The Morbid Me

What you need to know about Gastric Bypass

I just came across a very well written, news article from The Hartselle Enquirer, in Alabama. I would like to share it with you because it not only outlines clearly what Gastric Bypass is, but it talks about a few interesting points like “why" to get Gastric Bypass, a question we often forget to make ourselves.

It also suggests that High School students seeking surgery should look for alternative solutions first, a point I totally agree with. You can read about my view on this here.

Go here to read the full article, and if you have comments, as always, feel free to share it with me.

The Alli Hype Continues: Now on Video!

A few days ago I wrote extensively about my take on the Alli Diet Drug. Now, I have found many home-made videos popping up on YouTube. Here are a few of them, all related to Alli.

The Doctor with Perfect Patients

This doctor talks about Xenical (with references to Alli) and he says that none of his patients had the miserable side effects. What? A doctor prescribing Orlistat, a 9 year old drug, has never had patients  telling him about their bathroom accidents? Hmmm... Either he is only a few days practicing medicine, or he has only one or two patients:

The Muted News Report with a Marketing Doctor as a Bonus

This one is funny. It is a live news cast from KCRA 3 - Sacramento, CA: The news anchors not only try to be funny by introducing the Alli Drug and saying "Dieters have a new ally in the battle to loose wight" (got the joke? ally sounds exactly as Alli), but when they ask their expert doctor  "Does Alli really work?" ... a few seconds of silence, doctor moves her mouth, no sound... technical difficulties... Later Dr. Caroline Apovian not only tries to be unnaturally funny by also making the "Ally-Alli" analogy, but does, in my opinion a crucial mistake a doctor can't do: using the GlaxoSmithKline’s marketing phrase "Treatment Effects" instead of "Side Effects". Well, it's all about Marketing.

The Alli Poopy Pants TV Spot

From the makers of Leptopril, another of those  shady magic pills in the market, comes this anti-Alli TV spot. Not sure if it really airs on TV (I hope not, because it is really tasteless) but it is having a popular YouTube audience.

Alli the new Weight Loss Orlistat Marketing Drug

With the FDA banning last week the Rimonabant Obesity Drug, all eyes (and mouths) are now focused on the new drug Alli, that coincidentally was launched last week.

The main component of Alli, is Orlistat, a drug approved by the FDA in 1999 to treat obesity. Orlistat is marketed under the trade name Xenical by Roche. The only difference between Xenical and Alli is that the first comes in 120mg capsules and Alli in 60mg also, Alli does not require a prescription… here is where the fun begins!

So why all the hype about an 8 year old drug? Well, the answer is simple: Marketing! Yes, we are in America, and we will do whatever it takes to sell whatever we want to whoever is American enough to buy it.

Alli is all about marketing and hype, and soon you will see GlaxoSmithKline’s executives (the makers of this drug) showing off their new Bentleys all over the country. (Wait, a Bentley is a car for old fat rich people, since they sure are not fat, let’s change it for a slick Ferrari)

The over-the-counter dose of Alli is just half of the prescription one Xenical. Also, Orlistat as such, has a few side effects that Alli calls “Treatment Effects”. Wow, this is marketing! Have you ever heard a doctor tell you: “This medicine, has NO side effects, it has Treatment Effects!”

Well, who am I to write all of this? I am just a 35 year old former obese Gastric Bypass patient! Ohhh... wait a moment… Dr. Donald Hensrud MD a preventive medicine and nutrition specialist at Mayo Clinic, Rochester, Minn., answers some common questions about Alli here, and guess what, I might be considered a doctor myself after reading his post!

Thank God at least GlaxoSmithKline is fair with us and insists that if you decide to take Alli, you have to follow a strict diet and exercise plan… But, wait a minute! They just shoot themselves on their own foot! This solves the problem! There is no need for Alli! As per Dr. Hensrud “Alli could result in an average of 3 pounds lost in a year in addition to the approximately 8 pounds you could expect to lose from diet and exercise alone.” Great! So then, if a monthly supply of Alli will cost you about $60, you will have paid $720 for loosing 3 lbs in a year! This equals to $240 American Dollars a pound! Wow ! At that rate, I will start selling my excess fat to GlaxoSmithKline !!

Weight Loss Surgery OK After Age 60?

What happens if you are 60 years old (or even older) and you are extremely morbidly obese ? Well, first you are lucky to still be alive and secondly, you might have a chance to be accepted for Gastric Bypass.

Many people often confuse the fact that the main complications during gastric bypass surgery are not directly related to the bariatric surgery itself, but to the fact that a “surgery” is underway. So, from a Bariatric point of view, age on adult people is not considered as part of a risk factor.

Weight loss surgery should not be denied to patients based solely on age. With careful and professional screening, it may be safe for patients aged 60 and older.

As per a recent study by Peter Hallowell from the department of Case Western Reserve University's medical school, there are no differences in the occurrence of complications in patients younger than 60 years, or patients 60 years or older. (Read more here)

FDA Rejects Rimonabant Obesity Drug

An FDA advisory panel has voted unanimously not to recommend sale in the U.S. of rimonabant, a widely anticipated antiobesity drug, the New  York Times reports.

The drug, available in 37 countries, was rejected "because of worries that it causes neurological and psychiatric problems and increases the  risk of suicide," according to the newspaper.

Rimonabant is a cannabinoid-receptor blocker. In clinical studies, it had shown favorable effects not only on weight loss but also on fasting glucose, HDL cholesterol, and triglycerides.

TLC Big Medicine = Big Marketing

Equally as dramatic as TLC’s “Inside Brookhaven Obesity Clinic”, “Big Medicine” follows the personal stories of severely obese patients who turn to Houston’s Methodist Weight Management Center as a last resort to their weight problem. There, bariatric surgeons Dr. Robert and Garth Davis are not only the doctors, but also the stars of the show.

I really have mixed feelings about this show. It looks like the real purpose of this weekly documentary is more oriented as a big marketing and self-promoting (but well done) Infomercial.

I have no doubts about the professionalism of the doctors or about the hospital in particular. But there is something in every episode that makes me feel it is 2 AM in the morning and I am watching a 30 minute “As Seen on TV” commercial.

For example, I really feel sorry for Mary Jo Rapini, the groups Psychotherapist. She is never taken into consideration, and no matter what she suggests about her patients, she gets ignored by the surgery-hungry doctors.  I remember when I got my surgical procedure, I had a BMI of about 45 and weighted more than 331lbs, I had diabetes, hypertension and severe sleep apnea. In my mind, I was the perfect candidate for this operation. To my surprise, I was very close to being rejected because my Psychotherapist felt I was not mentally prepared to face a new way of living and to change my obscure exercise and eating habits and addictions.

From a physical point of view, my body was more than ready to even have brain and heart surgery at the same time, so my surgeon was already sharpening his knife. But he stressed-out to me that he would only perform the surgery if my Psychotherapist would give me the green light. Lately she did, but I realized that there is more than surgery in this ordeal.

Gastric Bypass surgery should be approached as a complete professional team effort of specialists. The surgery is performed in the guts, in the part of your being that you can physically touch (aka your body); but it is not performed in your mind, in your soul not even in your feelings and emotions.

So, no matter how successful Dr. Robert and Garth Davis are in performing their operations, by the end of the day, the patient has to live with a modified body but still with his or her unmodified mind.

I’ve lost 110 lbs after my gastric bypass more than a year and a half ago. I have had no complications, and I feel great and I am happy. But my success is not solely based on my surgeon’s ultra-modern laparoscopic tools, but equally on the drastic change in my lifestyle.

Remember that weight loss surgery can last from 30 minutes to 2 hours; but The Rest of your Life is measured in years and decades.

I think Big Medicine would be a better and more realistic and convincing program, if the producers would have walked into different doctors and hospitals every week, rather than focusing on one specific group. But well, we are in America, and we are the kings of Marketing.

Oh, don’t get me wrong. I love Dr. Robert and Garth Davis, they are not only good physicians but they perform excellent on camera too, very entertaining. I just can’t imagine seeing my doctor on a show like that… how boring would that be!

New Stydy: Many Dieters Keep the Weight Off

A new study just published in the American Journal of Preventive Medicine, looked at 1,310 adults from the 1999 to 2002 National Health and Nutrition Examination Survey who were overweight or obese at their heaviest weight, but who had lost at least 10 percent of their maximum weight a year before the survey. Many dieters who lose weight actually manage to keep it off. The results are more long lasting than before. (Read Here)

Food Addiction and Compulsive Overeating

For some people, eating is a compulsion. Men and women of all ages force themselves to eat too much or too little, and suffer tremendous psychological pain when they do. Eating, body weight and image become an obsession that damages relationships and has serious medical consequences.

Food addiction is a disorder characterized by preoccupation with food, the availability of food and the anticipation of pleasure from the ingestion of food.

Food addiction involves the repetitive consumption of food against the individual’s better judgment resulting in loss of control and preoccupation or the restriction of food and preoccupation with body weight and image.

Anorexia Nervosa is characterized by intense fear of gaining weight.

Behavior includes excessive weighing, excessive measuring of body parts, and persistently using a mirror to check body size. Self-esteem is dependent upon body shape and weight. Weight loss is viewed as an impressive achievement and an example of extraordinary self discipline.

Physical implications may include disruption of the menstrual cycle, signs of starvation, thinning of hair or hair loss, bloated feeling, yellowish palms/soles of feet, dry, pasty skin.

Bulimia Nervosa is described as binge eating and compensatory behavior to prevent weight gain.

Individuals become ashamed of their eating behavior and attempt to conceal symptoms through rapid consumption of food. They will eat until painfully full and stop if intruded upon.
80-90% of bulimics will induce vomiting. Other behaviors include, misuse of laxatives, fasting and excessive exercise.

Physical implications include, loss of dental enamel, increase of cavities, swollen saliva glands, calluses, scars on hands, irregular menstrual cycle, dependency on laxatives for bowel movements, fluid and electrolyte disturbance.

Compulsive Overeaters use food inappropriately and eventually become addicted to it and lose control over the amount of food they eat. Overeaters demonstrate uncontrollable binge eating without extreme weight control and see that behavior as normal.

Overeaters present with moderate to severe obesity, with an average binge eater being 60% overweight. Bingeing episodes consist of carbohydrates and junk food with most binges done in scheduled secrecy.