Tag Archives: side effects

Docs Admit Diet and Exercise Don’t Equal Weight Loss, Then Jump to Wrong Conclusion

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An article hit my feed from LA Times today and it seemed to offer some refreshing news.  It seems 4 doctors, weight-loss specialists set out to say what so many of us have been saying for so long now.  They admit that for the vast majority of obese children and adults in this country, telling them to eat less and move more is a prescription for failure.

They acknowledge that once a fat body begins to lose weight, a whole lot of processes, hormonal and otherwise kick in.  Hormones increase hunger signals.  Metabolisms slow down.  The body struggles to maintain the weight.

Furthermore, the 4 weight loss experts admit that a body that has lost weight are biologically quite different from bodies that have never been fat.  One states:

“Few individuals ever truly recover from obesity,” the authors wrote. Those that do, they add, “still have ‘obesity in remission,’ and are biologically very different from individuals of the same age, sex and body weight who never had obesity.” They are constantly at war with their bodies’ efforts to return to their highest sustained weight.

So far, so good.  Many of us have been pointing out the studies that show these results for years.  So after this, those docs recommend a behavior-based approach where we focus on exercising and eating well for their own sakes (as both have been demonstrated to improve health regardless of whether or not they are accompanied by weight loss), right?  Right?

Well, as it turns out, no not so much.  The docs are suggesting that we simply increase awareness of other tools for weight loss (pills, potions, surgeries and devices) and turn to them sooner.  They suggest we increase fear mongering in the overweight to help keep them from becoming obese.  They suggest a greater focus on weight maintenance for those who have lost weight in order to help them keep it off.  (They somehow neglect to tell us how this is going to work or how it will help.)

The funny thing is, that the doctors see the stigma.  They see how telling patients to just eat less and move more is cruel, since it for the most part doesn’t work.  They see how stigmatizing fat patients and simply labeling them as non-compliant isn’t the answer.

But they simply substitute in another bad answer.  And this bad answer is likely to drag along much more devastating side effects than the original bad answer.  At least suggesting people move their bodies more and eat more nutrient-dense foods is likely to improve health, regardless of whether or not it leads to the holy grail of weight loss.  While pills and potions and surgeries and devices are slightly less ineffective than diet and exercise alone for weight loss, these methods can also carry significant dangers like increased heart rate, higher blood pressure, heart defects, permanent disfigurement, malnutrition, depression, suicide and death from other causes.  And there is not much evidence that in the long run, the few people who do sustain weight loss from the pills and potions and surgeries and devices end up any healthier than the people who stayed fat.

Meanwhile, there is ample evidence that eating well and exercising have a positive impact on health regardless of whether they are accompanied by weight loss.

So why on earth are we not just focusing on healthy behaviors here?  Why do we insist on focusing on weight loss at all?  Well these docs do label themselves as weight loss specialists and that may have a lot to do with it.  And as a society, we do love to blame fat people for stuff.  So I guess they took a few steps out into the light and then fell into a deep, dark hole.

Oh well.

I for one am going to continue my focus on living the best life I can in the gloriously wondrous body I have now.  So if you’ll excuse me, I’mma gonna get on with it.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want me to talk about evidence-based medicine and wellness at your school or organization?  Learn more HERE.

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FDA Approves New (Torture?) Device for Fatties

I guess I should have seen it coming.  We’ve seen forks that talk to you and bracelets that shock you for eating too much.  We’ve seen painful patches you sew on your tongue, balloons you blow up in your guts and dramatic rerouting of your internal plumbing and drugs that cause high blood pressure, irreversible heart damage and death all in the name of weight loss.

Today, the FDA approved a new implanted electronic device for helping fatties lose weight.  Now, we don’t know that this product will fail as so many have before it.  It’s possible that this will be the miracle all the fat-hating world has been seeking.  But I have to say, I has a concerned.

Concerned kitteh is concerned.

First of all, let’s talk about the device.  According to the FDA News Release:

The Maestro Rechargeable System consists of a rechargeable electrical pulse generator, wire leads and electrodes implanted surgically into the abdomen. It works by sending intermittent electrical pulses to the trunks in the abdominal vagus nerve, which is involved in regulating stomach emptying and signaling to the brain that the stomach feels empty or full. Although it is known that the electric stimulation blocks nerve activity between the brain and the stomach, the specific mechanisms for weight loss due to use of the device are unknown.

Okay, first off, this abdominal lobotomy machine somehow uses electricity to block nerve activity between the brain and the stomach.  Is anybody else even a tiny bit uncomfortable about this?  I mean isn’t that connection between your mind and the fuel tank of your body kind of important?  What about cravings for things our bodies need?  We just do away with all of those?  Personally, I think that the link between my stomach is kind of important.

And then we get to the part that says, “the specific mechanisms for weight loss due to use of the device are unknown.”  Um, okay.  So somehow disrupting a key process of your body makes you lose weight, but we aren’t sure why.  It could be that you get the feeling of being full sooner.  It  could be that the tiny device is receiving signals from aliens from another star system that, frustrated with efforts to starve the human race by planting celebrity “fat shots” into the National Enquirer, have turned to more direct methods.  (It does stimulate the “Vagus Nerve” after all.)

It’s how the MIB know what’s what…

Now let’s talk about efficacy.  You know, whether or not it works.  The FDA approved this device despite it’s failure to meet the primary endpoint.  What does this mean?  It means that the device using group would lose at  least 10 percent more excess weight than the control group.  But despite missing this important marker, the device was approved because AAARGH, DEATHFAT, PANIC!  Now let’s look at the statistics.

The release states that a clinical trial was conducted with a whopping 233 patients.  The group with the functional version of the device lost 8.5 percent more weight than those with the non-functional version of the device and kept it off for 18 months.   So far that’s as far out as they have studied.  Despite the fact that most weight loss products, programs and potions work for 18 months.  Despite the fact that virtually every other weight loss product, program, plan or potion starts to fail shortly after that, leading to mass failure and frequently even higher weights within 5 years.

But that’s okay, because the FDA has rules, right.  The press release states:

As part of the approval, the manufacturer must conduct a five year post approval study that will follow at least 100 patients and collect additional safety and effectiveness data including weight loss, adverse events, surgical revisions and explants and changes in obesity-related conditions.

So the manufacturer (which has NO conflict of interest, right?) will conduct an ongoing study on less than half of the original patients to see if this thing works long term and/or causes more problems than it solves.  Uh huh.  In the mean time, the company that has created this thing faces unmitigated joy as their capital and stock prices rise.  By time we figure out that this thing is causing really big problems, or doesn’t work long term or is receiving signals from the Vega system, the guys that created this will be on their second yacht and summer home in Vail.  But that’s okay too, because AAARGH, DEATHFAT, OBESIPANIC!!!!!

I’m sighing deeply right now as I contemplate just how many more folks will sell their cows for this handful of magic beans, and how big and angry the giant will be, and who will be around to slay it.

Don’t mind me.  I’m going to do something I know will improve my health long term.  I’m just gonna shut off the computer and go for a walk.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want to hear Jeanette speak at your organization about sensible, sustainable, and research-driven ways to improve your health?  Click here.

P.S.S. Wanna buy stuff that will help you start and stay exercising?  Click here.

Weight Loss Surgery, Colon Cancer and Some Other Considerations

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Recently I read about a new study that links increased risk for colon cancer with weight loss surgery.  I thought it was important to share this information with you, because it seems to me that information about the possible negative side effects of weight loss surgery is so often buried in the general media.  And I think the positive effects of weight loss surgery are often blown out of proportion in the media as well.

That’s not to say that I have any interest in telling you what to do with your body.  It’s YOURS.  You should do whatever you think is best.  However, with over 100,000 weight loss surgeries performed in the US annually, I know that weight loss surgery is big business, and therefore, there are large financial incentives for certain companies to suppress information about the potential unfortunate side effects from these surgeries.  So I’d like to provide a few links to some of information about weight loss surgery that is not supported by those who profit from it.  And hopefully I can help “balance the scales” a little bit.

To be clear, one of the potential side effects of this surgery is death.  To be sure, there is a risk of death from any surgery.  But there is growing concern that the risks of weight loss surgery are often underplayed and that the evidence often cited concerning the potential upside to weight loss surgery (including savings in medical costs and lives) is deeply flawed.  It is also really important to understand that weight loss surgery is not a miracle cure, and it isn’t always the patient’s fault when things go wrong.  It seems that weight loss surgery is often treated like other weight loss techniques in that success is usually attributed to the surgery and failure is usually blamed on the patient.  Thus many who have negative experiences with weight loss surgery are often shamed and ridiculed and even asked to leave public forums where they might share their stories.  That’s why I think it’s important to share this link to a site dedicated to those who wish to share their stories about complications arising from weight loss surgery.  I think people who are considering weight loss surgery are provided with plenty of links to people often still experiencing the “honeymoon glow” of the initial weight loss.  But I think if you are considering this important life-changing step, you should also have access to a few of the heartbreaking stories of those who have not had such a wonderful experience.

To reiterate.  I am not telling you that you should or should not have weight loss surgery.  It is your body and your decision.  Clearly some people feel that the surgery has had a positive effect in their life and there are plenty of places where you can read about that.  I know people who have had the surgery and are glad they did.  But I have also known and cared for people who have died from these procedures.  I know people who have had these procedures and didn’t feel they were told the truth about what to expect.  I know people who felt that the potential downside was significantly underplayed and wish that they were given more balanced information before they had the surgery.  I simply wish to provide a few links that will hopefully help provide that balance.

Love,

The Fat Chick