Myths About Lap Band Surgery

I was looking through my blogroll today and found this interesting post from FiFi LaRoach at Banding Together.

Ever since I started considering the band, I’ve been pretty open about it. I’ve talked about it to friends and family, and anyone else who I thought might have a point of view.

I must say, during those conversations I’ve heard some of the same comments over and over again. I’ve noticed them as comments on blog entries, too. These ideas are  ill-informed and fairly innocent, but some of them are downright judgemental and cruel. Why do people feel the need to discourage us when we are trying to become better, more in control, healthier people?  I’m not sure of the answer, but this post tries to identify some of the things you’re bound to hear from friends and family if you’ve had or are considering the band.

What’s this? Our friends and family might attempt to discourage us from a medical procedure that will lead to me having a longer life and a happier life? Nah, not my friends.

Hmmm, well, there are lots of surgeons out there who tell their patients that they will not get through weight loss with the same group of friends that they went into it with. Now, I haven’t had my Lap Band yet, but I can tell you this – it’s the same thing in production. Make a movie and you’ll lose friends. Even actor friends. Even actors friends for whom you have a good role, that are talented, good looking and have $120k in student debt to pay for. Same thing here. Be prepared. People are irrational. Both your skinny friends and your fat friends may be unnerved by you moving forward in life.

There are a lot of myths that get rolled out to attempt to discourage you. FiFi lists several:

• You are taking the easy way out. Not! This one really chaps me. I spent  two years getting approved, dieting, seeing doctors and getting ready for surgery. I had an operation, for Pete’s Sake! I drank liquids for a few weeks. I’m getting fills, which really don’t hurt, but they’re scary looking. Plus, I’m having to listen to crap like, “You’re taking the easy way out.” Geez. Bite me!!

• You are going to be malnourished. Nope. Your doctor will give you information on how to get proper nutrition. You’ll also have to take supplents. But the lap band will not make you malnourished. Good grief! First, I have to hear that I’m self-indulgent. Now, I’m denying myself in a dangerous way. Make up your mind!

• After lose the weight, you’ll probably gain it back. This is one I hear all the time, and from just about everyone I mention the band to. It has assumed the level of an urban legend. I can’t tell you how often I see comments on blogs that someone knows someone who knows someone who lost a bunch of weight and gained it all back and now they’re fatter than ever. Not sure why people love this one so much. The fact is, if you get a band you’ll still have to deal with your weight and eating issues for the rest of your life. But if you keep up with your fills you’ll lose weight. Some people gain some of their weight back, but statistically, the great percentage of banders stay much leaner than they were before banding.
  

• You’re gonna lose weight too fast, and its not good for you! The same people who tell you you need to lose weight will turn around and tell you this one. In fact, you lose about 2 to 3 pounds a week.

• You’re going to have to drink your meals for the rest of your life. Of course not. After the initial period of healing you eat three small portioned meals a day.

• If you get the band you’ll never be able to get pregnant. Not true. Most docs want you to wait until your weight loss stabalizes. And if you need extra calories during your pregnancy, your doc can loosen the band.

• Lap Band surgery is dangerous. You could die on the table! The lap band is placed with minimal cutting. You’ll heal quickly and be back to your life in a couple of weeks. Lots of people confuse the band with gastric bypass, which is a very serious operation. I think that’s why so many people believe this.

Last but not least, she says this:

You’ll probably hear more nutty stuff, but this is a list you’re sure to hear. If you have one to add, please comment. The main thing is, don’t let other people’s ignorance, jealousy and all around mean-spiritedness get you down. The band has changed my life for the better, and its also helping me learn that it doesn’t really matter what other people think about me. I’m doing this for myself, and for my health, and that’s really all that’s important when you think about it.

One of things I’m trying to do with this blog is give you enough info that you can deal easily with this kind of nonsense. I call it nonsense, but I shouldn’t but I shouldn’t because people who say that stuff to you are discouraging you from taking action which will lengthen your life. All of us deserve as much joy and happiness and comfort as we can reasonably have. And families love and need their members for as long as they can have them. Who wants their parents, or children or siblings to live shorter than necessary lives? Very few of us. And if you would wish a long life for someone  that you love, someone else wishes it for you. Don’t let some unnerved friend shame you into a shorter life.

What To Do When Your Insurance Denies Your Claim For Weight Loss Surgery

I was very excited to see this comment from someone whom I admire quite a bit – Walter Lindstrom of the Obesity Law and Advocacy Center. One of Mr. Lindstrom’s specialties has been helping insurance company clients appeal declines for weight loss surgery. Today, he responded to a thread with some very, very good news for people who want to have Lap Band surgery:

Well thank you, Lori. I just happened to stumble upon this and it was a wonderful surprise. I’ll even make a better suggestion that yours!

The minute someone is denied insurance for a LAP-BAND their best alternative is to ask their surgeon’s office to contact their reimbursement support line to get the patient an Application for the Allergan LAP-BAND Appeals program. That way someone who qualifies under that program can have us work on their appeal AT NO COST TO THEM, using the same experienced team specialists of specialists that YOU recommended! People who handle nothing but weight loss surgery insurance matters of all types and have done so successfully for nearly 14 years!
Walter Lindstrom – Obesity Law & Advocacy Center
RNY – 1994
LAP-BAND – 2003

Wow.  If you qualify, Allergan will help you appeal an insurance denial! Mr. Lindstrom’s firm has an amazing record of success and you won’t be charged for the appeal.

And don’t let your insurance company buffalo you just because this is weight loss surgery. This is your life at stake. This is your health, your happiness and your longevity that you’re fighting for. Just because you have thrifty genes doesn’t mean that you are entitled to less than our slender, spendthrift DNA’d friends.

I have to find a way to sticky this. This is amazing news.

Thank you, Allergan. Thank you, Mr. Lindstrom.

Weight Loss Surgery Reduces The Risk of Cancer

I frequently link to a  study by Dr. Paul O’Brien at Monash University that found that the instance of mortality is lower among weight loss surgery patients than among obese people who don’t have a Lap Band.

Severely obese people who received the LAP-BAND Adjustable Gastric Banding System to lose weight had a 72 percent reduction in their risk of dying compared to obese people who were not offered any specific weight-loss treatment, according to findings published in the December issue of the Annals of Surgery (1).

And here is the math:

The study involved two groups of people who were between 37 and 70 years of age with a Body Mass Index (BMI) of 35 or greater: A LAP-BAND System group, which included 966 patients (average age 47, average BMI 45 ) and a previously established population-based cohort of 2119 people who were not offered any specific weight-loss treatment (average age 55, average BMI). There were four deaths (heart disease, cancer(2) and suicide) in the LAP-BAND System group after a median follow-up of four years, vs. 225 deaths after a median follow-up of 12 years in the non-treated group. After statistically controlling for the differences in follow up time, sex, age and BMI, the hazard for death was 72 percent lower for LAP-BAND System patients compared to the non-treated group (hazard ratio for death: 0.28, 95% confidence interval: 0.10-0.85). LAP-BAND System patients lost an average of approximately 63 pounds 2 years after installation.

So, now we have this new study out that finds that weight loss surgery cuts the risk of cancer.

Weight-loss surgery significantly reduces cancer risk, says Dr. Nicolas Christou, Director of Bariatric Surgery at the McGill University Health Centre in Montreal, Canada.

“There is no question whatsoever that weight-loss surgery reduces your relative risk of developing a cancer,” says Christou.

He and his colleagues compared more than 1,000 morbidly obese people who had weight-loss surgery to thousands of people with the same weight profile who did not have the surgery.

He found that the surgery patients’ overall risk of cancer was 78-percent lower over the five years of the study. For breast cancer the risk was reduced by 83-percent.

An 83% reduction in the risk of breast cancer is huge.

I know that so many of my readers are guilt tripped by their family and friends when they announce that they are considering weight loss surgery. But there is no evidence that diet and exercise is an effective way to lose weight. Until weight loss surgery came along, it was the only way, but that’s now changed. We have the studies that prove that people who have weight loss surgery live happier lives, healthier lives and longer lives. So go for the happy! Get the surgery and have a real shot at living a longer, healthier life. What could be better than that?

Fab Lap Band Blog With Awesome Before and After Pics!

:: {she shrinks} :: – I can’t believe I’ve never found this Lap Band blog before. She has a series of side by side pics taken month by month. It’s so easy to see what she looks like as she loses weight. In her last post, she’s laying on her side in a bikini and she looks good. How many of us can do that?As to the beginning of the journey, she has her surgery in September of 2005, so you can go back in her archives to trace the whole process.

Here’s a link to the picture page: “a visual companion to She Shrinks, a weight loss surgery journal”. I’d post one of the pics here, but I can’t upload photos for whatever reason without crashing my browser. Bummer. So you’re going to have to conquer your link-o-phobia and just go to the blog.

You’re going to love this.

Lap Band Surgeon Dr. Ariel Ortiz’ Amazing Video Library

What I don’t like about most Lap Band videos is that they are too casual and ramble, or they are too corporate and don’t actual provide much substance. What I like about Dr. Ortiz’ videos is that he is very good at asking patients the questions that you want to hear answered. How much did you weigh beforehand? How much did you lose? How long did it take? How has it changed your life?

Here’s a YouTube clip of Dr. Ortiz talking about the difference between patients who are successful and patients who aren’t successful:

He has a lot of interviews with patients. This very pretty woman is one my favorites:

This young man had Lap Band surgery when he was fifteen. Dr. Ortiz is a big believer that we should take action with obese adolescents before their long term health is impacted:

Anyway,  there is a lot of information contained in those videos and that’s what it is all about. Also, you’ll see the quality of the people who come to Ortiz for surgery, and it makes it very easy to be confident that the level of care he provides is superior.

Before and After Lap Band Pics of Dr. Grossbard

I’m happy to announce that I’m going to be having Lap Band surgery with Dr. Ariel Ortiz in Mexico.  He’s wonderful. He’s brilliant. He’s experienced. He’s funny. And his patients are successful.

Since there is always so much consternation about going to Mexico for Lap Band surgery, I wanted to take this time to introduce you to Dr. Lee Grossbard of Zephyrville, Florida who had his Lap Band surgery performed by Dr. Ariel Ortiz in Tijuana. When asked his reason for going out of the country, this is what he says:

The primary reason today for Americans to go to Mexico is for a particular surgeon with much larger experience and numbers of cases. We are starting to see larger and larger numbers of patients that go out of the US because they want the lapband and their BMI is less than the requisite 35 for operation in the US. Also, patients below the age of eighteen are starting to make their appearance in other countries because of the FDA rules.

Dr. Grossbard, who can more that afford to have surgery in the US, went to Mexico to have the procedure done by Ortiz who has more experience than almost anyone else out there.

And he finishes, with this:

The lapband is a wonderfully simple tool, or aid, in weight reduction. I was an obese surgeon. My BMI was 44. I now have a BMI of 25. I had a lapband one year ago. I reached my goal weight after 10 months. I needed to lose over 100 pounds of weight now I personally perform lapband surgery.

The pictures are at the link because my computer keeps freezing everytime I try and link the pics or upload them.

Dr. Ortiz also has this wonderful testimony from Tim L. Hunter, a bio-medical engineer whose wife received a Lap Band. I’m going to put the whole thing in here because he says a lot of stuff that will put your mind at ease:

Recently my wife was banded by Dr. Ortiz. I’ll let her speak to her positive experience with Dr. Ortiz and the center but I want to say how impressed I was with the facilities in general and the operating room in particular.

I design medical devices and have been in many operating rooms in the States. I asked if it was possible to observe the procedure. I knew I would not be allowed to view my wife’s procedure but another patient at the facility, a nurse, said it was fine for me to observe her surgery.

The O.R. was state of the art, unlike some I’ve been in, in the U.S. I was impressed by the time Dr. Ortiz took to investigate the area where he would place the band until he found the most suitable site. In so doing he discovered and corrected two hernias the nurse-patient had. One was a very rare type, close to the heart cavity.

I discovered that Dr. Ortiz helped design some of his instruments so they would cause less trauma for the patients. I was also impressed that he used skin glue as opposed to other kinds of suturing. My wife had breast reduction 18 months ago in the U.S. and if, like Dr. Ortiz, they had used glue instead of old-fashioned sutures, I’m sure there would have been less scarring.

Ma

ny Americans have the idea that U.S. facilities are superior. Our experience shows us that’s not true. By the way, Dr. Ortiz didn’t charge extra for the hernia repairs which took longer to complete than the band insertion. Somehow I don’t think that would have been the case in the States. My wife and I agree you can’t buy better medical skill “at any price” than we received from Dr. Ortiz and his associates at the Obesity Control Center.

Sincerely,
Tim L. Hunter

Dr. Ortiz has endorsements from several medical professionals who have had him perform their surgeries. You can read all of them here.

Dr. Ortiz wrote Lap Band For Life, one of the first books about Lap Bands. and it is available in the Love My Lap Band bookstore at Amazon. I’d encourage you to take a look around.

You should also know that Dr. Ortiz will donate 3% of every surgical fee to the Rady Children’s Hospital in San Diego. And considering that he is charging what everyone else is charging, that’s impressive. His own beautiful daughter is autistic and has received excellent care. He’s looking to make sure other children are as well cared for as his own.

Fabulous Lap Band Blog With Great Before And After Pictures

I’ve just found one of the best Lap Band Blogs ever – Chronicles From Lap Band Land! Catherine, the proprietress, is a smart, pretty, 38 year old attorney living in NYC and she can write. One of her blogs posts is a question and answer session with a friend of hers about food. Her answers are wonderfully informative.

My very good friend, Christina, just sent me an e-mail with some great questions about eating with the band. I thought I’d post them here, along with my responses. . .

What do you eat when you go out?
It varies a lot. If my band is feeling tight, I try to order something like soup or something mushy that will be easy to get down. Fish also is a great option, since most varieties are relatively soft in texture and easy to chew.

When you posted about sushi, you said that you didn’t eat the rice — why is that?
I was thinking of the rice as empty calories, and I wanted to be able to eat more fish, so I saved room by not eating the rice as well. I did eat a bite or two of it though, and it went down just fine.

What would you order in an Italian restaurant?
I went to a very nice Italian restaurant on Sunday night . . . Babbo (it’s one of Mario Battali’s places). I split an arugula salad with Erika (I just had a few bites) and ordered a small plate of gnocci with braised oxtail. It was DELICIOUS!

What would you order in a French restaurant?
Hmm. . I haven’t been out for French food recently, but fish is always good and is generally very easy to eat, so that would be one good option. I can actually eat most things, so there is never a problem finding something good on the menu.

How about Mexican?
I go to a Mexican restaurant for brunch most weekends. No problems there. I can have guacamole with a chip or two (not more because I get too full, plus, it’s fattening) and usually get either a quesadilla or carnitas (tacos with grilled pork — I only eat the pork and leave the tortilla).

Do you think you have already changed your eating habits?
Yes. Working with the band is not hard for me at this point — it has just become what I do.

You wrote what you do for breakfast, but what about other meals?
For lunch at work, I either bring a soup or I order food for delivery. I usually wind up getting soup, but sometimes I do sushi (would do it more, but it’s expensive), and I even get a salad once in a while. A few times, when I needed to get in more protein, I’ve ordered a tuna salad wrap and just ate the tuna. I keep my office door closed during lunch — that way if I get stuck, no one else has to know about it. (I kept my door closed during lunch before the surgery as well — that’s pretty common in my office.

Dinner varies a lot. If I’m home, I might make a scrambled egg (one egg. . a bit of cheese and some spices) or even have a low-calorie microwaveable dinner. If I’m feeling more festive, I might poach a piece of fish or cook some scallops.

Babbo’s gnocci with braised oxtail. I am drooling.

Do you ever fight against hunger?
No. I still get hungry when it’s time to eat, but I get satisfied pretty quickly. I eat whenever I am hungry, which is usually 3 times a day. Also, unlike before I was banded, I can’t really overeat anymore. I mean, I could, if I wanted to spend an hour or two trying to get down more food than I should have, but that’s a big time investment! Before the band, I would often eat whatever was on my plate without stopping until I felt full (and by that point, I surely was overly full). Or I’d finish something because it was delicious, even though my hunger was totally satisfied. So, I was frequently overeating.

Do you think you really need the band to eat and live like that or is it mostly a mental help?
I do think that I need it to keep me on the straight and narrow. I think that if I did not have it, it would be very easy to slip into my old habits without really thinking about it. In some ways, the band is a mental help, but the biggest help is that it physically limits me from overeating and from eating whatever I want without thinking about it (how it will go down, whether it is what I want — given that I only get to eat a small amount each day, etc.) first.

I thought these were great questions — and hope it made for an interesting post!

Every single post of hers is informative and has substantive information about life with a Lap Band. For those of you who are still contemplating having surgery, and for those of you who are newly banded, this is a goldmine of comfort and information.

Her friend asks her if she “needs” the Lap Band. The answer to that question is that Lap Bands do more than simply limit the amount of food that you can eat. When you diet, your ancient body, fearing that you’re in a famine situation, turns down your metabolism so that more of the food that you eat is stored as fat. That’s why so many dieters find it necessary to cut back further and further on the food they eat to lose weight. In addition, your body will flood you with hormones that make you want to eat. You know that moment when you’ve been losing weight and feeling great about it, but now find yourself in front of the refrigerator stuffing down the left over chicken parmagiane that you were planning on having for lunch tomorrow? Pop psychologists will tell you that’s a moment of emotional weakness – that you’re sabotaging your weight loss because you’re afraid of success and need to get to the bottom of why you want to be fat. Bullshit. It’s hormonal and it’s normal. Inconvenient. Frustating. Infuriating. But normal. It’s a hormonal tsunami designed to get a starving cave man out of the cave to hunt down some fattened prey and it is almost as powerful as the need to drink water. It has nothing to do with your last lover or how your parents treated you.

BTW, Catherine had her Lap Band surgery in Mexico. For those of you who are contemplating the trip to Mexico, and for those of you whose family is discouraging you from making the trip, this is an incredibly valuable blog. Being able to afford a cash payment for surgery here in the US is very difficult for most people. And why spend $20k, when you can spend $8k and have surgery performed by someone who has literally done thousands of surgeries? There are lots of first rate medical facilities in Mexico, as Catherine demonstrates, and they have modeled themselves to attract American consumers.

Here’s the link to her first month of blogging and covers her pre-op routine as well as her surgery. I’d encourage you to read all the way through. You’re going to know a lot more about life with a Lap Band when you get through.

60 Minutes Clip On Lap Bands And Diabetes Resolution

I found this clip over at the Centennial Center For The Treatment of Obesity site. It’s two physicians talking about Lap Bands and diabetes. What one doctor says is that diabetes diminishes in Lap Band patients as their weight decreases. Interesting.

If you have diabetes, and have not yet read up on it, the numbers are pretty impressive. A study published in Obesity Surgery, found resolution of diabetes in Lap Band patients was 66% at one year, and 80% at two years.

Yes, Blue Cross Blue Shield Covers Lap Bands Surgery II

I just spoke with the wonderfully informative Eloise Bray at Centennial Center For The Treatment of Obesity in Nashville, Tennessee and they have a current list of insurance companies that cover bariatric surgery available on their site.  Three pages worth. Scroll down to the bottom of the page, and they offer a PDF on each of the companies they have listed. In the next few days, I’ll do a post that links all the companies they cover for the link-a-phobics amongst my readers.

This group has a really good site with a lot of great information available. They’ve recently revamped and have been very conscientious to include a lot of the information that prospective patients are looking for. Whether you live in the Nashville area or not, I’d encourage you to spend some time looking around. They answer a tremendous number of relevant questions.

At the bottom of their home page, they have a calculator that allows you to determine your BMI. If you haven’t done so yet, that’s the first step in your journey.

Now, real life calls. I’m going to look around their site some more, but in the meantime, I’d encourage you to spend some time there as well.

Wonderful Information-Filled Lap Band Forum

Looking around for stuff today, I found Banded Together -a  Lap Band Forum I don’t think I’ve ever seen before. I found an interesting thread on the Ten Rules of Lap Bands, that has information I haven’t read before. H/T to Domestic Goddess Alicia for this information:

CONSISTENCY

*If the food you are eating is keeping you full for 3 or less hours you must increase the consistency/thickness of your food. (Generally when you are on clear liquids and ready to move to full liquids, full liquid to mushy, etc)

*If the food you are eating is keeping you full for 4 or more hours your food is at a good consistency/thickness.

*As soon as you feel full (this may feel like discomfort in your chest) STOP EATING. If you ever feel like something is stuck STOP! Do not drink or eat. Typically, in 30 minutes the food will come up or go down.

· Special note: If all you can eat is soft/mushy foods, you are too tight and need fluid out of the band.

ADJUSTMENTS

· You are ready for an adjustment when you are eating good solid nutritious food (the highest consistency) and it is no longer keeping you full for 4 hours and/or your portions are increasing, and/or you are not losing weight.

DAILY ROUTINE

· Upon waking drink 20 oz of water (anything 1 calorie or less, no caffeine, no carbonation). The first 8 oz may need to be hot clear liquid. This is also a good rule to apply when preparing your meals. (If you feel pressure/tightness, you need to loosen your band before you eat with hot clear liquids and deep breaths, then repeat water process)
· Wait 10 minutes. No eating or drinking (let the fluid drain out of the pouch).

When dining out, this would be when you are waiting on your food. At home this will be the time you take cutting meat, moistening meat, and getting it ready to eat)
· Breakfast: Protein 1st (use fork and knife and cut up food well), Fruit 2nd (Sample breakfast: ½ cup low fat, low sugar yogurt, 2 T of almonds, ¼ piece of fruit w/ no skin OR 1 very soft, moist scrambled egg, 1 crisp piece of bacon, ¼ piece of fruit w/ no skin
· Wait 1 ½ hours (no eating or drinking)
· Drink 20 oz of water up until time for lunch.
· Wait 10 minutes. No eating or drinking (let the fluid drain out of pouch)
· Lunch: Protein 1st (use fork and knife and cut up your food well), vegetable 2nd, carbohydrate 3rd (sample lunch: ½ cup chili (beef or turkey and beans), 4 whole grain crackers OR 1/3 cup chicken salad, ½ seedless cucumber, 4 whole grain crackers OR 1-2 oz grilled chicken on 1 cup garden salad w/ low fat dressing, 4 whole grain crackers
· Wait 1 ½ hours (no eating, drinking)
· Drink 20 oz of water up until time for supper.
· Wait 10 minutes. No eating or drinking (let fluid drain out of pouch)
· Supper: Protein 1st (use a fork and knife and cut up food well), vegetable 2nd, carbohydrate 3rd (sample supper: ½ cup stew (beef and vegetable), 4 whole grain crackers OR 1-2 oz meatloaf, ¼ cup green beans, ¼ cup mashed potatoes OR 1-2 oz bake or grilled fish, 2-3 tops of broccoli (steamed and very tender), very small baked potato w/ no skin
· Wait 1 ½ hours (no eating or drinking)
· If you are getting hungry between meals, you are waiting for an adjustment and you feel you must eat a snack, it should be a protein snack. (low fat chunk cheese, T of peanut butter, nuts, turkey jerky)
· Once you get close to your ideal body weight you may have to pay closer attention to your calories. You should not have more than 1200 calories a day.

They also recommend when drinking right before your meal to drink/gulp to see if it moves smoothly. This will let you know if you are ready to eat yet. Also, my doctor’s office does not recommend snacks. __________________

There’s lots and lots of good information over there. They see their mission as educating people about weight loss surgery – something this nation needs – and providing informed support to people who have Lap Bands. I’d encourage you to go look around. The more support you have, the more likely you are to get to goal.

Lap Bands: Why Diet and Exercise Doesn’t Work

Oh, I can feel the flames of public disapproval hotly licking my little pink toes under the desk just for typing that outrageous title. One thing that we are not allowed to admit in our culture is that obesity is anything but a failure of will power among low class, trailer-living, Springer-loving, fried Coca-Cola-scarfing, Mountain Dew-guzzling harbingers of the apocolypse.  But guess what? Obesity is a chronic disease and willpower has very little to do with curing it.

I was cruising the internet trying to find out if there is anything new with any of my favorite researchers. I found a three part article from  blogger  Maggie Mahar that talks about the PBS documentary Fat: What No One Is Telling You – a documentary that you must see. The entire show is online. Anyway, Miss Mahar follows up with a few of the researchers interviewed in the documentary. In the first entry, she talks about the variety of characters the film covers – the somewhat zaftig redhead who exercises three hours a day to keep the weight off, the former athlete who gained 125 pounds when she went to work for Microsoft, and the slender producer’s obese twin brother who is going in for a gastric bypass.

Although many physicians still “believe that obesity is caused by eating too much and not exercising enough, such thinking is too simplistic,” says Dr Robert Lustig, of the Division of Pediatric Endocrinology at the University of California, San Francisco. An expert in the field, he knows that obesity is “a chronic condition.” And we don’t have a cure.

This is why, even when patients enter medically supervised weight-loss programs, and stick with the rules, Lustig explains, “95 percent” regain whatever pounds they lose.

“This is not simply ‘energy in and energy out.’  If it were we would have solved it a long time ago,” says Harvard’s Dr. Lee Kaplan, who heads the Weight Reduction Program at Mass General Hospital and has established a new, comprehensive basic and clinical research program.

So what jumps out at me here is the statement that obesity is a “chronic problem” and Maggie’s reflection that we “don’t have a cure’. In addition, that 95% of  patients that enter medically supervised weight loss programs, regain whatever weight they lose. 95% – that’s a staggering rate of failure. We know this to be true from our own experience and the experience of our family and friends, and the experience of the celebrities who wrestle with obesity.

She then touches on a  review of the film from the Amazon website that gets at something that I think is incredibly important – namely, the degree to which we attempt to control the actions of obese people with shaming devices. I see it in discussions of weight loss surgery all the time. Obese people are shamed away from weight loss surgery all the time by the insistence that surgery is taking the easy way out – as if people must be saddled with the most difficult way possible to lose weight in order to restore their lost morality. Weight loss surgery patients live longer lives and happier lives than obese people who attempt to lose weight through diet and exercise.  Attempting to shame someone out of a procedure that will adds years to their life and volumes of joy is a truly destructive and sadistic impulse.

“I happened upon this movie on PBS when I was on a business trip, and it essentially helped to kick-start my journey into a healthier lifestyle, where I have lost 40 lbs already in a 150lb long term goal,” the reviewer wrote.

“I remember being deeply and personally moved by the stories, but it was also a game-changing flood of information about the latest biological research that did the trick for me. It allowed me to see the issue not in terms of will power and laziness (as is all too common in popular culture as well as years of medical haranguing), but in terms of physical compulsion akin to and even surpassing opiate addiction.

“Why was this new information so critical in my current success, where previously I had tried and failed? It is definitely that it shatters the myth that weight loss is as simple as consuming less than you expend—a glib and harmful misstatement of the problem as profound as saying that beating heroin addiction is as simple as going cold turkey. You’d think that learning exactly how hard it is, really, to lose weight would be discouraging, but it was exactly the opposite. After years of people, including my doctor and nutritionist, breezily tossing off advice and plans of action, I finally learned what I was up against.
Then I declared war on it.”

In Part II, she talks about how obesity is a disease where the body rejects the cure. I bet no one has ever said that to you before.

If you have ever dieted you may already know that, once you lose some weight, your metabolism slows down and you burn fewer calories. For all your body knows, you are stranded on a desert island, starving to death. So it tries to “help.” The brain is wired to eat and store fat to protect against starvation. In fact, when you lose weight, the human body has redundant systems to try to save you. That’s how the human species has survived.

She discusses the contributions of Dr. Jeffrey Friedman, an obesity researcher at Rockefeller University, to understanding our modern dilemma:

Friedman is famous for his 1994 discovery of the gene that codes for leptin. And for a brief moment in the mid-1990s, the MIT Technology Review explains, “leptin seemed to be a potential wonder cure for obesity.” Researchers hoped that leptin injection would turn up the POMC neuron that inhibits hunger. But leptin injections work for only a small percentage of the obese. It turns out that the majority [of obese people] do produce leptin, but their bodies actually resist the effects of the hormone by blocking its ability to turn up the hunger-suppressing action of the POMC neuron. So their appetites remain large, and they keep eating—and gaining weight—until they reach the point at which the resistance stops. Where that point lies, Friedman believes, is determined by genetic makeup.

Ahhh, genetics. The one thing that we are never allowed to blame our obesity on. Of course, we are willing participants in the deception that genetics are irrelevant because if they are irrelevant, then we still have some hope of getting our weight back to normal and maintaining it.

Some people appear to be hardwired to be particularly ravenous. When access to food is unlimited, say hunger-gene experts, these people can will themselves to eat less, but their efforts will almost inevitably be overridden by the far more powerful force of genetics. Studies show that invariably, weight loss is followed by weight gain, making obesity a life-long struggle. “You just have to keep falling off the horse and getting back on again,” says one woman who appears in “Fat.” A physician in the film points out that trying to continue eating less is like trying to run upstairs without breathing faster. “You can do it for a while, but not for that long.”

She goes on to discuss gastric bypass surgery and how it impacts the communication between the brain and the gut:

At Mass General, Dr. Lee Kaplan agrees: “We have two brains—in the stomach and ‘upstairs.’ The brain in the gut can disturb the brain in the head.”

“Neuro-chemical signals that flow between the two brains,” Kaplan adds and we have discovered that gastric bypass surgery (a.k.a. “stomach-stapling”) interrupts that flow.

Until recently, physicians believed that patients lost weight because the surgery reduced the size of the stomach, forcing them to eat less. But once again, it’s not that simple. Researchers performing gastric bypass surgery on rats have discovered that the surgery severs nerves in the bowel that communicate with the brain—and that this is tied to weight loss.

In Part III of her article, we learn a little bit about the mystery of exercising and dieting but not losing weight even as we get more fit. Turns out that’s good for us as well:

Nevertheless, for those who cannot lose weight, “Exercise without weight loss is an effective strategy for obesity reduction” according to a study published in the Journal of Applied Physiology in 2005.”

What exactly does “obesity reduction without weight loss” mean?  The obese men who participated in aerobic exercise, five times per week for 60 min, did not shed pounds. The study was designed to make sure that they wouldn’t: “To allow us to test the hypothesis that significant obesity reduction could occur despite the absence of change in body weight, all subjects were asked to maintain body weight, and they consumed the calories required to compensate for the energy expended during the exercise sessions,” the researchers explain.

Nevertheless, both the obese men and the control group of lean men who participated in the study watched their waist circumference shrink. Cardio-respiratory fitness increased in both groups, as did skeletal muscle with total fat was reduced.

These changes were roughly equal in both groups. But when it came time to measure abdominal fat, reductions in the obese group were significantly greater.

As the articles closes, she includes this observation:

I would add only that our obsession with whether or not people meet cultural norms for beauty—rather than whether they are happy and healthy—fuels the prejudice against obesity that can make even physicians cruel when their patients fail to lose weight. As the public health nurse in “Fat” observes: “These are free-range fat people, just trying to do their best in a culture that hates them.”

I hope you watch the documentary. Use this information to move forward in your life. Why should you eat right and exercise even if you aren’t losing weight? Because it is good for you and you’ll be happier, healthier and you will live longer. But also, once you understand that 95% of people who enter a medically supervised weight loss program fail to keep the pounds off, you can quit feeling guilty and simply get on with your life. If you’re more than 50 pounds overweight, it’s time to think about weight loss surgery. If you were going to be in that 5% who kept weight off, you’d probably know by now. If you have to give dieting one last shot, do so and do it with everything that you’ve got. Call your doctor, not Jenny Craig. Get the best advice you can. Get out and exercise, and throw any junk food you have out. And if it fails one more time, make the call about weight loss surgery.

Lap Band Radio – Coach Cher’s Band Banter

I forgot to post this. Coach Cher has been doing a weekly show for a couple years now geared towards inspiring weight loss surgery patients to work hard at getting healthy and getting to goal. Band Banter will be on  in just a few minutes. But always worth your time to go through her back episodes and see who she is interviewing. I’ve learned a lot of interesting from her, so check it out.

What You Can Eat With A Lap Band And How Much

If you’re considering having Lap Band surgery, you are probably very curious about what types of food you can easily and how much you can eat. This post from last year covers everything I’ve learned about eating with a Lap Band from the Band patients I’ve talked to.

I realized I’ve never done a post on what Lap Bandees are most comfortable eating. I have Lorraine Kay’s YouTube clip where she talks about what she can eat, but perhaps I should expand on this a bit more.

Let’s begin by addressing how one loses weight with a Lap Band. Lap Bands make your stomach much, much, much smaller. Typically, your stomach holds about one liter of food though it can be distended to hold up to four liters – close to a gallon! At the top of your stomach are stretch receptors and when they are stretched, they signal your brain that you’re full. With the Lap Band, you’ll be eating about six to eight ounces of food per meal. Because your stomach is so tiny now, those stretch receptors will be activated quickly, and you’ll feel satisfied with a far smaller amount of food than you would have before the Lap Band.

What makes Lap Bands so much more effective than diet and exercise is the capability to keep weight off once you lose it. Ninety eight percent of people who lose weight through diet and exercise put it right back on in under two years. That doesn’t usually happen with Lap Bands. Those stretch receptors being stretched after each meal tell your body that food is plentiful and because of that, your body doesn’t crank down your metabolism the way it does on a diet. And because your body doesn’t crank down your metabolism, you keep the weight off that you lose. Brilliant, eh? I should add that you’ll be consuming about 1100 to 1200 calories per day. Your body’s new set point will be established when the amount of energy you are burning at your new size equals the amount of calories you are consuming – same as for everyone else.

For the sake of a visual comparison, you’ll be eating the equivalent of McDonald’s Double Cheeseburger and a small order of French Fries per meal. Now, needless to say, your surgeon doesn’t want you eating those two things, but McDonalds’ food is internationally available and the same size everywhere.

Anyway, the first week, you just don’t feel any hunger by and large, and you only consume clear liquids. The point of this is to not stretch your stomach in anyway in the first days. Be of good cheer – I have yet to hear anyone complain about being hungry that week. After that, you begin a journey that will lead to your first fill and the adjustment process.

What so many Lap Bandees love about their Lap Band is that they can eat almost anything within reason – at holidays, you’ll eat what everyone else does, just less of it. Bread is the most consistently problematic because it mushes up into a gloopy little ball and doesn’t pass through the clip very well. Lots of bandees find that fish quickly becomes one of their favorite dishes – even the people who hated it before. Red meat needs to be cut into tiny pieces and chewed slowly. Crunchy stuff goes down well. As, Lorraine Kay says – tacos with crispy shells, good. Tacos with soft shells, not so good. Nachos, first rate. Some bandees do very well with rice and pasta, others less so. I think it may largely be a matter of being content with just a few bites and moving on. White meats tend to be easy though some people have to be very careful with chicken. You can have ice cream, of course, but it’s calorie dense and goes through the band quickly – thereby defeating the entire purpose.

That’s the short version of it all. I’ll be doing a couple more interviews this weekend, I think. I’ll be sure to talk to the bandees about it, and I’ll let you know what they have to say. In the meantime, if you haven’t watched Lorraine Kay’s interviews on this site, I’d encourage you to do so. She’s someone who thinks and speaks for succinctly. She covers a lot of territory in her interview and you’ll have a much better idea of the road ahead by listening to what she has to say.

I’ve covered caffeine a lot on this site. In fact, there is a whole category about it. The surgeons are split on the subject. Some don’t want you drinking any caffeine whatsoever, and some don’t mind. What I’ve noted in the past is that caffeine causes the blood sugar levels to spike in Type II Diabetics. Spiking blood sugar produces insulin and tells your body to store the energy you’re eating rather than to burn it. Atkins had long noted that people on his diet didn’t lose weight if they drank caffeine. Keep that in mind, and decide how much you value your morning Joe. Atkins now allows people to have one cup a day. If you’re a determined coffee or tea drinker, experiment to find out if there is a reasonable amount you can consume.

Some surgeons object to Lap Bandees having any alcohol at all – the feeling being that you are so restricted in the amount of calories than there are none available to waste on an alcoholic beverage. Dr. Paul O’Brien, of Monash University’s Centre for Obesity Research and Education, says that a glass of wine per day seems to do well by his patients. He’d encourage to check out Australia’s wines, as well.

Lap Band Weight Loss Surgery Covered By Medicare

Wow, this has got to be good news for a lot of people. Medicare is now covering Lap Band surgeries. Being a senior citizen and wrestling with obesity has got to be tough. Especially if you’re got grandchildren running around that you are dying to get down on the floor and play with.

I found this article about Tina Clark, who us 5 feet tall and at 39, weighed 235 pounds. To make matters worse, she was diagnosed with diabetes. And then:

In 2008, Tina was diagnosed with rheumatoid arthritis. She soon felt the nearly disabling effects of the R.A. medications that she was prescribed. The severe side effects included problems and pain with her knees and ankles. Although this autoimmune disease was unrelated to her weight issue, Tina knew that she needed to take considerable steps to increase her overall health, starting with her weight.

“I was only 39 years old, and I felt like I was 60.” Tina says.

Not that there is anything wrong with being sixty, still one hopes to be a bit more spry than that in their thirties.

Anyone she talked to a friend who works in the office of bariatric surgeon of Dr. Duc Vuong. Her friend invited her in for the seminar.

Ready for a fresh start, Tina began her educational period with Dr. Vuong’s office. She met with his dietitian and attended afternoon group meetings, learning about nutrition and what to expect both pre- and post-surgery.

Tina was delightfully surprised by the personalized and specialized service she received from the moment she walked into Dr. Vuong’s office.

She was also impressed that Dr. Vuong leads nearly all of the support groups himself. By the time she scheduled her surgery, she was very well informed of the many ways that the Lap-Band® procedure would positively affect her life, and she was involved in a support group that would help to keep her motivated and accountable.

“Our Program is very different from other clinics,” says Dr. Vuong. “I am becoming known as the ‘Support Surgeon’ because of all the personalized support I offer my patients.”

So, she had the surgery, and:

After her Lap-Band procedure, Tina started to see results immediately. She lost 2 to 3 pounds a week, going from 235 pounds to 180 pounds, and the weight is still coming off. She now eats smaller portions, chooses healthier options, and is proud to weigh in at Dr. Vuong’s office (all weigh-ins are private).

I love this:

“Dr. Vuong is one of a kind. His staff calls and checks on you even during hectic times, such as holidays or hurricane evacuations,” Tina says with a chuckle, referring to this past fall’s chaos. “He keeps in touch with his patients, unlike some other clinics.”

And the good health news:

Tina is no longer in the danger zone for diabetes, and she is off all of her rheumatoid arthritis medications. The only medicine she takes these days is vitamins!

These are the kinds of stories that you can find about Lap Band patient and I guarantee you that she loves her Lap Band. They make weight manageable. It’s not a miracle. It’s a tool. And if you’re wrestling with obesity, it’s a tool that you should look at very seriously.

Five Reasons To Have Weight Loss Surgery

I’m on a new computer and don’t have a lot of my links. I went looking for studies about how weight loss surgery extended the life of patients and found this little blog post from a former weight loss surgery skeptic who was now convinced that it was a worthwhile procedure.

She lists her five reasons to have surgery:

1. Reversal of Type 2 Diabetes: Losing enough weight can actually result in reversal of diabetes for 82% of patients in less than 2 years and 62% of patients more than 2 years after surgery (March 2009 study in American Journal of Medicine).
2. Improved or Eliminated Hypertension: Studies vary but one study in Journal of American Medical Association in 2004 showed hypertension eliminated in 61% and significantly improved in 78% of weight loss surgery patients.
3. Improved Fertility: Obesity affects fertility, especially in women. The American Society for Reproductive Medicine says that ovulatory function and pregnancy rates improve significantly after weight loss in women.
4. Easing of joint pain: The extra weight causes a lot of extra stress and pain, so weight loss can help immensely. Some studies show pain cut in half 6 months to a year after surgery. It can also help the inflammation in rheumatoid arthritis.
5. Live longer: Different studies show different numbers, but some studies show that the lifespan can be cut by up to 20 years with morbid obesity.