On an article I was reading, a commenter suggested that Weight Loss Surgery (WLS) should be mandatory for anyone with a BMI over 40. (I think that there are a lot of professional athletes who would take exception to this, but that’s another point). Ostensibly this commenter is just concerned about my health and how much money my deatfatz are going to cost the country.
As always, I absolutely respect people’s choices including their choice to have weight loss surgery. That being said, there’s some stuff I don’t get about the health thing.
First, from an intuitive perspective
Lap Band – I just don’t think that my internal organs do their best work when being cut in half by a foreign object.
Gastric Bypass – I think that my internal organs do their best work when they are left whole and in my body. I used to get horrible strep throat and my doctor said that surgery could cure it but at my age (27 at the time) is was pretty risky. Of course, I solved the problem with non-traditional medicine, but the point is that now at 34 they are perfectly happy to give me a more complicated surgery with a much lower track record of success.
You hear a lot that these surgeries “cure diabetes”. I don’t have diabetes but I did just read that more information is coming out saying that the claims that the lap band cures diabetes may be completely erroneous. Instead, studies are showing that the surgery may just mask it. Charming.
A team of Belgian Researchers found that “as many as half their patients, followed for at least 12 years, needed to have the band removed in that period. And in more than a quarter, the band had gnawed its way through the wall of the stomach.” There are issues with the sample size of research methods that cause this study to lack statistical significance, but when I hear “gnawed its way through the walls of the stomach” it’s enough to make me want to ask more questions.
Really, Really Bad Complications
And then there is this. It is a poster put out by the American Society for Metabolic and Bariatric Surgery for handling surgery patients who come into the emergency room. The first line I saw said “Bright red blood by mouth or rectum, bloody drainage”. Yikes – they did not have me at “hello”!
Here is a very well-written blog by someone who had three WLSs and is still fat – certainly not the WLS fairytale we’re so often sold.
I keep going back to the core philosophy of my personal health plan: Healthy behaviors have the best chance of leading to a healthy body.
So in order to evaluate WLS, I have to ask myself some questions. (For now I’ll set aside the fact that by every conceivable measure of health I am in perfect health)
- Do I believe that I would be healthier if I had elective surgery that puts a band around one of my internal organs to constrict its size and function?
- Do I think that a doctor (whose stands to make 20K from my surgery) has a better plan for the routing of my digestive system than my body does? (I once had a massage therapist who worked on a lot of ballerinas say to me “I just wish I could be there when they try to explain to their creator that they had a better idea for foot construction than the creator did”. I feel much the same way about Gastric Bypass)
- Do I think it’s healthy to eat an amount of food that is consistent with what we see in anorexic patients?
- Is it a good idea to undergo major surgery which in over forty years has never been shown in proper studies to have any long-term improvements to actual health or that lives are saved or extended. (For more on this, check out this excellent article on WLS, including links to the report that showed that “three years after surgery, the typical patient is still obese.”)
- How do I feel about my 68.8% chance of dealing with recurring vomiting and my 10% chance of becoming a chronic vomiter (referred to as “surgical induced bulimia”)?
- Do I want to volunteer for a surgery which causes somewhere between 2 and 6% of it’s patients to DIE in 30 days after surgery (making it the highest risk elective surgery)
No. No. No. No. No. Hell to the No. I think that the person who commented that I should be required to have WLS can go ahead and get it themselves and let me know how it goes, I’ll pass.