New recommendations from doctors take us even further in the wrong direction. Action Alert.
Three medical societies—the American Association of Clinical Endocrinologists, the Obesity Society, and the American Society for Metabolic and Bariatric Surgery—jointly announced last month that they were changing their guidance on who should get metabolic and bariatric surgery, and which methods should be used.
These new guidelines state that bariatric surgery should be expanded to include mildly to moderately obese people (class 1 obesity) who have diabetes or metabolic syndrome. Eligible patients would have a body mass index (BMI) of 30 or above; for a 5’9” adult, that’s a weight of 203 lbs. or higher—only 35 pounds over what is considered a healthy weight.
This recommendation comes with a disclaimer: “Current evidence is limited by the number of subjects studied and lack of long term data demonstrating net benefit.” It is further noted that there is currently insufficient evidence for recommending a bariatric surgical procedure specifically for glycemic control alone, fat reduction alone, or cardiovascular disease risk reduction alone, independent of BMI criteria.
In their press release, this statement is immediately followed up—with no irony whatsoever—with these words: “These clinical guidelines provide evidence-based recommendations and information to help surgeons, primary care doctors and other health professionals make the most informed decisions for the benefit of patients.” Evidence-based? How absurd! There’s no evidence at all for their recommendation, by their own admission!
This is not the first time conventional medicine has recommended reducing the threshold for bariatric surgery. In 2011 we told you about an FDA panel’s recommendation that lap-band surgery be made available to 12 million more people than before.
Gastric bypass surgery is not only a popular medical procedure; it is also an economic goldmine. Bariatric surgery has a 45% profit margin—larger than most procedures (by contrast, other money-making procedures like coronary artery bypass surgery have an estimated profit margin of only 30%). And it’s almost always covered by insurance.
Bariatric surgery can reduce weight—at least at first. But weight loss does not necessarily result from reducing stomach size or primarily from that. New research suggests that the weight loss that occurs after gastric bypass surgery may be the result of changes to stomach flora. This study is discussed in the May 2013 issue of Dr. David Williams’s Alternatives newsletter. It has been known for some time that after surgery, the gut changes in its chemistry, not just its size—but it wasn’t clear whether the chemical changes were produced by the weight reduction, or caused it. This study found that the chemical changes were the catalyst to weight loss.
The data isn’t conclusive for humans—the study used test animals—and much remains to be understood about the process involved. If chemical changes in the gut are what causes people to lose weight, not a change in stomach size, it is better by far to shift the gut bacteria using probiotics.
Bariatric surgery is far from routine. Studies show that 1% of patients die from the surgery, and complications affect up to 40% of patients, including vomiting, diarrhea, infections, hernias and respiratory failure; as well nutritional deficiency, potentially resulting in anemia, osteoporosis, and bizarre neurological problems. Seizures and paralysis have even been reported in extreme cases. One thing to worry about in particular is damage to the vagus nerve, which controls many important digestive functions including bile release and the movement of food.
Moreover, a study from the Journal of the American Medical Association shows that bariatric surgery does nothing to reduce a patient’s long-term health care expenses. On top of that, the surgery is considered a “success” if only 50% of one’s excess weight is lost—even though the patient would still be overweight or obese—and within ten years, as few as 20% of patients have maintained their weight loss. This may be because the chemical changes in the remaining gut do not persist—though they could be maintained with the right diet and supplements. Indeed, these ideal gut conditions could and should be created without the surgery in the first place.
Weight loss supplements are a hot topic right now. Not surprisingly, the FDA is considering completely banning weight loss claims for anything other than drugs. So far, they have hesitated because there aren’t many weight loss drugs and they often have horrifying side effects. But if you haven’t taken action by writing the FDA to tell them not to ban supplement weight loss claims, please do so now.
One supplement much discussed for weight loss now is Garcinia cambogia, an extract from the Malabar tamarind. Studies in the 1960s and ’70s showed that Garcinia cambogia contains hydroxycitirc acid (HCA), which inhibits the enzyme ATP citrate lyase, diverting the conversion of carbs from fat to energy production instead. Furthermore, fatty acids in the body’s “fat pool” continue to be released, contributing to overall fat loss.
As Dr. Harry G. Preuss, MACN, CNS, a member of our board, points out in his paper “Garcinia Cambogia: How to Optimize Effects,” the quality of the Garcinia extract is important—it must contain a minimum of 50% HCA, and must not be composed wholly of calcium salts as this would decrease bioavailability. Potassium and/or magnesium should be present (both increase bioavailability), and a product with low lactone content is recommended. It must also be taken on an empty stomach (at least 30 to 60 minutes before a meal), because otherwise it will bind to components in the meal and be inactivated. (This is called the “food effect,” and it can reduce bioavailability of many different supplements besides HCA).
Garcinia provides an object lesson in using supplements wisely. It is never as simple as just taking a pill. The formulation is important; the co-factors are important; and your individual body chemistry is important. Always consult a knowledgeable professional.
Besides Garcinia cambogia, there are curcumin and cinnamon, which control blood sugar levels; magnesium, chromium, amino acids, and green tea, which help with weight loss; and Irvingia gabonesis supplements (derived from a wild mango from central and western Africa), which has showed impressive weight loss effects in a recent ten-week RCT.
For more suggestions, including the importance of good fats, the right kind of exercise, and metabolic typing, see our earlier article, “Natural Solutions for Losing Weight.”
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I review medical records as a significant part of my job. Having seen the records of many of these individuals, I can attest to the health problems caused by this surgery. Anemia, fatigue, joint pain, diarrhea and a number of other symptoms appear common with this procedure. Also, physicians note prominently in the chart that the patient has undergone bypass surgery, indicating to me the significance of the procedure in diagnosing and treating various symptoms.
I saw Dr. Nancy Snyderman on Morning Joe the other day in a discussion about weight. She commented a few times that she thought stigmatization of overweight people was appropriate. With pressure from the public, pushed by media “experts” like her, moderately overweight people could feel forced to go under the knife to keep their job or to get public benefits or to avoid harassment.
A very close loved one had gastric bypass about five years ago. Within 12 months of the surgery, she was hospitalized with two bleeding ulcers. Last year, she had to have surgery to remove two tumors from her throat (one of which was attached to her vagus nerve). Despite eating extremely small portions, it seems as though almost every meal is followed by anything from exhaustion to dry heaves to outright vomiting spells. When she’s not suffering from insomnia, she’s sleep-walking. If you’ve ever been around someone after they’d just gotten home from a 20-hour shift, that’s how she acts most of the time – exhausted, almost zombie-like. If you absolutely must go to such extremes to lose weight, opt for the lap band. Stay away from gastric bypass surgery. There are worse things than obesity.
Clean up the food.. Make it safe again. Outlaw GMO’s. Get rid of all the chemicals and antibiotics you allow for use in the the animals we eat. Clean up the rivers, lakes and streams and the ocean. Then our people can heal from the inside out.
Gastric Bypass is just another bandaid on a huge problem….it does not fix anything.
my husband had lap band surgery in 2005, lost 50 lbs at first, now has gained it back, just became self-employed, was denied by two insurance companies coverage, third company wrote a temporary policy for one year and excludes any problems that occur with the lap band as pre- existing. No one ever told us getting insurance would ever be a problem.
Mainstream medicine doesn’t know how to do anything other than prescribe drugs and do surgery. They don’t know how to really support the body in its processes or look at underlying causes. That’s why I love holistic medicine, it helps the body’s own processes, to address the underlying cause only makes intellectual sense, and in most cases it does not require invasive surgery or harsh chemicals, etc. Given the limited scope of mainstream medicine, this recommendation for surgery does not surprise me at all.
Interesting that we now have an obesity and diabetes epidemic that have skyrocketed, while GMOs take over the country. Could there possibly be a connection?
PS One more concern is that with lyme disease physicians, the “recommendations” by the Feds end up really being unconstitutional mandates. Doctors who don’t do what the “guidelines” say, are either taken to court, have their licenses revoked, etc. while the patients meanwhile have seizures, heart issues, paralysis, speech loss, and more. Not at all funny.
The lyme doctors, under these Federal “guidelines”, are not allowed to think for themselves and practice medicine according to their own best judgment, based on individual needs.
Is this what we call American freedom?
I am concerned that the “recommendations” for obesity-related surgery may possibly (?) end up being similar mandates, falsely disguised as benign ‘recommendations”. Dear ANH, is this concern off the mark, or for real? Your thoughts would be appreciated.
PS I suggest that it’s high time to demand the resignations of any FDA members who:
a) usurp and undermine freedom of medical choice, whether that’s for naturopathics or mainstream, either way b) approve things that are untested and with unknown medical impacts c) allow known carcinogens into our food d) approve drugs with “side effects” such as leukemia, tumors, holes in the esophagus, heart attacks, stroke, seizures, perforations, etc…. http://www.drugs.com check it out for yourself, this is real! e) then point fingers to “The Quacks” *(The nerve of them, given the “side effects” of their own– sometimes— downright dangerous medications) f) squelch free speech about supplements g) attempt to undermine access to, practicing of, or manufacturing of naturopathics, H) and otherwise practice medical dictatorship.
This is completely unacceptable, and does not belong in a supposedly free country.
It’s time for them to resign!
“First do no harm” is not only an oath they take, but implies criminal activity, or criminal negligence, wherever this oath is ignored and stepped all over. We need to hold them legally and morally to account.
I’m always amazed that cereal manufacturers are allowed to advertise how their products support heart health, yet supplement manufacturers are prevented from making similar claims despite the fact that most of their ingredients have been successfully used for thousands of years. We are living in an upside down world at the hands of government bureaucrats and big business, including the chemical drug industry, the agricultural chemical manufacturers, and the major food producers. They all claim to care about the ordinary people. It’s time for us to reign in the big guys and get back to some semblance of sanity.
The more treatment we have the sicker we are. The more they tell us, the less we know.
Personally, I’d like to see an out-of-the-box thinker like Dr. Tedone, who originated the Deanna Protocol for ALS patients, be in charge of the FDA, or oversee the claims that would produce these inane guidelines.
In a word, the proposed guidance is absurd.
They (medical community, insurance) completely ignore the fact that there are metabolic diseases that cause weight gain. Reducing food intake won’t fix or change that and in those situations surgery can be a dangerous and costly departure from real solutions!
I’m in the bariatric bypass program at Highland Hosp. Rochester ,NY. My knees became injured 11/2003. I worked with steel and while I’m only 5′ 2″ I have to hold my end up. I was over muscled, but I needed every pound of my 150. I sat with my legs elevated with Ice then Hot wet therapy. I was x-rayed and MRIed.I was waiting for the new sports medicine clinic’s Doc. to arrive. In June of 2004 This quack did bilateral knees arthroscopy. I’ve been crippled ever since. Being sedentary did not slow my appetite. I blossomed up to a very unhealthy 250 lbs. I can’t get rid of this weight.. I’ve already had triple bypass in 2009. Diabetes ,high blood pressure, obstructive sleep apnea and other complications. All my doctors say go for the surgery, but I still .have doubts.
Cushing’s disease causes weight gain. Tumors cause weight gain. No amount of dieting will ever make you lose weight if your body is storing improperly due to mitigating factors. Does the medical community not have Internet access? Do they not have cable tv or access to libraries and bookstores? Why is there so much ignorance and stupidity being sold as “medicine”?
The English speaking world, ( USA UK, Australia, New Zealand etc) has the highest rate of obesity and overweight over 50% where China 10% why, ? English speaking counties need better education on natural, weight loss, most doctors and nurses and even dietitians dont know the world health guidelines for obese and over weight, which are 100% successfull, look at the biggest loser show ever seen anyone not lose weight.
The only think we hear is that weight loss surgery is the ( easiest) best? its the worst. only 30% success rate, irreversible, so if you are one of the 70% failures, and it dos not work you life is destroyed. Ban it and then people will have no option but the natural method.
eat and drink less calories, do more weight loss exercise every day, ( full body, like dancing, not walking, push ups, situps, squats, ) for 60 – 90 minutes a day or more like even 2 hours, 3 hours 4 hours. till it starts coming off at about 1 – 3 pounds a week.
3 hours, yes 3 hours a day if that is what it takes split up throughout your day, say 1/2 an hour every 3 hours, if that is what it takes, 3 hours of dancing a day is better then 24 hours of being dead a day.
more education, we are lagging behind the rest of the world, we should be smarter then that.