Archive for March, 2011|Monthly archive page

Dueling Research

In Weight-Loss Maintenance on March 29, 2011 at 11:59 am

Last night on ABC news, former director of the CDC and current ABC pontificator, Dr. Richard Besser reported that gastric bypass surgery reverses Type 2 Diabetes forever

This morning on Good Morning America, the story replayed and then in commentary, to Robin Roberts and George Stephanopoulos, Dr. Besser bemoaned how health care insurance won’t pay for bariatric surgery.  It is, after all, clearly a cure for Type 2 Diabetes.  

He doesn’t credit his source for this revelation.  His story begins, “Doctors have discovered something incredible. . .”   Ah, those ambiguous “doctors.”  And they all agree, eh?  Mmm.  As a hedge he slips in the modifier “may”:   “Gastric bypass surgery may actually reverse type 2 diabetes almost instantly.”  (What does that “may” modify — “almost instantly” or that surgery reverses diabetes?)   He goes on to interview Dr. Phil Schauer, the Director of the Bariatric and Metabolic Institute for the Cleveland Clinic (no vested interest there) who tells us that the cure is not only instant, but permanent.  “Before they leave the hospital, they will NEVER use insulin again.”  Hmmmm.  This is a miracle, indeed. 

Dr. Besser goes on to explain that “how the procedure normalizes blood sugar remains unclear.”  Then he speculates vaguely with Dr. Schauer about “incretins” and then “humanizes” the report (as journalists are supposed to do) with the story of Katy Wiley, and actual patient who once was a fat, diabetic train wreck and now claims to be “healthy, healthy, healthy!”

Diane Sawyer doesn’t tell us what Dr. Besser’s report is based on.  She introduces it as important medical news springing from “something making headlines today.”   I would guess that Dr. Besser is probably hanging his story on the statement issued by the International Diabetes Federation (IDF) yesterday at the Second World Conference on Interventional Therapies for Type 2 Diabetes in NYC.  Here’s a two-page executive summary.   The recommendation for surgery as treatment begins at subpoint 1.5: Read the rest of this entry »


“Experts”: Phooey

In Weight-Loss Maintenance on March 22, 2011 at 2:18 pm

Well, my colonoscopy has been postponed.  Yeesh.  And it wasn’t me; I didn’t chicken out.  The nurse called and the doctor is taking a day off on Friday.  I got all wound up, and now I’ll wind down until April 18th – prep day, followed by the no-big-deal procedure on the 19th.  Thank you for all your well wishes.  When it FINALLY happens, I’ll let you know how it goes with more subtlety and decorum (but less humor) than Dave Barry.  Thank you, alert reader, Mulberry for the link.

I am especially pleased to learn that many maintainer friends did not experience a weight shake-up from their colonoscopies.  Had I not heard from you, I wouldn’t have taken it for granted.  I don’t trust the words of doctors and other “experts.”  With regard to weight management and weight rebound, simply, they’re out of their depth.  What’s more aggravating, they don’t acknowledge how out-of-their-depth they are.

Regular reader, Ali, just recently ran into an “expert” (chiropractor) who dismissed her dietary choices (which were working pretty well for her) in a conversation that lasted less than ten minutes.  With the pseudo-scientific authority granted by the likes of journalist and weight-loss opportunist Gary Taubes, she stated simply, “you must go low carb.”  Well, Gee, lady.: thanks but no thanks.  Low carb works for some people, and I’m happy for them, but if it worked for everyone we’d all be trim.  Anyone over the age of 20 in this country saw the rise and crash of the New Atkins Revolution (which nearly killed our grain markets and bankrupted our grain farmers at the beginning of this century). Had the Revolution worked for everyone, I’d have jumped on board too.  Instead, most of us witnessed sad stories of radical weight loss and rebound among earnest, disciplined people.  The few who succeeded then must now work at least as hard as I do to maintain their losses in a carbolific society (who pushes them to portion control, while pushing Ali and me to drop our bananas).

One sure sign that you’ve found a person who knows something is that they are secure enough to acknowledge that they don’t know everything.  That’s why Arya and Yoni have charmed me.  And I especially love this post from Barbara Berkeley, The Perfect Diet:  Does it Exist?   The one word answer is “nope.”  People who have earned their bona fides do not pretend to have the one and only answer.  Read the rest of this entry »

Overreactions: The Price of being a Maintainer?

In Weight-Loss Maintenance on March 15, 2011 at 10:02 am

I’m saying this up front:  This is triggering.  I’m asking that my Size Acceptance friends don’t try to intervene or convert me.  Just acknowledge or don’t read.  Please.

In less than two weeks I go in for my first colonoscopy.  Yuck.  I’m feeling horribly anxious, but not because of the procedure.  It’s the prep.  And not the awful laxative.  That would be okay, by itself. 

I fear the fasting.   Not the discomfort, but how I will respond and rebound afterwards.

For the day before the procedure, I can have clear, golden or brown liquids and I can suck on hard candy, but nothing red or purple.  Selections include water, jello and popsicles (orange and lemon-lime flavored), apple juice, tea and coffee (sweetened, okay, but no milk).   That’s mostly carbs.  Except that I can also drink clear broth.

I will be hungry.  Anxious.  I know that I’ll be drugged for the procedure, but when I’m out of the fog, I’ll eat, and I don’t trust that my body will respond as I’ve been promised by all the people who have undergone this procedure before me – “Oh, it’s no big deal.  You lose a bunch of weight from the fast and the laxative, but it’s only temporary.  Once you’re eating again, you just jump right back to where you were.”

Oh, yeah?

Many people laugh about how they tried to hold on to their losses, but just couldn’t.  Ha ha.  They write it off as personal weakness.  We who are maintainers or who have given up on the weight-loss pursuit all together know it’s not weakness.  The body puts up an enormous fight to regain homeostasis at a particular weight.  And for those of us maintaining big losses, the body seems to look for opportunities to reclaim a pound or two, or five.  A yo-yo jolt like this may be just the ticket.

When I awake from the fog, I’m sure I’ll respond to the hunger, but will I then be hounded by those dreaded “eat now” impulses?  If so, for how long?  A couple of days?  A week?  Until I give my body back a pound?  Two?  How many?  I am edgy beyond what is “normal” for this procedure, and it’s because I’m a maintainer, I want to remain one, and I don’t take maintenance for granted. Read the rest of this entry »

Sanity Starts in the North

In Weight-Loss Maintenance on March 9, 2011 at 12:06 pm

I think Canada may have a fighting chance at keeping its “COACH” program from becoming another thinly veiled fat hatefest.  This is because Dr. Arya Sharma is calling out his forces, and maybe some balance and sanity will prevail.  Here’s the link to today’s post for you who are only now-and-again visitors to Dr. Sharma’s blog.  It is especially vital for you to visit this post if you are Canadian.  Click the button within his post that describes you, and enter the fray to reclaim your COACH program.

I considered clicking, even though I’m a US citizen.  I can mispronounce “about” to sound like “a boat.”  I can end every third sentence with an “eh.”  But I’m sure, eventually, I’d be outed, and it would be horribly embarrassing.

The COACH program seems to show some signs of innate sanity.  Its Readers’ Digest condensed description talks about “resources to manage . . . excess weight” not resources to lose weight.  It acknowledges that “eat less move more” is not a panacea. 

I also like that the acronym they chose, “COACH,” which suggests a helper, advisor.  I would change the words from Canadian Obesity Awareness and Control Initiative for Health (which, technically, would be COAHIC, anyway) to Canadian Obesity Acceptance and Commitment to Health.  For one, obesity has plenty of awareness.  Every idiot knows about obesity and has an opinion.  Control is, well, too controlling.  And often impossible.  What the developed world lacks is acceptance of obesity, and the understanding that it can co-exist with health.  Perhaps if the COACH founders had started with different wording for their acronym, then the idiots wouldn’t be trying to hijack the program today, and it wouldn’t be so vital that you Canadians go join Dr. Sharma and try to claim it back.

Meanwhile, how’s public policy south of the border shaping up?  Well, we’ve got Michelle Obama’s Let’s Move campaign.   Sadly, in the US, for some crazy reason, we have reached a consensus (enforced by “the American People,” excluding Democrats) that a society governed by the people for the people is inferior to a society controlled by the corporate elite to benefit the obscenely wealthy.  Therefore, for a government program to have any credibility, it must have corporate sponsorship.  Enter the Healthy Weight Commitment Foundation.  Doesn’t it just take your breath away to read this: Read the rest of this entry »

So, Will Obesity Kill our Children at a Younger Age that Us?

In Weight-Loss Maintenance on March 5, 2011 at 10:06 am

Today I’m going to blow more than 1,000 words examining a single sentence in the Linda Bacon/ Lucy Aphramor treatise, Weight Science:  Evaluating the Evidence for a Paradigm Shift.  This sentence appears in the final paragraph of the subsection entitled, “Assumption:  Adiposity poses significant morbidity risk.”   Before I present the sentence, some pre-amble (digression).

In this subsection Bacon and Aphramor cast doubt on the assumption that our fat is killing us.  They separate “causation” from “association,” and also talk about and footnote (to my satisfaction) the “obesity paradox,” a convincing pattern that has emerged in epidemiology that links “overweight” and “obesity” to improved outcomes and longer survival periods in the case of many critical medical battles. 

Why do we call this an obesity paradox?  Why does it surprise us?  I’d call in the “obesity survival rate no brainer.”  Isn’t it fully logical that a person could benefit from some added fuel if he or she is contending with a serious chronic disease, recovery from a violent medical event (such as a heart attack) or a radical surgery that involves a rehabilitation period in which appetite is suppressed?  If there is a medically induced period where the body must waste some of its stores, who’s gonna fare better:  the presumably unhealthy “obese” person or the “healthy weight” person with the 19 BMI?  I know where I’m placing my bets in Vegas. 

Nevertheless, despite the recent acknowledgement of this “obesity paradox,” and despite the US National Institutes of Health telling us we are living longer and more robustly now than in any preceding generation, we keep hearing that our fat is killing us.  Moreover, there is a recent insidious catch phrase that has emerged:  “this is the first generation of children that may have a shorter life expectancy than their parents.”  Huh?  As Bacon and Aphramor point out, this statement continues to appear in popular mainstream media and with the imprimatur of a former Surgeon General.  But, is it true?  It’s alarming to think our children will die younger than us! Read the rest of this entry »