Young, Obese and in Surgery

A surprisingly not too bad story from the frequently fact-/truth-challenged NYT about the IMHO malpractice known as bariatric surgery. Read it all. Here are some excerpts:

There was no question, at 5-foot-1 and more than 250 pounds, she was overweight. But she resisted, saying she could diet.

“I’ll lose weight,” Ms. Gofman assured her doctor.

Dr. Vayner said, prophetically, “It’s not your fault, but you’re not going to be able to do it.”

True and false.

True because almost all conventional diets are starvation diets. (e.g., see here, here, here, here, here and here).

False because all a person has to do to lose weight is consume fewer Calories than they burn. This should be apparent and within the reach of just about everyone.

And why is this IMHO malpractice really pushed by the sick care industry? Perhaps this is why:

The operation took about 25 minutes. Child Health Plus, a state insurance plan for low-income families, covered the $21,369 cost. Medicaid in almost every state and many private health plans now cover bariatric surgery, often more readily than diet or exercise plans.

On many days, Dr. Sherwinter performs three or four operations in a row.

And how good is this medical s**t? Maybe this good:

A Belgian study of adult patients found that nearly half had their bands removed within 12 years for various reasons, according to the study’s principal author, Dr. Jacques Himpens: they did not lose much weight; they regained what they had lost; they had frequent heartburn or vomiting; or the band would slip or perforate the stomach.

A German study found that 30 percent of patients needed new operations within 14 years, some because they wanted bands removed, and others because of complications like slippage.

Another study in Australia found that one-third of operations on teenagers required follow-up surgeries within two years, often because of “pouch dilation,” when the stomach above the band becomes enlarged, which can happen if the patient does not follow the regimen and tries to eat too much...

Stomach enlargement, she said, “speaks to the importance of additional education for the adolescent to understand the importance of adhering to the new eating program.”

Well, if these fat people could adhere to a new eating program, they would never had "needed" the surgery.

Duh.

And for how long does a victim of this surgery have to adhere to a new eating program?

“It’s not just you can’t eat Thanksgiving dinner,” Dr. Zuckerman said. “You’re going to have to have this tiny little meal for the rest of your life.”

Good luck with that.

More like little luck with that:

Ms. Gofman arrived for her first postoperative visit 13 days after the surgery, stylishly dressed in a bias-cut black sweater, blue pants and short snow boots. The scale read 251 pounds, 20 pounds below that of her last weigh-in.

But her mood did not match. “You know how you said I can have mashed potatoes a little bit,” she told Dr. Sherwinter. “I measured it. I didn’t feel full at all. Then I was bad. I ate a little bit more and a little bit more, and I still didn’t feel full, but I stopped.”

Ms. Gofman wanted a “fill” of her band, an infusion of saline to make it even more constricting, even though Dr. Sherwinter had told her to wait six weeks before tightening it. She then confessed that she had also eaten a dumpling skin.

“That’s probably not the best thing to do,” Dr. Sherwinter said. “Dumplings are fried and have mongo calories.”

“I’m just so nervous to fail my own diet,” she said. “There’s a diner downstairs from my apartment, and a Dunkin’ Donuts.”

“The key is moderation, having a little mashed potato but not a portion,” he said.

“I’m not good at moderation,” she replied.

And...

She would wolf down her food, and then she would run to the bathroom to vomit or sit in pain waiting for it to make its way through the band. “I couldn’t even have a single little sandwich without embarrassing myself and going to the bathroom,” she said.

To her dismay, she discovered that “all the fattening foods” — chips, chocolate — went down easily. “Apples and bread are hard,” she said. “It’s annoying how hungry I was.”...

Ms. Gofman, who has just turned 20, saw Dr. Sherwinter in November. She had regained not quite half of what she had lost. He did not scold or blame her. He tightened her band, so it now took an hour and a half to force down two scrambled eggs.

She does not want to reveal how much she weighs, but she is fighting constant hunger, and progress is slow.

And so it really goes.

In the real world.