One of the times I interviewed Dr. Mike Eades for Fat Head, he told me (after we were done shooting) that the usual treatment pattern for type 2 diabetes and other diet-related ailments goes something like this:
- Doctor puts patient on a low-fat diet
- Patient’s condition doesn’t get any better or gets even worse
- Doctor declares that diet won’t fix the problem and prescribes a drug
I’m afraid we’ll soon be seeing more and more of an alternate version of that treatment pattern:
- Doctor puts patient on a low-fat diet
- Patient’s condition doesn’t get any better or gets even worse
- Doctor declares that diet won’t fix the problem and recommends surgery
There were some dramatic headlines this week about a new study showing that weight-loss surgery works even better than diet or drugs (wow!) for reversing type 2 diabetes. Here are some quotes from a news story in the New York Times:
Two studies have found that weight-loss operations worked much better than the standard therapies for Type 2 diabetes in obese and overweight people whose blood sugar was out of control. Those who had surgery, which stapled the stomach and rerouted the small intestine, were much more likely to have a complete remission of diabetes, or to need less medicine, than people who were given the typical regimen of drugs, diet and exercise.
Hmm, I wonder what the typical regimen of drugs, diet and exercise would be? We’ll come back to that.
The new studies, published on Monday by The New England Journal of Medicine, are the first to rigorously compare medical treatment with these particular stomach and intestinal operations as ways to control diabetes. Doctors had been noticing for years that weight-loss operations, also called bariatric surgery, could sometimes get rid of Type 2 diabetes. But they had no hard data.
Experts say better treatments are desperately needed for the disease.
“Type 2 diabetes is one of the fastest growing epidemics in human history,” according to an editorial published with the two studies.
Yes indeed, rates of type 2 diabetes have been skyrocketing in the past few decades. Now … what’s changed in the population since, say, 1980? Have we been suffering from a shortage of bariatric surgery, whereas our grandparents all had their stomachs stapled as part of their high-school graduation ceremonies? I don’t think so.
One of the studies, conducted at the Catholic University in Rome, compared two types of surgery with usual medical treatment. After two years, the surgical groups had complete remission rates of 75 percent and 95 percent; there were no remissions in patients who received medical treatment.
The second study, at the Cleveland Clinic, compared two types of surgery with an intensive medical regimen. The remission rates one year after surgery were lower than in the Italian study — 42 percent and 37 percent — at least in part because the American study used a stricter definition of remission.
Sounds as if those Italians need to tighten up their definitions a bit. Otherwise we’ll have diabetics moving to Italy so they can become non-diabetics. The Italian Tourism Board may even start a new campaign.
Come to Italy! The scenery is a-lovely, the people are a-nice, and your fasting glucose will-a drop by 30 points!
I looked up the study conducted in the U.S. to see what “typical” regimen produced such lousy results compared to hacking up the digestive system. Can’t say I was surprised:
All patients received intensive medical therapy, as defined by American Diabetes Association (ADA) guidelines, including lifestyle counseling, weight management, frequent home glucose monitoring, and the use of newer drug therapies (e.g., incretin analogues) approved by the Food and Drug Administration.
Fabulous. The non-surgical patients were told to follow the ADA guidelines … you know, the guidelines that explain how carbohydrates drive up your blood sugar and therefore you should base your diet on them. Talk about rigging the game in your favor. That’s like spiking one team’s Gatorade with vodka before the Super Bowl.
Tom Brady is having a rough day out there. He’s been sacked six times, he’s been knocked down three times, and he’s fallen down 22 times for no apparent reason. I guess the Giants are just a better team, folks.
Every 3 months for the first 12 months, patients returned for study visits with a diabetes specialist at the Cleveland Clinic. Patients were counseled by a diabetes educator and evaluated for bariatric surgery by a psychologist and encouraged to participate in the Weight Watchers program.
Double fabulous. The patients were counseled by a diabetes educator. Here’s all you need to know about that: Hope Warshaw is a diabetes educator.
Then they were encouraged to follow the Weight Watchers diet – another low-fat diet. The researchers not only spiked the opposing team’s Gatorade with vodka, they added a few sleeping pills as well.
Folks, Brady just went down again despite not being touched, and I don’t think he’s getting up. This Giants defense is on fire today!
So we had one group of patients who were encouraged to follow a low-fat, high-carb diet and another group of patients who underwent surgery and – surprise! – the surgery group had higher rates of remission. Boy, mangling the digestive system Mother Nature gave us must perform some biological miracles.
It’s been nearly three years since I wrote about gastric bypass and lap-band surgery, so here’s a review of what patients are told to eat afterwards:
The second phase of the Lap-Band diet consists of 5 to 6 weeks of a modified full liquid diet; the key component of this phase is consuming two ounces of a protein shake every hour for ten to twelve hours a day with two ounces of other liquids such as soup, baby food, or sugar-free gelatin three times a day.
During the second six weeks following Lap-Band surgery patients may eat food that is shredded in a food processor prior to eating. The basic foods on the Lap-Band diet include meats or other forms of protein, vegetables, and salads.
After Lap-Band surgery the stomach will never hold more than 4 to 6 ounces per meal, so making every bite count is essential for healthy and nutritionally rounded weight loss success. Protein is especially important following Lap-Band surgery. The Lap-Band diet does not include most bread, potatoes and other starchy vegetables.
Surgeons reduce your stomach to an itty-bitty pouch, so you’re encouraged to base your itty-bitty meals on protein foods and vegetables while skipping the bread, potatoes and other starchy vegetables. In other words, it’s a low-carb diet … the itty-bitty version. Even if you ignored the advice and wanted to eat a big bowl of Kellogg’s Krave, you couldn’t. The itty-bitty pouch wouldn’t hold more than few ounces.
So we’re supposed to be impressed that people who undergo surgery and are limited afterwards to a few ounces of protein and vegetables end up reversing diabetes? Based on this rigged result, we’re perhaps going to start treating more diabetics with surgery – without first comparing surgery to a simple low-carb diet? What kind of doctors would promote that idea? Perhaps we should look at the disclosures in this (ahem) study:
Dr. Schauer reports receiving payment for board membership from Ethicon Endo-Surgery, Surgiquest, Barosense, RemedyMD, and Stryker, consulting fees from Ethicon Endo-Surgery, Stryker, Gore, and Carefusion, payment for expert testimony from Physicians Review of Surgery, and lecture fees from Ethicon Endo-Surgery, Allergan, Cinemed, and Quadrant Healthcare, holding a patent for a medical device to enhance weight loss in codevelopment with the Cleveland Clinic, royalties from Springer, having an equity interest in Intuitive Surgical, Barosense, Surgiquest, and RemedyMD, and receiving institutional grant support (to the Cleveland Clinic) from Ethicon Endo-Surgery and Bard Davol; Dr. Kashyap, receiving consulting fees from Ethicon; Dr. Brethauer, receiving consulting fees, lecture fees, and payment for board membership from Ethicon Endo-Surgery and lecture fees from Covidien; Dr. Kirwan, receiving grant support from Nestle and ScottCare.
Ah, I see. The study was conducted by a bunch of doctors who are paid by firms in the weight-loss surgery industry.
No other potential conflict of interest relevant to this article was reported.
Oh, that’s okay. I think the conflicts already reported were quite enough.
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Isn’t it amazing that so many otherwise-intelligent people (e.g., folks who graduated from medical school) can be so utterly blind to the truth staring them in the face?
“It’s hard to get a man to understand something if his salary depends on him not understanding it.” – Upton Sinclair.
Did you ever get a reply to that email you sent her?
The email to Hope Warshaw? No, of course not.
Have a psychosis? Get a lobotomy.
Have Type 2 diabetes? Get your stomach stapled.
I see some real parallels here.
Someday — and I hope it’s sooner rather than later — bariatric surgery will be viewed as a barbaric practice akin to lobotomies.
It’s criminal. There’s no other word for it. Very sad. I have a friend whose husband died of complications from bariatric surgery. Left her with a little girl and a baby on the way. And the sad thing is he wasn’t even fat. Stocky, but not fat. Some crooked surgeon convinced them he was headed for heart disease and had more chance of surviving to see his children grow up with the surgery. Yes, that worked out great!
That doctor should be banned from practicing.
So it seems to me that if people started on the post lap band diet, with out undertaking the surgery, they would have good fat loss results.
Would that be right?
thanks
Yes, and they wouldn’t have to limit themselves to 4-oz. meals. Dr. Westman and others have conducted studies in which a low-carb diet reduced or eliminated symptoms of diabetes in most of the patients.
Very timely. My husband just got back from the doctor for a check up. Last time he went he was told to change his lifestyle or go on statins etc. My husband changed his lifestlye. The doctor was quite frankly SHOCKED. He said “no one actually changes their lifestyle, they always come back for the drugs”. My thoughts are that many people probably try to change but can’t stick to the low fat diet!!
Indeed. Who wants to be fatigued and depressed?
I have a very close, obese friend who’s considering surgery to help with weightless and health issues. I want to be supportive of her, but I’ve read all your posts about weight loss surgery and I am a little frightened for her. She knows nutrition is my hobby and that I’ve lost a lot of weight and I’ve hinted that if she ever wants any advice, all she needs to do is ask, but she’s never taken me up on the offer. I don’t want to Be That Person that offers so much unsolicited advice that friends won’t confide in me. Have you ever been able to successfully steer anyone clear of the surgery path?
No, but I’ve never had a chance to talk to someone pre-surgery. I have a good friend who had bariatric surgery, which her doctor recommended because she was overweight and becoming diabetic. When she saw Fat Head later and realized she probably could have avoided he diabetes with a low-carb diet, she was royally pissed off. She’s had quite a few health issues since the surgery and regrets having it done.
Wow. I particularly liked the use of ‘incretin analogues’
Incretin? inCRETIN? Someone’s having fun…….
My head hurts, there is not enough padding in the world…..
My head hurts too, but mostly from banging it on my desk.
Isn’t it amazing that so many otherwise-intelligent people (e.g., folks who graduated from medical school) can be so utterly blind to the truth staring them in the face?
“It’s hard to get a man to understand something if his salary depends on him not understanding it.” – Upton Sinclair.
Did you ever get a reply to that email you sent her?
The email to Hope Warshaw? No, of course not.
Oh, but the paper was peer reviewed, wasn’t it? No doubt by others in the pay of the same organisations. It makes me want to scream!
Have a psychosis? Get a lobotomy.
Have Type 2 diabetes? Get your stomach stapled.
I see some real parallels here.
Someday — and I hope it’s sooner rather than later — bariatric surgery will be viewed as a barbaric practice akin to lobotomies.
It’s criminal. There’s no other word for it. Very sad. I have a friend whose husband died of complications from bariatric surgery. Left her with a little girl and a baby on the way. And the sad thing is he wasn’t even fat. Stocky, but not fat. Some crooked surgeon convinced them he was headed for heart disease and had more chance of surviving to see his children grow up with the surgery. Yes, that worked out great!
That doctor should be banned from practicing.
So it seems to me that if people started on the post lap band diet, with out undertaking the surgery, they would have good fat loss results.
Would that be right?
thanks
Yes, and they wouldn’t have to limit themselves to 4-oz. meals. Dr. Westman and others have conducted studies in which a low-carb diet reduced or eliminated symptoms of diabetes in most of the patients.
Very timely. My husband just got back from the doctor for a check up. Last time he went he was told to change his lifestyle or go on statins etc. My husband changed his lifestlye. The doctor was quite frankly SHOCKED. He said “no one actually changes their lifestyle, they always come back for the drugs”. My thoughts are that many people probably try to change but can’t stick to the low fat diet!!
Indeed. Who wants to be fatigued and depressed?
I have a very close, obese friend who’s considering surgery to help with weightless and health issues. I want to be supportive of her, but I’ve read all your posts about weight loss surgery and I am a little frightened for her. She knows nutrition is my hobby and that I’ve lost a lot of weight and I’ve hinted that if she ever wants any advice, all she needs to do is ask, but she’s never taken me up on the offer. I don’t want to Be That Person that offers so much unsolicited advice that friends won’t confide in me. Have you ever been able to successfully steer anyone clear of the surgery path?
No, but I’ve never had a chance to talk to someone pre-surgery. I have a good friend who had bariatric surgery, which her doctor recommended because she was overweight and becoming diabetic. When she saw Fat Head later and realized she probably could have avoided he diabetes with a low-carb diet, she was royally pissed off. She’s had quite a few health issues since the surgery and regrets having it done.
Wow. I particularly liked the use of ‘incretin analogues’
Incretin? inCRETIN? Someone’s having fun…….
My head hurts, there is not enough padding in the world…..
My head hurts too, but mostly from banging it on my desk.
On the plus side someone I know who was newly diagnosed with diabetes read that report and decided to skip the surgery and go straight for the diet. He’s doing really well. Yay!
On the other hand a colleague is really struggling with the standard diabetes advice. When I gently challenged it, he couldn’t get why the uk diabetes association would ‘recommend something that wasn’t good for you’. And ‘they know what they are doing’.
They do know what they’re doing: they’re guaranteeing a steady stream of long-term patients.
Speaking as an accountant, if conflicts like those existed between myself and one of our audit clients, I wouldn’t even be allowed to touch any of their work that came through the door. But it’s ok; they’re just doing research that could seriously affect the lives of thousands of people and convince many of them to get completely unnecessary surgery. It’s not like they’re doing anything really important like reporting on a company’s financial results.
Well put.
Seven years ago when I was a freshman in college my doctor told me I had insulin resistance and put me on metformin. I took it for years and then stopped after starting my paleo diet. I went for a check up a few months ago and asked her how my diet was affecting my insulin resistance and she denied I ever even had insulin resistance… Then why did you put me on that medicine and make me suffer those side effects for so many years????
Your doctor is having memory issuses. Give her some coconut oil.
As the wife of a surgeon, this is something we have discussed at our low carb dinner table on many occasions.
It makes no sense to us that pre-surgical nutrution is low fat, while after surgery the recommendation switches to low carb. You see it when you delve into the small print on weightloss surgery websites, but it’s generally not openly spoken about. It seems to me that this is often a cheap ploy to “prove” the need for surgery in the first place.
However, weightloss surgery is still pretty high risk, and people die both on the operating table and afterwards every year, even though, again, this isn’t something most people are terribly aware of.
Even worse, some people go through all that (well, not the death part) and still manage to gain back most of the weight over time.
Oh, but the paper was peer reviewed, wasn’t it? No doubt by others in the pay of the same organisations. It makes me want to scream!
Last year my Dad, a retired doctor, asked me to consider trying bariatric surgery to reduce my weight and get better control of my type 1 diabetes. (I weigh 260 pounds and I should weigh about 200.). I told him about the diet usual after the operation, and that it’s why the operation seems to work… well, he didn’t think much of Taubes’ Why We Get Fat, either. At least he’s given up suggesting that I get my innards mangled. My diabetic control is now very good on half the insulin, just that I can’t seem to stay under 250 pounds… Oh, and my last endocrinologist had me on the insanely expensive Symlin, an injectable that slows digestion and particularly that of carbohydrates, and causes perpetual nausea. So much better, it seems, than my not eating much carbohydrate…
Bariatric surgery also inhibits your ability to absorb fat, which will cause weight loss, but also lead to deficiencies in many fat-soluble vitamins, even if you supplement with them.
Duh, these people are losing weight (though certain surgeries do have interesting effects). Blood glucose is stable, and patients are indirectly on a high fat [from body fat] diet. That’s how this “works,” and it’s the same reason why even bulky Bernard vegan diets can work *short term*. Problems arise when weight loss ceases, unless you figure out that stable/decreasing blood glucose and hba1c is coming from high fat eating. Of course though, the next hurdle is to figure out the point of successfully treating diabetes when you’re just going to die from heart disease; or I guess the “disease” of “high cholesterol,” as it seems the what-would-be-logical focus on mortality and vitality is gone.
I kept reading the heading as “Sugary for Diabetes”, which amusingly (and sadly) still makes sense in context of the article.
When I started looking into ways to reduce my weight and control my blood sugars, I went to an Endocrinologist at the Cleveland Clinic in Weston, FL. She immediately cut my carbs to 38 g per meal (which seemed extreme at the time), and sent me to a diabetic educator who taught me how to calculate insulin dosage based on carb intake. I plotted my blood glucose readings and carb intake using an Android app called dbees.
After a month of this regime, it was apparent to me that the fewer carbs I ate, the less insulin I needed and the better my control. The follow up visit went well, with the DE suggesting that “now that I’m the poster child, continue in the direction I’m going”. No return visits were needed, and I decided against the use of a pump at this time.
I’ve since gone on the New Atkins diet, and have been in induction for a couple months. Net result, over 30lbs of weight lost, Insulin use dropped from 140 units a day to 22 units. I feel great, and have had no issues restricting myself to 20 g of carbs per day. Looking forward to my next blood work later this month. I’ve also cut out grains, and have been taken off Statins and Asthma meds. Blood pressure meds are next. Best of all, I don’t get the feeling that I must eat or pass out any more. And for the most part, I only take one shot of long-acting insulin a day. No more chasing meals with insulin!
I hope you reach the point where you don’t need medications at all.
Barbaric is the word I would use, too, Tom. How fitting that the words barbaric and bariatric are so similar! Why is Atkins too *dangerous* but doing surgeries that enforce an Atkins like diet for the rest of one’s life the latest and greatest medical discovery? It might put some perspective on all this to know that (at least according to Wiki) within my lifetime, the man who developed lobotomies was awarded half a Nobel Prize.
I see the marketing of bariatric surgery in this way as a sadistic extension of “you’re just too fat because you eat too much — and when you say you don’t eat too much, you’re just cheating and lying, and we’re going to make SURE you don’t eat too much.”
Here’s the really outrageous part: some doctor are suggesting this surgery would be good for diabetics who AREN’T OVERWEIGHT.
An old coworker of mine had gastric bypass surgery. First she lost over 100 lbs with the pre-diet. I remember wondering why she just didn’t continue with the diet. After the surgery she lost weight but within a year she suffered some complications and died. It’s horrible that they would push surgery over something natural. It sounds more like the maternity field of medicine where 1/3 of all pregnancies end in a c-section (me having an emergency c-section myself I can say I’m pretty mad about it, still). But I guess it’s whatever makes the most money for the insurance companies, doctors and hospitals that drives the decision making.
Surgery wards are big profit centers.
I agree with you, Tom. I actually just came across this article, and it proves just how detrimental diabetes is for many. Look what it did to this actor:
http://www.cbsnews.com/8301-31749_162-57383830-10391698/seinfeld-actor-shoots-self-in-apparent-suicide-attempt/
That’s heart-breaking. The poor guy.
Let’s see, low carb before surgery is toxic to your health because of all the fat and protein, however, after a surgery it suddenly becomes critical to follow and healthy. Oh and i forgot that if you are young or pregnant you need more fat and protein, but not once you have reached adulthood. Maybe they will start prescribing surgery like statins in the future. Bangs head on desk after a running start.
Careful with those running starts. We don’t want to lose readers.
On the plus side someone I know who was newly diagnosed with diabetes read that report and decided to skip the surgery and go straight for the diet. He’s doing really well. Yay!
On the other hand a colleague is really struggling with the standard diabetes advice. When I gently challenged it, he couldn’t get why the uk diabetes association would ‘recommend something that wasn’t good for you’. And ‘they know what they are doing’.
They do know what they’re doing: they’re guaranteeing a steady stream of long-term patients.
Please take it easy on us WLS people, Tom. I, for one, didn’t discover, or connect the dots, or phrase it how you will the low-carb, high-protein Fathead/Paleo style diet until years after I had an RNY gastric bypass. Do I sometimes wish I could have gone back and done it differently? Of course. But I don’t regret. My altered digestive system gave me a jumpstart on loss and lifestyle change and to this day presents few, in any problems (and I am SCRUPULOUS about checking my vitamin levels, bone density, etc.). Sometimes it’s not ignorance, or stupidity, or laziness. Sometimes it’s being on a diet since you were three years old (low-fat, high carb, of course) and needing more help than most people will ever need. There is also a huge hormonal component in the surgery that most people never hear about because the medical profession doesn’t understand it and therefore can’t report on it. But the surgery hugely reduces ghrelin production for anywhere from three to twelve months (sometimes longer, if you’re lucky) which makes making those high-protein, low-carb choices a piece of proverbial cake.
It’s not that I don’t agree with you completely. And I cracked up at the football analogies. But demonize the conventional wisdom, not its unwitting victims.
I don’t blame the surgery patients at all. They’ve been given bad information.
Speaking as an accountant, if conflicts like those existed between myself and one of our audit clients, I wouldn’t even be allowed to touch any of their work that came through the door. But it’s ok; they’re just doing research that could seriously affect the lives of thousands of people and convince many of them to get completely unnecessary surgery. It’s not like they’re doing anything really important like reporting on a company’s financial results.
Well put.
Reading posts like this makes my heart break It’s got to be awful: you get fat even though you try to cut calories and fat, just like your doctor told you to, but you just get hungrier and hungrier… What a nightmare – it’s like you body fat turns against you and destroys your vivacity, then health, then your life.
You know, progress wasn’t made in the treatment of mental illness until doctors realized that mental illness isn’t the patients fault, it’s something that happened to them. I doubt there will be significant advances in obesity treatment until the abandon the “lazy glutton” paradigm and realize that it’s something that’s happening to the patient, not a flaw in their character – a biochemical problem that needs biochemical treatment (i.e. low carb/leptin.) Right now, the treatment for obesity is akin to telling a schizophrenic to “just pay no mind to the voices.” It’s also just about as effective.
Exactly. That’s why most diets fail. This isn’t about character, it’s about biochemistry.
I know so many people who have had some form of weight loss surgery and every single one of them experienced horrific complications that continue to affect their every day lives. I admit that there was a time (before my low carb education) that I seriously considered weight loss surgery but always came to the conclusion that the risk just wasn’t worth it. Now that I know the same results can be achieved without maiming the body I wonder why doctors ever think it’s a good idea.
My doctor has mentioned both surgery and diet pills to get my weight under control. When I began losing weight doing low carb? He was reluctantly pleased but was sure to let me know that I needed to be sure and maintain a low FAT diet with plenty of low fat skinless chicken, egg WHITES (no yolks because those are BAD for you) or – well, I stopped listening to him at that point but I’m sure that something BAD was going to happen like toe fungus and zombies – or maybe zombie toe fungus?
When I got my last cholesterol test results they weren’t perfect (total: 219, trigs: 126, LDL: 140, HDL: 54, VLDL: 25) but they were a damn site better than they were when I was toeing the party line on the low fat – high whole grain diet (total: 222, trigs: 174, LDL 139, HDL: 48, VLDL: 35) so I just nod, smile and I keep my butter, my whole eggs and my steaks!
Keep it up. Your lipid profile may continue to improve.
The NY Times headline “Surgery for Diabetes May Be Better Than Standard Treatment” says it all. Awesome job in digging out the background information, missed by the vaunted and objective NYT reporter. Most importantly, each barbaric (oops, I mean bariatric) surgery runs between $11.6K to $26K. That’s a lot of loot.
Now it makes more sense that the latest American Diabetic Assocaition magazine includes a healthy banana bread recipe w/ banana, flour and 1/2 cup brown sugar. The more T22D folks eat this means more business for surgeons.
The ADA membership consists of doctors who depend on a stream of diabetic patients for their livelihoods.
Seven years ago when I was a freshman in college my doctor told me I had insulin resistance and put me on metformin. I took it for years and then stopped after starting my paleo diet. I went for a check up a few months ago and asked her how my diet was affecting my insulin resistance and she denied I ever even had insulin resistance… Then why did you put me on that medicine and make me suffer those side effects for so many years????
Your doctor is having memory issuses. Give her some coconut oil.
Tom,
I actually had a gastric bypass 10 years ago for reasons other than diabetes. I remember clear as day what I was to eat post-surgery….1 ounce diced chicken 4x a day. Talk about low cal protien diets! Since the surgery, I got pregnant, and had to ‘bypass the bypass’. I had to eat to gain weight to sustain the pregnancy (i.e. high carb foods), and ended up stretching out my ‘pouch’ in the process. When my son was 2, I was on my way back to where I was before. I did the low fat diet, and lost weight, but was ALWAYS hungry. I saw your movie, and have gone back to the high protein, high fat, low carb, no processed food eating… I feel great.
My brother is a surgeon who does lap bands, and agrees with you 100%; unfortunately, he is up against other doctors who tout the USDA…so he tries to advise patients the best he can when he can (i.e. after removing diverticula, hernia repair, etc) …..and then scrubs for another surgery….
I agree with Sarah…be gentle with us…we have seen the error of our ways, and are now enjoying a different lifestyle…….. with cream on top 🙂
I don’t blame the patients. I would guess most of them tried diets promoted by the supposed experts before giving up and going for surgery. That’s what happened to my friend who had the procedure. It was only after seeing Fat Head that she realized she was trying the wrong diets.
As the wife of a surgeon, this is something we have discussed at our low carb dinner table on many occasions.
It makes no sense to us that pre-surgical nutrution is low fat, while after surgery the recommendation switches to low carb. You see it when you delve into the small print on weightloss surgery websites, but it’s generally not openly spoken about. It seems to me that this is often a cheap ploy to “prove” the need for surgery in the first place.
However, weightloss surgery is still pretty high risk, and people die both on the operating table and afterwards every year, even though, again, this isn’t something most people are terribly aware of.
Even worse, some people go through all that (well, not the death part) and still manage to gain back most of the weight over time.
Don’t forget the “dumping!”
That’s the term for how what remains of your digestive tract responds when you eat a meal of more than about a half of a cup or cup of food. It’s pretty much exactly what it sounds like. And that’s the name people who promote gastric bypass give it.
The amazing part is the MSM articles pretty much tell you that the whole thing is done by doctors on the take to the surgery equipment and supply manufactures, but they print it anyway.
Oy.
Do “No Dumping” signs help at all?
In our pre-Paleo days, The Fiance and I went to a seminar given by a local hospital on weight loss surgery. I expected diagrams of the affected organs, maybe a video of the surgery, but what we got was two hours of how to ensure that your insurance company would pay for it. Helpful hospital billing people were on hand to look up your insurance policy and let you know if you qualified. For my insurance company, you had to work with a dietitian for six months to “prove you can lose weight” before they would pay for the surgery. I think that was when I started backing out of the room. If could have FREAKING lost weight on my low fat, high carb, exercise six-days-a-week lifestyle, I wouldn’t have been sitting in the audience in a room full of double-sized chairs!
By the way, at 310 lbs and 225 lbs respectively, we were the tiniest people in the room, apart from the surgeons and the obligatory formerly obese and now skinny ex-patient holding up her giant pants. Actually she wasn’t an ex-patient, as she still had to show up regularly to have her lap band adjusted, which the doctor didn’t mention cost money, but I’ve since read costs about $250 a pop.
Thank goodness The Fiance and I found Paleo and have since lost over 160 lbs between us, without the surgery. Though I think people like us make Ethicon Endosurgery sad.
By the way, I’m not a sports fan but I would TOTALLY pay to watch two drunken football teams play each other. Throw in a drunken marching band and drunk halftime performers, and you’ve got a sure-fire winner.
Personally, I’d pay to see drunken figure skating.
My wife had been considering the surgery years back and I had researched it and I seem to remember reading that something like 70% of people who had surgery will gain back all the weight lost after 7 years. Craziness!
Glad you did your research first.
Last year my Dad, a retired doctor, asked me to consider trying bariatric surgery to reduce my weight and get better control of my type 1 diabetes. (I weigh 260 pounds and I should weigh about 200.). I told him about the diet usual after the operation, and that it’s why the operation seems to work… well, he didn’t think much of Taubes’ Why We Get Fat, either. At least he’s given up suggesting that I get my innards mangled. My diabetic control is now very good on half the insulin, just that I can’t seem to stay under 250 pounds… Oh, and my last endocrinologist had me on the insanely expensive Symlin, an injectable that slows digestion and particularly that of carbohydrates, and causes perpetual nausea. So much better, it seems, than my not eating much carbohydrate…
Bariatric surgery also inhibits your ability to absorb fat, which will cause weight loss, but also lead to deficiencies in many fat-soluble vitamins, even if you supplement with them.
Duh, these people are losing weight (though certain surgeries do have interesting effects). Blood glucose is stable, and patients are indirectly on a high fat [from body fat] diet. That’s how this “works,” and it’s the same reason why even bulky Bernard vegan diets can work *short term*. Problems arise when weight loss ceases, unless you figure out that stable/decreasing blood glucose and hba1c is coming from high fat eating. Of course though, the next hurdle is to figure out the point of successfully treating diabetes when you’re just going to die from heart disease; or I guess the “disease” of “high cholesterol,” as it seems the what-would-be-logical focus on mortality and vitality is gone.
I kept reading the heading as “Sugary for Diabetes”, which amusingly (and sadly) still makes sense in context of the article.
When I started looking into ways to reduce my weight and control my blood sugars, I went to an Endocrinologist at the Cleveland Clinic in Weston, FL. She immediately cut my carbs to 38 g per meal (which seemed extreme at the time), and sent me to a diabetic educator who taught me how to calculate insulin dosage based on carb intake. I plotted my blood glucose readings and carb intake using an Android app called dbees.
After a month of this regime, it was apparent to me that the fewer carbs I ate, the less insulin I needed and the better my control. The follow up visit went well, with the DE suggesting that “now that I’m the poster child, continue in the direction I’m going”. No return visits were needed, and I decided against the use of a pump at this time.
I’ve since gone on the New Atkins diet, and have been in induction for a couple months. Net result, over 30lbs of weight lost, Insulin use dropped from 140 units a day to 22 units. I feel great, and have had no issues restricting myself to 20 g of carbs per day. Looking forward to my next blood work later this month. I’ve also cut out grains, and have been taken off Statins and Asthma meds. Blood pressure meds are next. Best of all, I don’t get the feeling that I must eat or pass out any more. And for the most part, I only take one shot of long-acting insulin a day. No more chasing meals with insulin!
I hope you reach the point where you don’t need medications at all.
Barbaric is the word I would use, too, Tom. How fitting that the words barbaric and bariatric are so similar! Why is Atkins too *dangerous* but doing surgeries that enforce an Atkins like diet for the rest of one’s life the latest and greatest medical discovery? It might put some perspective on all this to know that (at least according to Wiki) within my lifetime, the man who developed lobotomies was awarded half a Nobel Prize.
I see the marketing of bariatric surgery in this way as a sadistic extension of “you’re just too fat because you eat too much — and when you say you don’t eat too much, you’re just cheating and lying, and we’re going to make SURE you don’t eat too much.”
Here’s the really outrageous part: some doctor are suggesting this surgery would be good for diabetics who AREN’T OVERWEIGHT.
An old coworker of mine had gastric bypass surgery. First she lost over 100 lbs with the pre-diet. I remember wondering why she just didn’t continue with the diet. After the surgery she lost weight but within a year she suffered some complications and died. It’s horrible that they would push surgery over something natural. It sounds more like the maternity field of medicine where 1/3 of all pregnancies end in a c-section (me having an emergency c-section myself I can say I’m pretty mad about it, still). But I guess it’s whatever makes the most money for the insurance companies, doctors and hospitals that drives the decision making.
Surgery wards are big profit centers.
I agree with you, Tom. I actually just came across this article, and it proves just how detrimental diabetes is for many. Look what it did to this actor:
http://www.cbsnews.com/8301-31749_162-57383830-10391698/seinfeld-actor-shoots-self-in-apparent-suicide-attempt/
That’s heart-breaking. The poor guy.
Let’s see, low carb before surgery is toxic to your health because of all the fat and protein, however, after a surgery it suddenly becomes critical to follow and healthy. Oh and i forgot that if you are young or pregnant you need more fat and protein, but not once you have reached adulthood. Maybe they will start prescribing surgery like statins in the future. Bangs head on desk after a running start.
Careful with those running starts. We don’t want to lose readers.