Five people die after having gastric balloon (for weight loss) inserted

The idea of inserting a balloon in the stomach, and somehow inflating it to supposedly kill the appetite, is not new. It was first introduced as the state of the art, non invasive obesity treatment years ago but, I know patients who found the gastric bypass to be a lot kinder to live with than the gastric balloon and the bypass is not at all, easy to live with. But the earlier bad experiences with it which some describe as a nightmare, did not stop the providers from re-introducing the gastric balloon, a year or two ago.

Different this time, however, is the FDA put out a safety alert about it because five people have died after the insertion of the gastric balloon.  I know I've written about this before, telling folks to run the other way.  Hopefully, the word will finally get out that this procedure causes all kinds of problems in the stomach.

Reported on CNN, 

Three died one to three days after the balloon placement. The remaining two deaths could be related to "potential complications associated with balloon treatment," -- one was a stomach perforation and the other was a perforation in the esophagus, according to the FDA.

History repeats!

All the weight loss surgery procedures, assume that by mutilating or somehow disabling the stomach, the person will not have an appetite and people keep jumping on the operating table with all hopes of being "normal".

As Dr Livingston and others warned --- after weight loss surgery you are NOT normal, EVER, and people should keep in mind that the appetite centers are in the brain which is why, if the patient doesn't do the work - diet and exercise - which of course works fine without surgery, any weight loss surgery does not "work".

 

My 600 lb Life - Laura

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

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

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

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

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

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

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

The Dark Side of the Gastric Sleeve

There are apparently several famous people who got gastric sleeve or sleeve gastrectomy. It looks good. It's not a gastric bypass, so other than undermining protein and fat digestion in the stomach (some surgeons remove 90% of the stomach and put delicately, "send it to pathology"... in other words, discard it), the duodenum which is one of the main digestive organs is left in tact and after all, sleeve gastrectomy is or seems a less risky surgery than gastric bypass et al.

But the gastric sleeve appears to have a darker side. The stomach which is now, about as big as your thumb and twice as long as your thumb, doesn't hold much of anything...for example, patients describe difficulty in drinking liquids and some have observed brown urine from dehydration etc.

Mama June Shannon, mother of the cute little girl who starred on "Here Comes Honey Boo Boo" TV Show, was quite overweight although likely not, the 450 lbs she claimed, had the gastric sleeve.

She said it was an, a lot more painful process than she expected as she also had a couple of skin removal surgeries but on tonight's show, "Mama June, From Not to Hot", she was able to strut her stuff at her ex hubby's "Sugar Bear's" wedding. June was never married to Sugar Bear as she was likely still married to the father of one of her other kids but they made a commitment ceremony last season on Honey Boo Boo's show.

On tonight's show, Mama June, apparently healed from her multiple surgeries, thin and blond, went to her ex's wedding and after, had a fun burning of her old large clothing.  Since June and her daughters have moved into a new rather nice home (TV pays well!), she and friends went out to the middle of the woods for the burning ceremony. However, when she went back home afterward, she suddenly, got very sick. They rushed her to the ER, complaining of severe abdominal pain.  She lived and they promise that next week's show, will feature the entire story of what happened to her. She was in enough pain that she couldn't stand up.

One thing I've seen happen with the sleeve, is a staple line leakage. A patient I know, had to go through multiple surgeries to fix that and included in the dark side of the sleeve, is the fact that unlike the gastric bypass, there is no way to reverse it.

Bottom line, none of these surgeries are really effective because we now know the appetite centers are in the brain...thus surgery or no surgery, we can only lose weight and keep it off by reconfiguring our thinking processes and living in a jungle of high fat, high calorie food, this is never an easy process.  Even Dr Now of the TV show, "My 600 lb Life", admits that surgery is only effective IF the patient diets and exercises...which is, of course, effective without surgery.

So why do they still do weight loss surgery? Because it's a cash cow. The average weight loss surgery surgeon makes $1.5 million bucks a year. People have done strange things for much less than that!

I felt bad for Mama June...she was a happy, reasonably healthy, overweight person and now, she has all sorts of issues with her mutilated digestive tract. 

It's a vicious circle. Providers generally don't follow post ops and complications from all surgeries, are handled by emergency medicine. Overweight people, desperate to lose weight, tend to not do the research they should do, relying on their providers to inform them but without following up on post ops, the providers may not know much more of the long term repercussions than do the patients.

Buyer, beware...be very careful in surgically removing or mutilating the stomach.  That our digestive systems work, wasn't the reason we gained weight and disabling it, is likely to cause more problems than we bargained for.

Lap Band must be removed within 5 years

New research found that the lap band, previously considered the safest weight loss surgery procedure, "must be removed within 5 years to avoid complications". (Obese Surg. Published online January 12, 2017)

The complications are not available in the abstract but from my research, I can detail some of them.  Most prominent, is the fact that the stomach is muscular organ and the muscular movement of the stomach tends to cause the band to damage the place at the top of the stomach if left in for longer than a couple of years.

One of the doctors who does the gastric bypass, published photos of the stomach, bleeding and raw from the rubbing of the band.  Of course, the gastric bypass does damage to the GI tract from the get-go.

What we should remember about all these procedures, is the concept of weight loss surgery is an old one, before we knew the appetite centers are in the brain, which is why even Dr Nowzaradan, the TV weight loss surgeon, admits that any surgery (unless you get sick from it) is ineffective on the long term.

The facts are what we'd rather not accept.  Counting calories or points on the long term is the only way to control weight and it must be done carefully as to not get malnutrition. And even more unacceptable in our fat phobic world is that a person can be overweight and healthy if they exercise regularly (cardio, stretching and strength training) and eat healthy (the low fat diet is still the healthiest).

That being said can obesity bite on the long term?  Sadly, it can. But due to things like clogged arteries (from eating high fat or fast food).  Another no win situation of a body made to survive in eras before the American lifestyle.

Dominique Lanoise - an American Tragedy

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

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

Thoughts about the TV show "My 600 lb life"

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

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

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

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

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

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

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

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

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

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

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

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

Sue

Weight loss balloon - a good or very bad idea?

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

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

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

A weight loss journey with a lap band can be difficult

Melonie on the Rikki Lake show

 Melonie had a lap band in 2012 (approx) and she lost over 100 lbs in about 6-9 months. She loved her band in 2013 when she posted this video, saying it had given her a lot of restriction and was a great tool.  Would she have it again though? - even at that time she said "Probably not". She described it as "high Maintenance" - she had very tight fills (up to 7 cc) although she said she liked how you could adjust it. She also said that when she had lost her weight, she could feel her port (where a lap bander gets their "fills" to tighten or loosen the band) and that was uncomfortable - apparently she had a revision surgery to move the port but it still bothered her, she said.  

Unable to afford plastic surgery for all the loose skin, Melonie opted out to go to South America - She appeared on the Rikki Lake show, saying this had been a major mistake - they did several procedures including abdominoplasty, lower body lift and lipo suction in one 8 hour session.  And sent her home to the US with several drains and a lot of pain.

In a later video, made approx January 2014, she described a rather horrendous experience with her lap band when it slipped, causing excruciating pain and finally getting to the point where it prevented her from even drinking water.  She finally, went to the ER and they removed the band, saying that her stomach had begun to erode and that she'd made it to removal just in time...  She admitted that during her weight loss process and maintenance, she vomited a lot which is a "no no" with any weight loss surgery and especially with the lap band - vomiting can do a lot of damage including rip out internal stitches or in the case of the lap band, cause slippage.  As my weight loss surgery surgeon friend says "Measure twice, eat once, vomit never!" 

She did keep most of her weight off without her band although having to have it removed caused her a lot of emotional pain and in an update video, showed a body shot where she looked really good.

What folks don't understand about any weight loss surgery, is that the patient does most of the work (90% of the work, says one weight loss surgery surgeon). And that even the safer procedures can bite in the long run. 

UK teen wants gastric band but seems unaware of what she will face post surgery

A 238 lb UK teen is desperate (she writes) for a gastric band weight loss surgery because she says she's been taunted and bullied about her weight and she wants to "live a normal life" as a teenager which she apparently thinks she will be able to do after the weight loss surgery. Brook is 15 years old and says that she gained the weight eating junk food as a younger child and that her attempts at making healthy food choices have failed.

I have some concerns about this (and apparently the UK NHS has also because they have not yet, approved her for surgery).

First of all, if she gained the weight eating junk food, it's kind of a no brainer that junk food is the first thing she should give up and will have to give up if any sort of surgery or program is going to work.

Secondly, the comment that she thinks having a lap band will enable her to "live a normal life" kind of bothered me because it appears she doesn't have a concept of what weight loss surgery is and what it isn't. 

For example the release form for weight loss surgery used by several surgeons in our area includes the phrase, "you are NEVER NORMAL".

The reason her statement worries me is because the only chance she has of having success with weight loss surgery, is realizing that it is a big life change - a change in how and what she will eat and so forth. She may "look normal size" (if she abides strictly, by her surgeon's rules) but she will have restrictions and more for the rest of her life - for example, I have a hunch eating a piece of pizza with a lap band is next to impossible without the chance of it getting stuck on the way down (which is extremely painful for a couple of hours until it dissolves and/or the person is "scoped")

Pre ops should be shown exactly how life will be after surgery so that they are prepared for the fact that without dieting and exercise, their surgery will not be effective. Also, they should be made aware of the restrictions involved with any change to the digestive tract. 

As a weight loss surgery surgeon friend of mine says "Measure twice, eat once and vomit - never!" 

Gastric Sleeve revisited

The sleeve gastrectomy is the popular procedure these days.  Those promoting this surgery suggest it's safer than the gastric bypass because no bowel is bypassed.  But the problem with the procedure is that in order to promote weight loss, surgeons must cut away 90-95% of the stomach, leaving a remnant about twice as long as your thumb and the same size.

True to the "conspiracy of silence" about weight loss surgery, the dark side of this procedure has been mostly not told.

But as the procedure gets more popular, the dark side is emerging.

Some patients are beginning to tell their stories and there is a very dark side to this surgery - one patient mentioned that it's very difficult to get in even the minimum of 6 glasses of water daily and describes the shock of seeing brown urine (extremely dehydrated and hard on the kidneys). 

This makes sense because this procedure retains the lower stomach valve but the tiny thumb sized stomach doesn't really conduct the peristaltic wave very well so perhaps the valve which is dependent on the muscular movement of the stomach, doesn't really work very well (probably why they did not include it in the gastric bypass).  A swallow or two fills the tiny stomach and takes a while to empty - think of the difficulty of swallowing water slowly, a swallow or two at a time and it becomes a real chore just to get even a glass or two of water in, during the day.

Additionally, the tiny stomach likely does not do much digesting of either proteins or fats (we do need some fats) or calcium or B12.

Finally, patients describe a constant and very serious case of GERD or gastric reflux and well as problems with leaks and "fistulas".  The tiny size of the stomach would also tend to cause a detention of the esophagus, a problem seen in the gastric bypass also.

If the patients keep the weight off, it's by starvation and / or dehydration and/or illness - this is anything but healthy!

Patients should realize that doing something unhealthy is not worth getting the weight off - especially as there is no reversal possible of this procedure since the part of the stomach removed is discarded

.
The sleeve gastrectomy is a permanent change to the stomach in other words...

Bottom line, all that glitters is not only not gold but may not even be really glittering when you live with it... Caveat Emptor - or "let the buyer beware".

Maestro system - a v-bloc by any other name is still a v-bloc? :)

Entermedics has re-introduced in 2015, a device for weight loss which sounded good in 2008 and 2010 but did not produce good weight loss and was not non invasive as was first thought.  I researched this device in 2008 and 2010 and wrote a blog on it which I've updated to reflect the new device (which of course, isn't really new but perhaps they feel the public won't remember the last times around and they are probably right about this!).  You can read the details by clicking here (Vbloc blog)

This V-bloc has a new name ("The Maestro System") but turns out to be hauntingly similar to the device introduced in 2005 and 2010 and by the way, seems by same weight loss surgery surgeon who advocated it the last time(s) around.  I have talked to him on the phone and he is a fine man (and likely a good doctor) but I guess I'm wondering if it didn't work the last two times around, why should things be different now?  I guess we have to wait and see on this! :)

Gastric bypass on TLC TV show

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Permanent Weight loss only Possible with Surgery?

 

 

So say the providers in the latest article circulating the net...  that the ONLY way to keep off weight is to have one's stomach basically deleted!

 

Frankly, this article seems like it's another plug for surgery (picturing the usual midline shots of overweight people, of course) because they say permanent weight loss is just about impossible unless you get surgery preferably the surgery "du jour" now, the gastric sleeve which in most cases, calls for the removal of 95% of the stomach, leaving things wide open for not only nutritional deficiencies like B12 which is digested in the stomach but lack of necessary fats and more. (You can supplement protein if you drink protein drinks but things like calcium from supplements is not used well and can cause kidney stones - I found that out the hard way). Yes people can live without a stomach but how well they live, is questionable.

And the sleeve, unlike the gastric bypass, is in no way, reversible.  If people do some research on weight loss surgery, they might find that if it were so great, why do they have to keep coming up with "new procedures" (when the old procedures not only don't work for most people in the long run but also tend to cause rather gnarly health problems.)....

One individual who did stay slim and seemed the poster child for a drastric weight loss surgery which took out not only most of their stomach but most of their small bowel too, found out when they fell and broke several bones, that they had an extreme case of osteoporosis despite being careful about supplementing.

Watching a gastric sleeve surgery is interesting - the picture is worth 1000 words? As they staple away most of the stomach, leaving something about as big as your thumb (and about twice as long as your thumb), they take what looks like the stomach and toss it into a pan destined for "pathology" (i.e. the step before it becomes garbage).

And that's why if people have the gastric sleeve, even if they get very sick, there is no chance for reversal of this surgery.  As surgeon, Dr Terry Simpson puts it, "fat and healthy greatly beats slim and sick!"

Truth be known, even with basically no stomach, most people end up regaining weight and if you read the fine print on the surgical sites, the surgeons EXPECT people ... most people to regain at least 50% of what they lost... so... if you lose 100 lbs with the surgery, your surgeon will expect you to regain at least 50 lbs which still makes you significantly overweight even though you will be a success in the surgeon's book!

It has always amazed me how open surgeons are about these er...drawbacks to surgery.... how it's not going to work unless you diet and exercise (well that works without surgery too!).... how it causes repercussions....how 1% of patients die in the first month,  how if people eat too much, it comes up again (they joke about that).  And of course, there are lots of things one can eat too much of like milkshakes which go down well.

And yet people still keep opting for surgery - only to find out the sad truth later on - that with or without surgery, keeping weight off requires OUR OWN surgery to the brain - how well I know about that one.

"There is no easy road to a place worth going" (Beverly Sills)

Questionable studies on obesity and weight loss surgery abound

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

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

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

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

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

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

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

Another one lost

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

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

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

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

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

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

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

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

Weight Loss surgery stories or -- ads?

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


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

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

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

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

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

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

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

Guest blog - Daily Life with a gastric bypass

In this guest blog by Lisa Sargese, a college professor, who had a gastric bypass several years ago, she details how it feels to fight one's digestive tract at every meal.  I can relate because I have a bad case of GERD (hiatal hernia) - that and a bad medical procedure I got talked into called an "esphagoplasty", causes me a lot of grief in swallowing anything non liquid as my esophagus is narrowed and very scarred and does not conduct the peristaltic wave very well at all (the foolish procedure I had was that they blew up a balloon in my esophagus to supposedly, help the narrowing from the GERD - they said it would only last 6 months but I could have it done again... as I had a bolus of tuna firmly stuck in my lower esophagus and could not even keep water down, I was not really in a mood to bargain or question the medical profession - I was ready to have it done again, when in 6 months I experienced increased difficulty in swallowing, but then, I met a fellow who had had several of these esphagoplasty procedures and now was so scarred, he had a difficult time swallowing water - I decided against another esophagoplasty).

As people rush to get on the weight loss surgery table, they don't realize what it means to fight your GI tract at every meal, to plan how you are going to "get through" outings in a society where sharing a meal is the glue which brings friends and family together, how it feels to stand in front of some dirty restaurant toilet, trying to "get up" a piece of food which got stuck on the way down. Please read the following - it is very well written and very true.  Lisa has given her kind permission to me to reprint this:

 "A common misunderstanding
of gastric bypass surgery
 is that the pouch causes weight loss
because it is so small,
the patient eats less.
Although that is true for the first six months,
that is not how it works.
Some doctors have assumed that poor weight loss
in some patients is because
they aren't really trying to lose weight.
The truth is it may be because
they haven't learned how to get the "satisfied" feeling
 of being full to last long enough....
 it is NOT the size of the pouch
but how it is used
that makes weight loss maintenance possible."
- Pouch Rules for Dummies

Let me just preface this rant with the declaration that I don't believe weight loss surgery leads to overall good health. It may provide you with short term or drastic weight loss but it will cause side effects that make it not worth the pain and suffering.  Don't bother leaving me a comment to the contrary. I've heard it all. I've been called "bitter" and "a failure" and been yelled at for discouraging people form getting this "life saving surgery". I will glance at your comment and delete it.

That being said, let me tell you about overful pouch syndrome. It feels like dumping but it ain't.  It's when the pouch stretches too far and too much food needs to be processed. The symptoms are frightening: rapid heart pounding, weakness, dizziness, pain, pressure,and a sudden need to raise your legs higher than your heart no matter where you are.

Now, you mean-spirited, pro-wls cheerleaders are going to say that I should have learned by now exactly how much food I can tolerate. Let me school you. I am able to tolerate less and less food over time. I had my rny gastric bypass in 2006. I can now tolerate half of what I could eat when I first started this awful "journey". Different foods cause different reactions under different circumstances. It's always a surprise. I can eat and process less and less food.

One might think this is good news. One might expect me to be delightfully thin by now.

WRONG.

I fight fatigue due to my inability to take in enough food to give me the energy I need to live my life.

I can't tolerate protein shakes and never could.

My metabolism has slowed to accommodate my miniscule portions of food. I'm a sluggish, tired, cranky f*ck for a major portion of my day.

I have to load up on sugar and salt just to give me the energy to teach my classes.
When I'm hungry I can never eat enough to truly satisfy my hunger. The overfull pouch symptoms begin before I can get enough food into my body.

And so it goes...

Special occasions are difficult. Going out to eat is difficult. Social eating is difficult.
I have to gauge when I've had enough and put the fork down in time. Since there is a delayed reaction between swallowing and the food reaching my poor pouch, I often take a few bites too many. I pay dearly for every mis-bite.

Different foods produce different levels of discomfort. Sometimes I can eat a big salad. Sometimes I can eat lots of fruit. Sometimes I'm wrong and mere orange juice will cause the symptoms. It's a crap shoot every time I pick up a fork.

This weekend my brother and sister in law are visiting from Vermont. We had a lovely dinner at a Thai fusion place in Montclair. After dinner we went around the corner to Coldstone Creamery. We each got child's portions of dessert. We just wanted a taste. I took one spoonful too many. I had to explain why I was sighing and burping and roughly exhaling as I drove home.

I hate the weight loss surgery sales pitch. I was promised one thing and am experiencing another.

Satiety is not possible with water, I don't care what the literature says.

Protein shakes are odious. I am nauseated by them after the first sip.

All the tricks for feeling satisfied on a subsistence level of food don't work.

Our bodies are more complex than what the wls people want you to believe. Feeling satisfied after a meal is not just a function of the pouch or the stomach. Our bodies signal their need for food in many ways. Trying to cheat that system leads to a deficit, a debt, a bill that we have to pay to our bodies. Living on post-wls diets lead to problems, I don't care what the cheerleaders tell you. Some of them outright lie. Some are experiencing symptoms that their doctors won't admit are directly related to their weight loss surgery. Some are so delirious from being thin they ignore other areas of their physical existence. Many have stalled or gained weight back and disappear from the scene for fear of the shaming that comes from the cheerleaders and the medical people themselves.

My brother and sister in law are here with Theodore and Tilly Bear of the Teddy Bear Monastery founded by my brother. I'd like to enjoy their visit without having the burden of worrying that one bite too many will give me heart attack symptoms. That's not how it goes with wls. I'll be spending huge portions of their visit in major discomfort. I notice it more when I'm with people and when I'm eating outside the home.

Wls is the forever-f*ck-you for being fat. It is the forever-f*ck-you for being convinced that one has an eating disorder that only surgery can keep in check.

Every single time I eat I am reminded of my decision to alter my insides in an effort to be acceptably thin. I am reminded of my decision that I needed surgery to help me manage my eating because I decided I was untrustworthy as a self-caretaker.

Every single time I eat.
Every single day.

by Lisa Sargese, M.A.

Please consider subscribing to Lisa's blog - it's very interesting, inspirational and more!

We get angry letters sometimes....

We get angry letters sometimes ...

Wayne B, a gastric sleeve patient (and I would bet a "new op") writes the following:

Regarding the concern about nutrient absorption. You don't absorb nutrients in your stomach.. You absorb them in your small intestine and that is not touched by the surgery. Sue W rabbits on about here six years worth of success being enough o prove her point but demands ten years of success from a WLS recipient. Bit of a hypocritical double standard. on gastric sleeve story

Wayne, if you do not DIGEST food in your stomach then you cannot absorb it in your gut.  You digest proteins and fat in the stomach ... And vitamin B12. Before you get so self righteous, wait ten years... Wait until you get post gastrectomy syndrome... I've never met even ONE long term patient who was happy they had the surgery but because they get so much flack from the Weight loss surgery community, many are afraid to speak out...did you ever wonder why there is such a high rate of suicide among weight loss surgery patients or have you not read about that one yet?

Wayne further writes...

"SueW. You sound like a bit of a self righteous b*tch but hey thats your choice. I tried everything, and I mean everything so don't come back with some Whica health drink BS. Gastric sleeve saved my life so how about you crawl back into your health nut whole and leave people who are trying the best they can alone. on gastric sleeve story"

(Note I have left Wayne's original spelling! :) :) ) My word, Wayne, why so defensive that you feel the need to be ad hominem (that means insulting in case you wondered!).  I'm trying to get informed consent to folks like you because I have met countless patients who find about the repercussions of weight loss surgery, after the fact.  About 50% of those who know the risks, will go ahead and have surgery...the other half will skip it... (especially when they find out they need to diet and exercise to keep losing weight or at a lower weight!)  People deserve to know if there are any deal-breakers in the repercussions.  Many people who have surgery think they won't have to count calories etc to keep slim and nothing could be further from the truth.  The more invasive the procedure, the longer a patient might lose his/her appetite but when it does heal, the appetite comes back, with vengeance.

I've been in this for 14 years and from what I've seen, most of the folks who really hawked the surgery, as pre ops and new ops, when they start getting sick, (and often regain the weight), they get quiet and don't warn pre ops about what could happen after surgery.

Bottom line, no weight loss surgery saves your life...YOU save your life!  As Dr Terry Simpson says, "Success with weight loss surgery is 10% the surgery, and 90% the patient!"

And successful weight loss surgery patients do exactly what we non ops do. ...they journal or keep track of their food intake and exercise... Keeping weight off is work on a daily basis whether people have had surgery or not.  But in addition, weight loss surgery patients have to have frequent expensive blood work, drink protein shakes to avoid protein deficiency and take a lot of vitamins in addition to logging their food and exercising.

A sobering fact... A friend of mine who weighs in excess of 550 lbs says she's outlived 48 of her friends who had weight loss surgery.

According to the few studies which have looked at long term patients, only 2% more of wls patients keep off the weight they've lost.  That is 5% of people keep the weight off without surgery.  And 7% of weight loss surgery patients keep off all of their weight.

There is no such thing as "life saving weight loss surgery"... People save their lives, not any weight loss surgery.  Please don't fall for the used car hype!

Life saving weight loss surgery claims another

Since it's January, there is a big push by those selling weight loss and also for weight loss surgery.  TV is showing a lot of programs on weight loss, and weight loss surgery.

When they advertise weight loss surgery by giving case histories, there is a small (well, maybe not so small) problem.  Many patients die from the surgery which is supposed to induce an artificial case of anorexia so the patient either cannot eat much or as in the more invasive procedures like gastric bypass, cannot eat much and doesn't digest much of what they do eat.

One patient who had been followed since being featured on the first show in 2010, was a Haitian lady named Dominique Lanoise.  Lanoise weighed in the 600 lbs range and was bed bound.  From what is known about her, she was slim when younger and ended up having 6 children - she apparently gained after pregnancy.

She was a charming lady, who though bedbound, would sway to the music in her bed.  The documentary showed her eating large amounts of food, rejecting the diet food (they put her on a 700 calorie diet in order to reduce her for surgery) and kidding with her daughters who adored their mother.

Dominique was convinced that a gastric bypass would save her life and be a quick fix for her obesity problems which she felt was out of her control, so she searched until she found a surgeon willing to operate on her, at her current weight.

She lost weight after surgery and was transferred to a rehab facility but two weeks later, she checked herself out and returned home.  A couple of months later, she died, apparently from a heart attack which WLS afficionados assured us was "unrelated" to the surgery.

However, the nutrient shortage from the gastric bypass can raise the risk for heart attack significantly, because the heart is starved from essential nutrients, including protein.  That seems the "elephant in the room" when one researches Dominque's story - certainly those providing weight loss surgery do not want to admit that this "life saving surgery" actually hastened her to an early death.   

Another TLC patient, Donald, also had weight loss surgery.  He was also around 600 or 700 lbs.  Donald did try to move after surgery and do what the doctors told him to do.  Patients are told that unless they make lifestyle changes (like dieting, counting calories and exercise), the surgery will not work for them. Ironically, those same changes will work for weight loss without invasive surgery.

But then, suddenly and mysteriously, Donald went into a coma and emerged with Guillan Barre or "French Polio" - which put him into a wheelchair.  Disease after gastric bypass is common but again providers tell us it's unrelated to denying the body of proteins, fats and vitamins.  Last seen, Donald was getting around in a wheelchair and rapidly regaining weight although trying to exercise it off - another myth one sees on TV - exercise doesn't take much weight off us - how well I know about that one. It does make us healthier but it's not really good for weight loss.

That some are still selling a surgery which hasn't been done for years on non obese patients, a surgery which the inventor thereof dropped in 1980 because of the high complication rate, truly amazes me.

There seems a conspiracy of silence among patients as well as providers.  Patients who regain and live, are reluctant to tell about their surgeries  because both the public and their doctors blame them for their gain.  Patients who have become ill from the surgery and live long enough to be reversed and get back normal digestion, are often reluctant to talk about their bad experiences because new ops and providers can get mean to those who talk too negatively about weight loss surgery.

Patients are so sold on this surgery that until they get really ill, they refuse to admit that it has a high complication rate and a higher recidivism rate.  When I began to research it in 1999, I was shocked that many studies were on line and told the truth openly, but patients were not reading the studies and only listening to new ops who were excited and seemingly successful.  Even successful patients who have suffered difficult complications and talk about them in blogs, have taken a lot of criticism from "the community".

So people continue to jump on the table for a surgery which sounds like the ultimate cure because many do not encounter the "other side", i.e. the dark side especially if they do not have internet access or know where to look.

Informed consent information on all surgeries can be found at:
http://obesitysurgery-info.com   

In conclusion, a friend of mine who weighs over 500 lbs but has refused weight loss surgery, says she's outlived 48 of her friends who had weight loss surgery.