There was an article in the New York Times today that referred to a study done in Australia,
Sixty patients with diabetes were treated with lap band surgery and lost a significant amount of weight. Seventy-three percent of those treated this way had remission of their diabetes. Only 13% in the control group had a remission.
We know that lap band surgery can be successful for attaining and maintaining weight loss. Type 2 diabetes is for many a result of weight gain. It is no surprise that the results were as impressive as they were.
However, what does it say about us as a society that we can only maintain a healthy weight as a result of having our stomachs made smaller? What is it that is standing in the way of health for so many of us? Why is exercise and a healthy diet so hard to maintain? Is it lack of will power? Is it busy lives that don't allow for exercise? Is it temptations that are too difficult to resist, or is it subliminal messages that we get through the media? I would bet it is a combination of all of them.
I think that it is great that obese patients have an option for treatment that can result in remission of a serious chronic illness. However, we do not know what the long term affects of the surgery will be. Isn't it time for our entire society to rethink how we live and focus on how we can prevent obesity in the first place?
Posted: Jan 27, 08 8:32am
Are you obese? Have you ever had a serious health problem? How about any problem in your life that you have been unable to overcome in ways that seem to work for others?
What are you suggesting when you ask, "Isn't it time for our entire society to rethink how we live and focus on how we can prevent obesity in the first place?"
Will you please share more and especially elaborate on the final statement?
Posted: Jan 27, 08 12:43pm
No, I am not obese. However, I look at surgery as something I reserve for patients as a last resort. I believe that as a society there is more we can do to prevent and help those people who are overweight or obese. I hate to think that surgery will become a first line treatment.
Posted: Feb 3, 08 4:55pm
Hi Robin,hi ing
I have a very good friend that was obese.She was obese due to her lifestyle,too much food,no exercise.
And no will power!Thats not just my opinion,thats what she said because she knew it was true.
Nearly ten years ago she had the surgary to reduce her stomach.And her health has been horrible ever since.Since she couldnt eat but a bite or two at a time she wasnt getting proper nutrition .Her diabetes improved at first,that was the only improvement.She lost weight so fast that her skin just hung on her.Her hair thinned out to where she actually had bald spots.Her eyes sunk back into the sockets and her skin wrinkled from dryness.She had a heart attack and had to have triple bypass surgery.She was in a coma for three weeks afterwards and the doctors feared that she might not make it.
Now her stomach has stretched some and she can eat a normal full meal sometimes. She has gained some weight back,mostly in her stomach.
She is always depressed and says she wants to die.
She says there is no way she could ever date again even if she had the energy because of how her body looks.
Before this surgery she was a very pretty woman,overweight,but she had no problems getting dates.She was very outgoing and constantly having fun.And she had the prettiest hair and skin,I was jealous and told her so.I liked her a lot.We had been friends for over thirty years.
Now I dont really like her,I still love her but I dont like the woman she has become.All because she didnt like being fat and tried to take the easy way out.
I would advise anyone not to do it.Either stay big or get it off with nutrition and exercise.There is no easy way!
Posted: Feb 4, 08 11:28pm
hickchick46, I know that you were addressing Robin, but I have to throw in my two cents.
I'm obese 290#. I have been obese all my life...53yrs.
I will not run and do anything to lose weight, because I don't believe any of it. I also fear results like your friend had.
Fortunately I do NOT have diabetes or (high blood pressure.....and my 115# mother does.) Hmmm?
Years ago I met a woman who recognized me from retail. She weighed about 115# and was 5' if even that. I didn't recognize her. She said don't you remember me? I use to come in with my different raced spouse and I weighed 410#.
I almost fell on the floor....how could I have not remembered that? She must have been a ball!
Well still in my mind, I didn't believe in surgery and back then it was worse, if that is possible.
I didn't tell her my opinion, but she shared that she was going to commit suicide. So in her mind it was her last chance.
So for some people, and I can imagine a lot, it does work out for the better. But there are others that have transfered their addiction to drugs, alcohol, +/or sex. And then the ones like your friend that have a lot more medical problems. And then others that reveal their true personality...or so it seems.
But back to the article. Curing diabetes puts another plus on the positive side. But everyone +/- levels for making the choice of surgery are going to be different.
Posted: Feb 4, 08 5:50pm
(Robin, I know this does not address your original post, but I have a burning desire to respond the the comments here. I do agree that there are multiple factors that contribute to the growing obesity we are seeing in the US and increasing across the world.)
I think we need to change how we look at obesity for the individual and see it as another addiction. The models that we use now to treat it are ineffective. It is, also, the hardest addiction to treat because you cannot go cold turkey and just stop eating. This is why the surgery alone does not work - previous eating patterns return and the intervention fails.
One article below is focused on health care providers. The other is a description of a program that uses the stages to help its' participants understand the process.
But as family and friends, we all need to understand the stages of change and the role personal motivation plays the process. There are always pros and cons to change that the individual must sort out to create the motivation it takes. That is different for everyone and has little to do with what society or loved ones think or do.
http://www.fitwoman.com/updates/update_insight2action.shtml
http://www.medscape.com/viewarticle/472502
Posted: Feb 5, 08 7:42am
Thanks Otter. There are some people who are great candidates for the surgery. However, there are others who are left with continued dis-ease after the surgery and just switch one addiction for another such as alcohol. It is very important that anyone considering the surgery go through all the required steps, one of the most important being psychotherapy.
Posted: Feb 4, 08 7:08pm
Thanks for the article link
Posted: Feb 4, 08 11:13pm
As I'm sitting here reading your post, I am also watching Oprah about the same subject.
Having had weight problems all my life, but not to the point of being obese, it's very easy for someone to suggest diet and exercise.
Some people are entirely too obese to exercise for fear of suffering a heart attack, while others seek food as a means of escape from problems.
My problem was the later. The moment I became frustrated or depressed, I ate.
Fortunately, when I got into my 30's I was able to control my weight and keep it down by dieting and exercising. And, as of recent, I lost 23lbs by doing the same to fit into an ungodly bridesmaid dress come April '08. I am now very happy with my weight.
Unfortunately, there are many who cannot do so. For those who cannot, lapband or bypass surgery is their only means of survival.
So, having had weight problems since I was a teen, I have empathy and sympathize with those who are unable to follow the same regimine.
Posted: Feb 5, 08 6:50am
I forgot to add,my friends diabetis has returned.
I know there are those that have medical problems that warrent possibly lap band surgery,or which ever.I just wanted to say that not everyone should have surgery.Especially if they are barely 50 lbs. overweight and eat junk food constantly.Like my friend .
I constantly struggle with my weight for about 10 years now.Its hard,especially if you are basically homebound and bored to death.Not much to do but eat,read and watch the boob tube.
Thankfully Iam on my way to wellness and have started to take better care of myself.As a matter of fact I started going to a low impact exercise class for those 40 and older.Wish me luck that I dont get so dizzy I fall on my well padded butt!
Posted: Apr 10, 08 6:06am
* includes photos
It is a lack of metabolism and we lose interest in exercise if we do not choose a partner to exercise with, this is sooo important,
Posted: Apr 24, 08 2:03am
I have heard that a dog is the best exercise equipment because you cannot install it in your bedroom and turn it into a clothes rack... If only they did not smell so doggy and like things that smell even worse...
Posted: Apr 15, 08 12:11pm
I just finished a 7.5 month consulting gig for a surgical weight loss company (laparoscopic band).
Feel free to ask me any questions.
Posted: Apr 24, 08 2:01am
In what capacity were you a consultant? What are the differences between the lap band and other procedures? What are the realistic outcomes and complications? How much money are people (corporations, health care providers, hospitals)making on this business?
Posted: Apr 24, 08 12:33pm
Hi Ethnicomm,
Please feel free to promote your business interests and professional endeavors WITHIN your profile. We have specific guidelines against posting commercial content in discussions.
Thanks!
Kat Brennan (akabukowski)
TeeBeeDee Community Guide
http://www.tbd.com/company/terms-of-use.html
Posted: Apr 24, 08 12:09pm
Lap band and gastric bypass are two completely different surgical procedures. The lapband is an actual band placed around the opening of your stomach. It is "filled" on regular intervels so as to constrict the opening and thus prevent you from eating too much. Gastric bypass actually cuts your stomach, forms a small newer stomach and re-attaches it to your small intestine (thus: "bypass")
Gastric bypass works in two ways:
1. A smaller stomach means you eat less.
2. The bypass to your intestine means you absorb less in the ways of fat and calories.
I've had gastric bypass surgery after being overweight by 100 lbs for approx 10 years. Making this decision was very hard because life is altered forever. .
It bothers me tremendously when people so carelessly throw around having gastric bypass as if it is some lazy cheaters way out of being a big fat whale.
I went through one year of counseling, nutritionist appointments and consults. I also had to lose 20 lbs on a medically approved diet and attend support group meetings. People do not just "get" gastric bypass. It's a detailed process and it's not for the feint of heart. It's a tough, long road requiring a lot of committment and fortitude
My quality of life at almost 300 lbs was not at all enjoyable and i was not able to 'just diet and exercise' to lose weight. I did-- time and time again-- and everytime the weight would creep back on, more and more each time. At one time I lost all the weight and then slowly over about 4 years time, put it all back on. I even gained weight on a liquid diet!
Why is exercise and a healthy diet so hard to maintain? Because your body changes chemically and physcially every time you go on a diet. And DIET is screamed at you from a very young age. You change everything from the receptors in your tummy and brain to psychological thinking about your self image.
Yes, it IS time for our entire society to rethink how we live and focus on how we can prevent obesity in the first place. It's time for our society to stop thinking about the absolute here and now and what makes us feel good in the moment and concentrate on the bigger overall picture. It's time that big corperations and mainstream media stop feeding our children McDonalds and diet soda.
Until that time, however, gastric bypass is merely another tool used to help a morbidly obese person stay alive. Had I not had the surgery, I would have died.
Let me stress that again: Gastric bypass surgery is a TOOL. It is not a magical answer to all your problems. Your problem isn't that you are fat: Your problem(s) is/are much deeper than that. Surgery won't fix the underlying issues. But it will give you a chance to face them, one at a time and start your life over again, developing new habits.
Posted: Apr 24, 08 12:47pm
For better or worse, 60 MINUTES this past weekend may have put a stop to this as a tool and made it a necessity. One of their stories was about GI bypass and how successful it currently is (an error rate of something like .1% - point 1 percent). not only that but they have determined that performing the surgery offers an almost instant cure for diabetes, even before any weight is lost.
Unfortunately, their source was a doctor who had a(n obvious) vested interest in seeing the surgery increase in popularity (which doesn't make him wrong, merely highly biased).
The worst thing anyone had to say about Bypass surgery was that the average person could expect to lose only about 33% of their weight. (e.g. a 300-pound person would weigh 200 lbs after surgery)
I suspect that this will rapidly increase the number of bypass surgeries performed (as well as the lawsuits when (a) someone doesn't lose the weight he/she expects to lose; and (b) someone gets injured/died) We already had one of the latter here in NJ where a respected surgeon got nailed when his patient died. The mother sued (she let her son balloon up to 435 lbs) for negligence despite the fact that her son was sinmply too obese to fit in the MRI machine (and she was so informed). They settled the case so the woman can console herself with a mil or so
Posted: Apr 25, 08 2:14pm
First of all...I'm not soliciting any weight loss surgery business. Or any business for that matter. I'm not a surgeon nor am I with the client any more. I just thought I'd share the key learnings with the folks here. Just trying to help :)
@Mrs D.
In what capacity were you a consultant?
Marketing
What are the differences between the lap band and other procedures?
- lap band is minimally invasive, you're not out of commission for more than a couple of hours (unless you've got other issues)
- no deaths (at least in Canada) through the lap band unlike bypass
- lap bad is reversible (not that you'd really want to take it out)
What are the realistic outcomes and complications?
- if you're a BMI of less than 30 don't bother (you have other issues if you want to do surgery to lose those 20-30 lbs)
- if you are over 100lbs overweight, and have other "co-morbidities" like diabetes, high blood pressure, cardiovascular disease, sleep apnea, you NEED to do something before you croake - this is a solution that works if you are willing to stick with it
- it's a lifestyle change not a quick Jenny Craig or Weight Watchers type of thing
- if you're not prepared to change your lifestyle (cut back on the booze, do some exercise, eat proper foods in smaller quantities) don't bother doing this as it won't work for you
- many have other issues (psychological) that prevent them from successively losing and KEEPING the weight off
- realistic outcome is a 1-2 lbs/week weight loss, any faster and you run the risk of having things like gall stones (medical thing that I don't know much about)
- complications are slippage and erosion (not common and easily corrected)
- other complications are feeling like you can't breath or keep food down (but that is a simple adjustment)
- you MUST be serious about following along with "rules" otherwise this like all weight loss techiques will not work
- aside from diet, you probably need counseling on how to eat properly (chewing food, size of portions etc)
- best if you go to a place that offers nutrition, fitness and psychiatric services
How much money are people (corporations, health care providers, hospitals)making on this business?
- procedures cost about $18 - $20K
- in Canada, hospitals don't make much but they again, they don't do many procedures
- corporations can make anywhere from $2000-$5000 depending on what band they are using (some cost less) and what type of post-surgical support they offer
Most important question to ask is if they have lifetime support for fills/defills and counselling. Next question is can they sustain that support. What happens if the doctor that does your procedure decide to quit? Who will take care of you? It's not like getting a nose job or your tonsils removed.
Weight loss gems that I picked up from the client:
- never let yourself get hungry (eat many meals a day)
- if you are famished, don't gorge yourself, eat the normal amount and then wait 20 minutes as that is how long it takes your brain to figure out that you've got food in your belly
- NEVER skip breakfast - your brain detects that you have no food energy and it slows down your metabolism. When you then eat, the slower metabolism means the energy gets stored instead of burned off......FAT accumulates as a result!
- if you must snack, snack on almonds, soy nuts etc
- avoid high glycemic index foods like grapes, bananas (whatever the diabetics avoid you should avoid too)
Hope this helps - sorry for appearing to self-promote.
Please if you're obese, do something for yourself and your loved ones. There are options out there - never give up!
Posted: May 3, 08 3:59am
Just a couple quickie comments: I've met several folks in real life who had Lap Band and a couple years out decided to have it removed and have the RNY because it simply wasn't effective. The frequent fills are also an issue with insurance companies -- they only like to pay for a 3 or so a year!
Posted: May 3, 08 8:57pm
Ethnicom, thank you for a positive post.
You skinnies out there... being heavy is not fun and once you get there...it is tough to get out of it because you body metabolically works against you. Yes, a person is responsible for their plight to a degree but many have a little help along the way.
The surgery is last resort, I agree. My brother lost a friend to post-surgical complications to an early gastric bypass.
Blame is not just on the person. Parents, social networks can play a role. How about all the crap foods out there and the high-fructose corn syrup that is in almost everything. Some scientists feel this component is the trans-fat of carbohydrates.
Junk medicine is everywhere from the diet industry, TV doctors, Oprah, vitamin industry, on and on...all telling you this or that helps but the studies are always funded by someone with an agenda.
Many doctors are ill-prepared to help heavy patients...applying a one-size-fits-all mentality when a more analytical and thoughtful approach to diagnosis and treatment is needed.
And the skinnies ought to be more sympathetic and less critical. Weight seems to bring as much animosity as race or religion in this society. It's not politically incorrect to insult a fat person. But use a racial epithet and Rev Al pays you a visit.
A more comprehensive and patient-focused approach needs to be created that analyzes the patient...tries to determine the best path to normal weight -- specific to the patient -- and helps the patient along.
I work in the insurance industry and my company is a leader in health coaching... taking a personalized approach to helping members control their weight. This is a nonjudgemental approach that listens to the patient needs and directs them to corollary treatments for conditions such as diabetes, depression, etc while addressing their weight concerns in conjunction with their personal physicians.
Let's all stop thinking weight is just a matter of willpower or lack of character and a true disease and complex condition that cannot be wished away. Sympathy and encouragement go much further than ridicule and derision in helping people change their bodies.
Posted: May 8, 08 12:56pm
To add...
- obesity is not necessarily due to someone's lack of willpower or that they don't care
- surgery is the last resort
- most weight loss programs that I am aware of don't work if the patient has other issues like ADD, depression, anxiety disorders...
- whether it's pills, exercise programs, food programs or surgery, you need support/motivation to make it happen - it's tough to do alone
As far as health/wellness/insurance goes, unfortunately the costs of obesity, even when you factor in loss of productivity, meds, changes in office workspace/restrooms and even MORBIDITY do not seem to be considered high enough to warrant companies paying to subsidize or offset the costs. This is what needs to change. It has to be viewed the same way as smoking cessation programs.
Posted: May 8, 08 6:14pm
http://www.dumblittleman.com/2008/05/5-snacks-that-will-smash-that-afternoon.html