http://www.forbes.com/lifestyle/hea...cout531646.html

WEDNESDAY, March 22 (HealthDay News) -- Weight-loss surgery, called bariatric surgery, has become an increasingly popular solution to obesity, but as with any invasive procedure, there are some risks, according to a new report.

Increasing age and a type of surgery known as a "duodenal switch" are associated with an increased risk of complications after surgery, the study found.

"With every year of increasing age after the age of 60, there was a slightly increasing risk for complications," said lead author Dr. Robert W. O'Rourke, an assistant professor of surgery at Oregon Health & Science University in Portland. In addition, patients who chose a duodenal switch rather than a gastric bypass had a two-fold increased risk of complications, he added.

For the study, O'Rourke's team collected data on 452 patients -- 372 women and 80 men, with an average age of 44 -- who had had bariatric surgery. The patients received either gastric bypass surgery, which sections off a small portion of the stomach into a pouch that connects directly to the small intestine, or a duodenal switch. In this less-common procedure, part of the stomach is removed and a slightly larger pouch is left. In addition, an intestinal bypass-like-procedure is done that attaches the first part of the small intestine to the lower part of the small intestine.

During more than one year of follow-up, the patients lost an average of 54 percent of their excess weight. However, four patients died, 10 percent had major complications and 13 percent had minor complications. Patients who were 60 or older were more likely to develop complications than younger patients. And, the duodenal switch procedure was associated with more complications than gastric bypass surgery, the researchers found.

The findings appear in the March issue of the Archives of Surgery.

O'Rourke said that most of his patients receive gastric bypass surgery because of the data cited in the study. "The gastric bypass is the gold standard," he said. "The gastric bypass is the operation most often done in this country."

Dr. Shawn Garber, chief of bariatric surgery at Mercy Medical Center in Rockville Centre, N.Y., concurs that gastric bypass is the preferred procedure.

"I personally do not offer the duodenal switch procedure, because I feel the morbidity is much higher, even though some studies have shown that the weight loss is better than gastric bypass," he said.

"In this study, there was no better weight loss with the duodenal switch," Garber added.

Another study in the same issue of the journal looked at the potential for beneficial changes in blood pressure after bariatric surgery.

"Blood pressure doesn't always change after gastric bypass surgery," said co-author Madelyn H. Fernstrom, director of the University of Pittsburgh School of Medicine's Weight Management Center. "Most people do see some improvement. But it all depends on your blood pressure before surgery."

In this study, Fernstrom and her colleagues reviewed the medical charts of 347 patients who had undergone bariatric surgery between 1992 and 2001.

About half the patients had high blood pressure before surgery. After surgery, these patients saw a slight drop in systolic blood pressure and a significant drop in diastolic blood pressure, the researchers found.

Patients who didn't have high blood pressure and those taking blood pressure medications had smaller drops in blood pressure than those with high blood pressure who had not been taking medications prior to the operation.

Of the 103 patients who were taking blood-pressure medication before surgery, 35 were able to stop taking the drugs after surgery, Fernstrom's group found.

"Improvement in blood pressure depends on where you started," Fernstrom said.

Garber said: "This article confirms that surgery for morbid obesity results in significant improvement in patients' weight, which results in improvement of their hypertension.

"In the long run, weight loss improves patients' medical problems like diabetes, hypertension, and sleep apnea, and decreases the number of medications that patients need to take," he added. "This will lead to increases in the lifespan of patients that lose weight and resolve their medical co-morbidities. Surgery for obesity is the only effective means for long-term weight loss in patients that suffer from morbid obesity."

Hmmm, Maybe I should give up low carb now ?

Translation: Paying us heaps of cash so that is the only effective means of keeping us rich, so don't bother taking control of your life.


I know many people who have WLS are taking control of their lives, but telling people it's the only way to combat morbid obesity is pure bullcrap, imo.

Do you remember Dr. McCoy (Bones) in the original Star Trek? he was always going on about the primitive barbaric methods of medicine in the 20th century. Bet WLS surgery will one day rank right up there with drilling holes through the skull and hacking off limbs to prevent infection.

Funny. Right after posting this, I found the following article. It's resolutely one-sided but nevertheless, it echoes much of what a lot of people here believe.

http://www.newstarget.com/z019324.html
Originally published March 22 2006

A new analysis of bariatric surgery patients, published in the journal Nature, reveals that this surgical procedure may be far more dangerous than most people believe. An astonishing 4.6 percent of patients who undergo bariatric surgery are dead within a year. That's almost one out of 20 people who die within a year following the surgery.

That's a huge number, and it indicates the level of risk associated with bariatric surgery. With the number of bariatric surgeries performed each year in this country approaching 50,000, we're talking about several thousand people dying each year from this procedure.

Most surgeries are medically unjustified
I have no doubt that in the years and decades ahead, historians will look back on this present-day practice of surgically removing parts of people's digestive tracts, and they will characterize this as barbaric and medically unjustified. They will look back and wonder why surgeons would remove entire sections of people's digestive tracts in an effort to help them lose weight. Of course, part of the answer is because these surgeons are in business to make money, and they make money by performing surgeries, regardless of whether or not those surgeries are actually safe or effective.

For example, 60 percent of heart bypass surgeries performed in the United States are completely unnecessary. There's no medical justification whatsoever. However, they are huge profit centers for surgeons, hospitals and even anesthesiologists. Everyone makes a buck when people have heart bypass surgery, but is the patient truly helped by it?

More often than not, the patient isn't helped. In fact, they are harmed by it. The same thing happens with bariatric surgery, except in some ways it's even worse. You can't really grow back the stomach after a surgeon has cut half of it out. You can never fully recover from bariatric surgery. It is a permanent removal of vital organs and tissues that belong there. These are organs that you are supposed to have to be a healthy human being.

Fraudulent marketing schemes fool people into getting bariatric surgery
I strongly object to the kind of marketing being done to promote bariatric surgery. In the marketing materials for this procedure, there are always pictures of really thin people who have never actually undergone the procedure. There is a lot of verbiage that exaggerates the benefits of the procedure and minimizes the risks, if they are even mentioned.

For example, most bariatric surgery patients are never informed that one of the most common side effects of the surgery is hypoglycemia or a form of hyperinsulinemia, which is an insulin reaction to the ingestion of food. This is now recognized as a common side effect of bariatric surgery or gastric bypass surgery. When this happens to you, you're put in a very difficult spot as the patient because the thing that's typically suggested to you to solve this problem of your pancreas producing "too much insulin" is to surgically remove part of your pancreas.

How's that for brilliant? The surgeons harm your body with the first surgery, and then they create a condition where they get repeat business because they have to remove part of your pancreas to balance your blood sugar. If this is the approach to healing in this country, I'd hate to see what these people would actually do if they were trying to harm someone.

I don't think that's the way nature intended the human body to achieve a perfect state of health. It's not about figuring out how many organs or tissues you can remove. It is supposed to be about supporting the organs and tissues that are already there and helping them regain their strength and vitality. These surgeries accomplish none of that.

Getting back to the marketing of bariatric surgery, this procedure is frequently marketed to people using fraudulent means, because the real risks are never really communicated to patients. The difficulty of undergoing this procedure and recovering from it is never quite fully explained.

Healthy alternatives to bariatric surgery
All this makes you wonder what kind of person would undergo bariatric surgery. Obviously, they feel like they've run out of options. Maybe they have tried all kinds of diets, but they're still eating enormous amounts of food. I guarantee you there are a couple of things they've never tried.

One solution they've never tried is eating foods of high nutritional density. This means getting all the necessary minerals into the diet, because one of the reasons we keep craving and overeating is that we are de-mineralized. Our soils no longer contain trace minerals or even the macro minerals that the human body was designed to consume, so our fresh produce (fruits, vegetables, etc.) lacks these minerals. And when it comes to factory foods, nearly all of the food products on grocery store shelves is completely devoid of all but a few minerals.

Did you know that white flour has 90 percent less mineral content than whole grain wheat? You lose almost 100 percent of minerals like magnesium, zinc and calcium when you process these grains. When you live on the processed food diet, you're hungry all the time because your body says, "Keep on eating until I get the right minerals." So, you just keep eating and eating until you become obese. No matter what diet you try, you can't get any thinner because your body still isn't getting the minerals it needs.

If you really want to lose weight, one of the first things you've got to do is start eating organic fruits and vegetables. You must get away from processed foods. Ideally, you need to start taking supplements with minerals and trace minerals. That's a great combination to calm your cravings.

Avoid excitotoxins in foods
The other thing that I guarantee most people haven't tried in terms of losing weight is avoiding all of the chemicals added to foods to make you hungry. These chemicals are called excitotoxins. The most common one is monosodium glutamate, or MSG. This ingredient is hidden in lots of other food ingredients such as yeast extract, hydrolyzed vegetable protein, autolyzed vegetable protein and so on. This chemical interferes with the normal healthy function of your endocrine system. That's the system that regulates appetite in your body. When this system isn't functioning correctly, your body never knows when you've eaten enough, so it never turns off your appetite and you continue to eat and eat and eat.

Weight loss can be achieved quite easily through the re-mineralization of your body. Key factors include diet and supplementation, exposure to natural sunlight -- which is a natural appetite suppressant -- and the avoidance of all metabolic disrupters. Metabolic disruptors are ingredients in the food supply. I reveal them all in the book Grocery Warning, where I talk about them in great detail. The main ones to avoid are the excitotoxins, which include monosodium glutamate, yeast extract and other variations of this chemical. If you do that, you don't need bariatric surgery. You'll lose weight as a side effect of making healthy food choices.

Now, a few people will say, "I don't want to give up my nacho chips; they have MSG, but I don' t want to give those up. I don't want to give up eating my canned soup." It's always a choice for each and every person. If you choose that route, and you get super obese, you may end up needing bariatric surgery, because nothing else is going to lose weight for you, and guess what? When you have bariatric surgery, you won't be able to eat those Doritos, canned soups and all those other excitotoxins anyway. Plus, half of your digestive tract will be gone, ripped out of your body. You'll have internal scar tissue, and you may have pain for the rest of your life. You may have hypoglycemia that might require surgery to remove part of your pancreas. Statistics show you might have a 4.6 percent chance of being dead within one year after undergoing bariatric surgery. So, if having your nacho chips, canned soup and MSG-tainted salad dressing is really that important to you, it's your choice.

MSG is present in most processed meats, including bacon, breakfast sausage, beef jerky and pepperoni. Almost all of these contain MSG, but you can read food labels to find out which ones do and which ones don't. Some people are so unwilling to change their diet that they simply refuse to stop eating these dangerous foods. In fact, they opt to undergo surgery instead. That's a choice I do not understand. I honestly believe that most people are only making that choice because they have never been given access to true information about foods, healing, weight loss and nutrition, which could save them from obesity, bariatric surgery, and a painful death.

Avoid dangerous surgeries to obtain ideal health
People are intentionally misinformed about health by the medical industry, drug companies and the FDA, all of which want to limit the treatment of disease to drugs, surgery, chemotherapy and other conventional therapies. If patients just had access to good information, they'd make better choices, and far fewer patients would undergo gastric bypass surgery in the first place. Of course, that's exactly what the surgeons in this country don't want to happen. They want to see more people opting for surgery, because that means more money in their pockets.

Hospitals and clinics want the same thing. Disease = revenue. Education = loss of revenue. In this way, conventional medicine is clearly against patient education about disease prevention. The only "education" provided by conventional medicine is based on claims for a new drug or surgical procedure.

But things are different here on NewsTarget.com. I want you to be a healthy, thin, fit person at your ideal bodyweight. I want you to avoid dangerous surgical procedures. I don't want you to die within a year or live the rest of your life obese, in a state of chronic pain and addicted to prescription drugs or under the care of a surgeon who thinks of you as merely another source of revenue. I want you to be free to make your own choices about the future of your health and free to experience all the wonderful lessons that go hand-in-hand with that kind of healing journey. I believe in education and free access to health-enhancing information, and I am strongly opposed to the outright censorship and propaganda currently practiced by Big Pharma, the FDA, and almost all participants in conventional medicine.

And Leeches and bloodletting....

McCoy is cool!

There were 452 people in the study. Four died, and 10% (say 45 people) had major complications. That's about 11% of people undergoing bariatric surgery who die or have major complications as a result of the surgery. These stats are documented, uncontested, and uncontroversial. And they say LOW CARB has health risks????

What are the choices for an unhealthily obese person:
-do nothing, which will kill you eventually?
-have surgery, with an 11% risk of death or major complications?
-try low carb, which, in study after study, shows NO documented significant health risks?

It seems like a no-brainer to me!

Ahem...let's not take everything printed as fact.

The first article seems not too far off base, but the second one is typical of publications that have their own agenda to push. First of all the mortality rate for the gastric bypass is one of 200 patients - really higher than anyone would wish. At obesityhelp.com there's a memorial site for people on the board who died of complications. It's a sad, sad place. People electing the surgery are told from the beginning what the complications can be and how many die from them. No one is suckered into this unless that person deliberately avoids the information. Like anyone undergoing surgery, these patients give the hospital a living will. It doesn't pull any punches and lists all the circumstances that would leave their loved ones in a position of having to decide whether or not to pull the plug on their brain-dead body. Obviously someone choosing a bypass does feel this is a last chance precisely because they cannot stop eating. Please consider that at some point a person may be beyond help by the simple correction of diet. I can attest that my body at a BMI (yes, I know BMI is not a great measurement) of 50, my body no longer responded well to a very low carbohydrate diet, it refused to lose weight, stabilize the blood sugar among other things and left me feeling like crap. My entire endocrine system was screwed. Please don't assume that these people haven't tried organic food, supplements of all kinds, etc., etc. Some of us got to that place while compulsively trying every new healthy thing. That assumption is just as arrogant as all the garbage printed telling how dangerous low carbing is and if only we'd listen to reason and not try this terrible way of eating based only on meat and fat. (I got that same feeling from Oprah in a preview clip on weight loss where she said "you can say you've tried everything, but you haven't." It made me want to smack her. Icon that she is, she doesn't know what I've tried.)

Statistically all weight loss programs & diets achieve a 1% weight loss that is sustained for a year. I've never seen a figure given for people completely committed to low-carb ways of eating. It would be hard to weed out the uncommitted low-carber who wants to drop weight really fast to fit into a wedding dress. That's a hefty failure rate and we all know that the disease and death rates for seriously obese people are sky high.

I considered my odds of a healthy life and they weren't very good. I was 57 and that's only middle age if you live to 114 (and I don't want to live that long). I would like my last 30 to 35 years to be more pleasant than the preceding. If not, I was ready to go. I didn't elect the bypass but chose a much less dangerous surgical option, the adjustable gastric band (mortality rate 1 of 2000). I didn't like the idea of permanent malabsorption problems. I speak of myself because you should have a real live human example of someone who considered and chose weight loss surgery. I didn't see some advertisement showing good looking people who hadn't even had the surgery. I saw a great many before and after pictures and the after pictures are not all that attractive. Doctors, as a rule, want patients to have realistic expectations. They tell you up front that the average weight loss is about 50% of what needs to be lost. They don't tell you it will be easy or that you won't have bad days or possibly complications. It's not that difficult to find out what a doctor's complication rate is for the different surgeries. Choosing the doctor is paramount in having a safe procedure. There are quacks and liars out there as in everything else.

I just don't like arrogance and I don't think it's warranted from anyone. We all have a bias and want our way to be the "correct way." Apparently we humans become upset when our choice isn't someone else's choice. We assume a position of superiority. Aren't we just so smart that we are doing things as they should be done. Everyone should do as we do because our way is the only right way. Some citizens are more equal than others (?) You haven't stood in their shoes, nor mine.

Actually Betnich, you are too quick to dismiss leeches. They are actually very effective for some applications. They are used, for example, in the re-attachment of severed limbs (like fingers). They help remove the blood that pools when you reattach a limb. Their saliva includes a painkiller and an anti-coagulant that helps this process. They are an approved medical device. I believe that they use a special leech raised in antiseptic conditions. Something else, used in medicine, that is effective but cringe-worthy: maggots. They are used on infected open wounds that resist more conventional treatment. Diabetics are prone to those. They eat only putrefying flesh, leaving healthy tissue alone. They have saved many limbs from amputation.


Frogbreath:

Not having walked a mile in your shoes, it's easy enough to be arrogant, I'll give you that.

I still believe it's necessary to caution people, especially the larger public. Due to our modern obsession with external solutions to our health problems (read pills, and surgery), people too readily embrace those methods, at the detriment of other alternatives. I can't really blame anyone, as it's pushed by every health practitioner at every turn. It's a HUGE industry.

I will readily believe that at 57 you have tried everything that can be tried, and faced with hard choices, you made the best one you could for yourself.

It should still be a last resort (as it was for you). I just can't believe that's the case for everyone on who it's performed, especially on the younger and younger patients.

I think it might be a little too popular with some surgeons, because it's a good moneymaker and it fits in well with modern thinking of "disease management".

I'll buy that many are planning to do this way too soon. I know two young women (barely 21) who are looking forward to getting health insurance so they can get the bypass. From what I've seen having spent many lunch hours with them over a couple of years, I can't see that they make any effort to watch their eating and drinking habits. They are looking for what they think is any easy option and I think they are in for a rude awakening. There is always going to be abuse like this. Some doctors are out for the buck and others sincerely want to help obese people. Some of them were obese themselves and have had the surgery. It's not the majority of gastric operations my doctor does. I never saw a commercial for him. I sought him out and not the other way around. My primary doctor never said a word about it until I brought it up and he didn't refer me to a particular doctor. We shouldn't lump them all together.

And, truth be told, I only wish I could have had the band put in sooner. Things were clearly out of control over 15 years ago. It would have saved me a lot of misery.

As for surgery being the only effective method, well, statistically it is. Very few people lose weight on their own and maintain the loss. Of course it is very do-able, as evidenced by all the success stories on this forum. But, statistically, the only method proven to result in long term weight loss is gastric reduction surgery. Forced willpower I guess.

De-mineralization, that sounds like a pretty dicey explanation for hunger. I suppose if you took a vitamin-mineral supplement, you wouldn't feel hungry then?

My mother-in-law just had a gastric banding procedure done. I'm hoping it has fewer potential side-effects than these other procedures, it seems like it would. It is done laparoscopically, and it is reversible. She had tried lots of diets to no avail, due to lack of willpower. Now she is forced to diet as the result of this procedure, and guess what? The stuff she can eat, is basically a low carb diet. So I have high hopes for her being able to lose weight without too much discomfort or hunger.

there have been plenty of people that, over the years have gained their weight back after surgery as well. There is no proven method other than taking proper care of yourself and doing what works and is healthy.

For the most part those people got the gastric bypass. Not only can the stomach pouch stretch out but the body can adapt to the malabsorption. The band is adjustable for just that reason. If I start to gain or stop losing too soon I can have it tightened a bit. The band diet is a low carb plan - but it is possible to "eat around" it. All I have to do is go to soft or liquid high carb/cal food. But all I have to do is eat normal meals to get out of that habit. The main thing is that I'm not hungry between meals. Some people get that effect from doing LC. I didn't.