This is the Weight and Healthcare newsletter! If you appreciate the content here, please consider supporting the newsletter by subscribing and/or sharing! In October, “Guidelines on Indications for Metabolic and Bariatric Surgery” were put out. While I don’t think that these surgeries meet the
This is incredibly frustrating. I’ve shared this before, but I was diagnosed with heart failure this summer, and my first cardiologist said “you have heart failure, a 50% chance of dying in the next 5 years, and have you considered bariatric surgery” in that order and that quickly. You know what he did not suggest? Referral to a specialized heart failure clinic provided by their practice, fine-tuning medications, or healthy behaviors like eating low-sodium and exercise, all of which I did on my own and am now in a “dormant” state with my condition, without mutilating my digestive system. The level of irresponsibility in providers recommending this surgery is egregious.
I am a dietitian who did my dietetic internship in Louisiana. We had to a rotation in a bariatric clinic, which was incredibly depressing. It’s one of the few places in the healthcare system where dietitians’ hours are covered by insurance so they could spend time with people in a way that few other dietitians can, but at the price of pushing a life-altering surgery on them. I never saw anyone truly emphasizing the risks and trade offs of the surgery and many patients were there for a second procedure because the first had “failed,” (i.e. they started eating normally again.) It was an inhumane place.
The diet industry has really latched on to the idea of "metabolic syndrome" and "metabolic health," with no actual causation yet found.
A recent study [https://doi.org/10.1089/met.2022.0061] done with 3000 teenagers found a correlation between "metabolic syndrome symptoms" and perception of being fat, whether or not the teen was fat. That alone implies that this so-called "syndrome" is far more complicated than the Fix the Fatties brigade wants to believe, and furthers the theory that stress is a very critical part of overall health.
What next, will they start recommending WLS to people who think they're fat, independent of body size, as if it's some kind of special cosmetic surgery?
Another comment I’ll add - I work for a big insurance company that has embraced inclusion and diversity, but not yet body diversity. I’ve had talks with our clinical team about the damage of weight loss programs. Their answer? “Ob*sity is a disease, and we know diets don’t work, so that’s why we focus on medical interventions like surgery and medications!” UGH!!
My favorite quote: "The industry also has a history of making small changes to the procedure, then claiming that the new procedures are safer than the old procedures based on very short-term data. This also conveniently allows them to claim that unfavorable research is outdated." Yep, they have been pulling that off for more than 50 years. Since I have had friends who died of WLS, and others who have endured long-lasting problems because of it, I find it hard to keep an open mind. Another group who don't keep an open mind--GI doctors who are usually the ones who get consulted by desperate patients who need to repair the damage done by their WLS. Most Gi doctors aren't so pleased with WLS, and many counsel against it.
Hi Ragen. It seems like some body like the AMA or other organization should need to approve these guidelines. It's so obvious why this particular organization wants to expand the use of their surgeries that there should be more of a review process prior to an official approval. And if there isn't, how do they get the word out to doctors? I don't imagine all doctors read their magazines. I guess I'm just hoping that something exists to head off a guideline this blatant and egregious. As always, thank you for all the work you do for all of us.
Ragen - I don't know how you can do this work without turning into a raging beast & taking after
all the weight-loss pushers with a mallet. Whenever I come across someone pushing WLS (as it was
pushed at me when I was larger), I simply refer them to the obits for 6 of the 7 people I knew who
underwent one procedure or another. (Person #7 has been in & out of hospital over a dozen time
in the 3 years since she had the surgery & her future does NOT look bright re:her health).
You are on the money (literally) in saying that these "guidelines" are basically showing the butchers
a faster way to the bank at the expense of their fat patients. Can you imagine something like
joint replacement being suggested for someone who doens't need it, or a mastectomy for a woman
with no history of cancer? This seems to be the level on which the WLS guys are operating. KEEP
AFTER THEM! Someone HAS to listen someitme. Thank you for letting in this rant.
This is incredibly frustrating. I’ve shared this before, but I was diagnosed with heart failure this summer, and my first cardiologist said “you have heart failure, a 50% chance of dying in the next 5 years, and have you considered bariatric surgery” in that order and that quickly. You know what he did not suggest? Referral to a specialized heart failure clinic provided by their practice, fine-tuning medications, or healthy behaviors like eating low-sodium and exercise, all of which I did on my own and am now in a “dormant” state with my condition, without mutilating my digestive system. The level of irresponsibility in providers recommending this surgery is egregious.
I am a dietitian who did my dietetic internship in Louisiana. We had to a rotation in a bariatric clinic, which was incredibly depressing. It’s one of the few places in the healthcare system where dietitians’ hours are covered by insurance so they could spend time with people in a way that few other dietitians can, but at the price of pushing a life-altering surgery on them. I never saw anyone truly emphasizing the risks and trade offs of the surgery and many patients were there for a second procedure because the first had “failed,” (i.e. they started eating normally again.) It was an inhumane place.
The diet industry has really latched on to the idea of "metabolic syndrome" and "metabolic health," with no actual causation yet found.
A recent study [https://doi.org/10.1089/met.2022.0061] done with 3000 teenagers found a correlation between "metabolic syndrome symptoms" and perception of being fat, whether or not the teen was fat. That alone implies that this so-called "syndrome" is far more complicated than the Fix the Fatties brigade wants to believe, and furthers the theory that stress is a very critical part of overall health.
What next, will they start recommending WLS to people who think they're fat, independent of body size, as if it's some kind of special cosmetic surgery?
Another comment I’ll add - I work for a big insurance company that has embraced inclusion and diversity, but not yet body diversity. I’ve had talks with our clinical team about the damage of weight loss programs. Their answer? “Ob*sity is a disease, and we know diets don’t work, so that’s why we focus on medical interventions like surgery and medications!” UGH!!
My favorite quote: "The industry also has a history of making small changes to the procedure, then claiming that the new procedures are safer than the old procedures based on very short-term data. This also conveniently allows them to claim that unfavorable research is outdated." Yep, they have been pulling that off for more than 50 years. Since I have had friends who died of WLS, and others who have endured long-lasting problems because of it, I find it hard to keep an open mind. Another group who don't keep an open mind--GI doctors who are usually the ones who get consulted by desperate patients who need to repair the damage done by their WLS. Most Gi doctors aren't so pleased with WLS, and many counsel against it.
Hi Ragen. It seems like some body like the AMA or other organization should need to approve these guidelines. It's so obvious why this particular organization wants to expand the use of their surgeries that there should be more of a review process prior to an official approval. And if there isn't, how do they get the word out to doctors? I don't imagine all doctors read their magazines. I guess I'm just hoping that something exists to head off a guideline this blatant and egregious. As always, thank you for all the work you do for all of us.