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EventsWhy weight loss surgery is not the solution
in Weight loss surgery 
Weight loss surgery is hot. A lot of people are starting to see it as the only effective treatment we have for obesity. That’s just insane.
Here are some slides from a lecture at the obesity conference last weekend. The slide above shows the magnitude of the obesity problem. Bariatric (weight loss) surgery will hopefully never have to be used on more than a small minority of obese patients.
Why not operate on everyone? Here’s why:
Removing healthy organs
Here’s the three most common surgical procedures today. All of them are about stopping the normal function of the digestive system. The more effective surgeries (like Gastric Bypass) actually disconnect or remove healthy organs.
We live in a sick world when we need to surgically adapt our bodies to our industrial processed food.
Complications
The bigger the surgery the more effective it is, with a higher percentage of EWL (Excess Weight Loss). But at the same time the risk of compications increase.
What kind of complications? Here’s one list:
Vitamin deficiencies are common after weight loss surgery, but here they don’t tell us how common. I love how they instead claim that “Vitamin/Protein malnutrition is a result of non-compliance with vitamin recommendations and food sources”. Really?
Another explanation could be that vitamin / protein malnutrition is a result of removing or disconnecting the organs that absorb vitamins and protein. But of course then doctors couldn’t just blame the fat patient.
Bottom line
Why isn’t weight loss surgery the solution to the obesity epidemic? There’s a simple answer:
Removing healthy organs is not the solution to bad food.
89 comments
I have very good friends (all physicians) who advocate semi-starvation diets to patients for weight loss, all the while admitting that the long term success of calorie restriction is dismal (I tell them to starve themselves and see how it feels). Starvation is a cruel thing to inflict on people and especially young inocent children. Cutting a patient for short term results is even worse!!
We need to stop this madness. We need to protect patients, and young children who are made to feel awful about this diagnosis! I am tired of this nonesense!
Dr. J
"A woman that I met in Jackson Memorial Hospital was not so lucky. This woman had lost her intestines due to a blood clot in her mesenteric artery, cutting off the blood flow to the bowels. The thrombosis was caused by a faulty gastric bypass surgery she underwent sometime earlier.
(A side point I’d like to cover; I was told by the transplant staff at Jackson Memorial that the number one cause of people losing their intestines and needing transplants are as a result of gastric bypass surgery, so if you’re considering that procedure, you might want to give some consideration concerning its safety)."
Especially because we are mammals we should NOT consume milk products and derivatives as ADULTS!! this is my point. Do you see ANY other ADULT MAMMAL in nature drinking the milk of their own species let alone that of an alien species (as adults I must emphasise this)? In fact most humans have as I said previously retained the healthy mutation that makes lactose in milk indigestible as adults.
So biologically and ancestrally as adults we are not meant to be able to digest and consume a body fluid that is intended solely for the growth of the young.
We Europeans have recently 'acquired' the ability to digest lactose as adults but vraious levels on intolerance persist. This is important in some way to your adaptation to cooler climates perhaps but in teh long run milk and derivatives consumptation has left us as osteoporotic as ever.
I remind you to the Ancestral Health Society they have a good video on the topic
The tribes you refer to like Masai etc are regarded as neolithic herders with some hunter-gatherer practices. Anything that involves domestication from a puritst paleo point of view is to be regarded as Neolithic.
Ethically I also have strong reservations at how dairy cattle are treated hence my strong stance.
From teh point of view that i think everybody is free to make their own decisions...the products are out tehre so you jsut have to help yourself.
Ciao
Also try search pub med with his name or even google and you will find more.
bye for now
Actually, yes. Bears and other predators will attack cows and tear the udders to get the milk. I also seem to remember something about people leaving a saucer of milk for the cat... ;-)
There might be arguments to be made about whether humans should consume milk, but the argument that no other adult mammals drink milk is not one of them.
there are many things that only humans and no other animals do. that list is exhaustive and does not only include drinking milk: driving cars, using the internet etc etc
i understand where you are coming from, but disagree with you on this.
Milk over and above any other substance induces Insulin-like-growth-Factor 1 (IGF1) in humans (admittedly Pasteurisation does attenuate IGF1). This is a powerful mitogent and growth promoting factor that has been linked to epithelial cancers that predominate in western societies where milk and its products are almost ubiquitous. Raw milk may not be such a good diea after all
Yes humans are the only creatures who make and drive cars and who are destroying teh planet and themselves in teh process...how can you say an argument is flawed without providing a valid or any coutner argument?
Interesting stance yours.
Simply put you guys wish to continue to consume dairies without the worry. be my guest I doubt the dairy industry is going anywhere...so enjoy at your peril but do not try to make it sound normal as it is NOT no matter what you say drinking milk of another species in teh adult is NOT normal!
Salut!
Alexandra I looked into your bear/wolf attacking the udders..ahahahah they are after the udders themselves as they are full of yummie fat and fat as we know is good for us!
Anyway I have made my point so this is my last post on this....
Cia'
Link?
I was a low carber before the surgery, but as some of us, I couldn't keep it so strict that I could have lost my extra 60 kg of weight. After 2 years I'm back on low carb, but my control over what I'm eating, and even over my whole life has improved majorly. As I see it, it's good for people with very mild eating behavioral problems that aren't actual eating disorders.
I was fortunate and didn't gain any complications or staying problems (other than the dependency of vitamin B supplement). If I had a daughter that would weight 130 kg, would I recommend the surgery for her? Would I pay it for her? The answer is a definite YES.
To determine whether it is purely carbohydrate restriction or a combination of low carb/ starvation will require a clinical trial. Until then it is purely speculation, but fun to contemplate. You do however raise an interesting point.
I think someone msut be spiking your milk...vodka comes to mind.
I have exausted this topic from my part. I was never evangelic neither as a vegan (I have always cooked meat for my husband for example and learned to season food by eye without need to taste)...now I cna apply this skill to wheat as my husband does not wish to go completely paleo so I do cook pasta/rice etc for him on occasion but he is losing weight even on a type III permissive paleo diet (see Loren Cordain's book)....anyway venison for dinner tonight and NOT a drop of milk in sight! ;-)
There may be many explanations for this.
Lactase persistance may mean a reduced level of activity on this enzyme over time in people that would not have considered themselves as intolerant
Even amongst overtly lactose intolerant people (anybody here with that problem?) there are differences in the way they react. For some is immediate sickness including vomiting upon injesting the offending substance...for others is heartburn. others still is tummy problems diarrhoea and gas...also milk like wheat and grains in general may take a while to have its effect.
Casein, one the bioactive proteins in milk is known to cause long term gut leakage so a building up of immune response to casein epitopes that can after many years of milk consumption manifest itself in various guises including intoelrance like symptoms and eczema. There could also be a shift in gut flora in a given individual that exacerbates or in the opposite direction attenuates symptoms or their diet might change and as we know certain food comibations are more harmful than others...
I am sure other people cna think of more reasons why it is not a black and white phenomenon...
I was faithfully taking bariatric specific vitamins from day one. Drinking protein shakes daily. Both of which my surgeon said I did NOT need to do. I knew better.
Yet despite my supplementing, I still ended up with malnutrition issues that continue to this day. It's very difficult to take in enough supplements - when you don't absorb all you take in; and have a small pouch in which to fit everything.
I now am battling issues from osteoporosis, low vitamin D, low calcium, low iron and I struggle to maintain good B12 levels. Some things I do sub-lingual, some dry pill form, some liquid. Depends on the supplement.
I have developed reactive hypoglycemia and now also hypothyroidism and I have hyperparathyroidism as well. I basically traded one set of problems for another - and at my own doing.
What really irks me is that I got obese eating only 1600 calories per day. It wasn't how much I was eating that made me obese - but what I was eating. My metabolism does much better on a low carb diet.
I know much more now about nutrition and what is and is not good food. I absolutely do NOT recommend weight loss surgery.
I'm not sure what you think "evangelic" [sic] means, but
"PEOLPE DRINKNIG TEH MLIK IS NOT NORMAL!!!!"
is a pretty good example of evangelizing. Also:
"Drink teh milk at your own risk! Drink teh milk and you will be cast into the lake of fire..."
Whoops. Switched over into the wrong sermon, there.
I understand that you are obsessed about milk and milk products, but there isn't the same sort of science supporting your assertions as there is supporting LCHF diets.
I support the "fringe" theory of LCHF because there are peer reviewed studies to support it. When you bring the same number of peer-reviewed studies to support your theories about the dangers of milk, I'll pay attention.
I happen to be suspicious about soy, but since there aren't a large number of studies demonstrating that it's dangerous, I pretty much STFU about it, and don’t shout at people and tell them they’re stupidly risking their lives by eating it.
As far as my statement about bears, I work for the county extension. I came across this when I was researching some other wildlife management issue. In that capacity I look at a LOT of university websites, but I can't find the one that caught my attention back then (and summer program hasn't started, so I can't get to my bookmarks on the office computer), but a quick search brought up this:
http://icwdm.org/inspection/Livestock.aspx
(which used to be the Cornell / Clemson University website)
Yep, I admit it says, “possibly” to get the milk.
BUT – it doesn’t matter, because you’re still arguing from the Naturalistic Fallacy. And that won’t work:
http://en.wikipedia.org/wiki/Naturalistic_fallacy
That was my point.
"I think someone msut be spiking your milk...vodka comes to mind."
Nice. Very nice.
I'm not vegan and I enjoy wine and quorn (doesnt taste much but is a nice substitute for meat if you add spices and sauce to it). My boyfriend doesnt like the british minced meat so whenever I want to cook tacos or bolognese he only eats it if I use minced quorn (he is NOT vegetarian).
http://greatestviews.com/the-diet-solution-program-does-it-really-work/
Could you explain the significance of Parkinsons and AIDS in the image above?
Thanks.
Just for comparing the size of the circles, i.e. the number of people affected by the problem.
Also, if I may, are you aware by any chance of the role of stealth infections/viruses in obesity? Many people are silently suffering from ME/CFS and similar hard to define ailments and increasing evidence is pointing to stealth viral infections. Kenny De Meirleir, a Belgian specialist, treats obesity in many of his CFS patients with free T3 since reverse T3 levels are high and renders them thyroid-resistant, not that dis-similar really to insulin-resistance, and thus fail to lose weight even on diets of 800 calories/day. The obesity story is in fact far more complicated than even Taubes would have us believe and in the future the role of infectious pathogens in obesity will gain far more attention than now.
But, I can't see it as anything but more mutilation. The only time I've ever had surgery was to remove a very large ovarian cyst and the ovary it was attached to (after a torsion turned it necrotic), and I had a thyroidectomy with cervical lymph dissection (because of cancer).
I will only ever have surgery under extreme circumstances.
I just need someone to talk to me about this. Literally anyone. I decided to take action because my health is in the gutter right now. After having my thyroid removed my hair started falling out in bunches and I started gaining SO MUCH weight. My endocrinologist said that I would probably be easier to regulate now that I don't have a thyroid, but wow. It's not going that way at all...
I want to continue with this low carb, no meat, no dairy diet and I need to know at some point that I'm going to see some effect. At my size "the weight should be flying off." That is what I am told. But... My TSH level was recently 50. My T4 (low) and my T3 was close to zero. Having a history of bad thyroid problems and now, having no thyroid at all, I am dependent on synthroid. Even with it, my metabolism is all screwed up..... I maintain my current weight at a 1000 kcal/day diet. And that is only if I am eating 1000 kcal/day of fruits and vegetables (not meat, not dairy). The moment I touch meat or dairy (even the lean kind) I gain weight. The only fats I consume come from extra virgin olive oil, fish oil supplement, black currant oil supplement, or avocado. I take a daily MTV along with metformin, vitex, aspirin, lisinopril, and aldactone. I am not diabetic, but have horrible acanthosis nigricans from insulin resistance.
Gastric bypass cuts away your stomach/resections it so that you feel full. It causes a lot of people to eat <700kcals/day and go into ketoacidosis. Gastric bypass people don't have much energy while they are still overweight and on a starvation diet. They have headaches from too few carbs and the same risk of kidney stones (if not more) than people who are starving themselves to become thin.
If I eat a starvation diet of fruits and veggies I am still going to be taking in more nutrients than gastric bypass pts. And I will be better able to tolerate water in the amounts needed to avoid stones. Right?
I'm doing this and I'm committed. I would rather die than go off of this restriction and see myself gain more weight. But it is discouraging. I've been hovering 500-800kcal/day for the last week and only seen two pounds shed. And... don't they always say the first week you see the most results because of water weight? I mean. This is pretty discouraging. Still, it's the only thing I can do. For this first month, I'm not going to exercise, just calorie restrict. Next month I'm going to start light aerobic activity (walking). And I will progress as soon as I see weight come off.
A lot of people keep talking to me about muscle wasting. Well.... Having had hypothyroidism for so many years AND losing my thyroid and becoming EXTREMELY symptomatic, I'm pretty sure I've been muscle wasting anyway. The protein I get in my diet now comes from eggs, nuts, beans, and legumes. But I am not eating a ton. I still think I'm getting enough protein and nutrients though... Unless anyone can tell me how many grams I should strive for a day while still being able to lose weight...
Though weight-loss surgery has a reputation for being risky, the procedures have improved over the years and are a lot safer now; the ASMBS reports that the chances of having a major complication are only about 4.3 percent. The risks of staying obese — heart disease, diabetes, stroke, and even death – are far more dangerous.
10. Most people say they'd do it again in a heartbeat.
Though success is a long-term project for patients who undergo this serious procedure, most people say that if they could go back in time, they'd choose to have the surgery again. Many people report that after the surgery and subsequent weight loss they feel better, are more active, and take fewer medications to treat the complications of obesity — all of which can greatly improve a person's quality of life.
Last Updated: 2/27/2015
Why are carbs out to be the bad guy?
Think about it. The staple food in Asian countries is white rice, and the majority of the people are slim. They even eat rice 3 times a day!!!
We need to be eating the right carbs. Don't get it confused with cakes and pies and breads, I'm talking about beans, lentils, potatoes and rice.
When we think of carbs we think of cakes and pies filled with animal fat and carbs combined.
But when we take away animal fats then people start to become healthier
How long does it take...how many days..to stop the intense cravings once i've switched to LCHF? One of the reasons i crave is that my serotonin and dopamine levels are so low due to long term depression and anxiety. Also chronic low blood sugar that after a 5 hr glucose tolerance test, never does go back up to a "comfortable" range.
I feel like a drug addict! Cravings for chocolate, bread, corn fruit, it's extreme....even if i am full from eating proteins and fats.
I know, as any addict in recovery does, that I need to have a "one day at a time" mentality. I would so appreciate any tips and advise, especially in answereing my question: How many days until the cravings stop or lessen?
If you are a member why not ask our food addict expert Bitten for advice here:
http://www.dietdoctor.com/member/ask-bitten-jonsson-rn
Cristinadoescartweels@gmail.com
Obese people arent victims, they are liabilities, to their families, their society and to themselves. No sympathy for you.
People severely obese desperately want to lose the weight and are trying their best to follow their doctor advice but, if the advice is wrong, it is not their fault if it's not working when they "overhaul" their diet and actively exercise.
DietDoctor site is discouraging bariatric surgery, offering a solution that works, based on science: Low Carb High Fat. It does not cost anything to taxpayers!!!!
If you have never been 100 pounds overweight and unable to lose it, then you should not judge people and offer "simple" solutions when you obviously don't know what you are talking about.
Your comment makes you sound like a mean and insensitive "know it all".
By the way obesity is a "legitimate" metabolic disease.
Like many other people, I thought Gastric Bypass was the answer to my battle with Obesity. After 18 years, I live everyday with regret. I lost 145 lbs. going from 280 down to 135 at my lowest weight.
It is my life goal to make sure that everyone who is considering Gastric Bypass make sure they know what they are getting into. Complications are not rare. Malabsorption is a dangerous thing. You can live with out most of your small intestine, but at what cost, and for how long? There have not been enough long term studies done on patients post Surgery longterm. Why? Because there are not many of us that have reached past the 20 year mark. I have searched for studies and there are only a handful. You have to weigh the pros and Cons. I'm not talking about the big scary Complications. This list of complications is from a yahoo support group
"Dehydration, Chronic Vomiting and Nausea, Stroke, Heart Attack,
Arrythmia, Kidney stones, Kidney Failure, Liver Failure, Anemia, Deficiencies (B-12,potassium, iron, B-1, B-6, etc.), Malabsorbtion of supplements
(calcium, minerals, nutrients from food), Blurred Vision, Muscle and
Bone Pain, Loss of Teeth, Bleeding Gums, Rotting Teeth Due to
Vomiting Requiring Root Canals, Hypoglycemia, Headaches, Black
outs/Seizures, Lactose Intolorant, Injury to Spleen during surgery,
Coma, Paralysis/Blindness after coma, Osteoporsis, Burst Pouch,
Lupus, Auto-Immune Disease, Looped Intestines, Ruptured Esophagus
from vomiting, Misfired Staper during surgery, Ulcers, Pneumonia/Lung
Problems, Arthritis, Weakness and Fatigue from Malnutrition, Overall
Pain, Metabolic Bone Disease, Food Blocking Stoma Causing Severe
Pain, Stoma Needing Stretched Repeatedly, Neuropathy, Beri Beri, Put
on Feeding Tubes/PICC Lines, Fibromyalgia, Chronic Fatigue,
Fistulas, Atrophy of Muscles, Hair Loss, Hernias, Blood Clots, Leaks,
Peritonitis, Heart Burn/Gerd/Acid Reflux, Bowel Obstructions,
Gallstones and Gallbladder Removal, Severe Depression, Anxiety, Loss
of Memory, Poor Concentration, Irrigular Blood Pressure, Diahhrea,
Constipation, Opening Of Outer Incision-Needing Packing Until Healed
From The Inside Out, Insomnia/Sleep Disorders, Unforced Anorexia and
Bulemia, Gas, Silent Stroke, Vertigo, Malnutrition which is the cause
of many of the above problems, Many End Up Becoming Invalids, and
then there is death.
This list continues to grow.
These complications can happen right after surgery, days, weeks,
months, many years, and even when taking all the required
supplements.
Besides physical complications there is financial hardship and
families who are devastated. "
Complications Rare I think Not!!! I have lost my teeth and had to have crowns placed on most of them. This is something that is becoming more of a thing long term. I hd no prior dental problems. I have to have Iron Iv therapy every 3 months 5 units at a time 1200 dollars a pop. Living in the United States, I have a high Deductible of 12,000 a year. I have met that deductible every year for the past 6 years. This surgery has a high price. And my insurance paid 100% of the surgery, but they will not pay for any of the complications.
I know that some people may continue to support Gastric Bypass, But I will not. There are better ways of losing weight and LCHF is so far the Best I have found. AND I will say getting your head right is part of the battle.
This article may be helpful for you! https://www.dietdoctor.com/fix-broken-metabolism-exact-opposite