During her time at NYU Langone Medical Center's Surgical Weight Loss Program, Pal witnessed two surgeons -- Dr. Christine Ren and Dr. George Fielding -- implant gastric bands into as many as 20 patients in a single day.
Fielding and Ren are also paid consultants of Allergan Inc, the Botox and breast implant maker which is the leading manufacturer of the gastric band.
And their business could soon increase even more if U.S. regulators grant permission to perform the procedure on overweight teens.
"Ren was an investigator in an Allergan-sponsored clinical trial studying the use of bands on teens. And the company has an application with the U.S. Food and Drug Administration seeking approval to market the device to teens as young as 14. A decision could come any time."
When I was in grade school in the early 1960's, 24 percent of Americans were overweight. Today, two-thirds of Americans fall into this category, and the numbers keep rising.
This basic health factor puts them at increased risk of heart disease, diabetes, stroke, arthritis, depression, and several forms of cancer, just to name a few. (In fact, there are more than 20 diseases and conditions that are directly attributable to carrying excess weight.)
This is a major public health crisis, but one that can be relatively easily corrected.
Weight loss surgery, which includes gastric banding and the more invasive gastric bypass may seem like the quick fix, but it is NOT the solution because of the many negative long-term health consequences inherent with either of these surgical options.
Still, there's no shortage of people desperate to shed their excess pounds as easily as possible. According to Reuters, gastric banding is a $300 million to $400 million market, and manufacturers are eager to expand it to over a billion dollars a year as soon as possible.
Needless to say, I am not an advocate of bariatric surgeries and believe there are far safer, more effective, more healthful and less expensive options.
The Often Ignored Dangers of Weight Loss Surgery
Adjustable gastric banding, the so-called 'lap band,' consists of surgically inserting a band around the top section of your stomach, and cinching it into a small pouch. Twenty-five to 30 percent of the more than 200,000 weight-loss operations performed in the United States in 2007 used gastric banding.
Despite the fact that no long-term studies on the health and longevity of bariatric surgery patients have been published, the FDA is considering approving gastric banding for teens aged 14 to 17. (The lack of such long-term data could very well in and of itself be an indication that it's all bad news.)
Short-term, however, the lap band does produce significantly greater weight loss compared to lifestyle modification, but the health risks are VERY high, and long term safety and effectiveness are questionable at best.
The procedure limits the amount of food you can consume, and the rapid weight loss is clearly the natural effect of this forced starvation.
However, both the gastric banding and gastric bypass surgeries are loaded with potential complications and risks.
Whereas all surgeries have inherent risks, bariatric surgeries seem to have a much higher ratio of complications. In fact, you are far more likely to suffer an adverse event from these types of surgeries than not.
According to LapBand.com, one American clinical study that included a 3-year follow-up reported that a staggering 88 percent of gastric banding patients experienced one or more adverse events, ranging from mild to severe.
Twenty-five percent of the patients ended up getting the lap band permanently removed. Two-thirds of those had them removed due the adverse events suffered.
Common complications from gastric banding included:
- Gastroesophageal reflux, 34 percent
- Band slippage and/or pouch dilation, 24 percent, (which means you'll need another surgery)
- Stomach obstruction, 14 percent
- Esophageal dilation and reduced esophageal function, 11 percent
- Difficulty swallowing, 9 percent
- Leaking or twisted access port into the stomach, 9 percent
- Band eroding into the stomach, 1.3 percent, which requires band removal
Nine percent of patients had to undergo a second surgery to correct a problem with the band and/or complication from the initial surgery.
Other potential side effects include black-outs, malnutrition, infection, kidney stones, bowel and gallbladder problems, and, of course, an increased risk of death.
It's also worth noting that, unless you address the emotional aspects of your eating, you could very easily stretch your stomach to again be able to accommodate increasing amounts of food, effectively negating the entire surgery.
As for the effects on teens, according to Dr. Thomas Inge, chair of the Teen Longitudinal Assessment of Bariatric Surgery (a government study assessing the safety of this surgery in adolescents) gastric bands are both less effective, and more problematic in younger patients.
The final verdict from the study is expected to be available sometime in 2012, but Reuters reports that:
"In more than one in five teens in another study, Inge noted a high rate of "symmetric pouch dilation" -- a complication in which the small pouch created at the top of the stomach by the band gets bigger, allowing patients to consume more food."
In my opinion, bariatric surgery for youngsters is doomed to fail for this reason. Restricting your food consumption to mere spoonfuls of food can be just as detrimental to your health and as emotionally devastating as overeating is.
The only strategy that has the potential to improve your health, longevity, and decrease your body size, long term, is a change in lifestyle habits – eating healthier and exercising, as opposed to starving yourself.
As Reuters states:
"Success depends most on a patient's ability to modify their behavior. "The band doesn't reduce the desire to eat emotionally. That has to be addressed," said Dr. Maller. "Teens tend to need more hands-on, one-to-one support."
Since success depends on your ability to modify your behavior anyway, why not simply modify your behavior without going through the surgical procedure and taking all those health risks?!
I guarantee you, modifying your lifestyle to achieve safe and effective weight loss – through a healthy diet and exercise – is going to be FAR easier, and more enjoyable, than the rigorous starvation routine you have to follow post weight loss surgery.
Gastric Bypass – An Even Riskier Option
Gastric bypass is a much more invasive procedure and have even greater health risks than gastric banding.
Whereas gastric banding is reversible, gastric bypass is not. In this procedure, a section of your small intestine is typically removed entirely, and your stomach is reconnected further down your intestine, bypassing the duodenum.
Your duodenum -- that first section of your small intestine -- is responsible for the majority of nutrient absorption. Hence malnutrition is a concern after this type of surgery.
Other adverse effects of gastric bypass include:
- Liver failure
- Weakened bones
- Eye problems
- Immune system damage
- Mental deterioration
A Saner, Safer Alternative to Lose Weight Without Surgery
If you or your child is overweight or obese, understand that your number one dietary enemy is fructose.
The health effects of fructose are now becoming quite well understood, and it is very clear that fructose is the leading culprit for our obesity epidemic.
That includes fructose in the form of high fructose corn syrup (HFCS), other added sugars, and natural fructose found in fruit and fruit juices.
Avoiding fructose means severely limiting or eliminating sodas, sugary drinks, and nearly all processed foods from your diet, as they are loaded with HFCS. Eating a diet based on processed foods is a well-known way to do two things that are nearly guaranteed to make you pack on the pounds:
- Interfere with your body's ability to regulate insulin
- Interfere with your body's ability to regulate leptin
As for fruit, although whole fruits contain synergistic factors that ameliorate much of the detrimental health effects of fructose, if you are overweight or are insulin resistant, you do need to carefully limit your fruit intake as well.
I believe most everyone needs to limit their fructose intake to 25 grams a day, but if you are overweight, diabetic, or have high blood pressure or high cholesterol, you'll want to limit your fructose intake even further -- to 15 grams a day, until your condition normalizes.
This chart can help you determine the fructose content of many common fruits.
In addition, the latest research shows that your uric acid levels can be used as an indicator of fructose toxicity. If you have a level of below 4 for men, or 3.5 for women, you probably are at a very low risk for fructose toxicity and can be more liberal with these limits.
The higher your uric acid though, the more you need to limit or even avoid fructose until your uric acid level normalizes. For more information, please review this recent article.
In addition, please do not fall for the misconception that artificial sweeteners promote weight loss because they don't contain calories. Nothing could be further from the truth!
Helping Your Kids Get Fit
If you want to keep your children fit:
- Limit their TV time and get it out of their bedroom immediately.
- Get your children off the couch and onto the playground or, at the very least, to move around vigorously while they are watching TV!
- Replace those sugary juices and soft drinks with clean water.
I believe the topic of childhood obesity is so important I wrote an entire book on it, called Generation XL, which is a comprehensive review of childhood obesity.
Weight gain is obviously influenced by many factors, but the two that everyone keeps coming back to -- diet and exercise -- are still the biggies in my mind. Combine a healthy diet with exercise -- and be sure you are addressing the emotional component of food, eating and weight gain -- and most people WILL lose weight.
But it's not always as simple as just eating a salad and going out for a walk. Here are the three tips that everyone who is trying to lose weight should focus on:
- Tailor your diet to your nutritional type. These are the foods that are right for your biochemistry, and these are the foods that will push your body toward its ideal weight. (By the way, these foods may be high in fat, high in carbs, heavy on protein or heavy on veggies, it all depends on YOU).
- View exercise as a drug. When you're trying to lose weight, a casual walk here and there is not going to cut it. There are a number of routes you can go here, but ideally, you need to exercise each and every day.
Fortunately, there's a highly effective exercise strategy that can dramatically reduce your workout time. For more guidance on exercise to optimize weight loss, please see this recent article.
- Address your emotional blocks. Tools like the Emotional Freedom Technique (EFT) are your friend and ally when it comes to losing weight. For some, emotional eating is more complex, and an experienced EFT practitioner may be able to help unravel some of your deeper emotional issues.