Weight loss balloon - a good or very bad idea?

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

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

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

Gastric bypass patients should consider reversal!

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

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

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

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

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

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

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

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

New old program for WLS patients?

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

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

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

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

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

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

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

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

Magic Quick Weight loss? Really?

(Written with tongue firmly held in cheek!) 

Every so often when I write a blog about weight loss surgery or other types of weight loss, I get comments from folks advertising quick weight loss.  The latest comments I've received came from a couple of people who claim that some individual helped them quickly lose weight! (I looked him up on the web and he, calling himself a doctor (?) goes by a couple of different names apparently), - are you ready for he helped them?  He cast a spell on the individuals and caused a weight loss.  The individuals don't claim large losses, 15 lbs or so but still.

Spells?  Like waving a magic wand or ?  In the 21st century?  Really?  I'm not kidding - these people gave me links to this guy's email (he doesn't have a website) and seemed totally serious.

One individual commented on one of my blogs, the following: 

"All thanks to Dr ---- who helped me loose weight when all effots proved abortive. Am on this blog to help those in need of weight loss get the help you need. Worry no more just contact this great man via (email address on yahoo!) and he will help you with a spell, in less than 1 week after i contacted him i lost 15 pounds and ever since i have been having normal meals no more diets and my shape is perfect. What more can i say than a big thank you "

I left the misspellings in there (emphasis on "spell" is mine). Perhaps English is not this person's first language but I think they could have paid more attention to the built-in spell checker (that's the red line under a word). :)

I frankly didn't believe folks in the 21st century believed in "spells" anymore but I guess I stand corrected.  Someone should tell these folks that the reason they lost weight was all their work and not some web foot muttering some words over them.  Take the credit for your weight loss - it's yours to take.

PS: I'm sure these individuals did not say their "magic" words without a fee.  Makes me think I'm in the wrong business! :)

Garcinia Cambogia - neither effective nor safe

Weight loss supplements are many and varied.  The idea of just consuming a pill or a drink, appeals more to prospective dieters than counting calories or points and/or exercising.

One supplement I often see advertised, is Garcinia Cambogia, whose advocates are all over blogs like this one.  Whenever I post a blog here, whether about weight loss surgery or some other diet craze, I almost, invaribly, get a comment or two advocating Garcinia Cambogia and so I decided to research it a bit.

In investigating it, I found that there were concerns about how safe it was to use as well as not being effective for what they are pushing it for ... weight loss. The active ingredient in Garcinia Cambogia which supposedly causes weight loss, is hydroxycitric acid, or HCA = this is also included in other weight loss supplements.

In one study, the average weight loss in folks taking Garcinia Cambogia, was 2 lbs and the researchers couldn't really say if it was the lowered calories or the supplement that caused the weight loss, but they concluded it was likely the lower calorie intake of the cohort that caused the weight loss.

Garcinia Cambogia is apparently a tropical fruit which resembles grapefruit - people who have eaten it, say it tastes good but the medical profession does not feel it's a good weight loss supplement. As for the claims of lowering the blood sugar levels in diabetics, this, again, is unproven.

One article advocates a person wishing to lose weight would be better off, buying an exercise DVD than investing in Garcinia Cambogia.  I agree there.  Although convincing people to buy Garcinia Cambogia might be a cash cow for those selling it, it appears to be a waste of time for those wanting to lose weight or control diabetes. 

New Diabetes drugs have gnarly side effects!

New diabetes drugs?  ... they have some gnarly side effects! 

The promos want to make it look like low sugar levels are the worst side effect of the new class of diabetes drugs - however according to drugs dot com, there is a rather long list of gnarly side effects... including .... Anxiety, bladder pain,bloody or cloudy urine, blurred vision. chills, cold sweats, coma, confusion, cool, pale skin, decreased frequency or amount of urine, depression, difficult, burning, or painful urination, dizziness, fast heartbeat, frequent urge to urinate, headache, increased hunger, increased thirst, itching of the vagina or genitals, loss of appetite, lower back or side pain, nausea, nightmares, seizures, shakiness, slurred speech, swelling of the face, fingers, or lower legs, thick, white vaginal discharge with mild or no odor, troubled breathing, unusual tiredness or weakness, vomiting and weight gain.

You might want to skip this class of drugs!  The side effects seem worse than the blood sugar levels it is said to lower...

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!" 

Big Push for Weight Loss surgery

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

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

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

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

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

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

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

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

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

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

Gastric 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...

The Demise of a Great Blog

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

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

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

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

Another one lost

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

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

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

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

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

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

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

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

Weight Loss surgery stories or -- ads?

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


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

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

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

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

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

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

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

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!

Gastric bypass - the holy grail of weight loss surgery?

The holy grail of weight loss, is hoping that somehow food will not appeal to us so we will lose weight.  A new study states that weight loss long term ( 10 years) is better after gastric bypass than after getting the lap band.  And why is this?  Because food is not as appealing to gastric bypass patients, the researchers found.

Well, true, a good percentage of gastric bypass patients get reactive hypoglycemia which means you feel really crummy after eating a plethora of foods, not just sweet stuff. (The patients refer to this type of becoming ill as "dumping")

The problem is, if you are getting sick after eating and you lose weight, that doesn't really count.  Because cancer patients and terminal AIDS patients also lose weight from being sick, but it's so not worth getting sick to lose weight.

What they are hoping you don't know about is for one, the Roslin study which found that 3 months after a gastric bypass, the appetite comes back worse than before surgery in many patients.

This clinical study of 63 gastric bypass patients (that means the researcher, a gastric bypass surgeon himself, actually examined the patients), also found that many of these patients had "glucose abnormalities" which would, in part, explain their voracious appetites.

Bottom line - to lose weight by getting sick after you eat?  Life is just too short for that one, you may well find.  5% of people on non surgical diet nutritional programs can keep off the weight.  7% of weight loss surgery patients (all surgeries, several studies) can keep off the weight.  But that extra 2% which isn't very much of a differential, is counting those with "glucose abnormalities" and other health problems after weight loss surgery.

Dr Terry Simpson tells us that success with Weight Loss surgery (any procedure) is 10% the surgery and 90% the patient.

So after taking rather serious and sometimes life threatening risks to have one's digestive tract rearranged, you can see that it is not very much more effective in keeping off weight than is a non surgical program.

Looking at things this way, the seeker should also be aware that merely embracing a healthy lifestyle of mostly wise food choices and cardio exercise 5 days a week will keep you healthy at any weight.(Lee CD, Blair SN, Jackson AS. Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men. American Journal of Clinical Nutrition. 1999 Mar;69(3):373-80)

Ask yourself, in view of the foregoing, is weight loss surgery really worth the risks?

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!