Reader Question - Was there really a contest to win weight loss surgery?

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I got the following question from reader Jill who attended a recent talk that I gave at her medical center:

”During the question and answer part you mentioned a contest to win weight loss surgery. Did that really happen? I hope you’ll write about it on your newsletter.”

Yeah, it did and yes, I will Jill, thanks for asking.

As the weight loss industry, often through their astroturf “patient advocacy” groups , lobbies state and national governments to have their marketing priorities written into legislation I thought we would look back on one of the most unhinged attempts at this as reminder that we are just the next stage in a long and extremely well-funded con.

It’s December 2010 and people are receiving an email from Allergan. The email is encouraging them to enter a contest to win a weight loss surgery. But we’re getting ahead of ourselves.

Allergan has since become part of AbbVie but at the time they were an independent healthcare company. Their products included botox, juvederm, latisse (your eyelashes will most likely get longer and hey, the skin discoloration is only probably permanent,) and the lap band. This is a band inserted during what Allergan referred to as a “major surgery”, used to make the stomach tiny, thereby forcing the patient to eat amounts consistent with what we see in people dealing with eating disorders or experience extreme discomfort. The surgery has since fallen out of favor due to a very high failure rate and a long list of adverse events including and especially a sky high rate of required re-surgery (in some studies the risk was 60%.)

Allergan was also the company who funded the astonishingly bad study that claims that ob*sity costs the workplace $73 Billion a year, then used that study to attempt to convince health insurance companies to pay for lap band surgery. I wrote about that here.

Let me be clear that I take a firm view of bodily autonomy including people’s right to get botox, a lapband, if someone wants to apply Latisse creatively and grow eyelashes on their … whatever…that’s their business.

My problem is with the company profiting from weight loss surgery claiming to be a healthcare company but acting like the Home Shopping Network. Marketing is used to position products in their best possible light so as to sell them to as many people as possible and I understand that. If you’re selling a vegetable chopper on late night television without telling people that they will have to hit it with the power of a sledgehammer to dice those carrots, that’s one thing. If you are selling major surgery I don’t think that the same marketing techniques remotely meet the requirements of ethical, evidence-based medicine.

All of which is to say that even if they had made some kind of attempt to make this contest seem ethical, I would have found it inappropriate. But there’s no need to worry, because they didn’t even try.

The email was sent to me by someone who received it. The complete text is at the end of this post, but I want to point out some of the more horrifying bits.

Note: the indented items are quotes from, or summaries of, the email and they contain weight stigma and misinformation. You can skip them and still get the gist of this post.

They explained:

The contest program is a part of Allergan’s public advocacy campaign, launched in May 2010, called C.H.O.I.C.E. (Choosing Health over Ob*sity Inspiring Change through Empowerment)

They urges readers to

Sign the online petition to tell Congress it’s time to recognize ob*sity as a disease, NOT a choice, and focus on prevention and treatment, and accept all treatments, including weight-loss surgery …Tools are available to help you spread the word about the campaign and encourage your friends to join our movement.

Oh, this is a movement. And here I thought it was a for-profit corporation. Wait – it IS a for-profit corporation. It was, in fact, a publicly traded for-profit corporation and therefore its fiduciary responsibility was to its shareholders and not its clients/patients. This means that people being adversely affected by their products (including fatalities) can be considered an “acceptable loss” as long as they stay on the good side of regulatory bodies and keep making money.

But Allergan pinky swears that this is public advocacy. Wow, they do all this public advocacy and all they got for their trouble is a lousy $159.5 Million in sales in 2012. The selflessness is just overwhelming.

Look, it is impossible to “choose health over ob*sity” because they aren’t opposites. First of all “health” is a gooey, amorphous concept and by any definition is not an obligation, barometer of worthiness, or entirely within our control. So-called “ob*sity” is just a ratio of weight and height. There are people of very different sizes with the exact same health statuses and there are people of the exact same size with very different health statuses. Some health issues are correlated with being higher weight, but weight stigma, weight cycling, and healthcare inequalities are all well researched contenders for being the actual cause.

They are giving away the surgery and a year of follow up care.

Many people have side effects for far longer than a year after their surgery – including the need to completely re-operate due to band slippage or erosion over time and other side effects. Their e-mailwasn’t clear about what this surgery could cost the “winners” over time (or if their insurance is going to cover those issues).

You can enter yourself or “A family member or close friend may also enter the contest on a person’s behalf.”

Holy ethics disaster Batman. Were this my friend or family member, instead of the OR to get my stomach squeezed, I’m afraid I’d find myself in front of a judge trying to use the “Your Honor, they had it comin’” defense.

If someone is going to undertake a major surgery that carries with it risks including reflux, obstruction of the stomach, dilation of the esophagus, infection, nausea and vomiting, and death, it seems that it should be after careful consideration and informed consent, not under the auspices of “JOHNNY, TELL HIM WHAT HE’S WON!”

This Allergan fiasco is the early version of the absurd “Ob*sity Bill of Rights” Their techniques have gotten more sophisticated and less crass (at least overtly crass) but the goal is still the same - create internalized oppression in higher-weight people, make them believe that their bodies are a problem and weight loss is the answer, and then get them to engage in weight loss attempts and lobby the government on behalf of the for (staggering) profit weight loss industry.

Like the song says, it’s all just a little bit of history repeating and we’ve got to call it out when we see it and push back however we can.

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*Note on language: I use “fat” as a neutral descriptor as used by the fat activist community, I use “ob*se” and “overw*ight” to acknowledge that these are terms that were created to medicalize and pathologize fat bodies, with roots in racism and specifically anti-Blackness. Please read Sabrina Strings’ Fearing the Black Body – the Racial Origins of Fat Phobia and Da’Shaun Harrison’

Here’ s the full text (absent the links, obviously). Warning : side effects may include feeling stabby and losing some of your faith in humanity:

Enter the The Live My Choice Contest Program

To raise awareness of the challenges those 100 pounds or more overweight face and to highlight the critical need to ensure access to treatment, Allergan, Inc. has launched the Live My C.H.O.I.C.E. Contest Program to prov ide three individuals with a LAP-BAND® Adjustable Gastric Banding System procedure, performed by a certified LAP-BAND® System surgeon of their choice, and one year of follow-up care, compliments of Allergan, Inc. The contest program is a part of Allergan’s public advocacy campaign, launched in May 2010, called C.H.O.I.C.E. (Choosing Health over Ob*sity Inspiring Change through Empowerment).

The contest ends December 14th. To qualify you must meet the clinical criteria for the LAP-BAND® System procedure: Body Mass Index (BMI) of at least 40; BMI of at least 35 with one or more serious comorbid conditions; or be at least 100 pounds over your ideal weight as determined by a physician. To enter the contest, submit a short essay or video at [no effing way will you get this link here] about how your weight has impacted your health and life, and why the LAP-BAND® System may be the tool to help you achieve your weight-loss goal. A family member or close friend may also enter the contest on a person’s behalf.

Individuals selected to receive a LAP-BAND® System procedure will publicly share their weight-loss journey in an effort to inspire others who are severely ob*se to reclaim their health and their lives. As part of this Contest Program, Allergan will provide all entrants the opportunity to receive free telephone consultations with a health educator who can provide one-on-one support, such as assistance in finding a local patient seminar, access to more information and resources regarding the LAP-BAND® System.

More information about the contest, including details on the rules and eligibility, can be accessed at [not a chance of getting that link here].

Additional Ways to Get Involved in C.H.O.I.C.E.Sign our Petition to Congress: Sign the online petition to tell Congress it’s time to recognize ob*sity as a disease,1 NOT a choice, and focus on prevention and treatment, and accept all treatments, including weight-loss surgery for those 100 pounds or more overweight.
Join the Facebook Cause Page and Follow us on Twitter: Join the campaign Cause page on Facebook and follow updates on the campaign on Twitter. Tools are available to help you spread the word about the campaign and encourage your friends to join our movement.

IMPORTANT LAP-BAND® SAFETY INFORMATION

Indications: The LAP-BAND® System is indicated for use in weight reduction for severely ob*se patients with a Body Mass Index (BMI) of at least 40, or a BMI of at least 35 with one or more severe comorbid conditions, or those who are 100 lbs. or more over their estimated ideal weight.

Contraindications: The LAP-BAND® System is not recommended for non-adult patients, patients with conditions that may make them poor surgical candidates or increase the risk of poor results (e.g., inflammatory or cardiopulmonary diseases, GI conditions, symptoms or family history of autoimmune disease, cirrhosis) who are unwilling or unable to comply with the required dietary restrictions, who have alcohol or drug addictions or who currently are or may be pregnant.

Warnings: The LAP-BAND® System is a long-term implant. Explant and replacement surgery may be required. Patients who become pregnant or severely ill, or who require more extensive nutrition, may require deflation of their bands. Anti-inflammatory agents, such as aspirin, should be used with caution and may contribute to an increased risk of band erosion.

Adverse Events: Placement of the LAP-BAND® System is major surgery and, as with any surgery, death can occur. Possible complications include the risks associated with the medications and methods used during surgery, the risks associated with any surgical procedure and the patient’s ability to tolerate a foreign object implanted in the body.

Band slippage, erosion and deflation, reflux, obstruction of the stomach, dilation of the esophagus, infection or nausea and vomiting may occur. Reoperation may be required.

Rapid weight loss may result in complications that may require additional surgery. Deflation of the band may alleviate excessively rapid weight loss or esophageal dilation.

Important: For full safety information, please visit [no, no, no, no link], talk with your doctor or call Allergan Product Support at [a galaxy of no on the 1-800 number].

CAUTION: Rx only.