Pizza, Fat and Genetics

My 12 year old granddaughter is as slim as a rail. Not "skinny" but just perfect... looks great in pants etc. Like I never did, never was. And she basically eats what she wants too. Fast food, pizza, whatever. Even according to the fat-a-phobes, she is apparently like 90 percent of the other kids because the so called "obesity epidemic" only affects 10 percent of kids!

And I was in the "lucky" 10 percent!

I remember those darned kids who lived on pizza and coke when we were in High School and never had a weight problem. I had to starve, literally, to get down to 135-140 and then the minute I stopped starving I gained right up to 170. (And I'm 5'5" so I'm somewhat altitudinally challenged). Unlike these modern kids, pizza and coke was basically never in the house for us - neither candy except at Christmastime and Easter. We had apples and oranges for snacks.

Pretty much through elementary school, I did 2 hours daily of bicycle riding or skating or playing ball (after school that is, and during school, we had P.E. daily and also active recesses - something kids do not have now).

In High School, I was in intramurals twice a week (played volleyball or tennis or badminton or had trampoline), I swam during my study halls and I walked home from school, 3 miles every day with books and a violin. I also walked to stores and/or my violin students homes (what I did to make a few bucks in High School) That kept me at a weight of 170 lbs, unless I starved (ate about 500-800 calories a day) so I DID starve to stay within a somewhat normal size in High School. No breakfast, no lunch and then, a small supper... can we say "eating disorder" sports fans? Of course no pizza and very little coke. My High School social life was spent in watching others stuff their faces with goodies with apparently no worries about "getting fat".

So, my 12 year old granddaughter told me that they had pizza the other night. Now she's somewhat active but not near as active as I was, riding my bicycle for hours etc - Just out of curiosity, I asked her if pizza filled her up. She answered "Oh yes!" and I said "how much pizza do you have to eat because you are full" and she answered "about 1 and 1/2 pieces!"

I remember distinctly, not only did pizza NOT fill me up but left me with hidden hunger and a sick stomach if I ate more than a bite. And that to fill me up, took at least 3 or 4 pieces of pizza. And at 400 calories a slice, that's a bunch of calories to consume at one time.

Maybe there is something to this satiety disorder thing.

So now I eat mostly veggies, still no pizza, fast food, candy or junk food. And I exercise at least 40 minutes of cardio a day and often more. That to keep at a svelte (not) 250 lbs. (I'm not counting the half hour of yoga I do daily because that's not "fat burning" - actually seems nothing is fat burning for me!)

I talk about this because I see in the papers daily and on TV, slim people expounding about how ALL fat people eat too much and move too little. The latest study (maybe I should put that in quotes!) tells us that you should diet when you are pregnant because if you have a big baby, you are "dooming" your child to a "miserable" lifetime of obesity.

Well, ironically enough, I -ate- during my pregnancy (gained 40 lbs), was clinically obese when I delivered by natural childbirth - I also exercised daily during my pregnancy so was a fit fat mom. I had a normal sized baby who was an Apgar 10 (that's a scoring system from 1 to 10, 10 being the highest score a baby can get meaning no birth defects and perfect healthwise).

So much for the "diet during pregnancy - deliver a small baby" myth. Add that to the numerous myths we hear daily about obesity - like the one which states that -all- fat people eat too much and move too little.

And my 12 year old granddaughter, you know the one with the ideal figure? She weighed 9 lbs at birth and now can eat anything she wants and still is slim without being overly active (like I was).

The name of the game here is -genetics! As geneticist Rudy Leibel states "Size is 40-80 percent genetically controlled".

Genetics, the big "G" word that no one wants to put in the media because we people of size are not only a great target for derision and bad examples, we also are a great market for the diet industry which has now "ballooned" to 55 billion bucks a year just in the USA.

That's a twofer - two for the price of one. Verbally abuse fat people then sell them a diet, over and over again. No wonder the 90 percenters who do not have to deal with clinical obesity are not wild about stopping -that- gravy train!

is this a diet blog?

I had a gent leave a comment here, saying he just loved the content of this blog. And then, in the next sentence, he advertised his favorite -diet- site.

And I am wondering about this. I'd love to believe his first sentence but I have to say that if he's read my blog at all, how could he ever think I would be amenable to advertising a diet blog?

To paraphrase one of my favorite movie characters (the bad cricket in one of the ant movies) "Do -I- -Look- like a person who is into diets?"

I am actually a fat gurl (well, not such a girl maybe) who is 120 lbs overweight, lives a healthy lifestyle without the worry of pleasing the scale OR medical providers with fat-a-phobia, who seems to be outliving many of my slimmer friends.

And I must say that in my long life of 63 years, I have -never- seen a good result of any kind of dieting.

Maybe that's kind of a no brainer because when you diet, you deny your body nutrients and put your body into starvation mode - how ever can this be healthy?

I've known people who lost 70-100 lbs .... and then came down with cancer (and died). And I've known people who lost 30 lbs only to regain 70 lbs. In fact most people I've known who have lost weight, are lucky if they -only- regain what they lost. I've known people who restrict calories to low amounts, run marathons, have low risk numbers, are congratulated by every doctor they see and then, come down with their last illness in their 40's and 50's and die a couple of years later.

My so called risk numbers are not low. They are not extremely high but according to the fat-a-phobics, way to high for me to be so doggoned healthy. My cholesterol's about 250 (of course my HDLs are 56 and the ratio is "correct"), my LDLs are 139, my blood pressure is 140/90 on a good day (without medications).

Frankly I'm not sure this is anything to worry about (and worrying about it may be much more dangerous to my health than my numbers not fitting in to the ever decreasing "perfect numbers") Because the risk numbers are also very low in anorexics, and terminal AIDS and cancer patients yet can we really say they are "at less risk"?

Oh and my waist measurement is um.... generous. Not the equator but way into the area which Dr Oz says is highly risky.

I find some things in life rather interesting such as:

1. a dear friend of mine who describes herself as "super sized" has outlived 48 of her large friends who had weight loss surgery

2. my slim father was always given a good bill of health by the medical community while my BBW mother was told she was on the brink of death because of her weight and yet, my slim Dad (also a lifelong smoker) died suddenly of a heart attack when he was 63 and my high BMI Mom was still going strong at the age of 68 when she decided they had lied to her and obesity was -not- going to kill her so she used a more traditional method to hasten her demise - a gun.

3. a relative who is in her 70's is super sized and diabetic and very healthy - travels all over the world, takes cruises and only quit working last year.

According to the diet industry-driven media, all this is not supposed to be.

Meanwhile, society keeps buying this message that we -must- starve ourselves to a certain weight despite increasing evidence that not only does dieting -not- work but several studies suggest it is a risk practice to diet. But then, why would starvation, practiced or environmental be healthy?

Lately evidence keeps pouring in that our 65 percent fat society is actually living -longer- than society did in days of yore before the deadly obesity hit us.

For example, yesterday a news item told us that we just are -not- seeing the deaths from heart disease we expected. In fact, heart disease deaths have "plummeted" the article says, continuing to warn us that due to the obesity they are going to get worse. But wait, the obesity is already here and they are plummeting? Is this like the killer bees which never arrived or the Y2K which was supposed to shut the the world which -never- happened or the bird flu pandemic which we have been waiting for, for 4 years now? Media spin to get our attention so we buy diet products?

In the last couple of years, the average lifespan, in case you didn't notice, has been creeping ... down? Nope, in fact it's been creeping upwards. Last year we were told that women could be expected to live until 80 now.

Has anyone noticed that before the days of obesity, like at the turn of the 20th century, the average lifespan was 45? Back then, people got lots of exercise, they did not have any transfat or fast food and obesity was just about unheard of. Yet the average lifespan was so low.

Maybe just maybe (heresy alert) we are -designed- to be chubby animals in an environment where food is abundant?

Do I -look- like I support diets? Perish the thought. My philosophy is more like "eat dessert first because life is too short"!

Why are so many weight loss surgery patients on antidepressants?

A friend sent me an article today from one of the large medical sites. The article was authored by Drs Roizen and Mehmet Oz (of "You On A Diet" and Oprah show fame). Although they are two of my favorite health authors, they sometimes do not distinguish between when they are giving facts and when they are expounding on their theories.

This article talked about gut hormones and how they can affect the moods and my friend, a gastric bypass patient, asked if this was the reason why so many longer term gastric bypass patients require anti-depressant medication.

A logical question which I began to think about.

Truth is, no one knows why, although several studies done by psychologists have suggested that gastric bypass surgery seems to cause more psychological problems and relationship problems than it cures (despite what the TV ads tell us).

However, in pondering this, I came up with a few of my own theories. For what they are worth (probably not much) - I am not a psychologist and I don't even play one on TV.

I think so many gastric bypass patients are on anti depressants for the following reasons (and this is -my- opinion, not scientific fact - how's that for a disclaimer?):

1. Many people including those who become severely overweight are handling some of their stressful situations with food (it's a well known fact that a goodly portion of the population can medicate with food without becoming severely overweight although this is something the diet industry works earnestly to keep secret). For some, the consumption of food causes the production of endorphins (our body's natural -feel good- pain killer which actually has a similar structure to the opioid drugs). This, in some folks, can actually function as an anti depressant. When the person is severely calorie restricting in dieting or gastric bypass surgery and not able to use food as a comfort, they miss that "anti depressant". And of course, foods which are low calories are generally not the ones which produce endorphins (like broccoli).

2. Gastric bypass pre ops are never warned that in order to keep some weight off (in some people) the doctors will be giving them a disability of the digestive tract. Gastric bypass is sold as a fix rather than the introduction of one illness which hopefully causes less pain than the one it's supposed to cure.

"By doing this surgery, you're creating a medical disease in the body. Before you expose someone to that risk, you have to be absolutely sure that you are treating an illness which is equal to or greater than the one you are creating."
(Dr Edward Livingston, bariatric surgeon in Self Magazine, 4-2001)

So when they wake up with a disability, they are totally unprepared... never expecting they would be coping with new illness. And to make things worse, there is no help for them. No one takes them through the four stages of getting used to a disability (similar to the four stages of mourning) because no one wants to admit that gastric bypass -is- a disability.

Generally speaking, disabilities you cannot see, tend to cause problems with doctors and friends alike. People are often, overly considerate at the sight of a wheelchair but not considerate at all to someone who is struggling to walk on their feet (who may need the help much more than someone who has become mobile via a wheelchair). Likewise for a doctor confronted by a gastric bypass patient with gut pain or stomach pain which likely has a real underlying physical cause. It's so less troublesome to say "it's in your head" and prescribe anti depressants which only are a bandaid, than it is to try and unravel the complexities of illness which drastically cutting up and rearranging your stomach and gut can cause.

3. The high number of marriages which break up after WLS is similar to the high number of marriages which break up after a person gets, for example, multiple sclerosis or a spinal cord injury. The spouse sometimes, can not handle the disability and what goes along with it... visits to the ER, illness and/or inconvenience plus the pain and suffering which accompanies this. Many marriages may be more based on the fact that they like to have fun together rather than the "better or worse" principle and so when the "worse" comes along, it can do damage to the well being of the couple. Additionally, the couple was never expecting anything but an almost magical "cure" to obesity when the patient got WLS and so, both are shocked and unprepared at the reality.

4. As mentioned before, people tend to lack sympathy for disabilities which are not obvious to the casual observer, as is true of those in the digestive tract. To make things worse, the person might "look good" and be "the picture of health" according to what we are told - slim - so what on earth is their problem, people wonder. That the patient is often sick a lot, losing efficiency at work, depressed, suffering pain and more must be in their head because they are slim, right? The gastric bypass patient who has regained a lot of weight, fares even worse. One often hears horror stories of patients with serious physical problems, having their medical providers tell them that all their problems would be solved if they -only- could lay down their fork, the provider totally ignoring a potentially serious problem the patient is complaining about!

5. Somehow, a disability which seems a result of a decision one has made, is worse than one which happens by luck of the draw. But, truth is, that many patients were -not- aware that they were, in fact, chosing a disability because the media sells the gastric bypass as a medical cure for diabetes, and whatever illness people have, as well as a fix for being socially unacceptable i.e. fat. So when illness and repercussions occur, the patient has an easy time agreeing with the medical providers and the rest of the WLS community in saying that somehow -they- caused the problems they are having. This is depressing to think about and may explain the reactive depression which many patients suffer. That is, they blame themselves but somehow can not -do- anything to help the situation.

6. Ok, perhaps Dr Oz and Roizen's theory of gut hormones being disarranged might play into the equation too. I wouldn't doubt it. The drastic rearrangement of digestive organs is bound to cause severe repercussions. That seems a no brainer.

7. And last but not least, many people were depressed before surgery and those providers who promised that being slim or losing weight would solve all problems were simply not even close to the reality.

Whatever the case, people who decide on gastric bypass surgery should be totally aware of all the repercussions which can occur by making sure they have informed consent, and that they understand that this is the type of medical procedure which "breaks" one thing (the digestive system) to hopefully fix another thing "obesity" and that they will be dealing with new disabilities and co-morbidities even if their procedures go well for them.

I feel that medical providers who tend to not give us lay folk informed consent (one medical provider told me "if we gave informed consent, no one would ever have anything done") need to consider distinguishing between those surgeries which are essential for survival, and those which are elective. I think they also need to trust us more - that we can do research and that we can know what will work best for us even if our answer to their proposed medical procedure is negative.

It's all her fault that she got a repercussion of WLS

In my favorite WLSer blog, "Melting Mama" , Beth details how some "rocket scientists" are accusing her of -causing- her reactive hypoglycemia. "You ate too many carbs" they tell her.

She answers:

"I'm currently diagnosed as a reactive hypoglycemic, and The Cause IS my Roux En Y Gastric Bypass. I do not know if I have nesidioblastosis, because that is tested by doing an arterial calcium stimulation test to the pancreas, which is probably in my future if my episodes of hypoglycemia do not improve with medication and diet, or get worse.

Seriously, though, do you really, truly, think that eating carbohydrates CAUSED this?

It's a fair question, I guess, but, really? If that were the case - everyone around me should be dead."

I hate it when patients get a repercussion of the bypass and both the WLS community AND medical providers blame -them-.

For example the other day, I phoned a 9 year post op gastric bypass patient who had been repeatedly told she was a failure. She had originally lost 150 lbs (from 320 to 170) but had had a rebound gain of 85 lbs. In addition, she has anemia requiring iron infusions a few times a year. She is a very compliant patient, following carefully the rules for post gastric bypass including taking her supplements, getting regular medical follow-up and watching what she eats.

The bottom line though is that she is -keeping off-, 70 lbs - something she likely, would not be able to do without WLS.

She was extremely surprised when I told her she was a textbook success. Repercussions like anemia are expected in some patients (after all, the part which digests iron has been bypassed in a gastric bypass) and surgeons write in the medical papers that they expect most patients to have a 50-60 percent rebound gain within a few years of surgery.

The problem is that this is -seldom- what the patient has been told. Most patients have been to seminars where the small percentage of patients who can remain slim after their surgery have been paraded, thus strongly suggesting that this is or can be, a cosmetic procedure to make them _look_ better and fit in better. They are told things like "if you don't like this you can have it reversed" (- not - true - the gastric bypass is considered a -permanent- change to the body) or "You will never have a weight problem again" (very not true - post WLS patients of any procedure are -expected- to diet and exercise to maintain their weight loss and only a small percentage will maintain the -entire- weight loss, that is, most will regain a significant amount of weight).

One patient who had regained it all and complains that anything she eats will cause more gain, was told by a medical provider:

"You are regaining weight because your body is in starvation mode from the malnutrition caused by the WLS"

Kind of a no brainer so why aren't -more- patients told this? Simple - because in my observations when patients are told the full informed consent information about Weight Loss Surgery, only 50 percent or less of those who were originally investigating, go ahead with the procedure. Even many who are keeping off as much as 100 lbs feel that the repercussions they got like neuropathy were -not- worth suffering the comorbities caused by the surgery.

And if you do the math, if half of those seeking WLS, decide against it, that means they will -only- be doing 100,000 WLS surgeries a year instead of 200,000. While 100,000 WLS procedures sounds like a lot, it's not what will keep the providers in the style to which they have become accustomed.

Whatever, the case, patients have a right to know the informed consent information, before surgery - if nothing else than to be able to answer the naysayers who will blame them if they get normal and usual repercussions after their WLS procedures.

"An informed patient is a healthy patient"

(Note the pictured person is not a gastric bypass patient but rather a fashion model)

Queen Size movie was a Queen size diet ad

Recently Lifetime aired a movie called "Queen Sized" about a very fat High School lady who was nominated for Homecoming queen as a joke and then, decides to run. A good summation of the plot of the movie, stars, movie trailer and short analysis can be found here.

About the only positive thing I found in the movie was the main character played by Nikki Blonsky, was really fat and actually wore somewhat youngish clothing.

But the movie was actually anti fat and perpetuating the same tired old myths about fatness over and over.

Based on a real incident which happened in 2004 in Detroit to Allie Burris, various facts about Burris were changed in order to push the anti fat agenda. Whereas Burris' Dad died of asthma, a non fat related disorder, Maggie's dad died of diabetes which is said to be fat related (it is genetically related rather than fat related but it's one of the sound bites they use to scare people into dieting). Throughout the movie, although we are reminded that it - isn't nice - to make fun of fat people, we are also reminded that Maggie should lose weight to save herself from the deadly diabetes which killed her Dad.

In the real incident, Burris got the support of the other High Schoolers and got elected to Homecoming Princess (she was supposedly elected so they could jeer while she was riding in the parade but her ride was without incident). In the movie Maggie got the support of a lot of her contemporaries who were tired of the lady who usually won, but when Maggie stood up to accept the honor, she was almost unanimously booed.

Supposedly, the audience was told she brought that upon herself when she took a TV interview and acted fat and proud. "We want the old Maggie back" said several kids to her. That is, the Maggie who hated herself and thought she was a failure and buried her sorrows in food -that's the one the High Schoolers liked, NOT the new Maggie who actually thought she could do something. Ostensibly some kids who worked in her campaign got angry at her because she didn't mention them as having a part, on TV but they helped, the movie gave us the impression, because they "felt sorry for her" and not because she had any attributes worth anything.

Everyone else in Maggie's family was Hollywood slim and the movie clearly suggested that Maggie was fat because she was out of shape (they showed her running and puffing, walking and not being able to keep up with the other kids and so forth, implying the only exercise she did was opening the fridge plus the arm exercise of putting the food in her mouth). Maggie was also fat, the film showed us, because everytime something went wrong, she ate - all of the wrong things of course. Never did so much as a veggie pass over her lips.

The usual stereotypes we all are familiar with. People are fat because they eat too much and move too little. Only like other stereotypes, these are equally erroneous. There are plenty of slim High Schoolers with binge eating disorder and plenty of fat High Schoolers who are like I was - exercising MORE than the average person (I walked EVERYWHERE I went, I swam during my study halls, I ran from class to class) and STILL only achieving a somewhat large-normal size by starvation. Society doesn't want to admit fatness is mostly genetic because then they couldn't have their fat-a-phobia in comfort. But science says that size IS genetic. The "Queen Sized" movie did not teach people that however. On the contrary.

Interestingly enough, all the high schoolers were shown as slim and perfect looking. I guess the makers of that movie hoped we wouldn't ask difficult questions like "where are all these fat kids that the obesity epidemic mongers are telling us about?" Two fat kids in a large school? Where is the epidemic and why do we have to be "worried" if only 2 out of 1000 kids is fat? Guys, you cannot have it both ways!

"Queen Sized" wasn't even that interesting to watch. It dragged in several places. I fast forwarded through the commercials but I'm told the diet industry was advertising a lot.

The end of the movie was like the rest of it. Maggie goes back to being humble and carefully finds all the candy she has hidden in her room and throws it in the garbage so the audience is consoled with the fact that she has finally decided to get with the crowd and lose weight.

If you haven't seen this movie, I don't think you've missed anything but more of the same dose of fat-a-phobia we get on a daily basis. It was just cleverly (or not so cleverly) cloaked in a different wrapper.

Weight loss surgery ads disguise themselves

I shouldn't write another blog so soon, but an article I saw in Newsweek annoyed me just a bit too much.

It's because the article tries to disguise itself as written by a person who is "concerned" about fat prejudice and trying to "find herself" but is basically, merely, a blatant commercial for gastric bypass surgery.

It appeared in Newsweek Magazine and is entitled "My Secret History". It doesn't say it's a commercial for gastric bypass but it hits all the high points, including a photo of a lovely young lady who has likely had a tummy tuck and a makeover. She greatly resembles the lovely young ladies who smile out from the TV ads for Nutrasystems, telling us how wonderful it is to be slim. Her "before photo" is NOT included at least not in the web version of the article (maybe because she might have been equally lovely weighing 265 at 5'6"???).

In fact this lady DOES tell us how wonderful it is to be slim. For example, the handsome young doctor (ding-dong for point one - she's dating and she's dating MONEY $$$) she went out with, was obviously disgusted at one of his fat patients. Message - this handsome "catch" of a man would NEVER have dated her when she was fat. I'm sure it will never occur to either this lady or the readers that if this guy has such a nasty attitude toward fat patients, will he really accept her when she's pregnant, and/or gains the weight back and/or gets a few wrinkles?

She then describes her Great humiliation of her life. This was when she got her butt stuck in a hanging tire swing at the age of 19. (that's so important - she could have been smaller and gotten stuck also but would have laughed it off).

Not too far down in the article she writes:

I've had nothing but success, healthwise, from the decision to have gastric bypass surgery. I've even run a half-marathon since then (not a superhuman feat by any means, but one almost unimaginable to that girl dangling in that tire).

Oh my, a reference to the tire nightmare again. If that's the worse thing she can pull up about being a teenager in general, she's lived a charmed life, fat or slim!

I'd like to point out that she is not even 1 year out and probably was about 9 months out from her surgery in Feb 2007 when she wrote the article - those magazines have a lag of 2-3 months from writing to publication for non news articles.

The testimonial from the new op who is enamored with the fact that she lost a bunch of weight fast.

The problem is, we can only get sugar out of body fat so when we are only eating 300-500 calories a day during a quick weight loss period, most of what we lose is NOT bodyfat. It weighs heavy on the scale and so we FEEL like we are losing A LOT of weight, but does NOT really reduce our inches that much.

So doing the math, if she lost 135 lbs then only 40 lbs of that was likely, FAT. (about 20-30 percent of the gross loss). The rest was muscle tissue, bone mass (and organ meat) which her body "ate" to provide protein during her "quick weight loss" period. Well, just where do people THINK the NECESSARY calcium, protein and vitamins come from, when we do not eat enough food and have digestive problems?

• B12 and iron from the liver
• iron from the heart
• protein from the muscles
• calcium from the bones

YUM. Not quite the lovely "magic bullet" picture we are getting from the article, is it?

40 lbs???? She didn't need surgery to do THAT. She could have lost that and gained muscle and lost bunches of inches working just as hard as she obviously did (to be able to run a half marathon) WITHOUT the surgeon's knife. Eye opening, isn't it?

One doctor told a gastric bypass patient recently that he had seen many patients suffering the numerous maladies she is enduring, 8 years post op, including auto immune disorder, osteoporosis, anemia requiring iron infusion and more. He said:

"When you bypass the main food and vitamin processing center, there shouldn't be any surprise when deficiencies show up."

Oh but there WILL be surprise when the gaggle of desperate fat people running to their surgeons now with the dream of their gastric bypass making them look like the lovely lady in the article, start having those problems. Because no one ever told them about the other side. And media articles like this make folks think surgery is a "magic bullet" instead of what it really is, a medical procedure done for medical reasons when the co morbidities of obesity are thought to be worse than the co mobidities from the gastric bypass.

Did I say co morbidities from the gastric bypass? Yes that is EXACTLY what I said. And what potential patients are never told about in the media advertising.

I hope potential patients will research the internet including the yahoo group which has a membership of close to 2000 members, many of whom have seen the "other side of the mountain" which is never portrayed in the new op interviews in the media:

http://groups.yahoo.com/group/ossg-gone_wrong

And the website:

obesity-info.com

Which contains informed consent information, patient histories and more.

Gastric bypass surgery has become for many longer term patients, what Stephen King prophetically wrote about in the novel "THINNER"

Perhaps, he thought, Houston was right and I'm thinking myself thin ... because that old Gypsy wanted me to. Only now I can't stop. I could make a million bucks writing a response to that Norman Vincent Peale book ... call it The Power of Negative Thinking. But his mind suggested that was a pile of crap. All that gypsy had said was "Thinner". He didn't say "By the power vested in me, I curse you to lose six to eight pounds a week until you die."

Luckily thanks to modern medicine, the picture for gastric bypass patients who have problems in the long term is not as bleak. But gastric bypass is by no means the magic bullet or "easy way out" that the media wants us to believe, either...

The lady pictured in this blog was a close friend of mine, a teacher, a mother and beloved friend who died way too soon. To see her memorial, click here

But it's NOT a diet!

Weight Watchers has a new ad campaign. They tell their viewers that "Diets don't work". Which is true - countless studies suggest that 95 percent of dieters regain the weight within four years of losing it. So that's great but they go on to say "Weight Watchers works". Wait a minute. Weight Watchers is a DIET and they just said "Diets don't work". And Weight Watchers, although one of the healthiest weight loss programs out there, is STILL a DIET.

My personal opinion is, although that seems a good idea, it may backfire on them because if they ADMIT that diets don't work (and everyone knows that Weight Watchers IS a diet) then, folks might get to thinking that maybe it's NOT time to re-join!

Resolutions to "lose weight" were somewhat absent from the numerous New Year's interviews and news articles. And a news article suggests that Americans are AT LEAST as interested in health as they are in thinness. Only 29 percent of those asked, admitting to dieting (but remember many dieters do not admit that a weight loss program is "dieting"). Of course, people may be going underground with their interest in slimness because it's fallen out of style to admit that you want to be slim. However, diets or weight loss programs are STILL being sold as a looks improvement - with smiling slim ladies and a few gents saying how wonderful it is to be slim, how they can buy clothing off the shelves and fit on carnival rides. The usual sound bites.

And despite the word "diet" being a no no now, Diets are going strong in 2008...

Discovery Channel's "body challenge" is one diet which has been heavily advertised. That's 8 weeks long and encourages a quick weight loss with supposedly changing one's habits (an 8 week membership at Bally's is included). But as we all know the quicker you lose the weight, the quicker it comes back. And will people REALLY change their habits in 8 weeks? Questionable.

Of course, the 55 BILLION buck a year diet industry doesn't mind repeat customers, in fact they thrive on repeat customers.

Oklahoma City is being put on a diet by their mayor who brags he wants his people to lose 1 MILLION pounds. (will they gain back 2 million lbs then?). The enthusiastic mayor of OK city has TWO domain names for the program and fancy websites with messages like how much obesity costs. Their program encourages exercise and watching what you eat. The 2600 people who have signed up already, have lost 300 lbs (they say). Nice but 2600 is but a small percentage of those who live in OK city. Perhaps not all residents are that enthusiastic about the major's challenge!

And NutraSystem has a new ad (with plenty of happy smiling slim people) and a new program called Nutrasystem advanced. You get 2 free weeks of food, food is shipped in plain boxes so your mailman doesn't know you are on a (gag) diet and the smiling slim folks in the ad tell us how much they love the food and especially the chocolate. The small print in the ad (which becomes available to those of us who have DVR's and can stop the action) tells us that those used in the ad were "renumerated" i.e. paid, and that they lost weight on the OLD program and that it isn't exactly 2 free weeks - it's more like buy 3 weeks, get on free, twice. Also says the small print, you only get the entre for $10 bucks a day. You have to buy the fruit and veggies. Seems rather pricey to me.

And then, somewhere in a quiet corner amidst all the noise of all the diet (oops NOT DIET - weight loss) groups advertising is HAES, Health at Every Size. The only program which has been suggested by CLINICAL studies to really work to help people GET HEALTHY. HAES is where you try to eat healthy and exercise a few times a week and don't fret about your weight. Because we know that DIETS DON'T WORK for most people. HAES, unlike diets, DOES work.

Problem is, I think just about EVERY American knows how to lose weight and what they SHOULD be doing for health but many choose to not do it. And maybe, that's ok too. It's nothing to feel guilty about, because for as many epidemiological studies which suggest that being obese is dangerous, there are an equal number of epidemiological studies which suggest that obesity really isn't a big factor in health, one way or another.

One of my favorite things to think about is this:

On the Titanic, destined to sink that night, how many women denied themselves desserts due to "watching their weight"? And if they had it to do over, would they have skipped that dessert?

So take a walk a few times a week, try to eat more veggies, don't fret about your weight and .... enjoy your dessert because you never know when it will be your last.

Big Medicine revisited

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

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

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

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

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

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

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

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

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

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

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

SOURCE: New England Journal of Medicine: Volume 351:2683-2693 December 23, 2004 Number 26
Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery
Lars Sjostrom, M.D., Ph.D et al

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

New "Prevent childhood obesity" initiative forgets some things

Today we got the news that Laura Bush (our First Lady) saluted the announcement of a new initiative to prevent "childhood obesity" and promote "healthy weight".

Although I generally like the Bush administration, what I do NOT like is that they are even MORE in bed with the pharmaceuticals and the diet industry than are the Democrats. I guess they really believe in this stuff because the President with a healthy cholesterol level of 170 is , believe it or not, exposing himself to muscle weakness risks and cancer risks by taking one of the statin drugs.

There are two problems with the childhood obesity "epidemic". Judging on 2 large survey studies (you know how accurate epidemiological survey studies are.... NOT), the CDC came up with the following:

According to the Centers for Disease Control and Prevention, data from two National Health and Nutrition Examination Surveys (NHANES) (1976-1980 and 2003-2004) show that prevalence of childhood overweight is increasing. For children aged 2-5 years, the prevalence increased from 5.0 percent to 13.9 percent; for those aged 6-11 years, prevalence increased from 6.5 percent to 18.8 percent; and for those aged 12-19 years, prevalence increased from 5.0 percent to 17.4 percent.

Well that's all well and good but even the worse stats such as those for those kids aged 12-19 years old put "obese" kids at a MINORITY. 19 percent obese means that 81 percent of the kids ARE NOT obese.

The other problem is, of course, that the BMI scale, an outdated inaccurate scale which was invented in the 1850's which does NOT take into consideration, muscle, gender or bone mass, puts many who are NOT obese into the "obese" area...

Finally when we think of "obese" we think of those very large kids like "the Maury Show" features from time to time (you know the ones they put in diapers and give donuts to before they show them on TV and berate the parents for "childhood abuse"?). But "obese" is medically defined as any BMI over 30.

For example, some very slim but muscular Hollywood stars and many Olympic athletes are also classified as "obese" (including the governor of California).

So no one is really sure whether those "classified" as "obese" by weight are really obese or just very muscular and/or big boned.

In any case, by any measurement, the majority of kids ARE NOT OBESE. Has anyone asked the question, why start a weight based initiative when MOST of the kids are not obese?

What this is ESSENTIALLY doing is making ALL kids including the non obese ones, utterly paranoid about BECOMING obese. Disturbing reports from the UK and Australia, both of which have stressed weight based initiatives against "childhood obesity" stated that a raising percentage of kids 12 and up are dieting, vomiting, starting smoking and doing other unhealthy things to avoid the "dreaded" obesity because the bottom line is that any kid who has a "normal" BMI will be accepted as living a healthy lifestyle REGARDLESS of how that "normal" BMI was attained.

One of the kids on a "National Body Challenge show" who was very slim asked their nutritionist why HE had to eat the "healthy food" because he wasn't fat. I have met several people who feel that they don't have to eat healthy because they are not fat therefore they assume they are healthy. Also several people who smoke who feel they are healthy because they are not fat regardless of the fact that smoking is directly associated with 400,000 deaths a year and 95 percent of chronic lung disease.

When I was a kid, they were hung up on the one number classification of IQ. Despite the many drawbacks of IQ tests and the numerous talents they do NOT test (IQ scales were never meant to be a one number fits all), children were judged and branded by their IQ number and many children were emotionally scarred for life because of this judgment. Now the one number gauge of worth is BMI.

So have these initiatives inspired kids to exercise or eat more veggies and eschew fast foods, potato chips, French fries and the like? NO WAY! Kids are MORE sedentary today than ever, they fill up on junk food and fast food and avoid good food.

So if we THINK we are giving kids the message they ought to live eat more healthy and exercise more, we are badly mistaken. The message we are giving kids is as long as they are slim, they can be as sedentary as they want and stuff junk food all day and all is ok.

Meanwhile, we are seeing outbreaks of childhood diseases which were only a memory in my day, like whooping cough, among vaccinated kids, and even things like cancer and sudden heart attack are on the rise in our kids. Maybe, just maybe, a factor in this might be that they are undernourished for fear of "obesity" (which 81 percent or more never had to worry about anyway)?

One wonders if society will ever learn to use their brains. Or are THOSE brains getting starved out also?

BBC investigation shows obesity crisis to be overblown!

We used to believe scientists and what they told us. We used to
believe official reports. Now it turns out that, more often than not,
they are telling us nonsense. We just want the truth. Sensationalist
scaremongering used to be confined to the tabloids. Now it's done by
every quango and official body in an effort to justify their existence.
Tim H, UK (comment about the "obesity epidemic" media blitz)

A new BBC program states that the "obesity epidemic" risks may be way overblown, and points out that childhood obesity statistics were not based on real data but on projected and computed data (the largest children regardless of size would be called "extremely obese").

The investigators also state that "most teachers they talk to" have NOT seen this vast amount of obesity in the schools! (neither have I seen "all these obese kids" - most kids I see in school today are painfully slim with the same percentage (or less) of obese children we saw in the fifties in each class - 1 to 3 kids)

Further, continues the investigation, the estimations of the "cost of obesity" in Britain (from a well publicized report) were computed on an error which the author of the report admits but said it made "little difference" (and the error was never corrected). Turns out the error DOUBLES the figures (incorrectly) in places.

The Foresight report put the cost to the UK by 2050 at over
45bn(pnds) a year, almost half the NHS budget.

But Radio 4's The Investigation found the estimate was based
on a misreading of figures from a parliamentary report.
The report's author admitted to the programme that he had
made an error but claimed that it made little difference.
The calculations were based on a Commons Health Select
Committee Report which estimated that in 2001, obese
people cost the NHS 1bn (pnds) a year.
But the calculations for the Foresight report failed to
notice that figure doubled to 2bn (pnds) when allowing for the
costs of both obese and overweight people.

http://news.bbc.co.uk/2/hi/health/7106219.stm

Another British govt report found that:

The increase in obesity will have surprisingly little impact
on period life expectancy of the population

http://news.bbc.co.uk/1/shared/bsp/hi/pdfs/22_11_07_modelling_fat.pdf

Finally, although a British study attempts to "show" that obesity raises the risk for cancer, the real statistics show that there are no more deaths from cancer in the obese than in slim people.

(If this "obesity epidemic" is threatening us with diabetes, why is it that in the last several decades though the INCIDENCE of obesity has doubled, the NUMBER of cases of diabetes has remained relatively the same with only a few more reported cases now than several decades ago?)

You can download the investigation podcast here:

http://www.bbc.co.uk/radio/podcasts/fileon4/

Source:

http://news.bbc.co.uk/1/hi/magazine/7105630.stm

Obesity and Cancer - Food and Cancer

Actually if you read the news articles about the Report claiming to "prove without a doubt" that obesity is a serious risk factor for cancer, which I understand has been making the headline news for many days, you might get the impression that it talks about obesity alone. But the report which is available at View/Download report actually only has one chapter on obesity although mini rants on obesity and cancer are woven into the report in several other places. And what I found while perusing the actual report is that the news claims about it, far exceed the real thing - the report talks about probabilities mostly and does not provide any new information (although they take hundreds of pages for their non informative report).

According the excellent analysis article on the Junk Food Science blog, these scientists somehow avoided including the largest and one of the most respected studies done on cancer risks called the "Women's Health Initiative". It seems, the blog continues, that they left out quite a few important studies, all of which did not agree with their desired premise i.e. that obesity causes cancer.

They do admit that they are guessing why fatness might raise the risk for cancer (and they also admit that fatness LOWERS the risk for pre menopausal breast cancer). Here is the excerpt:

There are several general mechanisms through which body
fatness and abdominal fatness could plausibly influence cancer risk. For example, increasing body fatness raises the
inflammatory response, increases circulating oestrogens, and
decreases insulin sensitivity. The physiological effects of obesity are described in more detail in Chapter 8. The effects of body fatness-related hormonal changes and inflammation on cancer processes are detailed in box 2.4

In searching for box 2.4, referenced throughout the paper, I found that their big theory is that fat is chronically inflamed due to the fact that fat tissue stores macrophages. But this is a connection which has not been proven to be bad and in fact, fat people tend to have LESS cancer and when they DO get cancer, they survive chemo better than slim people. (Gaesser, BIG FAT LIES, CA, 2002 for one). Also in the pig study, it was strongly suggested that the bodyfat in a pig helped NOT only protect against infectuous disease but ALSO against cancer - the opposite of what this new report is claiming (the pig study was one which did NOT make front page news of course).

Based on studies of pigs, researchers said, that fat helps fend off illness.
Besides keeping a body warmer, fat cells, or adipocytes, produce hormonelike proteins in reaction to invading toxins, behaving much like immune cells that fight disease.
"Adipocytes can be functional and beneficial without creating obesity," said Michael Spurlock, an animal sciences professor at Purdue University in West Lafayette, Ind.
Writing in the American Journal of Physiology, Spurlock and colleagues from the university's veterinary school said fat cells play a role in helping insulin regulate blood sugar levels and can aid the immune system's response to cancerous cells. (American Journal of Physiology, Jan 2004)

Stephen Milloy points out in his article debunking this study that:

scientists don’t really understand carcinogenesis very well. It’s known that the risk of cancer increases with age possibly because of the deterioration of DNA repair mechanisms and a few well-documented risk factors, such as family history of cancer, heavy smoking, and exposure to certain viruses and some exposures to radiation. Outside of those and perhaps a few other risk factors, the occurrence of cancer is largely inexplicable.

There are many of us who might have noticed that the groups which seem to get the most cancer are

1) slim people
2) dieters (i.e. I have known MANY people who lose a great deal of weight and THEN come down with cancer!)
3) smokers
4) for the female cancers - those on birth control medication (placed on the FDA list of cancer causing chemicals in 2004)

This report offers some insights on the whys and wherefores of cancer which may be, according to the American Cancer Society, as much as 85 percent LIFESTYLE related. And because of the erroneous information on obesity and the constant admonitions to "maintain a healthy weight" as determined by BMI, a scale invented in the mid 1800's which does not take bone mass, muscle or even gender into consideration and is, according to the CDC, suggesting weights which are "underweight" and thus not healthy for many people, I fear some of the good things the report has to say might be missed by all in the media's frenzied effort to sell us - yet another - diet.

Most cancer is preventable, the report tells us. Considering that in 1900 they reported 210 cases of cancer in the USA and even when I was a tot in the 1950's, cancer was a relatively rare disease, one does wonder about how much IS preventable. However the suggestions by the researchers seem over simplified and missing quite a few key factors which have been identified as carcinogenic in many other sources. Here's what they say:

Most cancer is preventable. The risk of cancers is
often influenced by inherited factors. Nevertheless,
it is generally agreed that the two main ways to
reduce the risk of cancer are achievable by most
well informed people, if they have the necessary
resources. These are not to smoke tobacco and to
avoid exposure to tobacco smoke; and to consume
healthy diets and be physically active, and to
maintain a healthy weight. Other factors, in
particular infectious agents, and also radiation,
industrial chemicals, and medication, affect the risk
of some cancers.

But making healthy food choices, a balanced diet containing fiber as well as a lot of veggies but low in saturated fat and avoiding transfat completely will likely reduce the risk of cancer as will as little as 20 minutes of walking, 4 or 5 times a week. However, the report's caution to avoid red meat again has no real foundation in science and in fact, red meat may have some micronutrients which are not found in other foods and even in other meats. Obviously if you eat nothing BUT red meat that may not be healthy but avoiding it altogether might be equally unhealthy. Red Meat is a good source of vitamin B12, the lack thereof which can cause neuropathy and more.

Also my bet is that the scientists totally ignored that some 94 worldwide studies suggested a strong link between the artificial sweetener, "aspartame" or "nutrasweet" and cancer especially leukemia and brain cancer!

As for maintaining a healthy weight, science STILL has not determined what IS a healthy weight for most people (but the CDC noted that people with BMIs in the overweight range seem to live longer than those in the "normal" (BMI 22-25) range.

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

Report on CDC and healthy weights and obesity deaths


It should also be noted that for 95 percent of the public, maintaining a "healthy weight" (according to BMI) means yo yo dieting or weight cycling which has been STRONGLY suggested in many clinical studies to not only RAISE the risk for most illness but also raise the risk for heart disease as well.

I haven't heard the news stories (I don't listen to the news - because it's so filled with lies) but I would bet that they DON'T AT ALL, emphasize the suggestion in the report to exercise cardio 30 minutes daily, which is a very good idea for all of us regardless of weight.

My bets are that this study was supposed to be the "piéce de resistance" - the study no one could argue with but since there are already two fine articles debunking the study's claims, perhaps it may fall short of its expectations and merely provide news headlines perhaps scaring a few fat people into Weight Loss Surgery.

Bottom line, this report provides nothing new, and a lot of wrong information about obesity AND cancer yet leaves out some of the most IMPORTANT information about carcinogens in the environment and in the foods we consume. In short it is just the usual rant against obesity cloaked in a different format and published for one reason alone... to sell diets and news papers. ho hum....

Most kids dieting or calorie restricting

A survey of 500 teens in the UK revealed that 33 percent of girls between the ages of 13-18 years old are dieting however, 50 percent of the girls admitted to eating less than 1200 calories a day (under the excuse of "eating healthy"). The suggested calorie intake for a growing teen is at least 2000 calories and 3000 calories for boys (some of whom were eating 800 calories or less per day). (see www.mypyramid.gov )

Many adults are ignoring the need to look like a concentration camp victim but teens are taking these messages seriously and confusing being super slim with healthy. The same survey found that less than 25 percent of the teens were eating the proper amount of vegetables - most were eating less than 2 portions a day of veggies.

Other surveys have found that more teens are starting smoking today than in the 1960's before all the dangers of cigarette smoking were known. Most teens start smoking in an attempt to control their weight. But those same kids exercise very little when at least 60 minutes of cardio daily is recommended for children to stay healthy. One little boy on TV, a participant in one of those health - lose weight shows, told the nutritionist that he doesn't have to eat well and exercise because he's slim. This is the common misconception that TV is giving our kids.

All this dieting and calorie restriction may be one reason why autoimmune disorder is becoming that "epidemic" that obesity never was. Or why whole schools of vaccinated kids are coming down with whooping cough. Dieting is a known challenge to the immune system even in adults - imagine how it might devastate the immune system of a growing kid.

I took a 10 year old shopping for clothing this weekend and she was painfully aware of her size.... and wanted to squeeze into a smaller size which didn't fit her just to avoid the larger size. She has a large frame and is of endomorphic bodytype but her size in the 1950's when I was in elementary school would have been considered "normal". Today in our efforts to make our kids boney, her size is larger than average.

Worried parents, concerned at all the TV messages about "widespread obesity in children" are, it seems, ending up giving their children grief if they are even slightly larger than very slim. One young girl who is a bit chunky told me that her slim sister is allowed to eat candy but she is not allowed. That same young girl told me that she skips lunch most days in school because she "doesn't like the food".

But as one RN told me, only 1 in 5 children is overweight or obese. That's 20 percent of kids who are overweight or obese which means 80 percent of children are NOT overweight or obese (and many that I see in school are painfully slim) and that is even by the very narrow measuring of the BMI scale which does not take bone mass or muscle mass or gender into consideration. Since when is 20 percent an "epidemic"?

We know from the experience of the very obese adults that many of them GOT that way from ruining their metabolisms as kids dieting...

So when do we stop punishing our kids for being healthy?

Obese children - what is abuse?

If we would listen to the media, we would put our kids on a diet, at the first sign of any fat we see. Unfortunately, our medical providers might agree with dieting our kids and look smilingly upon the parents for doing this. Weight Watchers has special programs where a kid can attend meetings for free with a member parent and get the same treatment which would include weekly weigh-ins and sometimes includes fat phobic advice.

How sad that today so many parents regard healthy kids with a bit of fat on their bodies (or even a lot of fat on their bodies) as our forefathers regarded lepers or severely disabled.

I am reminded of a comment made by Jerry Lewis in trying to raise more money for the Muscular Dystrophy Association at the 11th hour of the telethon.

"Would you like to be saddled with a crippled child?" he asked his audience by way of telling them if not, they should give more money. I wonder if today's parents would ask "would you like to be saddled with a fat child?"

And of course, the ultimate we are seeing more and more often is weight loss surgery for kids at a time when they NEED all their vitamins and nutrients. Sometimes kids get a lap band which at least allows normal digestion but also, sometimes kids are given gastric bypass which causes a lifelong illness of their digestive system.

One doctor opined that these surgeries may have an impact on children's health in adulthood. Understatement of the year.

One news interviewer asked a young person who had had a Lap band placed, if she was exercising now and the parents said she was joined up with a gym but when the parents were asked if she had exercised before she got the lap band, they both said "well... no"

Often I have seen that parents and doctors do NOT seem to be emphasizing healthy food choices for kids, only LESS Food and to be slim. I have two teenage grandkids who began smoking to control their weight. Most people DO begin smoking for that reason.

Having sat on the phone with a 48 year old woman who got weight loss surgery in her early 20's, mostly because of parental pressure and having her, now, ill in bed from the repercussions, weep bitterly and tell me how her mother didn't love her because she was fat, I think the physical repercussions of weight loss surgery, liposuction and dieting for any young girl, are nothing compared to the psychological trauma she may face later on.

And as the Swedish Obesity Study has shown us, weight loss surgery patients after 10 years, had only kept off an average of 16 percent of their original body weight.

We should really question this business of dieting our overweight kids - is it a type of abuse where the parents, albeit well meaning, might induce physical and psychological trauma for life? This might well end up in the wasting of a life and all because of a bit of extra bodyfat. A girl who is not using her talents because she is so busy with the hard work of dealing with stomach surgery to maintain a weight that is acceptable to a society which values not much more in a woman than the way she looks.

Read this and weep, for our children are suffering.... Will the insanity ever stop?

NOTE: for an update of Brooke Bates, please read blog of June 16, 2008.

Actually fat people live longer than WLS patients, suggests study

Those researchers on the Swedish Obesity Study (one of the studies which the news media is using to "prove" that gastric bypass patients live longer than fat people), admitted that they did not randomize the study and thus they could pick and choose which fat people they wanted in the study (in the control group which did not receive WLS). The fat people chosen had 25 percent more heart disease and 6.3 percent more diabetes than those chosen to receive WLS.

So if all things had been even, there should have been 25 percent more deaths in the fat (no WLS) group than in the WLS patients.

But there was only 1.3 percent more deaths in the fat group despite the 25 percent more heart disease. Which means the fat people survived better than the WLS patients.

So much for media spin. It should be mentioned that the Swedish Obesity study was HEAVILY funded by several American pharmaceutical firms and Johnson & Johnson (which makes surgical instruments and gastric bands).

For a detailed analysis of the studies visit this blog.

For my blog on this (in August) visit here.

Do gastric bypass patients really live longer than fat people?

In the last couple of days, the headliner news has been that two studies have suggested that gastric bypass patients live longer than fat people.

"Weight loss surgery patients are SIGNIFICANTLY LESS likely to die prematurely" stated an article in the Washington Post.
"This is HUGE!", commented Dr David Flum, to the Washington Post. Dr Flum is a bariatric surgeon.
"It's going to dispel the notion that bariatric surgery is cosmetic surgery and support the notion that it saves lives," boasted Dr. Philip Schauer, another weight loss surgery surgeon who has been prominent in the news articles denying the negative repercussions of bariatric surgery.
"The question as to whether intentional weight loss improves life span has been answered," wrote George Bray, a known enthusiastic advocate of the diet industry.

All well and good but do the two studies they quoted really prove their point?

The answer is no.

In the Swedish Obesity Study (reported in NEJ Dec 23, 2004, vol 351, no. 126) , although 11,000 people applied to be included, only 3900 were accepted to receive weight loss surgery in 1987 when the study was initiated. A matched equal number of controls were selected and given diet advice. The cohort was examined at the 2 year point in the study and at the 10 year point.

At the 2 year point (2 years post op for the weight loss surgery patients), a goodly portion had been "lost to follow up" and only 2010 patients (out of the original 3900) were examined. It's likely that most of these were gastric banding because that was the more often done procedure in the 1980's. Two years is obviously NOT long term follow up.

At the 10 year point, only 627 of the original 3900 were left to examine - the rest had been "lost to followup". And of these 627, only 34 were gastric bypass patients. Of the rest, 400 some were vertical gastric banding and the remainder were adjustable banding.

Since only 16 percent of the weight loss surgery patients were available to examine at the 10 year point, this study poses more questions than answers including the usual question "where are the others?"

Well, we got sort of an answer on this one. Apparently, the 85 percent could be tracked as far as whether they died because of Sweden's nationalized health care records. But that they were "lost for follow up" suggests that their results were even less impressive than the 641 they COULD follow up - i.e. those folks available for follow up had only kept off an average of 16 percent of their weight!

So lets talk about the deaths. A fine analysis by a medical expert solves the mystery. The fat people had a 1.3 percent greater death rate which works out to 100 and some more deaths in the 3900 fat people than in the WLS patients. BUT, apparently, according to the researchers on the the Swedish Obesity study, they did not randomize the study which means instead of taking a random section of fat people, they could pick and choose. And pick and choose they did. Turns out the fat people chosen for this study had 25 percent MORE heart disease, 6.3 percent more diabetes than did those chosen to receive WLS and also the fat folks were an average of 1.5 years older than those who got WLS.

So the S.O.S. if properly interpreted, suggests the opposite of what the news told us... that fat people live significantly longer than WLS patients (and keep in mind most of the cohort in the S.O.S. were gastric banding which has a much lower death rate than gastric bypass). Why? Because there was 25 percent MORE heart disease in the fat people but only a 1.3 greater incidence of death! (To be even with the WLS patients, the fat people should have had a 25 percent greater incidence of death). That causes a hmmm, doesn't it? For details of the analysis please visit here (it's a great blog and you might want to read all the posts!).


The second study took place in Utah. Here 7925 gastric bypass patients were compared to 7925 fat people. The fat people were selected by weight recorded on their driver's licenses.

Researchers found that there were 108 more deaths in the fat people than in the gastric bypass patients (231 deaths in the fat controls, 113 deaths in the gastric bypass patients).

This study seems to have all kinds of problems in my book. First of all, who puts their real weight on their driver's license? Secondly there seems to have been no contact with any kind of medical records on the fat people... the deaths were taken from the death certificates on file. So we have no idea whether the fat people chosen to be the controls were smokers (greatly increases their risk) or yo yo dieters which greatly increases the death risk. We also have no idea of whether they exercised or not which greatly DECREASES the risk of death in people of all sizes. (REF: 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)

Secondly with regards to the gastric bypass patients, the followup was only 7 years and the serious repercussions of vitamin deficiencies and nutrient shortages in gastric bypass tend to show up after the 10th year post op. Basically this was NOT a long term study.

So these two studies don't prove ANYTHING about longevity after gastric bypass.

And also, the end weight results of both studies were a bit disappointing to some gastric bypass patients. At the 10 year point patients had only retained an average of a 50 - 60 lb weight loss (for those 350 lbs to start with and up). And only 35 percent of patients were still "diabetes free" so the weight loss surgery didn't work really well for diabetes either, it seems.

Meanwhile the ASBS, the professional organization for bariatric surgeons, has renamed themselves to include "metabolic diseases" in anticipation of greatly increasing their client base to normal weight diabetics.

I guess since Edward Mason, the inventor of the gastric bypass, left their presidency, they might have forgotten that the reason he thought a "billroth II" (predecessor of today's gastric bypass) would work for fat people was because normal weight patients after a billroth II could not keep their weight at anything close to normal!

Also the expected lifespan (for normal weight patients) after a Billroth II was 15 to 25 years. Since modern medication and treatment there is no expected shortening of lifespan for type II diabetics.

As far as the news media's exaggeration of these NON findings from the two studies, a quote by Stephen Milloy comes to mind:

"But who needs data when you can spoon-feed junk science to a gullible media?"
- Steven Milloy, Fox News

How the Biggest Loser lost 214 lbs

Erik Chopin, 36 years old and winner of the "The biggest loser", revealed in an interview on Fox news how he lost 214 lbs. This was in response to the story on how the cold virus might cause obesity.

"So did a virus cause YOUR obesity?," asked Neil Cavuto
"Well, I don't know," said Erik, "but that would be nice if they'd make a vaccine for obesity - would have saved me a whole lot of work!"

"It's exercise and cutting the calories", Erik said, in answer to how he lost the weight, "Anyone can do it!"

Well, not exactly. When asked HOW MUCH exercise he did, Erik admitted that he did 4 or 5 hours of cardio exercise daily. "It was pretty intense," he admitted, " Basically, while I was on the show, it was my job!"

He apparently continued this killer workout program for a couple of months after he returned home but now has to go to work in a regular job - probably because of something silly like the need to have money to live. So he has geared down his program, he told the reporter... he only does 1 hour of running a day.

And from the tape we watched, he has definitely gained back some weight, so I guess his running one hour a day didn't keep off all the weight as the reporter said it had... The collage (above) shows Erik how he looked after he lost 214 lbs and how he looked a few days ago (in the black shirt) as he appeared on Neil Cavuto show.

One thing which strikes me about all of this. How come when people tell us fat folks "all you have to do is slightly cut the calories and walk for 20 minutes a day and the weight will come off", why did Erik Chopin have to work out 4 and 5 HOURS a day (and cut the calories) for HIS weight to come off?

So anyway, there you have it. Just work out 4 and 5 hours a day and if you are 36 years old, YOU TOO, can look like Erik Chopin DID after his stint on the Biggest Loser. What? Don't have the time? Have to work and do other things besides exercise? Older than 36 years old? Details details.... :)

Sue

Your fat friends can make you fat? III

The full text for the New England Journal of Medicine, "fat is contagious" study is available for free at this url:

http://content.nejm.org/cgi/content/full/357/4/370?query=TOC

The collection of the data seems hit or miss - individuals in the cohort were apparently asked to identify spouse, sibs and at least one close friend. Over the years, some individuals choose a different close friend.

The closest ties of friendship were viewed when two individuals chose each other as close friends. This was identified by the researchers as a "mutual friendship".

The problem with this is the "social network" of any given individual includes far more than merely ONE close friend but rather up to 30 or more close friends. Thus it might be said that the original information which the researchers fed into the computer in order to derive this analysis was erroneous and thus this would make the resulting analysis, invalid. As we say in the computer field "garbage-in/ garbage out".

Also, their results suggested that sibs were LESS likely than friends to "cause" or "influence" obesity in other sibs and spouses were the LEAST likely to influence their spouses as far as weight.

From observation, this result seems very erroneous... spouses OFTEN influence each other's weight as they share mutual cooking, often recreate together and enjoy similar interests... and sibs more often than not, show the same body type as other sibs due to shared genetics... so it seems like their computer generated results came out backward from what the reality might be....

Finally the last sentence of the conclusion is most troubling. From this erroneous study based on a false picture of the social network of the cohort (a picture which only depicts members of the cohort as having only ONE close friend at any given time), these researchers concluded that:

"This highlights the necessity of approaching obesity not only as a clinical problem but also as a public health problem."

It's almost as if this "study" builds and analyzes a false picture of the social network of the individuals of the cohort to come to a conclusion with political overtones based on what is a buzz word to many Americans i.e. "public health", the implications of which in the extreme, could lead to treating overweight people like lepers were treated in the past. That is, falsely portraying obesity as a "contagious disease" in order to perpetuate the ostracism of anyone who is overweight. Hopefully society is not that insane - yet, but this type of thing is a bit chilling to think about, to put it mildly.