a week. (this was omitted from the media hype about the procedure - how surprising!) :)

So I would wonder why do they even run a trial of this because it seems doom to fail, even at keeping off the weight any length of time.

The answer may be in the funding they are getting from the manufacturers...

Dr. Scott reports a financial relationship with Satiety, Inc. Dr. Zundel reports financial relationships with Ethicon and Inamed.

And of course, as Roy Spenser remarks in "CLIMATE CONFUSION" (he was senior scientist and climatologist for NASA), any newspaper reporter will jump at "big news" (like "NEW WLS") in hopes of the typically elusive Pulitzer Prize. "Scientists are human" writes Roy continuing that proclamation of "truths" is likely to get scientists, more and better funding. But writes Roy, dourly:

"If you want possible explanations of nature, go to science. If you want truth, go to church!" (Spencer, Roy, PhD: CLIMATE CONFUSION, NY, 2008)