From NYT - Why WLS Works When Diets Don't

Don't shoot the messenger, I'm sharing this for my blog's historical reference because it's AMAZING INFORMATION -- and even if you "don't agree," because it's not your experience, it's science!

Via New York Times - https://nyti.ms/2kBVirc

“Bariatric surgery is probably the most effective intervention we have in health care,” says Laurie K. Twells, a clinical epidemiologist at Memorial University of Newfoundland. She bases this bold claim on her experience with seriously obese patients and a detailed analysis of the best studies yet done showing weight-loss surgery’s ability to reverse the often devastating effects of being extremely overweight on health and quality of life.

“I haven’t come across a patient yet who wouldn’t recommend it,” Dr. Twells said in an interview. “Most say they wish they’d done it 10 years sooner.” She explained that the overwhelming majority of patients who undergo bariatric surgery have spent many years trying — and failing — to lose weight and keep it off. And the reason is not a lack of willpower.

“These patients have lost hundreds of pounds over and over again,” Dr. Twells said. “The weight that it takes them one year to lose is typically back in two months,” often because a body with longstanding obesity defends itself against weight loss by drastically reducing its metabolic rate, an effect not seen after bariatric surgery, which permanently changes the contours of the digestive tract.

In reviewing studies that followed patients for five to 25 years after weight-loss surgery, Dr. Twells and colleagues found major long-lasting benefits to the patients’ health and quality of life. Matched with comparable patients who did not have surgery, those who did fared much better physically, emotionally and socially. They rated themselves as healthier and were less likely to report problems with mobility, pain, daily activities, social interactions and feelings of depression and anxiety, among other factors that can compromise well-being.

Equally important are the undeniable medical benefits of surgically induced weight loss. They include normalizing blood sugar, blood pressure and blood lipid levels and curing sleep apnea. Although bariatric surgery cannot cure Type 2 diabetes, it nearly always puts the disease into remission and slows or prevents the life-threatening damage it can cause to the heart and blood vessels.

 

Even in the small percentage of patients who ultimately lose little weight after surgery, significant metabolic benefits persist, according to findings at the Cleveland Clinic. In a study of 31 obese diabetic patients who had not lost a lot of excess weight five to nine years after surgery, a “modest” weight loss of just 5 to 10 percent resulted in a reduction of cardiovascular risk factors and blood sugar abnormalities, Dr. Stacy Brethauer and colleagues reported.

For the two most popular surgical techniques — the gastric bypass and the gastric sleeve — “the metabolic benefits are independent of weight loss,” Dr. Brethauer said in an interview. Both methods permanently reduce the size of the stomach. However, the gastric band procedure, which is reversible, lacks these benefits unless patients achieve and maintain significant weight loss, he said.

Furthermore, as a study last year of 2,500 surgical patients at the Veterans Affairs Medical Center in Durham, N.C., found, those who underwent bariatric surgery had lower overall death rates up to 14 years later than comparable patients who did not have weight-loss surgery.

Experts in the field regard the reluctance of some medical insurers, including Medicaid programs in many states, to cover the cost of bariatric surgery as a penny-wise, pound-foolish position. Failing to reverse extreme obesity can end up costing far more per patient than the typical $30,000 price tag of bariatric surgery — sometimes even millions of dollars more.

 

Counter to popular impressions that most people treated surgically regain most or all the weight they lose initially, the latest long-term research has shown otherwise. In a decade-long follow-up of 1,787 veterans who underwent gastric bypass, a mere 3.4 percent returned to within 5 percent of their initial weight 10 years later. This finding is especially meaningful because the researchers at the V.A. center in Durham were able to keep track of 82 percent of gastric bypass patients, a task too challenging for most clinics.

The study, by Matthew L. Maciejewski and colleagues published in August in JAMA Surgery, found that 10 years later, more than 70 percent of surgical patients lost more than 20 percent of their starting weight, and about 40 percent had lost more than 30 percent. Gastric bypass, an operation called Roux-en-Y, resulted in a somewhat greater weight loss at 10 years than the newer gastric sleeve surgery and significantly more than the adjustable gastric band (Lap-Band) surgery, which “has fallen out of favor in the last two or three years,” Dr. Maciejewski said.

 

Bariatric surgery, regardless of the method used, is also much safer nowadays than it was even a decade ago, said Dr. Jon C. Gould, a surgeon at the Medical College of Wisconsin in Milwaukee who wrote a commentary on the V.A. study. However, he noted, the surgery is “vastly underutilized,” to the detriment of patients’ health and the nation’s health care costs.

“Less than 1 percent who would qualify for bariatric surgery are actually getting it,” Dr. Gould said. “Although the vast majority have health coverage, insurance companies and many Medicaid programs put it out of reach for most people by demanding that they already have several obesity-related health conditions and are taking a slew of medications to control them.”

 

For example, he said, to be covered for bariatric surgery, Wisconsin Medicaid requires that a person with dangerously high blood pressure has to be taking three or more medications for it and still not have a normal pressure.

He cited a further deterrent to bariatric surgery: “a perception that it’s dangerous and doesn’t work,” beliefs countered by the research findings cited above. Most of the surgeries are now done laparoscopically through tiny incisions.

 

Given the well-documented safety and effectiveness of bariatric surgery, it is now increasingly being performed in people whose obesity is less severe — those with a body mass index (B.M.I.) of 35 or perhaps even less — but who have a metabolic disorder like Type 2 diabetes related to their weight.

In recent years, the profession has promoted what Dr. Gould calls “centers of excellence,” where 100 or more bariatric operations are usually done in a year. Practitioners at these centers “learn from experience, share their knowledge and push for quality improvements,” he said.

Dr. Gould suggested that people interested in bariatric surgery seek out programs that have been jointly accredited by the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery, which have combined forces to promote quality control.

While experts agree that money would be better spent on prevention than treatment, Dr. Twells pointed out that “we have yet to find a way to prevent obesity, and people whose health is compromised by their weight deserve to be treated by the most effective method we have.”

 

Related articles

Forget #WLS - just exercise 4-6 hours a day says Dr. Huizenga

Bariatric surgery may improve pregnancy outcomes - mostly

HEYYYYY #RosieO'Donnell The View - Lap band is “antiquated” Band Bashing and Hating

Via - The View & Rosie.com

• Chris Christie in the news: The New Jersey Governor was recently seen at a GOP fundraiser showing off his 85 lb. weight loss from last year’s lap-band surgery. Whoopi said at first he said his weight was no one’s business. Nicollethinks if Chris Christie wants to run for President his health is everyone’s business as he has to have the stamina for the job.  Nicolle is a big fan of Chris Christie and observed that even Republicans who don’t want him to become president should “want our field to be as populated as possible, ruling people in not out.”  Rosie O didn’t think Governor Christie chose the right kind of weight loss surgery.  She said lap band is “antiquated” and in half the cases it has to be removed.  She recommended people who are interested in weight loss surgery do the research and choose what works best for them.  

Hey ROSIE - you gots a HATER. 

She thinks you WATCH HER CHANNEL. Check it. She sells coaching for regainers because bands work.   Riiiiiight?  Heyyyyyy.

I don't get it.  I just. don't. get. it.  

Lap Band Loans - Finance Your Weight Loss Surgery New From Apollo Endosurgery - And I qualify! GO MM.

I should preface this press release with my opinion because it dragged my sorry butt out of the not-posting-to-my-blog-corner to share it.  (Don't ask.)

Why is that?  

Because I am the Bariatric Bad Girl with the dissenting opinion that is screaming on the inside NOT TO FINANCE A DAMNED THING LET AND LAWD BABY JESUS NOT A GASTRIC BAND. 

Call Suze Orman.  Ask her what she thinks about financing a gastric band. 

Via American Healthcare Funding - (NOT AN AD.  I SWEAR.)

• Loan terms up to 60 months
• Rates starting at 7.00% (Starting APR for best borrrowers)

If it is anything like a car loan -- you are not a best borrower.  Go get your free credit score first.  That 7.0% APR will jump to 12 - 20++% and HEY, look, you're paying $800.00 a month for, your weight loss!

Have you paid for weight loss before, how much per month?  

Then please look at the rates of success in the Lapband in the time it will take you to pay off your loan. 

• Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature.
• Sustained weight loss after gastric banding revision for pouch-related problems.

"But, Beth, I've got to lose weight For My Health!  Lap-Band Surgery Is My Last Option!"  

Fair enough.  I understand.  I totally do.  I have lived the roux en y gastric bypass weight loss surgery lifestyle for ten years and four months.  I am married to a roux en y gastric bypass patient.  We have, collectively twenty years of bypassed-belly between us.  Add his family members, thirty years of gastric bypass experience.  I will tell you anything that you want to know, and it is not all good.    I am not your typical WEIGHT LOSS MADE THE WORLD GLITTERY AND SHINY BLOGGER.  

I can validate that urgency of wanting to do anything it takes to get the weight gone, even paying $$$.$$ per month to do so, because (for many!) it is desperation.

You know, for what it is worth I understand the feeling because of the MARKETING check this out - "LAGB is the least invasive surgical option among bariatric weight loss procedures. LAP-BAND® Adjustable Gastric Banding System, the number one brand in the category, remains the only bariatric weight reduction surgical procedure approved by the U.S. Food and Drug Administration (FDA) for people with a BMI of at least 30 with one or more obesity-related comorbid conditions."

I qualify for a LapBand, Apollo, in approximately  less than three BMI points, at my lowest adult weight.   That there is some smart marketing.   Apollo could totally band my ass in three points.  That is me, adding back bagels with butter and quitting my gym habit, and I am a revolving credit account JUST. LIKE. THAT.

This is my "I qualify for a band face."

 

Do you realize HOW many adults that qualifies?  I wear a size 8.  

Right. 

No.   I am sorry and I reserve the right to say it.   

I can understand the desire, put me back in my size 28W and I would likely be signing the loan documents right now.    Ten years of history and watching the weight loss community has changed that.

Please talk to MANY long-term band patients first and long term debtors as well because both have lots to share with you.  I am not a band patient, I only speak to patients on a support level and I can only imagine the frustration of those whom will now have the added stab of a monthly incurred payment along with any potential band failures.  Again, please talk to current banded patients, revisals, removals, and such.  

For some, it may be the right decision.  Talk it over with patients, family, friends, your therapist, get a good support group.   

____________________

PR below in full --  Not my PR.   They don't pay me.  They might pay others.  

(Business Wire)

Apollo Endosurgery, Inc., a leader in minimally invasive endoscopic surgical products for bariatric and gastrointestinal procedures, today announced the company has partnered with American Healthcare Lending to offer affordable financing for the LAP-BAND® System to increase patient access to the weight loss solution. The patient financing service is part of Apollo Endosurgery’s ongoing efforts to provide physicians and patients with high quality services and support beyond the LAP-BAND® procedure. The LAP-BAND® System is FDA approved for weight reduction for people with a body mass index (BMI) of at least 40 kg/m² and is the only FDA approved device for weight reduction for people with a BMI of 30 kg/m² or greater and one or more weight-related health problem.

“There are millions of people struggling to lose 30 or more pounds on their own who are eligible for the LAP-BAND® System but do not qualify for healthcare insurance coverage for weight loss treatments due to their BMI,” said Dennis McWilliams, President and Chief Commercial Officer of Apollo Endosurgery. “Weight loss with the LAP-BAND® System is about more than just a procedure. This is why we are working with innovative companies, like American Healthcare Lending, to provide the best services and support to our physicians and patients throughout the weight loss journey.”

“Studies show that obese patients spend significantly more money on healthcare costs each year than non-obese patients as well as have an increased chance of developing other conditions, like diabetes and heart disease, that can impact their quality of life,” said Vafa Shayani, MD, FACS, FASMBS, Chairman of Surgery, Medical Director of Bariatric Surgery at Adventist Bolingbrook Hospital and Vice President of the Illinois Association of Bariatric Surgeons. “Patients with a lower BMI are often not covered for any weight loss treatment options, despite the health and economic benefits. By investing in their health with the LAP-BAND® System, patients have the opportunity to finally achieve their weight loss goals, allowing them to live a healthier life by avoiding potential health concerns as well as reduce their healthcare costs associated with obesity.”

The Apollo Endosurgery and American Healthcare Lending partnership was designed to offer a financing service that is beneficial to both physicians and patients. American Healthcare Lending has assisted over 300,000 individuals in obtaining over $5 billion in loans. In partnership with Apollo Endosurgery, American Healthcare Lending is now offering patients low monthly payment plans to cover the cost of LAP-BAND® System procedures and aftercare, including deductibles, self-pays, and co-pays. Patients can be pre-qualified for a loan in two minutes or less by visiting www.lapband.com orwww.americanhealthcarelending.com/lapbandloan/.

Once a patient is pre-qualified for a loan through American Healthcare Lending, the program also provides assistance in finding a physician offering the procedure that is engaged with the financing service. Physicians who are enrolled in the LAP-BAND® financing program benefit by having only one low annual fee of $2,990, regardless of how many of their patients utilize the financing service, rather than paying a merchant fee of up to 8% per loan, which is standard with other financing programs.

About Apollo Endosurgery, Inc.

Apollo Endosurgery, Inc. is a leader in minimally invasive endoscopic surgical products for bariatric and gastrointestinal procedures. Apollo Endosurgery was cofounded with the Apollo Group, a unique collaboration of physicians from the Mayo Clinic, Johns Hopkins University, Medical University of South Carolina, the University of Texas Medical Branch and the Chinese University of Hong Kong. This collaboration developed a broad portfolio of patents in the field of endoscopic surgery that became the foundation of Apollo Endosurgery. For more information regarding Apollo Endosurgery, go to: www.apolloendo.com and follow us @Apollo_Endo.

APOLLO ENDOSURGERY and LAP-BAND are worldwide trademarks or registered trademarks of Apollo Endosurgery, Inc.

About LAP-BAND® System

In a LAGB procedure, a band is placed around the upper part of the stomach. As the band inflates, it shrinks the size of the stomach. This helps individuals reduce the amount of food intake and slows emptying into the lower stomach. This helps individuals feel full sooner, stay full longer and reduce hunger urge.

The LAP-BAND® System was acquired in late 2013 by Apollo Endosurgery, Inc. of Austin, Texas, from Allergan, Inc.

Warnings: The LAP-BAND® System is a long-term implant. Explant and replacement surgery may be required. Patients who become pregnant or severely ill or who require more extensive nutrition may require deflation of their bands. Adverse Events: Placement of the LAP-BAND System is major surgery and, as with any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedures, and the patient’s ability to tolerate a foreign object implanted in the body. Band slippage, erosion and deflation, reflux, obstruction of the stomach, dilation of the esophagus, infection, or nausea and vomiting may occur. Reoperation may be required. Rapid weight loss may result in complications that may require additional surgery. Deflation of the band may require additional surgery. Deflation of the band may alleviate excessively rapid weight loss or esophageal dilation.

Read more: http://www.digitaljournal.com/pr/2085568#ixzz38x9xQ4O7

All Of Me - PBS Independent Lens

OAC members were included in the “All of Me” documentary film about women on the journey with weight. Show times: http://t.co/CYPTKBpSw3

— OAC (@ObesityAction) March 15, 2014

http://www.pbs.org/independentlens/all-of-me/

Chris Christie Joins Team WLS - gets a band! (Got a band, months ago!)

New Jersey Governor Chris Christie has come to the dark side. 

He got banded.   Go him.   Good for him.

New York Post -

New Jersey Gov. Chris Christie secretly underwent lap-band stomach surgery to aggressively slim down for the sake of his wife and kids, he revealed to The Post last night.

The Garden State governor agreed to the operation at the urging of family and friends after turning 50 last September. He told The Post he was thinking of his four kids and how it was time to start improving his health when he decided to have the procedure.

“I’ve struggled with this issue for 20 years,” he said. “For me, this is about turning 50 and looking at my children and wanting to be there for them.”

He also insisted that, contrary to what observers may say, the effort to slim down was not motivated by thoughts of a presidential bid.

“It’s so much more important than that,” he said.

Christie checked in to a surgery center on Feb. 16. A source said he registered under a false name.

The operation included placing a silicone tube around the top of his stomach, where it restricts the amount of food he can eat at one time and makes him feel fuller, faster.

“A week or two ago, I went to a steakhouse and ordered a steak and ate about a third of it and I was full,” he said of his newly tamed appetite. He declined to say how much he lost, but sources said he has already shed nearly 40 pounds.

Christie has struggled with his weight for decades. He sometimes jokes about it, while other times, it’s a sensitive topic. Insiders said it was the only thing keeping the straight-talking executive from higher office.

Despite Christie’s denials, political fund-raisers say that the surgery is a clear sign that he’s going to join the 2016 race — and will do whatever it takes to win.

“This means he’s running for president. He’s showing people he can get his weight in control. It was the one thing holding him back,” a top political donor told The Post.

Sources said Christie didn’t make the decision lightly — he even had private conversations about the operation with once-rotund Jet coach Rex Ryan.

Ryan lost about 100 pounds — down from a massive 350 — after he had the same procedure done in 2010.

Christie has never revealed his weight, but estimates have run from about 300 to 350 pounds.

He hired the same ace laparoscopic and bariatric surgeon as Ryan — Dr. George Fielding, head of NYU Medical Center’s Weight Management Program.

Read more:

New Jersey Gov. Christie has stomach surgery as part of weight-loss plan - NYPOST.com

http://www.nypost.com/p/news/national/chris_cuts_waist_oAUDrJ8Sm1fY6awWgFY6nN#ixzz2SbUfkYFX

Related articles

Report: Some money in Lap-Band settlement to pay for billboards on weight-loss surgery risks

2013 WLS Awards Announcements

Katie Jay Keynote Speaking at Southcoast Center for Weight Loss - Video

Katie Jay of www.nawls.com was the keynote speaker at an event at Southcoast Center for Weight Loss in Wareham, MA yesterday.

She is amazing.  

Thank you, Katie.  

Here we are -

150 patients returned to the Southcoast Center for Weight Loss Saturday for a reunion as the group marked its own milestone: 3,500 patients since Dr. Rayford Kruger launched the unit nine years ago.It is now the largest and busiest bariatric surgery program in New England, with three surgeons who perform about 650 procedures at Wareham's Tobey Hospital a year.

 

Related articles

Report: Some money in Lap-Band settlement to pay for billboards on weight-loss surgery risks

Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient - 2013 Update

Obesity Help Announces Keynote Speaker for 2013 National Conference

Apathy and failure

Gastric Bypass Supplements to Attend Bariatric Patient Reunion

Report: Some money in Lap-Band settlement to pay for billboards on weight-loss surgery risks

AP -  Report: Some money in Lap-Band settlement to pay for billboards on weight-loss surgery risks

LOS ANGELES — A company that promoted Lap-Band weight-loss surgery has agreed to pay $1.3 million to settle a false-advertising lawsuit, with some of the money going to billboards warning the public about the risks of weight-loss surgery, a newspaper reported Thursday.

From 2009 to 2011, five patients died after Lap-Band surgeries at clinics affiliated with the 1-800-GET-THIN ad campaign, according to the Los Angeles Times (http://lat.ms/11knLBS ).

The proposed settlement still needs the approval of Los Angeles County Superior Court Judge Kenneth Freeman, who asked attorneys at a hearing Thursday to provide more information and resubmit their settlement motion before he gives the deal his OK.

Relatives of two of the dead patients, Ana Renteria and Laura Faitro, filed the lawsuit as a class action in 2011.

The lawsuit sought damages from several companies and two brothers, Michael and Julian Omidi, who court documents said owned and managed Top Surgeons, a weight-loss business.

John Hueston, an attorney for the Omidis, said the settlement was not an admission of wrongdoing.

“Under the agreement, our clients ... are dismissed without any admission of liability, and made no contribution whatsoever to the settlements,” Hueston said in a statement cited by the Times.

A lawyer for the surgery centers, Konrad Trope, said the action against the facilities was dismissed without admission of liability or financial penalty.

The proposed settlement will be paid only by Top Surgeons, one of the companies behind the GET-THIN operation, the newspaper said. The company did not immediately return a message from The Associated Press.

The lawsuits and other public documents showed that 1-800-GET-THIN was a marketing company that steered patients to a network of outpatient clinics, where thousands of weight-loss surgeries were performed.

The company used dozens of billboards — along with ads on television, radio and the Internet — to promote Lap-Band weight-loss surgery.

Some of the suits alleged that the clinics put profits above patient safety, employing physicians who were unqualified and allowing surgeries to be performed in unsanitary conditions, the Times said.

The proposed deal calls for $100,000 to be spent on billboard advertising throughout Southern California “intended to explain the risks of weight-loss surgery.” The agreement does not specify the language to be used in the ads but says it must be approved by the court.

Related articles

Regain After Weight Loss Surgery.

Study - Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery.

Imagining WLS? Weight loss surgery hypnosis?

Weight-Loss Surgery's Weird Alcoholism Risk (It's not weird.)

No long-term cost savings with weight loss surgery

Allergan might sell off LapBand Arm - Surprised?

Allergan is considering selling out its Lap-Band arm of weight loss surgical devices -- after a rapid decline in sales and huge public perception fail.  Shocking, right?  Uh, no.

Mini Squee - #YWMconvention #OAC

On October 27th, 2012, during the Obesity Action Coalition "Your Weight Matters" Event at the Hilton Anatole, there will be another first: the first annual OAC Awards!

Your friendly blogger was nominated in one of these categories, and I am thankful to you for that.  Thank you.  And, really, thank you.

I will be present at the events, dinner, ceremony, and of course the Walk From Obesity with at least $6000.00 in donations from Team MM + BBGC.  

Have I mentioned that there is still time to donate to Team MM + BBGC and I do not see your donation in yet?  

Go ahead, I will wait for you!

Thank you - and see you there? 

There is still time to register for the OAC event!  

Do. not. miss. it.

 Join the OAC event on Facebook!

 

 

About the OAC Awards -

The following awards will be presented during the OAC Inaugural Your Weight Matters National Convention:

OAC Advocate of the Year - This award is given to the OAC Member who has lead the charge in taking on National, local and state advocacy issues. This individual should be a tireless advocate to advance the cause of fighting obesity and the individual affected by obesity.

Community Leader of the Year - This award is given to an individual who continually works in their community to advance the cause of fighting obesity. The recipient should be an individual who actively engages their community or with their constituency in spreading awareness of obesity and encourages others to get involved in activities that further the mission of the OAC.

Outstanding Membership Recruitment by an OAC Member - This award is designated for the individual OAC member who is an active membership recruiter in the OAC. The individual is a regular membership promoter and continually encourages membership in the OAC.

Outstanding Membership Recruitment by a Physician - This award is given to the Sponsored Membership Program participant (physician) that has recruited the most new members in the OAC in the 12 months prior to the Convention month. The recipient of the award has encouraged membership in the OAC by purchasing it on behalf of the patient.

Bias Buster of the Year - The OAC’s Bias Buster of the Year is awarded to the individual who has lead the charge to put the OAC on path to effect change in mindsets, policies and public perception of weight bias. This individual is both proactive and reactive in responding to weight bias issues and is an example to others on how to get involved as a Bias Buster.

OAC Member of the Year - This is the OAC’s highest honor and is awarded to an OAC member who goes above and beyond to help the OAC in its efforts to achieve its mission and goals. This individual is an exemplary OAC member and continually represents the OAC in impacting the obesity epidemic.

______________________________________________________

The Obesity Action Coalition (OAC) is set to host a ground-breaking educational convention on weight and health, the Inaugural “Your Weight Matters” National Convention. Join them in Dallas, October 25-28 for this ground-breaking Convention that will answer all your questions about weight and health! For more information, please visit www.YWMConvention.com.

 

Woman Suffers from Lap Band Surgery Gone Wrong - Wernicke's Disease

Neurological diseases sometimes occur (if very rarely) triggered in part by a weight loss surgical procedure for various reasons -- some avoidable -- some not, please don't hate.  (Says she who developed a cognitive disorder and intractible epilepsy after weight loss surgery.  Be kind.)  The woman in the following story developed Wernicke's Disease after gastric banding surgery in 2009.

Wernicke's disease occurs at times with persistent vomiting after WLS, a study in Neurology (2007) states that in a review of cases a "majority of the patients (25 of the 32) had vomiting as a risk factor, and 21 had the classic Wernicke's triad of confusion, ataxia, and nystagmus. Other symptoms seen in these patients included optic neuropathy, papilledema, deafness, seizures, asterixis (bilateral) flapping tremor of the hands and wrist, weakness, and sensory and motor neuropathies."

• A small number of cases, patients who undergo weight reduction surgery may develop Wernicke's encephalopathy, marked by confusion and problems with movement and eye control.
• The cause is a thiamine (vitamin B1) deficiency and, if detected, can be easily corrected with dietary supplements. Untreated, it can be fatal and cause severe neurologic morbidity.

Woman Suffers from Lap Band Surgery Gone Wrong -   Video at the link

Shacka says she suffers from multiple health issues because of a lap band surgery she had in California back in 2009. It went horribly wrong.  And since then her independence is gone and her life has never been the same.

"At some point, I say I don't know what my life is supposed to be like now.  Like, where am I supposed to go?  Where do I fit in?," said Shacka.

But what is lap band surgery?

"They're a weight loss surgery where this band is placed around the top part of the stomach.  The bands have a balloon on the inside on the inner surface and through adjustments in clinic, the balloon can be tightened or loosened and help people feel full on a smaller amount of food," said M.D. Corrigan McBride of the Nebraska Medical Center.

Officials from the Nebraska Medical Center say health issues with weight are a common factor for patients battling weight gain and obesity.

"There's a certain percentage of patients that it's just not the right weight loss tool for them and they will elect to have the bands removed and converted to a different surgery," said McBride.

"I said I can't do this anymore, I need to go to the hospital.  This is not right, I'm still throwing up.  And finally I went in, and by then I had double vision and that's a sign of neurological disease," said Shacka.

Shacka also suffers from Wernicke disease—a form of brain damage.  She says this was a result of her surgery.  Through years of therapy, learning how to walk, speak and use her hands again, Shacka says her journey to better health isn't over.

"I beat the odds twice.  They told me I would be in a wheelchair for the rest of my life…and I'm walking.  They told me I would never do steps again, I went up four flights of steps with one physical therapist.  So I beat the odds and I need more additional help," said Shacka.

But through this traumatic experience, Shacka says she sees the bright side of it all.

"I met some wonderful, wonderful angels who've helped me to know what life is about.  I can't take that back and I would have never gotten it if I wouldn't have gotten sick," she said.

And her fight to spread awareness about the risks of lap band surgery keeps her motivated.

"You don't give up, and I'm not going to give up.  And I guess this is my way of not giving up and living life," she said.

Shacka plans to sue the doctors in California that did the surgery.  She's had some financial struggles raising enough money to hire a lawyer, but finally met that goal.  Now, she is trying to raise enough money to receive therapy and more medical treatment at Mayo Clinic. 

Clin Nutr. 2000 Oct;19(5):371-3.  Wernicke's syndrome after bariatric surgery.

 

RHONJ Lauren Manzo on Bethenny - "I hated me."

Really. STOP.  "It was like an intervention?" 

STOP.

Did Lauren Manzo's gastric band made her "happy?"  No.  It does not work that way.  And, Bethenny, it's not up to you to tell her she looks "Uh-MAZING..." and that she doesn't "need to lose more weight."

 

ABC 20/20 Losing It: The Big Fat Trap - Full Episode - The Greatest Scams Goin'!

Pamela R Davis Bariatric Program Director of the Centennial Center for the Treatment of Obesity writes 

"I am completely disappointed, irritated and flat out disgusted at the so called "journalism" that went into this ABC 20/20 episode. They completely and totally missed the opportunity to focus on legitimate, successful medically [and surgically] appropriate treatment for obesity and severe obesity. Instead I felt like I was watching a rogue episode of Entertainment Tonight.

When I first heard they were pulling the segment with Dr. Robin Blackstone and Melting Mama, I thought it was so they could dedicate an entire episode to bariatric and metabolic surgery and how it is a life saving treatment for so many. Instead we got a 60 minute long sensationalistic expose on practices those of us who are healthcare professionals working diligently to help those with obesity and severe obesity would never support!

Not good ABC, not good-shame on you."

the full episode '20/20 5/11: Losing It: The Big Fat Trap' from ABC's 20/20
abc.go.com

Thank-you Pamela, you echo my feelings that I was not able to accurately share last night, and surely not before I saw the episode.

I watched it, I did.

This is what I got out of it... and I am full of the snark right now.  (I just started a new anti-seizure medication with a big fat black box warning, so hey!)

I learned a few things from the 20/20 episode!  

• It's important to have cute boobs.  NUMBER ONE.
• And Charles Barkley's Vegabuls! 
• If you want to make some fast cash, get famous, really really famous?  Gain weight on purpose to get sponsored by a diet or supplement company.  Celebrity, Inc.: How Famous People Make Money
• This works better if you are Jessica Simpson and have a beautiful frame to start with, because selling diet plans is about selling the IDEA THAT A DESPERATE DIETER MIGHT BE ABLE TO LOOK LIKE JESSICA SIMPSON *WILL LOOK LIKE IN ABOUT 9-12 MONTHS FROM THIS PHOTO-

• It does not work if you are a short balding man celebrity.  *See cute boobs.
• If you want to crash diet for $150 a day, get a NG tube and look super-sexy at work.  Then you can plan to regain and rebuy the diet.
• Diet pills are wicked awesome!  Take them!  Except they don't help you lose weight.  You are buying the idea.  You hope for a Kardashian badonkandonk, but there's about 0.0% chance you can actually do it.
• And, for the quickest weight loss, try the death method a la 1-800-Get-Thin, but they don't care, cause they be RICHER THAN YOU COULD EVER IMAGINE.

And, when you are finished messing around with all of these weight loss methods and you are more desperate than you've ever been AND morbidly obese?

Come talk to me, talk to all of us, because then?  

...You will have a safe and effective weight loss procedure with a Reputable Bariatric Surgeon.

Don't say I didn't tell you so.

Should I have weight loss surgery?

It's a search I see often -- "should I have weight loss surgery?"  

It's a very personal decision, but people do ask the Google for advice.  Doing such, results in a page full of advertisements and opinions.  Certain pages should be obviously ignored, "LOSE WEIGHT THE EZ WAY!"   Um.  No.

Celebrate Vitamins Multi-Complete Chewable with Iron - ORANGE

A box from Celebrate Vitamins just arrived.  I opened it within seconds of it's drop at my door because I love mail. 

Seeing the Fed Ex or UPS man makes Beth a happy girl. (When you don't get out much, it takes little to please you.  Don't discuss this.)

In the box, a bottle of Celebrate Multi-Complete Chewable with Iron (Orange) which is a brand-new flavor from Celebrate!

Now.  Let's talk.

My favorite Celebrate Multi in terms of TASTE is the PINEAPPLE STRAWBERRY.  I would do bad things to get more.  I adore these chewables.

But, this -- this chewable -- is a multivitamin complete!  That means -- it's got iron in it.  36 grams of the good stuff. 

It's formulated particularly for gastric sleeve patients, but gastric bypass patients could also take it to avoid taking a separate iron supplement. 

You know your WLS is getting more special when you get your own vitamins.  Mmm hmm!

Hunger Hormones May Be Dieters' Worst Enemy - in Primary Care, Obesity from MedPage Today

There could be a REASON why we fail diets. Or -- diets fail us.

One year after initial weight reduction, levels of the circulating mediators of appetite that encourage weight regain after diet-induced weight loss do not revert to the levels recorded before weight loss. Long-term strategies to counteract this change may be needed to prevent obesity relapse.

Ghrelin.  You may have heard of this evil little hormone.

Nature -

Do you follow?

*blink blink*  Wikipedia tells me --

Ghrelin  is a 28 amino acid peptide and hormone that is produced mainly by P/D1 cells lining the fundus of the human stomach and epsilon cells of the pancreas that stimulates hunger.^[1] Ghrelin levels increase before meals and decrease after meals. It is considered the counterpart of the hormone leptin, produced by adipose tissue, which induces satiation when present at higher levels.

In some bariatric procedures, the level of ghrelin is reduced in patients, thus causing satiation before it would normally occur.

Medical News: Hunger Hormones May Be Dieters' Worst Enemy - in Primary Care, Obesity from MedPage Today.

Hormones regulating when a person feels hungry or sated do not rapidly adjust to weight loss, which may be a factor in the yo-yo effect observed among dieters, researchers found.

One year after losing weight, levels of appetite-regulating hormones didn't revert to baseline levels, Joseph Proietto, PhD, of Heidelberg Repatriation Hospital in Australia, and colleagues reported in the Oct. 27 issue of the New England Journal of Medicine.

The findings suggest that the "high rate of relapse among obese people who have lost weight has a strong physiological basis and is not simply the result of the voluntary resumption of old habits," Proietto and colleagues wrote.

It's well established that heavy patients who lose weight dieting often fail to keep the pounds off, the researchers explained.

Studies have shown that restricting calories can lower levels of the hormones leptin -- which tells the brain that the body is full -- and ghrelin -- which stimulates hunger.

Doesn't this also help explain why some forms of weight loss surgery ... work better overall in the long term?  In certain types of WLS -- most of ghrelin producing factor -- is removed. 

Go DS.  Or not. It's up to you.  Surgery flame wars!

DSFacts.com -

Approximately 70% of the stomach is removed along the greater curvature, also called a vertical sleeve gastrectomy (VSG). The remaining stomach is fully functioning, banana shaped and about 3 - 5 oz in size which restricts the amount you can consume. The pylorus continues to control the stomach emptying into the small intestine; as a result patients do not experience "dumping". The upper portion of the duodenum remains in use; food digests to an absorbable consistency in the stomach before moving into the small intestine. This allows for better absorption of nutrients like vitamin B12, calcium, iron and protein when compared to gastric bypass procedures.

A benefit of removing a portion of the stomach is that it also greatly reduces the amount of ghrelin producing tissue and amount of acid in the stomach.

Ghrelin is the "hunger hormone" and by reducing the amount of the hormone produced the appetite is suppressed.

Study -

Sumithran P, et al "Long-term persistence of hormonal adaptations to weight loss" N Engl J Med 2011; 365:1597-1604.

Gastric bypass helps curb temptation better than banding?

A small study was done on roux en y gastric bypass patients and gastric band patients in the UK, to test the temptation of naughty foods on both types of post ops. 

Reuters -

After surveying patients who had either type of surgery, and performing brain scans on several dozen of them, Dr. Tony Goldstone of Imperial College London and Hammersmith Hospital and his colleagues found that even deep down in their brains, the gastric bypass patients seemed to like high-calorie foods less.

"The results suggest that gastric-banding patients had to exert quite a lot of self-control over their eating behavior. Banding patients also had higher concern about their weight," Goldstone told Reuters Health.

In contrast, gastric bypass patients "don't feel they have to exert as much cognitive control over what they're eating," said Goldstone

Although I don't have a gastric band, I have lived seven and a half years with a gastric bypass, married to a man with a gastric bypass -- who's mom and sister who have had a gastric bypass.  I would agree with this study for myself -- the gastric bypass did shut down a lot of the mind-gut connection for me.  

Why?

Honestly, gastric bypass can cause such serious distress when eating so-called tempting foods, that once we DO try them again?  (And, we do!)  

We may make that cognitive connection that food = discomfort = sick = don't do that again.  Certainly it doesn't always work, and we might continue to eat foods that cause us distress because We Are Human and make mistakes and food sometimes just appeals to us too much.  Also, gastric bypass has a funny way of making some foods appeal to us, make us sick ONE TIME, and the the NEXT TIME?  We have zero reaction.  

This is a sticky situation -- and it's a gastric bypass food roulette.  Many of us have a list of foods that cause a reaction every single time we try them, or just sometimes, and a list of perfectly safe foods.

Not everyone has a reaction to food -- some gastric bypassers get by with no reaction to any food, ever -- and love to announce this -- but they're crazy and we don't talk about them.  (I'm kidding.)  

I would say that banders have it rough when it comes to food choices -- they don't get the hand-slap fun that bypassers do.  This cognitive "don't eat that, it will make you sick" fun of the gastric bypass is a big part why people choose to have the roux en y to begin with.  This is a big reason why I did not have a band.  I know what I would be doing.  "Hello, ice cream.  I have missed you."  

My MRI reactions would be food-gasming over Mint Chocolate Chip again.  Which, right now?  I have COMPLETE aversion toward -- because of the gastric bypass.

1-800-Get-Thin Centers get new law... and some control.

Image - 1-800-Get-Thin Facebook

After five patient deaths in recent years via outpatient weight loss surgery clinics affiliated with 1-800-Get-Thin, a new law has been established to maintain control over the facilities.

The Lap-Band, is manufactured by Allergan Inc.

The patients' deaths and injuries have led to a series of wrongful death and personal injury lawsuits against 1-800-GET-THIN, its affiliated surgery centers and doctors who performed the procedures, says the LA Times.  Allergan is not affiliated with 1-800-GET-THIN.

Los Angeles Times -

Outpatient surgery centers in California that perform Lap-Band operations and other procedures will face new scrutiny under a law signed by Gov. Jerry Brown.

The legislation requires private accrediting firms to inspect outpatient centers at least once every three years and allows for surprise inspections to ensure the centers meet safety standards for such things as cleanliness and proper use of medication.

It also requires accrediting firms to demand improvements or revoke certification if a surgery center does not meet the standards.

The author of the law, state Sen. Curren Price Jr. (D-Los Angeles), said he became interested in the safety of outpatient centers after singer Kanye West's mother died in 2007 after liposuction and breast augmentation surgery at a Westside clinic.

"It brings oversight that's long overdue over these clinics," Price said Sunday after the governor signed the law. "It's going to protect the public's health and safety."

FDA panel approves Lap-Band for the not-so-fat.

The FDA panel has approved the use of gastric banding on lower BMI individuals with one co-morbidity of their obesity.  This is HUGE, no pun intended, 'cause the patients aren't really that big.   (A little bigger than your friendly bypassed blogger here.)

I know I am overweight at 165 pounds, however, this still blows my mind a bit. 

It blows my mind that I (just as an example) could potentially qualify for weight loss surgery so very easily. 

I was at a qualifying weight last winter!  I am sure we'd find a co-morbid too! 

We found one the first time around.  I didn't have any known co-morbidities when I had my roux en y gastric bypass surgery in 2004. 

I am torn.  Is this a blessing or a curse?

^{Graphic from Florida Bariatric Center}

OC Register - FDA panel approves Lap-Band for the less fat

The Lap-Band, made by Irvine-based Allergan Inc., is only FDA-approved for people with a body-mass index of 40 or higher, or 35 if they have associated problems like high blood pressure or diabetes. The panel granted Allergan's request for permission to market the device to people with a BMI of 35, or 30 with related problems.