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.

Carnie Wilson - 2nd weight loss surgery

Carnie Wilson, singer and daughter of Beach Boy, Brian Wilson (pictured in red dress in photo with her singing group);  got a RNY gastric bypass, 12 years ago. She lost 150 lbs initially, and told the press, "It was so easy -- it was like I blinked my eyes and the scale went WHUUP!". 

A frenzy of people signed up for gastric bypass surgeries. One person who worked for a weight loss surgery surgeon, told the news that every time Carnie Wilson appeared on TV, their phones rang off the hook!  The surgical group who did Carnie's surgery, dramatically simulcasting on the internet during her surgery and launching a huge publicity campaign in partnership with the manufacturer of surgical instruments, went from doing 5-7 weight loss surgery procedures a week to doing 12 weight loss surgery procedures a week.  The future looked rosy, for Carnie and the Weight Loss surgery industry.

But dark clouds were gathering on the horizon.

Soon after Carnie Wilson's famous quote to the press above, she began regaining the weight, despite fighting hard to keep her weight off, including, hours of exercise, engaging personal trainers, putting salt on desserts so she wouldn't be tempted and publicly humiliating herself, talking about her weight problem. By 2011 when she appeared on the Dr Oz show, she'd regained to her average weight before surgery, about 240 which is a lot for her since she's only 5'1".

Apparently, she lately, had a gastric band placed over her bypass to force a restriction of her food intake, and has lost 30 lbs so far.

The bottom line is the gastric bypass or any weight loss surgery, is no free ride.  Just like using a non surgical tool like weight watchers, it's a lot of work on a daily basis for the rest of your life or you will regain the weight and/or get sick!  A percentage of gastric bypass patients get sick anyway, even if they do everything right.

Carnie Wilson, like so many others, was given the impression surgery worked automatically and easily.



That so many people embark on weight loss surgery seemingly ill prepared for the reality, can be at least, partially blamed on allowing the mass advertising of surgery without requiring the advertiser to list side effects and disclaimers like "results not typical".  Some weight loss surgery surgeons have an annual income of $1.5 million dollars - people have done strange things for much less money than that.

Let's hope the second weight loss surgery procedure will bring her what she's looking for.  She's such a beautiful woman and a great singer and somehow all of that tends to get lost in her frantic efforts to get slimmer. To me, that is sad.

Click on this blog link to see photos and story.

Big Medicine revisited

People may remember a blog I wrote in June 2007 in which I accused the TV show "BIG MEDICINE" of being an infomercial for weight loss surgery.

In retrospect, now that I have watched the first season of this Discovery channel show twice, I will say that if you watch it carefully, it actually shows some instances which give a clue about how risky this surgery (gastric bypass) IS.

For example, the one large lady in the last or second to the last episode who was rejected for WLS, was told by Dr Garth (the young WLS surgeon) that he did not feel it safe to operate on her because she lived too far away and did not have any family to support her (she had moved from one of the Southern states to Houston in hopes of getting the surgery). He went on to say something about how he had to bring one of his recently post op gastric bypass patients back to the hospital four times and pointed out to her that if that was her, living an hour away from the hospital, she could die.

In another show, Dr Davis senior remarks that the gastric bypass is basically creating a situation of malnutrition in a patient and that SOME patients would be better off remaining fat. Big admission.

And finally, each episode has one patient who has HAD a gastric bypass and ended up with very little muscle tissue (the body in starvation in the quick weight loss period eats its own muscle to obtain the protein it needs on a daily basis - if it did not do this the patient would die). These 1-4 year post ops especially the larger weight losers were shown sans clothing and looked like melted candles with a very unusual shape. Some needed several plastic surgery procedures and STILL after all of that pain and work (and risk) felt the need to cover up their bodies.

I have heard this from countless patients... those going in with a looks expectation especially, that they say they looked worse AFTER surgery than before.

A sad thing especially as some of the muscle which has been wasted in the starvation/quick weight loss period does not seem to be able to be rebuilt (perhaps because even when the weight loss stops, there are still hundreds of nutrients which gastric bypass patients cannot digest and cannot supplement through injection or sublingually).

So the bottom line is that I think the show has the potential of informing prospective patients about things they might not think about or read about before but unfortunately many will see only the end story which is the usual gushy "I'm so happy now, I can buy clothing off the shelves, I can ride on carnival rides" which one hears from some of the new post ops.... these stories tend to make people forget all the darker possibilities in their desperate hope that this surgery will magically heal them of obesity.

I did receive a letter responding to this blog which I'd like to share with you. It's obviously from a gastric bypass new op and reads:

Wow - This is some great research. To site articles from 15 years ago. Hate to tell you, but surgery has advanced since then. Also doctors such as Drs Davis will not do surgery on patients just because the want it. The patient has to meet certain criteria. You make it sound as though a person who is 20lbs overweight will get this surgery, then die. I'm certainly glad you have no weight issue yourself. Otherwise you might know what it feels like to be sick and in pain all the time. Oh and by the way-My surgery was a success, and I plan on keeping it that way. I did my research so I know how to make that happen.

I would like to respond here. I quoted three studies - one dated 2002 and one dated 2003 and true, the Hebrew University Study in 1992, however, studies published later such as the Swedish Obesity study published in the NEJM Dec. 23, 2004 issue showed similar results as to weight loss (or lack thereof). At the 10 year point, the 541 patients who were available for followup, had only kept off an average of 16 percent of their original weight. (BTW, that same report stated that only 35 percent of the diabetic patients were still - at the 10 year post op point - "disease free").

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

And earlier in 2007, the ASBS, (the weight loss surgeons professional organization) in endorsing a new revision procedure called "STOMAPHYX", admitted that 30 percent of gastric bypass patients gain all or most of the weight back (thus the ASBS felt there was a need for this procedure which is less invasive than other types of revision).

It should be noted that the inventor of the gastric bypass, Edward Mason, who after his initial follow up has recommended people have RESTRICTIVE ONLY surgery (like the gastric band) because of the inherent vitamin deficiencies of the gastric bypass, has written several articles with that recommendation, one of the most recent ones being in 2003 for the U of I healthletter, reminding that we know a lot more now, about the digestive tract than we did in 1965 when he adapted the gastric bypass from the 1880's billroth II surgery - this article included the following:

Bypassing the first part of the intestine interferes with normal absorption of critical nutrients and causes complications related to vitamin and mineral deficiencies such as anemia (iron deficiency) and metabolic bone disease (calcium and vitamin D deficiency).

These side effects led Mason to develop a simpler procedure known as vertical banded gastroplasty, which he began performing in 1980. Vertical banded gastroplasty reduces the region of the stomach that can initially receive food, but does not alter the rest of the digestive process.

" The future of weight loss surgery rests in greater use of simple stomach restriction procedures like vertical banded gastroplasty, which preserve the normal weight-maintenance mechanisms of the body," Mason said. "If simple restriction procedures did not produce sufficient weight loss, it was always my inclination to work with the patient to solve other problems affecting weight loss rather than going to a more radical procedure."

http://www.uihealthcare.com/news/news/2003/04/14obesitysurg.html

The writer of the letter assumes I have no weight problem myself. This is only partially true. I am, according to BMI standards, 120 lbs overweight but this is NOT a problem for me. Overweight does not automatically mean "sick" just as much as slim does not automatically mean "healthy". The writer apparently managed to miss the many studies including one published recently which point out that fitness determines lifespan and NOT fatness (or thinness). This study which hit the news on Dec 4, 2007 (even discoveryhealth news - home of the National body challenge DIET and Dr Oz of "You on a diet" fame) clearly suggested (AGAIN) that a fat person who exercised regularly was expected to live MUCH LONGER than a slim person who did NOT exercise and that the amount of exercise a person does predicts lifespan REGARDLESS OF WEIGHT.

So have I fought the battle of weight all 63 years of my life - the answer is yes but because I have also exercised for the last 14 years without stop, my weight is NOT a problem. See - weight but not a "weight problem".

I must say however, that the so called "risks" of obesity even in a person who does NOT exercise seem basically unproven. That is, although there are a bunch of epidemiological studies suggesting a fat person is under greater risk of illness etc there are an EQUAL amount of epidemiological studies which suggest that being under risk more involves things like being HUMAN and/or what we eat and/or how much we exercise rather than whether we are fat or not.

Finally the writer of the letter assures me that SHE will NOT fail with her gastric bypass because SHE did the research before and knows how to do the aftercare.

Surely if she remains faithful to all the rules suggested for post op gastric bypass patients including regular exercise, protein drinks and B12 / B6 injections at least once a week, and she gets a measure of luck mixed in, she has a better chance of avoiding serious repercussions at least for the first several years or so.

However, that being said, I also know gastric bypass patients who did all of the above but just by the luck of the draw, ended up fighting rather difficult health issues like post gastric bypass hypoglycemia (that's where you can "dump" i.e. feel faint and ill - after every meal) and bowel obstruction. I also know gastric bypass patients several years post op who have faithfully exercised and strictly watched what they ate and STILL regained a significant amount of weight.

How the body will react in the long run to such a drastic "re-plumbing" of the digestive system is unknown before the surgery which is why the American Medical association warned physicians to alert patients about the "unknowns" of the surgery to avoid lawsuits and the "ethical haze":

"The ethical haze surrounding bariatric procedures is not unknown in surgery", said Laurence B. McCullough, PhD, a professor of medicine and medical ethics at Baylor College of Medicine in Houston, Texas.

"This is the classic problem in surgery-innovation without the research to guide it. So all this should be brought under experimental protocols," McCullough said. "That's how you handle the conflict of interest make sure you tell the patient, 'The procedure is investigational; we don't know if it will help you."'

1762 JAMA, April 9, 2003-VoL 289, No. 14

In that same issue of the Journal of the American Medical association (JAMA), they commented that although the early results are impressive, the repercussions and even whether the weight stays off are unknown:

" Short-term outcomes are impressive-patients undergoing bariatric surgery maintain more weight loss compared with diet and exercise. Comorbidities such as type 2 diabetes can be reversed. But long-term consequences remain uncertain. Issues such as whether weight loss is maintained and the long-term effects of altering nutrient absorption remain unresolved."

1762-JAMA, April 9, 2003-VoL 289, No. 14

I thank this gastric bypass patient for reading my blog and for writing to me and wish her the best of luck with her surgery.