Friday, March 4, 2016

Gastric bypass surgery

In the United States morbid obesity is a real epidemic, with something like 33% of the entire population being obese. (As a side note, there is a difference between "overweight" and "obese". The latter is defined as the person's weight surpassing a certain limit and becoming significantly unhealthy and significantly increasing the risk of all kinds of diseases. And we are talking about 33% of the population being obese, not just overweight.)

In recent decades a medical procedure named gastric bypass surgery has become popular there, often recommended by doctors to combat obesity and lose weight. In fact, there is evidence that many doctors prescribe it even too liberally, and without telling their patients of all the risks and consequences. (And, of course, their websites are full of carefully-selected success stories and testimonials.)

The thing is, the procedure is both dangerous and may not remove all the existing diseases and risks. In fact, in some cases it might be the opposite.

Firstly, according to studies there is an approximately 0.5% mortality rate within the first month after surgery. That's 1 in 200 patients. That's not, in my opinion, an insignificant number. From 1000 patients, on average five of them will be dead within one month of the surgery.

Many doctors will argue that the risk is lower than the health risks associated with obesity (which are indeed great; a morbidly obese person could have, for example, a 30% of risk of a heart attack or stroke within their next 5 years of life.) However, by making this kind of argument they are implying that the surgery is the only solution; that it's impossible to lose the weight otherwise. This is absolutely bollocks.

It's not easy, for certain, but even morbidly obese people can become ideal weight with healthy dieting and exercise alone, without the need for any kind of surgeries or anything else. Yes, even a 200+ kg (440+ lb) person can reach their ideal weight (eg. 80 kg / 176 lb) with healthy food and exercising alone. Basically any person, no matter how sick or how much in bad shape they may be. There are plenty of such examples.

And the thing is, if it's done with healthy food and exercising, not only will all the obesity-related risks be reduced significantly, their health will be much improved even compared to other people of that ideal weight who nevertheless eat unhealthily and don't exercise.

And that was just about the mortality rate. That's not the only, nor even the major problem.

Secondly, gastric bypass surgery is not a magical panacea that will simply allow you to eat whatever you want, get full quicker and thus start losing weight. Many of these doctors don't really like to talk about the requirements and side-effects related to the operation.

The amount of risks and possible side-effects of the surgery are plentiful. However, even in the best case scenario, ie. even if everything goes absolutely perfectly and there are no complications whatsoever, the patient still needs to follow a super-strict diet for months, maybe even years. (The strict diet is required to avoid all kinds of deficiencies and risks related to eating too little of the wrong stuff, and not getting all the necessary nutrients.)

That's right: The patient needs to follow an extremely strict diet for months, perhaps even years, after the surgery.

Let that sink in for a moment.

Hint: What exactly is needed, in addition to exercise, to lose weight in the normal, healthy way?

That's right. Losing weight in the healthy way could be done by doing the exact same thing, but without the dangerous surgery with all of its risks and side-effects. The only thing that the person needs is the motivation to do so.

This also reveals one of the major problems with the surgery: Patients may follow the strict diet out of necessity, but very often they do not exercise nor otherwise live a healthy life. Their fitness level may not increase at all. In fact, one of the common side-effects is the fitness level of the patient actually decreasing, due to nutrient deficiencies and lack of exercise. Essentially, the patient loses muscle and bone tissue alongside the fat, because these go alongside it if the person does not eat enough nor exercises to keep them fit.

And that was assuming that the operation goes perfectly and none of the risks associated with it realize themselves.

And the thing is, most people who have had this surgery never actually become ideal weight. Many of them in fact remain obese. They may lose some weight, but not enough to become "only" overweight, much less normal weight. And in most cases their life quality will not improve much because they will be in extremely poor shape, and still obese. And in many cases many of the obesity-related diseases (such as diabetes) may not be cured at all. What's worse, since these people seldom exercise and keep themselves in good muscular shape, they will lose muscle tissue alongside fat, which may cause, ironically, for their fat percentage to remain about the same, or even increase (with all the subsequent health problems). Also, in many patients the distribution of fat gets all weird. (In some cases it's actually possible to distinguish a gastric surgery patient because of their odd body shape.)

As far as I understand, there are actually doctors in the United States who do not know that a morbidly obese person can physically lose all of their extra weight and become ideal weight, just with exercise and eating healthy. They might not even recommend it as the best possible option. They might examine a 250-kg person and conclude that it's a lost case; it's impossible for that person to lose all that weight on their own, and that surgery is the only option.

Yet that's just not true. Most people can lose the weight, and do it in a healthy manner, becoming even fitter than the average person of that ideal weight in the process. I'm not saying it's easy. Of course it's not easy. But it's possible. And it's a much better, safer and healthier option than a surgery.

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