Fat Chance – more about gastric banding
Tonight Channel 7 (Australia) screened a segment, as part of their Sunday Night program, concerning gastric banding (lap banding) and the fact that patients (and wider society) are not informed of the potential risks involved with the procedure.You can see the segment here but be warned, lots of triggering stuff on there.
Host Mike Munro speaks to Professor Paul O’Brien, a surgeon who is also a part of CORE (Centre for Obesity Research and Education) at Monash University in Melbourne and to Dr Samantha Thomas, also from Monash University who is a medical sociologist and ethicist. Despite the fact that Allergan (the manufacturer of the Lap Band) are CORES major funding source, Prof. O’Brien expects us to believe there is no conflict of interest whatsoever. The man must think we are all stupid as well as fat. Who is he kidding? Are Allergan likely to pump millions of dollars into research that comes out and says their product is anything other than wonderful? I doubt it. Big pharma isn’t known for its altruism. Dr Thomas on the other hand has no vested interest in Allergan and has actually been threatened for speaking out against banding. Just tonight since the segment aired a few hours ago she has been inundated with emails, both from supporters of the band (who are ‘disappointed’ in her, and that is the polite ones) as well as from people who have bands, have had nothing but trouble with them and want them out. Just tonight I have had another commenter share her experience of banding, you can read Chantelle’s heartbreaking comment at the bottom of this post.
Also featured is a young woman, Jessica, who is shown before, during and after her banding surgery and Justin, a man who has had the surgery and ended up spending 13 weeks in hospital (and having 10 operations during that time) and was on life support because of an error made during his banding surgery. The footage is pretty confronting stuff. Inanely it is said that ‘obesity surgery is Jess’s last chance’ and that she is ‘facing Type 2 diabetes’. She may well be facing Type 2 diabetes but she is also very upfront in that she eats crap and a lot of it. Maybe if someone told her about HAES the threat of diabetes wouldn’t be so large on her horizon? But no, let’s just band her stomach instead. Jessica obviously thinks banding is the answer to her problems, she even says she thinks banding will make her a better person. I find that incredibly sad. Jessica weighs only slightly more than I do. She is an extremely attractive young woman. It is devastating to think that she believes being thin is going to make her a better person. on the other hand, is lucky to be alive. His stomach looks like a patchwork quilt thanks to all the surgery he had to have following his botched banding. For all the rhetoric about banding prolonging life expectancy, banding very nearly killed this man, and that is no exaggeration.
It is refreshing to see a story that is at least a little more balanced than the usual pro-WLS information that we hear and see. Personally I would have liked to see the inclusion of a post-banding individual who has experienced problems further down the track with their band, gods know, there are enough of these people out there. But I guess we can’t everything and this is a start.
Just for the record, what you eat doesn’t cause diabetes & Type II is even more hereditary & genetically caused than Type I & they are assuming she risks diabetes because she is fat. Plenty of people who eat a lot of sweets never become diabetic & plenty of people who always eat ‘healthy’ do become diabetic. I am very hesitant to label food ‘crap’, because all food is food, & because, contrary to what all the voices out there (including the so-called ‘experts’ who claim to support HAES) like to say, we have far less control over our health or longevity, etc., than they want us to believe. It is mostly more tactics to convince us that anything which happens to us MUST be our fault & that we deserve to be denied medical treatment, or overcharged, or denied insurance coverage or have our carrier refuse to pay for treatments/medications, etc., because we have been ‘bad’. WLS is always a bad idea & is not the answer to anything & food is not either demonic or magical, also contrary to what those who are issuing ‘lists’ or writing books tell us. Yes, it is a good idea to eat a variety of foods from different food groups to prevent deficiencies & most of us can benefit from including some moderate activity in our lives, but ultimately our bodies belong to us & how we live in them is our choice & this young woman has just dramatically increased her risk for a lot of health problems & very possibly an early death by believing that she will somehow be a better or ‘healthier’ person or cut her risk of any disease by allowing herself to be butchered.
I am, btw, speaking as a 60-year-old woman from Maine who has spent most of her life living among people at or below or just above the poverty line, including many fat relatives who ate what they damn well pleased or what they could get & lived well into their late 80’s & 90’s, all without benefit of a special diet or a bariatric surgeon. I am also speaking as someone who has been working on fat acceptance for 30 years now & who is very independent & strong-willed, most like a libertarian with a small ‘l’ & I claim ownership of my own life & my own body & do not hesitate to call bullshit on those who try to guilt or manipulate me &/or spread misinformation about health/fat/life expectancy/risks, or whatever. I truly wish those who permit themselves to be brainwashed & bullied into surgeries the best, but I do wish that more people would wake up & see the coffee, accept & appreciate & respect themselves, & learn to their best lives THEIR way in the bodies they have.
SMELL the coffee, obviously. My mind & my fingers are frequently not in sync with each other at all times.
I personally know many (at least a dozen) people who have had gastric bypass, banding, etc. surgeries. I wouldn’t recommend it to anyone. Maybe there are some 800 lb people out there for whom the choice really is death or surgery, but everyone I know who had the surgery weighed between 200 and 450 lbs and all of them gained back a significant amount of the weight they initially lost, and almost all of them (if not all of them) have worse health now than they did before the surgery. I was appalled to find out a relative of mine had the surgery – she weighed maybe 250 pounds?! MAYBE! I couldn’t believe a doctor would even perform a surgery like this on a person of that size! At the time my thinking was that a regimen of healthy eating and exercise would better accomplish the weight loss, but now I think the weight loss piece was beside the point. The relative who had this surgery wasn’t interested in being healthy, she just wanted to be THIN.
I think a lot of these doctors are glorified plastic surgeons.
I didn’t watch the story – but gathered what it was about with the uproar in forums over the internet.
I was banded in 2005 and have probably lost 25kg. Would I do it again? Probably not.
I have a lot of trouble with what I can eat. What I can eat one day – I cannot necessarily eat the next day. Unfortunately a lot of stuff I wish I could not eat does go down to well.
Do you know awful it is to be out in public and realise that on the 3rd mouthful you might not get it down – and you are looking around you for the toilet to get rid of it… You just hope there is one nearby!
When you go out or to parties – you scan the menu or what is on the table to see if there is something you can eat – something that you will be able to get down.
At fill time – it is not a simple trip to the Drs for me to get my fill. They have too much trouble giving me a fill in the office – so I have to have it done under x-ray each time (guess that can’t be too healthy!).
Did you know I once spent each day in hospital for 3 days on a drip with severe dehydration because I couldn’t swallow anything! I had to wait for the X-Ray guy who does the fills to come back from days off! When he did they realised my band area is extremely sensitive and with the extra mil they put into me it was totally blocked off!
Now I have to have swallow a barium mix?? to make sure I definately have a small passage through my band to be able to swallow things.
There are lots of positive journeys with the band and they are certainly the ones you hear about in the media.
I think it should be more balanced though – so people know it is not a quick-fix solution and it is a total lifestyle change.
I wish I could jump up and down and be happy I have the band… but I can’t
Patsy: Thankyou for pointing that out (about Type 2 diabetes). I was (wrongly) under the impression that if you had the gene for diabetes you could possibly ‘manage’ the condition with diet. Obviously I need to do more reading on this! I am glad you were here to point out my error, thanks! : ) I also agree with you about being hesitant to label food as crap. I went with that labelling because that was what the woman in the segment referred to her diet as, I tend to think more along the same lines as you do, that food is food. I would be interested to see where Jessica (the woman in the segment) is at in 5 or 10 years time. And I know ’see the coffee’ was a typo but I liked it all the same! lol
hsofia: You hit the nail on the head, WLS is actually being marketed as cosmetic surgery these days… if that doesn’t say something then what does?!
Tracey: I am so sorry to hear what you have gone through (and are continuing to go through) since your banding. I totally agree that people need to be more informed about the procedure. It will never be banned but if we can get people to really make an informed choice (as opposed to what they are making now) that would be good. I just want to give you a big hug right now. Thankyou for commenting.
I was (wrongly) under the impression that if you had the gene for diabetes you could possibly ‘manage’ the condition with diet.
Some people who have Type II diabetes can manage their conditions through food choices and timing of meals without also needing medication.
However, you can’t avoid getting diabetes entirely by managing you what you eat.
Did you read that CORE blurb? I quote;
Obesity is shaping to be the pathogen of the 21st century.
A pathogen huh? What’s the betting they’ll be lobbying to expand the meaning of this term?
It goes on;
Obesity is now a disease considered at least equal to smoking as a preventable cause of premature death. Obesity ruins health, destroys quality of life, and generates premature death.
Where to even start?
JupiterPluvius is correct. I have diabetes (type1) and it requires a lot of dietary control to manage my BG (plus an insulin pump), but it doesn’t effect the actual presence of the disease. The disease (whether type 1 or 2) is about the body’s response to a rise in glucose levels… the symptoms can be managed by not eating things that cause sharp rises in bg, but the disease is still there. Conversely, for people who don’t have the disease, even scarfing down the contents of the sugar bowl won’t create it.
i wish i could *see* some coffee right now!!!!
too early!!!
interesting article & of course boo to big pharma & their banding mutilation
xx
Hi Bri,
We have a mutual friend, and when I spoke about this report today on my blog she referred me over here.
Firstly I will say that I have had the gastric band,my weight been ballooning all my life and it was defiantly affecting my quality of life. I know have knee troubles because of my weight and no surgeon will look at me until I loose weight. I had high blood pressure and my doctor continually reminded me of the risk of Type II diabetes.
Fair to say then that I watched this article from the other side of the fence.
Firstly my heart goes out to the poor bloke in Tasmania that had his bowel “Nicked” during the operation. The fact remains however that any surgeon worth there salt should have found and fixed problem that before he closed on the operation. It is an unfortunate fact that there are risks involved with any form of surgery, regardless of the operation and this gent was very unfortunate, and the surgeon in my opinion is almost completely to blame in this.
There are of course things you can do to mitigate those risks, going with a surgeon that has placed over 100 bands for example, or speaking with others at the clinic you are attending who have had the operation with the surgeon you are considering. I know the clinic I attend, has all its doctors perform over 100 bands as an assistant before doing them under supervision for many more before they then pass that knowledge and experience on by then supervising any new surgeons.
The other point is one of Dr Thomas’s comments stuck with me, this point seemed to be the crux of the banding patients only for Money theme that the piece seemed to portray, the line was that there was no follow up on Gastric Band patients after the operation. While I can not ask her directly I wonder what sort of follow up she expects and indeed if that no follow ups is the norm here in Australia, because for myself that is quite a long way from the truth.
The morning after the surgery, I was required to go back to the clinic (Inside the same hospital) to get my first 3 follow up appointments scheduled. For 2 weeks, 4 weeks and 6 weeks post surgery with the clinic dietitian to guide you through the different foods you should eat to help the band heal into place and then transition you back to normal foods, then I am asked to attend once a month for the first 12 months to get my band adjusted and working well, Then every 6 months in the 2nd year and then once a year there after. These visits are Standard Medicare doctors visit, and are also there to encourage and support you, any issues bought up with the Doctor can be referred to the on site dietitian, Psychologist or the surgeon operating that day to help the patients with their weight loss goals or any issues.
Indeed I know a story of 2 patents from our clinic who have had band malfunctions, the first a band slip and the next a band rupture, both have been found by the clinic doctor and the patent has had the operation within a few days of the issue being diagnosed. Both of these patients, still swear by the band can call it the best decision of their lives.
I will agree there may be some dodgey dealers out there, but when calling for balance, I wonder those who have failed on the band are truly the silent majority or if afterwards weight loss patients are getting on with their lives?
The best advise I could give anyone considering any form of gastric surgery is to do your research and don’t go in blind. Don’t be pushed into doing it and don’t do it unless you are comfortable and all your questions have been answered. Having said that the band after 7 months is the best thing I have ever done in my life, I am down 35 Kilos since I first entered the clinic and my quality of life is improving exponentially.
Hi Mark!
Thankyou for your comment : )
I understand where you are coming from and I am glad that so far the banding has been working for you. From what I know, your followup is quite unusual as most people who get bands do not have any follow up other than going in for fills. I totally agree with you about the case of the man from Tasmania. I wish the segment had featured one of the many many banding patients who have had actual problems with the band itself. Not that I wish trouble on anyone with a band, far from it, I just want people to be informed about the possible side effects, something that rarely seems to be happening. The risks that I am mainly talking about are not surgical risks, they are not things that a ‘good surgeon’ can mitigate. They are issues with actually having the band inside you. None of the people I have spoken to who have had negative experiences with banding (and I am talking well over 50 people) have had a ‘clinic’ to attend afterwards, as I said, they see their surgeon for fills (sometimes his nurse) and that is it. This is not my idea of good follow up.
I know Dr Thomas personally and the sort of followup both she and I think is necessary would involve psychological, physiological, nutritional and possibly exercise componnents. None of the people we have spoken to have had ANY of those things in their followup (if indeed they have had any followup at all other than fills). Your experience is quite extraordinary in that you have had so much followup.
From my experience, those with bands who have lost weight generally dont seem to mind telling people about it. I am sure there are those who don’t share their experience too. However both Dr Thomas and I have been contacted by SO MANY people who have had banding ‘failures’ and they are not supported by anyone. They are ashamed and they feel like they have failed. And they shouldnt have to feel that way.
I sincerely hope that you stay as happy with your banding as you are now and that you don’t experience any of the issues that can happen post banding. Like you, I want people to be able to make an informed choice and for the most part, that just isnt happening at the moment.
cheers Bri
Hello Bri,
Just to follow up on well the follow ups. Part of the fee I was charged for the band (a total of $6500 out of pockets) was $2800 aftercare fee. For this fee I get the support group which is a once a month group meetings with Clinic Nurse, Psychologist and sometimes dietician to work through issues and discuss different topics with the band. I get my dietician visits for free and my regular monthly follow-ups via Medicare
As I said, I have known a few people who have had band malfunctions, and yes they can happen. But in the case of those that have had a problem, they see our Clinic doctor, who works quite hard to make sure things are going right. Indeed our Clinic doctor was on Channel 10 News recently, treating Golfer John Daly. If a problems is found they will be operated on within a few days and apart from the 6 week food transition program afterwards be back to the challenge of losing weight effectively again. Those operations are done for free as long as you maintain your private health cover, the clinic and the doctor only charge what your health fund will give them.
The only reason patients at my clinic would not be following up is because they scheduling to make appointments. If they come in for “Just a fill” the doctors will speak with them, about issues they have had with the band, check their weight loss and other vitals and only give a fill if it is required.
Speaking personally I have had 3 fills but I have visited my clinic for aftercare on 9 occasions and gone back to 2 support group meetings that were not scheduled at the same time as my appointments.
The clinic is also looking to put on a Trainer to help with exercise and possibly run exercise routines for groups and individuals if required, as well as a retreat for patients, a weekend to work on some more specific issues of weight loss in a greater detail.
If that is not the norm, then in reality the other clinics are not up to the standard of my clinic. I only had this operation done because of the standard of care offered at my clinic, I went to their information night and I was told of the risks, no fluffy this won’t happen to you stuff. Hard facts 15% I think it was of banding patients will need some form of corrective surgery involving the band within the first 5 years, 3 in 20, and so far my experience is tracking that way.
I know our clinic has a sister clinic in Melbourne whose program is the basis for the Sydney Program. So I guess all we can hope for is that this program is seen to not the best of care, but a standard for all patients who wish to undergo this procedure.
For your reference and you can delete this afterwards if you feel it is advertising, the Clinic I attended was SIOS at Sydney Private Hospital in Ashfield. http://www.sios.com.au