Fri, Jan-12-18, 07:57
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CBC Marketplace: The true cost of gastric band procedure hyped as weight-loss fix
Debt, pain and more surgery: The true cost of gastric band procedure hyped as weight-loss fix
CBC Marketplace investigation: Patients of private Toronto clinic still on the hook for pricey weight loss procedure ó even when it failed
By Asha Tomlinson, Tyana Grundig, CBC News Posted: Jan 12, 2018 5:00 AM ET
link to article
Barb Litt, 49, decided to have gastric band surgery at a private clinic in Toronto two years ago because she'd hit a low point in her life. She was depressed, unemployed and desperate to lose weight.
But rather than shedding a few pounds, the mother of two ended up gaining a $12,000 debt she can't shake and a shooting pain in her side that ultimately required a second operation in hospital to remove the silicone band around her stomach that was supposed to shrink her appetite.
A new Marketplace investigation reveals Litt's painful experience is hardly unique.
The clinic that performed Litt's surgery, Slimband, no longer offers the procedure. Its former chief surgeon had his licence temporarily suspended by the Ontario College of Physicians and Surgeons last April, following years of complaints from clients.
But the financing company linked to the clinic, Credit Medical, is still busy collecting money from clients like Litt, who took out high-interest loans to pay for the procedure.
Because of the many complications with gastric bands, including erosion, bleeding, slippage and blockages, 2,363 of the devices have had to be surgically removed in public hospitals across Canada, excluding Quebec, since 2010, according to the Canadian Institute for Health Information.
Each removal costs between $3,000 and $14,000, meaning taxpayers are on the hook for up to $33 million.
Loans for $16K surgery
Litt wishes she knew all that back in 2015, when a flashy Slimband commercial caught her eye.
It featured former clients offering glowing testimonials.
"Say goodbye to plus sizes. Say goodbye to diet pills, fat burners and meal replacements," one woman says. "Say goodbye to every diet under the sun."
Another woman;s testimonial said of the procedure: "You're in, you're out and you're shopping Ö what could be better?"
Litt decided to give Slimband a call. She spoke to a representative named Aviva, who claimed she wasn't just a Slimband employee but a former client who lost 79 pounds.
Aviva's before-and-after photos were posted on the clinic's website.
"And she was like ... 'Oh yeah, it was the best thing I ever did.' She got me all pumped up," Litt said. "I believed my life was going to change the day I had surgery."
The big catch was the cost: nearly $16,000. Litt didn't have the money. But Slimband quickly arranged for a loan through Credit Medical, which loans money to Canadians for cosmetic and bariatric surgeries at private clinics and shares the same director as Slimband, Michael Scot-Smith.
Litt showed up for the day surgery at the Toronto clinic with her sisters. It takes about an hour to implant the band, which is placed around the top of the stomach.
After her surgery, Litt said she had very little post-op support from the clinic. There were no followup visits to discuss her health or weight-loss progress, she said.
She lost about 25 pounds initially but gained 15 pounds back within a year and a half. And during that time, she started to experience intense pain in her side where the band was implanted.
If Litt leaned on something, or bumped into something, she'd be "doubled over in pain," she said.
Finally, in August 2016, her family doctor referred her to a publicly funded bariatric clinic at St. Joseph's Health Centre in Hamilton, where she was approved for a gastric bypass operation, a surgery that divides the stomach and re-positions the small intestine.
The surgeon also removed her gastric band.
'They've got enough out of me'
Meanwhile, Litt was still expected to make monthly payments on her loan for the Slimband procedure, with its interest rate of 12.5 per cent. She still owes Credit Medical more than $12,000, but she stopped making payments last spring.
She says she refuses to pay for a program that failed her.
"I've paid $8,000. I'm done. I think they've got enough out of me."
Marketplace has found nearly 100 complaints about Slimband from clients across Canada on websites such as RateMDs, Yelp and the Better Business Bureau. There are two recurring themes: the gastric band failed, and clients felt they received no support from Slimband or its medical director and chief surgeon, Dr. Patrick Yau.
At least four official complaints were filed about Yau specifically to the Ontario College of Physicians and Surgeons, the independent organization that oversees doctors' conduct across the province, dating back as far as 2010.
One of the complaints is from a mother whose diabetic son died of bacterial meningitis two days after surgery. The college's findings say her son's blood sugar and glucose levels weren't properly monitored following the operation and prior to discharge, which led to him developing diabetic ketoacidosis, a contributing factor in his death.
The college launched an investigation into Yau's conduct in 2012.
In 2014, while the investigation was ongoing, Slimband sent a memo to patients saying Yau was no longer a part of the team. And yet, Marketplace discovered that he continued to perform gastric band surgeries at the Toronto clinic after that.
In April 2017, the college found Yau guilty of professional misconduct. His medical licence was suspended for three months. He's now back practising general surgery at the Scarborough Hospital and works out of his general practice clinic in northeast Toronto.
'I'm sorry they feel that way'
Maxine Jeffrey, 25, a former patient of Yau's, says "it's disgusting" he's still practising medicine. Yau installed Jeffrey's gastric band in 2014, but she found she couldn't keep food down.
Yau performed a second band operation about a year later that failed to solve the problem. It got so bad Jeffrey went 48 hours without being able to even drink water. That led to an emergency surgery at Toronto's Humber River Hospital in November 2016 to remove the band.
When Jeffrey called Yau, she says he wasn't very helpful. "He was like, 'This band isn't failing you; you're failing the band.'"
Jeffrey says she broke down in tears after the call.
Marketplace caught up with Yau at his office late last year to ask if he has anything to say to his patients who believe he failed them. His response: "I'm sorry they feel that way." He refused to answer any more questions.
On its website, the Slimband clinic says it's no longer accepting new patients but is providing support to existing ones.
Since Litt stopped paying her outstanding bill, she's been bombarded with registered letters and emails from Credit Medical threatening her credit rating.
Credit Medical and Slimband director Michael Scot-Smith is a former developer who was convicted of real estate fraud and sentenced in 1993 to two years in jail. In 2000, he was convicted of obtaining bank loans under false pretenses. He didn't respond to Marketplace's requests for comment.
Litt has a warning for others considering weight loss surgery: Don't do it through a private clinic. Go through the public system, if you can.
Bariatric surgery in public system not cosmetic
Dr. David Urbach, chief of surgery at Women's College Hospital in Toronto, performs gastric bypass surgeries, which he considers to be the gold standard of bariatric operations.
"We really apply surgery not for cosmetic purposes, but for health purposes," he said. "And we offer surgery to people whose life expectancy would be shortened by their obesity."
He says he removes one to two gastric bands every month.
"We suspect that nearly all the bands that are placed, at some point, will need to be removed for one reason or another," he said.
The public system has strict criteria for weight loss surgery, which include a very high body mass index along with other pre-existing health conditions such as diabetes or sleep apnea. Private clinics are not as selective, Urbach says, which can lead to all kinds of problems.
"When problems do arise, they're typically not able to deal with those complications, especially if they're severe or require hospitalization," he said.
For people who are significantly obese, Urbach suggests getting a referral through a family doctor to a publicly funded obesity surgery program. And for those who don't meet the qualifications, he says the good news is they're actually otherwise healthy and should talk to their family doctor about a balanced approach to managing both their weight and overall health.
"There's no rule that everybody has to be a certain body weight.
Lots of "eat less move more" and "obesity is a choice" rhetoric in the comments section
edit to add: This Marketplace episode will air tonight (Friday Jan.12) on CBC Television at 8 p.m. and again on Saturday Jan.13 at 6:30 p.m.