Comments on: The Lap Band Still Plays On

By: Rambodoc

Rambodoc — Wed, 27 May 2009 23:22:40 +0000

Yes, there are some ‘malabsorptive’ dominant procedures where a patient would be unable to digest and absorb fats: how else, apart from eating less, would a person shed off huge excess poundage? What, ‘low carb’- what IS that??
One thing I have always felt is that surgeons just dismiss away patients not willing for surgery, and refer them to a dietician or internist. Internists will just tell you to go on ‘1800 cals, 80 grams proteins, Sibutramine for 6 months, Orlistat for 3 months’, as if that would take care of everything, while dieticians would start the usual ‘7 AM- 1 cup of tea, two biscuits, 8.30 AM- bowl of corn flakes, one fruit, one piece of toast with light butter’ crap…..
So the whole system sucks for the non-bariatric obese patient.
Thanks!

By: Pam

Pam — Wed, 27 May 2009 12:36:39 +0000

My sister had the surgery and has gained back most of her weight and is now struggling to lose again!! So sad!!!! I went on low carb 2 years ago and lost most of my excess weight. Keeping it off and trying to lose more. Happy, healthy and loving life!! Glad I didn’t go under the knife with her.

Your sister is proof that even small amounts of the wrong foods can bring the weight back for someone who continues eating foods that drive up insulin.

And we’ve got public-policy bozos who still think it’s all about just eating less …

By: Rambodoc

Rambodoc — Wed, 27 May 2009 09:11:24 +0000

Not that I know of. You know how confusing scientific literature can be. Even on the basic subject of very low carb diet versus conventional diet, there are lots of controversies, with several mainstream papers stating that low carb diets get their weight loss leverage merely from caloric restriction and that, too, for a short duration. Here is one such example: http://www.ncbi.nlm.nih.gov/pubmed/15148064.
OTOH, we all know how good low carb diets can be with obese people as well as in metabolic syndrome. The problem is with the contradictions with published studies.

There is another point I would like to make here: as bariatric surgery candidates are not able to achieve or maintain weight loss with lifestyle changes (only 5% are), surgery provides them a way they can sustain weight loss. It would be very interesting to compare patients after bariatric surgery with a very low carb diet versus a high carb diet. In fact, after gastric bypass, patients become intolerant to sugars, and possibly become relatively lower carb consumers. I am not aware of specific numbers on this, though.

That’s what my friend who went through surgery told me. She was basically forced onto a diet that’s mostly protein and greens; i.e., a low-carb diet. The trouble is, she now also has a difficult time digesting fats — another side effect of the surgery.

When she saw Fat Head, she realized she probably could’ve solved all her problems by changing her diet — but no one told her that. They kept telling her just to eat less, which didn’t help.

By: Rambodoc

Rambodoc — Mon, 25 May 2009 14:14:40 +0000

I recently bookmarked your site, and am coming back for second helpings. There is definitely some truth in all you say here in this post, but not all. You are making some empirical statements which fly in the face of all current evidence.
As far as bariatric surgery is concerned, I have the following points to make (and certainly not the only ones, being one myself!):
1. It is the only scientifically proven weight loss method for the Clinically Severe Obese (the politically correct term for ‘morbidly obese’) patients. The resolution of excess fat mass is in the range of 50% (lap bands) to around 85% (BPDs or duodenal switches).
2. The resolution of associated major diseases like diabetes, high blood pressure, sleep apnea, etc. is very high (85% for diabetes, for example).
3. Multiple high level trials have shown the efficacy of weight loss in these patients where clinically supervised weight loss methods have failed on at least two or more occasions.
4. The lives of most of these patients is completely turned around for the better in most cases.
5. There is a percentage of patients who are worse off after surgery, whether due to technical complications or lack of counseling.
6. It is very typical of surgeons to oversell the surgery because of money and because of industry-related links.
7. The bariatric fraternity is too knife-oriented for its own good.
I suppose there are lots more to say here, but I gotta go now.
Thanks for indulging my comment in your blog!

I appreciate the commments. Has anyone, as far as you know, compared the efficacy of the surgery vs. simply following a zero-carb diet for alleviating diabetes, sleep apnea, etc?

By: D

Fri, 22 May 2009 13:33:44 +0000

I just saw this article about a woman in Britain who was hypnotized into thinking she had the lap band surgery, and lost 55 lbs. She “remembers” having the surgery and can now eat only small amounts of food due to her “surgery”. It sounds as scary as the actual surgery. Weight loss is great, but if you aren’t eating enough food for optimum nutrition, what good is it? Give me a good old low carb diet any day, and bring on the steak!

http://www.thesun.co.uk/sol/homepage/news/article2439766.ece

I should try being hypnotized into thinking I’ve had hair transplants.

I agree; limiting yourself to a few ounces of food per day isn’t good in the long run, surgery or not.

By: DCellen

DCellen — Thu, 21 May 2009 11:04:09 +0000

I had gastric bypass in 2002 and I regret it. Yes, I lost 180 lbs. But after about a year or two, I was on my own in terms of weight loss and ended up having to maintain a low-carb diet for life. I could have just done a low-carb diet in the first place. After surgery, I had gall bladder disease, significant loss of bone mass, anemia, vitamin deficiency, “dumping syndrome” (as unpleasant as it sounds) which happens at random and has sent me to the emergency room a couple of times, and I literally have an entire cabinet in my kitchen full of vitamins that I take to try to stave off the detrimental effects of the surgery. The weight loss benefits of surgery last a year or two, but the health problems last forever. People always ask me how I lost weight and I HATE telling them I had the surgery because they assume that’s the answer to obesity. It’s not. What I’ve done for 7 years after the surgery was the answer.

I’m surprised 20/20 or 60 Minutes has doesn’t done an expose on this scam. (If they have, I missed it.)

By: Lisa Sargese

Lisa Sargese — Wed, 20 May 2009 06:43:11 +0000

I’ve undergone BOTH surgeries and can tell you from experience, they do not work. I am now rehabilitating myself after years of malnutrition. It’s not called the Weight Loss Surgery Industry for nothing. These folks are surgeons. They’re not interested in nourishment or overall wellness. They’re interested in their field and in statistics supporting what they do. The patients end up being victims. And if we gain back weight we’re always made to feel it’s our fault.

I’ve read your blog, and you do a good job of educating people about what the surgeries accomplish … and don’t. How would you feel about writing up a guest column to be posted here as well? I’m seeing these ads everywhere now, including on TV, and I believe it’s important for people who may be lured into surgery out of desperation to get the scoop from people who’ve gone through it.

Lemme know.

By: KD

KD — Wed, 20 May 2009 03:04:07 +0000

I saw yet another billboard today advertising lapband that had a guy eating a sandwich and large text saying, “Dieting sucks”

I don’t think I’ve seen such misleading advertising in a long time, even by lapband standards.

My wife and I just saw a TV ad for lap-band surgery about an hour ago. All these happy, skinny people, etc. I was ready to throw my dish of almonds through the screen.

By: Danielle

Danielle — Tue, 19 May 2009 17:09:07 +0000

Dave -

That was a great response to a very interesting post. It altered my thinking.

By: Brian

Brian — Tue, 19 May 2009 12:45:31 +0000

This reminds me, I used to consult in the bariatric program at a major hospital here in Houston. I say used to because the dieticians wanted nothing to do with me…one can only wonder why.

Those coming in for surgery, lapband or bypass had livers that were about to explode. Coupled with their weight, any type of surgery was a major risk. Since their livers had to be “fixed” before surgery and given their state of desperation, they gladly obliged.

So what did they do to fix their livers? They put them on a liquid diet that was 50% protein, 45% fat and 5% carbohydrate. Their livers rebounded and they lost weight.

Blinded by the fact their livers were healthier, they eagerly went into surgery. Not once did I hear a doctor or dietician say, “Why don’t you continue this diet and see were it takes you?”

Funny, in a sadistic sort of way.

Brian

Someday we’ll look back on this procedure and see it for the abomination that it is.