Weight Loss Surgery Medical Publications: Some things you can’t Google

by Lonicera The Bandit
(Bristol, United Kingdom)

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Innovations in the medical world take a while to percolate through to the common woman/man, even if they are being broadcast with screaming headlines by the yellow press. If you have a particular medical complaint, careful research on the internet can help you learn quite a lot about it because – well, it i€™s probably been around for a very long time, even if you weren’t aware of it. However, new medical procedures keep appearing on the horizon all the time, and if you a€™re particularly interested in any of them, it is up to you to look them up to get a sensible assessment of their effectiveness.

So far so good€“ I think most of us do this. Were overweight, we€™re constantly looking for magic solutions. Fad diets, miraculous potions, psychological fixes… we read avidly about them all. And then, either through the internet or friends or celebrities€™ interviews we learn about bariatric surgery. A new world opens up, our desperate hope turns them into the lasting solution for our eating behavior problems. €œI want some of that, I want it now!! Gimme, gimme bariatric surgery!

OK, this is no longer a world of quack doctors who give you elixirs, fix you with leeches or knock out your teeth as a catch-all cure to just about everything (on the whole!). We now have qualified, conscientious people in the medical profession to advise us which makes us feel it i€™s not just final, but fail-safe too. Cut me open!€ you cry €œHelp yourself!€ Up to a point thats OK too, because they tend to know what they a€™re doing.

The point I wanted to make to you today is that these bariatric surgeries are not a solution, they a€™re merely a starting point, and from that moment on, the future of your physical shape and eating habits depend on you. Your body has been given a tool, now you have to use it, drive it, steer it.

You probably go carefully with the food you eat after bariatric surgery, learn lessons about quantities, hunger, blockages (the hard way!), restriction, recipes, sugar dumping syndrome… the everyday stuff. For anything else there i€™s always the forums to ask. BUT€“ the forums are merely someone€™s opinion, which at best is well informed and full of common sense. They a€™re OK up to a point, but they never tell you WHY. Wouldn’t it help you to cope with what’s happening to your body if you understood why?

My bariatric surgeon a sweet, gentle man with a quiet sense of humor and a twinkle in his eye tended to be too busy to devote more than a few chatty minutes to each patient when I visited him for fills, but it invariably wound me up when my €œwhy questions were usually answered with This is an art not a science€.

No, sorry, Mr Handsome Thoroughly Nice Guy Surgeon and Frightfully Important Consultant, it’s time you stopped saying that. It’€™s time you and your colleagues demonstrated that it’€™s not just a question of cutting us open and sewing us closed because you know that the method sort of works for most people but you are not sure about the details or how to stop things going wrong. Go find out, do a bit of research; if you must go for the anecdotal then let it be thousands of them which are analyzed under strict conditions with total data integrity, then go write a paper about it. Don’€™t talk to me about art, it just reveals that you don’t know.

Now I turn to you, the patient, the person who says Why oh why…? about the inconsistency of your body, about possible leaking lap bands, who wants to know about the long term future of these procedures, who jumps to dramatic conclusions when something hurts and seeks reassurance in forums where people, though well meaning, have limited clinical knowledge apart from what happened to them or their friends.

If you are not one of the wonder people who lost all their excess weight in 12 months, then you do need to educate yourself on the issues which HAVE been studied, and put pressure on the bariatric world about the ones that HAVEN’T, and to do more than just take your money.

These are some of the questions we want answered by properly constituted and audited studies, backed up with a lot of data we€™re all out there just waiting to be asked to participate:

1. Long term effect of gastric banding and gastric bypass;

2. The benefits of self help versus lead groups;

3. Durability of the band;

4. Data about the conditions under which sleeves stretch and how to avoid it;

5. Understanding how shifts in band and port happen and how to avoid it; surgical ways to prevent it from happening;

6. Why the band mechanism can leak, how to avoid it from the point of surgery and subsequent fills;

7. More about the development of the band which tightens via a receiver installed at the time of surgical intervention, rather than with subsequent puncture-risk fills;

8. Scar tissue €“ a big subject, but in this case how it affects restriction, fills, shifts/flips, and the sleeve;

9. Restriction, variations according to time of day and types of food, which are then inexplicably reversed days later;

10. Why certain foods can be eaten by certain patients and not others;

11. Why some pregnant women are affected by gastric bands and need to have them removed, yet not others, and whether there is a solution to this.

There are many others, I a€™m sure.

Have you ever heard of PubMed? It stands for Medical Publications, and is available to all. I believe it covers every English medical paper ever written, and although due to copyright issues the likes of you and me are prevented from reading the paper itself, which would probably be too technical for us anyway, you can read the abstract or summary, and if it i€™s directly relevant to you and you are keen enough, you could find a clinician who will obtain it for you.

On your behalf I ha€™ve done a bit of studying of PubMed, and these are the studies I ha€™ve found so far:

Complications of gastric banding versus gastric bypass

Does laparoscopic gastric banding create hiatal hernias?

Long-term Outcome after Laparoscopic Adjustable Gastric Banding for Morbid Obesity

A 5-Year Experience with Laparoscopic Adjustable Gastric Banding-Focus on Outcomes, Complications, and Their Management.

Systematic review of erosion after laparoscopic adjustable gastric banding.

Long-term outcomes of laparoscopic adjustable gastric banding

Fourteen-year long-term results after gastric banding

High-protein, reduced-carbohydrate weight-loss diets promote metabolite
profiles likely to be detrimental to colonic health.

The mechanism of weight loss with laparoscopic adjustable gastric banding:
induction of satiety not restriction.

A dynamical model for describing behavioural interventions for weight loss and body composition change

Predictors of dropout in weight loss interventions: a systematic review of the literature

A comparative analysis of Type 2 diabetes and binge eating disorder in a
bariatric sample

So, why not have a go? The more you understand about your body the better placed you are to lose your excess weight.

Lonicera The Bandit

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Editor’s Note: Most of LS Free House has been and continues to be written and updated using credible studies published in PubMed and other peer-reviewed publications. For additional topic-specific studies, see references posted throughout LS Free House at the bottom of many charts and in the Reference boxes at the bottom of most pages.

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