Junkfood Science: The other side of the story — Part One

April 26, 2008

The other side of the story — Part One

Medical news stories on television serve one purpose: to air entertainment of sufficient shock and awe value to generate the most viewers and advertising income for the networks. The lure of advertising dollars, and efforts to please advertisers, has led to content that is little more than infomercials.

Viewers who forget this fact and believe that these stories are anything other than fiction and marketing can put themselves in danger. When viewers think they are getting accurate presentations of medical research, balanced portrayals of risks and benefits, and of reality — because these news stories look like credible medical investigative reports — and use them to make health decisions, television can become life-threatening.

This danger was best exampled on Sunday when CBS 60 Minutes aired a special claiming that gastric bypass surgery cures diabetes and cancer.

Not a single medical professional has subsequently come forward in mainstream media to correct any of the factual errors and misrepresentations, or to balance the glowing portrayals with the reality for most bariatric patients. As you can imagine, the blog world has been filled with posts from bariatric surgery survivors, stunned and upset over this broadcast. Those beyond the initial 5-7 year honeymoon period and coming to terms with the long-term effects are the most distressed. JFS has received numerous emails.

One couple each wrote impassioned and personal letters of what life has been like after bariatric surgery for them — Mark from the perspectives of a patient and Jeanette from the perspectives of a loved one. I’d hesitated to post them at first, and most of all to share their names, but Mark wrote back insistent, with the strongest letter of all about why he wanted people to hear their story.

This is what is the reality for many bariatric survivors. THIS is the story that CBS news didn’t give and that people need to hear — that doctors referring their fat or diabetic patients to bariatric surgeons need to hear; that people considering these surgeries need to hear; that politicians, government agencies, insurers and employers promoting bariatric surgeries need to hear; that friends, co-workers and loved ones of fat people need to hear; that reporters continuing to shill for the weight loss industry need to hear...

So, before posting a review of the CBS show, here are two of the emails from this most generous and caring couple [edited to remove contact and surgeon information; printed with their permission and final okay] to remind all of us that this issue is more than sales and marketing. It affects real people and real lives.

Dear Sandy,

I’m not sure if you’ve seen this yet or not, but the 60 Minutes piece on gastric bypass was horrendous. It's horrifying. Sorry, it's a sore spot — my fiancée is 3 years post-bypass now, and it is certainly not all that it's advertised to be. There's no doubt that the gastric bypass helped him lose weight (over 200 pounds), but it's certainly not the wonder that it's made out to be. He had it done by one of the supposed "experts"... and even 3 years afterwards neither of us know whether it was the right decision. He's not fat any more, but he's also got incredible bone loss, is severely anemic, has lost all of his teeth [he's only 40 years old now], should probably be hospitalized (again) soon to get his electrolytes balanced, is severely deficient in pretty much everything, can eat about 4 different foods without throwing up/passing out, and has received basically no support at all from his "team" since he was operated on (and according to his surgeon he doesn't have any "surgical complications").

One of the constant frustrations that he's had is that his surgical follow-up team consisted of a nurse-practitioner who had him work with a dietitian, who, after he had gone down to 149 pounds (from 378 pounds, in one year!), told him that the sum total of her experience was working with cancer patients. A year post-surgery, this dietitian told him that he "should" be able to eat solid food any time now. And when he asked her why he still can’t move past the very soft-food stage and why almost everything made him vomit, she told him that she could only tell him what she told patients that had had gastrostomies due to stomach cancers that she could only tell him to try everything that he could. He's never really moved off of the soft food stage, except for very crunchy things. Almost down the line, everything that works well in terms of retaining food is bad for him nutritionally.

Fortunately I'm a good cook and love cooking, but it's frustrating as hell when he says that he "thinks" that he can eat something, and I cook it, and he has one bite and vomits. (I know that it's not my cooking, lol.) I'm worried about his physical condition as obviously you can only go on for so long, but even more so I'm worried about him spiritually and psychologically. We won't even talk about the lack of psychological counseling before and after about the effects of the surgery.

I'm surprised that the suicide rate isn't higher than what it is post bypass. There HAS to be more psychological care both pre- and post-surgery. When Mark went for his initial "consultation" pre-surgery, he was in a room full of 25 year old women, all of whom were told essentially that the surgery would make them skinny and happy, and all of the side effects and complications were glossed over very deftly. He got exactly 20 minutes with the surgeon, and when he asked about complications and post-surgery life he was given the brush-off. Unfortunately (to my way of thinking), a lot of these surgeons and specialty clinics pander to what is the most damaging part of obese people... the belief that their "fat" causes all of their problems. Unfortunately 3 years ago there wasn't even as much information as is available now, so neither of us really made an informed decision about the surgery. Hearing the "doctor" on 60 Minutes talk about the low mortality rate and lack of complications was nauseating. And one of the most frustrating things about that 60 Minutes episode was that there was not a single post-gastric bypass patient interviewed who was over one year post-surgery. It is going to get a lot worse — at least he was an adult who made his own decision, but I feel ill about what different places are doing with children now.

I can't tell you how worried I am about him — I fell in love with Mark when he was fat, and knowing what I know now, I still don't know what decision I would have helped him to make with better information. He just passed his 3 year post-surgery mark on April 17, and we actually had a conversation last night about whether the surgery was the best move or not. It's impossible to say, as it's already done, but I can tell you for sure that it's not the picnic that the media makes it out to be as you well know. There are many more important things in the world than being thinner. He has so much to offer the world, and as long as I've known him, he's done the best that he can to make the world a better place. But for various reasons (including the always present pressure to be "thin"), he decided to have the surgery, and all that I can say is that the world would be a much poorer place without him in it, thin or fat...

Thank you from both of us, because you really don't know what it means to have someone who's obviously intelligent, well-read, and scientifically based to validate the things that you go through. Please feel free to post our story and feel free to publish our names. — Jeanette Niebler

Dear Sandy,

I understand your hesitancy [about posting our names], but I particularly do not want to be anonymous. I want people to know this is me. You see, I want people to understand what I was driven to do and what it is costing me. I want them to know that they can be looking at a guy who looks like the healthiest handsomest guy in the world and never know that 3 years ago most of the same people would have fought to have me not sit next to them on an airplane. I want people who have only known me as a slim man to know that they would most likely not have even spoken to me 3 years ago. I want people to know that they look at me and see a healthy man just because I am thin…When really I am thin and getting unhealthy… every day I find something new.

I want people to see a face and know that I did this only because of the pain that the media, the world and even my friends and family put me in, because I was a large man with a weight problem. And if it kills me, I want them to know that I died trying to meet a false perfection.

I want people to look at me and know I was no less of a human being or less deserving of respect or love before. I just had to take this journey to know that. But I bought into a false thing; I was sold a bill of goods that was untrue… Because I stopped getting jobs in favor of thin people less qualified. Because girls would not look at me when I was a kid. Because I was always fighting one kid or another about being fat. The world told me I was shit and I chose to believe it …but it was never true. And it’s not true for any of us, for any reason. We are all universally worthy of love and basic dignity and the world treats fat people like shit and we will do anything, anything to get away from it. We are inevitably, what we choose to make of ourselves and I think we use this surgery as a false start. If you can do it, you can do it, and being 100 pounds thinner does not increase your ability to demand that the world treats you as it should. Like the False wizard of Oz... It’s a power we had with us all the time.

I relegated myself to the bowels of society because that is where I thought the only real place for me was. Because I did not look like the guys on TV. Because I never sat on the bus or the train, even when there was enough room, because I got tired of having fights, I got tired of standing up for myself as I was, so I did this. And for a while it was lovely, it was great to be thin but that was short lived and every day gets harder then the last, physically and now I have starting getting these sugar things where I have to crawl downstairs in the middle of the night for fear of falling ,and just get sugar in me because I feel like I’ll die if I don’t.

Because now I take more meds now then I did then. Because the actual act of being suddenly thin was so...traumatic that I acted out in every way I could. Because I woke up every morning, scared, every day in a body that felt like it was someone else’s.

See Jeanette won’t say it, but we both know that we are waiting for the other shoe to drop… and the terrifying thing is neither one of us know what that will be …before I could have told you…it might have been heart problems.. Except my arteries are just as blocked as they were before …we checked. Or it could be diabetes. Except I think that’s what this sugar thing is in some weird way. Maybe not true diabetes (or maybe it is) but there is something wrong with my blood sugar that I can’t correct by normal eating… now the future is more unknown. And as it is slowly turning out, I have many of the same problems … they’re just harder to work on....not being able to eat enough ...that prevents you from fighting it.

But I know one thing. Every day I feel a little less healthy. Everyday those protein shakes become harder to get down, every few weeks a food that I could eat before comes off the list. And neither my fiancée, my doctors nor I or anyone knows why or what will happen. But we know something will. And we know that when it does I probably will not have enough nutrition to fight it as well as I should.

Do what you like with using my name or not, but please keep doing what you do. Because we need you… Because every other person who is about to go and do this needs to know that the infomercials the bariatric doctors are putting on in their offices everyday are not telling you the whole truth. And the scariest part of this is… If I started gaining weight, knowing everything I know now…I would still, in the back of my mind think…I can’t live like this. I don’t want my step kid to hear all her friends asking her what’s wrong with her stepdad. Because I do not want people to wonder why my beautiful wife chose a guy like me…. maybe I should just have them redo it….

And that is the most horrific thing about all of this.


My Best Personal Regards.

Mark Blei

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