It's the Vacuum Cleaner's Fault!

In a world full of extremely difficult issues, you can depend on the media to give you very easy answers. Studies with incomplete data make the front page and it seems like every online news story points to some kind of magic bullet in terms of either the cause or the cure for obesity. As practitioners of weight loss surgery, we're especially annoyed by stories that point to a truly tiny data point and extrapolate it into something immensely larger.

An excellent example of building these molehills into mountains is a story we saw entitled "Obesity: Is the Vacuum Cleaner to Blame?" The topic was a study that looked at such labor-saving cleaning devices as the Roomba and tried to assess their impact on the nation's collective weight problem. The study was funded by Coca-Cola and it's easy to see why the nation's #1 distributor of sugary sodas was interested in looking at the exercise end of the weight equation. As long as we're focusing on even one very minor reason Americans are getting less exercise than we used to, we're not talking about all those empty, non-filling calories so many of us become almost literally addicted to on on our way to becoming candidates for obesity surgery.

These news stories are pointless because we already know that lack of exercise is a major issue for most of us in this world of sedentary work and leisure time pursuits. We also know exactly as well that doing away with Roombas won't get us any closer to dealing with the root issues of weight. After all, every moment that disc-schaped robot saves us from sweeping and operating a vacuum is more time we could just as easily be spending at the gym or a dance class as sitting in front of the television or the laptop.

In the very same way, it doesn't make a whole lot of sense to draw big conclusions from a study that tries to look at the cost-effectiveness of bariatric procedures but looks at only two of several available operations and completely ignores sleeve gastrectomy. It's not that the data isn't valid, it's just that it examines only the tiniest part of the data that's out there. Obesity is a big problem, and the answer to it is going to be a little larger than a vacuum cleaner or a very partial and preliminary study.

New Standards for Bariatric Surgery?

Up until pretty recently, the fairly universal standard for health insurance coverage of weight loss surgery was a BMI (body mass index) of 35. However, today's news (also featured on our Facebook page today), tells us that the Cleveland Clinic, which is ranked as one one the top four hospitals nationwide, now considers people with BMIs as low as 30 to be candidates for bariatric procedures. There is another proviso, however. They must also have type 2 diabetes, an increasingly common illness and one that is more serious than a lot of people think.

While 30 on the BMI scale is the lowest possible measurement considered obese, the growing evidence of the effectiveness of obesity surgery against diabetes has obviously been a major factor in the Cleveland Clinic's decision. Moreover, considering the possible outcomes of type 2 diabetes, which range from heart disease to outright destruction of the kidneys, especially when combined with high blood pressure, it seems to us that it's more than past time for a reevaluation of when a bariatric procedure is medically beneficial or even, in some instances, necessary.

Of course, all patients are different and BMI by itself is something of a blunt instrument when measuring obesity. Still, patients who may be only mildly obese may be excellent candidates for a sleeve gastrectomy, a lap band, or other less invasive procedures. Bariatric surgery isn't for everyone, but if you've seen what diabetes can do to a person over the course of a lifetime, you might agree that perhaps more people cold benefit from it.

Uncompromising Commitment is the Key to Success

Weight loss through bariatric surgery begins with a decision and is followed by uncompromising commitment. The success stories of Dr. Michael Feiz’ Patient Ambassadors have been published by news outlets throughout the country over the past several months. In reading many of these testimonies, one sees that the dramatic and necessary weight loss of each person was indeed a result of the FDA approved lap band and gastric sleeve surgeries officiated by Dr. Feiz & Associates. However, this is not to discount the patient’s ongoing commitment to a healthy lifestyle. In the days or months leading up to each surgery, Dr. Feiz builds a solid working relationship with each client for an easy flow of communication on all aspects of the procedure. It is very important that each band or  gastric sleeve patient follows recovery guidelines, with diet as a key element. While Dr. Feiz and his team are continually available to the patient, the day will come when he or she has recovered from surgery and settles back into daily life.

After taking initial cues from Dr. Feiz, the patient utilizes his or her own will power to stick to a healthy diet and exercise plan. Many of our patients relate that going to the gym or getting some cardio in isn’t always first on the list, but they realize the benefits of staying true to the fitness regimen, in addition to watching portion size, avoiding alcohol and sodas, taking proper nutritional supplements, and so on. The clinic would like to take the opportunity to commend all of our wonderful patients, to say well done and keep it going! Those who are a part of the Dr. Feiz family are all too aware of the commitment that is involved in achieving and then maintaining a healthy weight. Our clinic congratulates you.

Information, Misinformation, Exaggeration...So What?

There's been a lot of talk all over the media this week about an article in the highly prestigious New England Journal of Medicine called "Myths, Presumptions, and Facts about Obesity." Considering our successful efforts at combating obesity through using the latest techniques in weight loss surgery, this is obviously a subject of interest to us. We certainly applaud the effort of the very large number of experts who collaborated on this study.

Still, looking at the way the article is being covered in the mass press, it's easy to see one reason why so many overweight people feel like traditional weight loss efforts are nearly pointless. So many conclusions appear vague and, worse, unhelpful. Sure, it's interesting to hear that reports that the amount of calories that some people think they are burning with certain types of exercise might be exaggerated. Still, we think most dieters know intuitively that you'll only burn 500 calories in just 15 minutes of jogging if you are something very near to a professional athlete. Similarly, it turns out that breastfeeding might not be as effective a preventive of obesity as some once thought -- but, giving the rise in obesity is concurrent with the rise in breastfeeding, a lot of us already had a pretty good idea that the practice is no magic bullet when it comes to obesity.

We're not sure what kind of effect this kind of coverage has other than reinforcing what we already know -- getting fat is easy for many of us and losing weight through diet and exercise is really hard. The good news is that, at least for some people, such outstanding bariatric procedures as the sleeve gastrectomy really are making a tremendous difference in people lives.  Moreover, the growing evidence that the hormone ghrelin lies behind our seemingly eternal urges to overeat is directly related to many types of obesity surgery in which the fundus, where most ghrelin is produced, is removed.

What does this all mean? We're not sure, but clearly there's a need for information about obesity and health that's actionable. We've already got enough confusion and despair in the weight loss world.