I received this email today from fellow comedian and blogger Josh Goguen:
Hey, Tom –
I have satellite radio and they have a channel called Doctor Radio. I happened to be listening when they had a LAP BAND/Gastric ByPass doctor on and I couldn’t believe the things they were saying. She made it sound like something that’s just so great and easy and, aww come on, you’re not going to diet, who are you kidding?
Then she rattled off all these benefits of losing weight (diabetes relief, lower cholesterol, etc.) while completely glossing over how restrictive the diet is or how risky surgery itself is. It almost seemed sadistic. I could almost picture POWs being returned, emaciated while their captors say, “Yes, we did starve our prisoners, but if you look at their triglyceride levels, you’ll see they’ve benefited tremendously.”
Not one person who called in compared it to a forced diet and asked if a person skipped the surgery and just ate the post op food if they’d lose the same weight. It was recorded early in the week, so the opportunity wasn’t there for me to do so.
It seems as if a segment of the medical community isn’t interested in actually educating and helping people help themselves but rather just devising new means to “effortlessly” fix a problem. I wonder what will happen to these people should government healthcare takes effect.
Honestly, if that happens, I believe we can say good bye to the hopes of the lipid hypothesis overturned. I wrote a blog based off of it, but I couldn’t help but share this with you via e-mail.
Josh Goguen
Josh’s blog post on the topic, in which he creates his own miracle diet plan, is spot-on. (And I recommend adding his blog to your reading list, because he covers a nice variety of topics and makes a habit of being spot-on.)
In my previous post about the Lap-Band surgery, I mentioned that a friend of mine had gastric bypass surgery and now regrets it. So imagine my surprise when I poked through some bariatric-sugery literature available at our family doctor’s office and found that this same friend is mentioned as a surgery success story. This is what the literature said about her:
[Her name] is a size 4 today after losing more than 100 pounds from her peak weight of 230. A mother of three, her drive was to be able to be active with her youngest, the way she used to be.
Before her surgery, she had diabetes, sleep apnea, and was on heart medication. That’s all in the past. Today she and her husband and the kids play golf and tennis together.
Why, doesn’t that just sound fantastic? So I emailed her to ask if she knew she was being used as an example of the wonders of weight-loss surgery. Her reply:
Had I done it your way, I truly would have been a success story. Glad they’re excited about cutting out 20 feet of intestines and subsequently yanking out my gallbladder and keeping me in a constant state of vitamin deficiency.
But gee whiz, she can play tennis now and wear size 4 clothes …
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“It seems as if a segment of the medical community isn’t interested in actually educating and helping people help themselves but rather just devising new means to “effortlessly” fix a problem. I wonder what will happen to these people should government healthcare takes effect.”
My wife is a physician and I asked her this question in how it relates to them prescribing statins to patients. Why would you prescribe a drug when if they eat better and exercise they won’t need it. The answer is pretty simple in that they won’t. You can educate people all you want but they still have to put that education to use.
True enough. But the education side of the equation has been screwed up for some time. I had a friend who was on statins because his cholesterol was very high, despite the lowfat diet his doctor recommended. After seeing Fat Head, he gave up the carbs and his cholesterol and triglycerides plummeted. He was always willing to do the right thing, but was given the wrong definition of the right thing.
This is what I hate about the American medical system. Drugs, medical devices and surgery are pushed because they return a profit for the pushers. Good nutrition, on the other hand, only helps the person who eats well.. it won’t ever buy a surgeon a Mercedes, so by all means, let’s ignore it as a solution. I wonder how much money the hospital and surgeon make each time they do one of these “easy” lapband surgeries. Must be a lot since they push the procedure so hard.
I believe most doctors who push lowfat diets, etc., are sincere and mean well, but happen to be misinformed.
But these lap-band surgeons are starting to impress me as the medical version of ambulance-chasing attorneys. It’s all about the money, period.
(My song about attorneys, by the way, made a brief appearance in the film. You can hear the entire version on my other blog.)
How can they call abdominal surgery “easy”. Certainly not for the patient.
Reminds me of the camel dealer showing how bringing two bricks together with the camel’s testicles would cause the camel to take on the last bit of water for a long desert crossing. The novice replied, “Doesn’t that hurt? The dealer replied, “Not if you keep your thumbs on the outside of the bricks.”
“I could almost picture POWs being returned, emaciated while their captors say, ‘Yes, we did starve our prisoners, but if you look at their triglyceride levels, you’ll see they’ve benefited tremendously.'”
Yeah, good and funny analogy. Got to love those secondary benefits, eh?
Of course lap-bands have a miserable long-term success rate. Most keep eating the carbs and raising the insulin. I have wondered how these surgeons rationalize their “cure.” Do they argue that overweight people were just born with too much intestinal surface area, genetic freaks of gastro-intestinal largess?
Perhaps this just shows what Taubes said in GCBC: Obesity research is not a science, it is a cult — in which case it makes sense, the high priests will take every bloody sacrifice they can get.
Don
I still can’t believe they have people undergo surgery, then put them on a low-carb diet. Why not try the diet first? Well, we know … you can’t charge $25,000 for dietary advice.
Just curious, did she write the doctor and tell them to stop misrepresenting her?
Not her style, although she did ask me to save her a copy of the literature.
All science is a cult, to some extent, because most scientists don’t think for themselves. Dr. Eades used a great George Carlin quote recently, something to the effect of “Think of how stupid the average person is. Then realize that half the people are stupider than that”. This applies to doctors and scientists as well, all the more reason to use your own functioning brain (depending on which side of Carlin’s fence you fall, I suppose).
We put medical doctors on quite a pedestal in this country, a status they do not share in other parts of the world. I’m reminded of a story Prof. Peter Kaus once told me. UC Riverside used to have (and maybe still has) an accelerated program for pre-med students. We had a special physics class for these future doctors, and one of the topics dealt with a commonly used example called the Atwood machine. At one point in the class, a frustrated future physician was having difficulty grasping the problem and asked Prof. Kaus “What’s the point of this Atwood machine anyway?”
Prof. Kaus replied, “It keeps people like you from becoming a doctor.”
Love it!
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.
Remember a sadist is a person whose kind to a masochist.
I refer to it as “barbaric surgery”.
Dave –
That was a great response to a very interesting post. It altered my thinking.
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.
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.
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.)
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.
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?
There is no money in low carb or fasting al la Dr. Jason Fung et. al, and there is much less need for scientific proof because they are easily reversible and not traumatic.
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.
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 …
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!
Josh Gordan’s site is for sale.