Tuesday, December 7, 2010

Sometimes The Headline Is Enough

There’s nothing like a good headline. Good as in clever, odd, or hilarious when it doesn’t mean to be. (Ever watch the Headlines segment on the "Tonight Show"?) It’s not easy summing up a story in 10 words or less while also making the headline compelling or inviting enough to lure readers.

Here are a few of the ones I’ve collected from online stories over the last year, headlines that actually made me open the story and read it:

Tyra Banks likes to be naked

Old lady finds fawn, beats it with a shovel

Microwaved baby scarred, but thriving

Kitten kicked like football by teenagers

Preacher killed wife, stuffed body in freezer, police say

Man shoots lawn mower, police say

Stripper, 80, still taking her clothes off

Brother to be jailed again for sex with sis

Man escapes from jail after losing weight

Where are the worst teeth in the U.S.?

Oklahoma may allow students to carry guns

Wife with 5 dead husbands investigated

Police shoot man as he beats toddler

5th severed foot found on Canadian coast

Girl divorced at 10

No more skinning seals alive, Canada says

Ad placement is also critical when putting together a newspaper page. I’m not sure if the irony was intentional, but this was page A5 of the Pittsburgh Tribune-Review on Saturday:


“FDA backs expansion of gastric band surgery” alongside an ad for G&G Fitness.

I’m not anti-gastric band surgery per se (click here for a link to the FDA story online), but I’m a little concerned over the new recommendations by the FDA that patients with a BMI of 35 (or 30 if the person has high blood pressure or diabetes) be eligible for the procedure, reduced from the current standard: 40 BMI. This would make 27 million more Americans eligible for gastric bands. 27 million. I can’t fathom.

My hope is that people like me with high blood pressure and who have a 30 BMI (at 5’5”, I would weigh 180 pounds) would maybe look to the right of the page and see the ad for treadmills, ellipticals and bikes and consider diet and exercise before surgery. When I was 180 pounds, I needed to lose 30 pounds to be at a normal BMI of 25. I won’t say “just 30 pounds” because I know losing 30 pounds can be very difficult for some people. But is the reason it’s difficult physical or emotional? I would guess the majority of the time it’s emotional.

I’ve known two people who’ve died from gastric bypass. I’ve also known two people who successfully lost and are maintaining 150-pound losses from the surgery. We could debate the pros and cons ad nauseum, and when someone is morbidly obese (such as I was when my BMI was nearly 50), it might be the right course of action. But 30 pounds? 27 million more people? I’d much rather see us first attack weight issues from the inside out rather than the outside in.

Stepping down off my soap box and opening the question to you. Do you think the FDA is right in recommending lowering the BMI requirements for gastric band surgery?

21 comments:

  1. I say no it should be left at 40. I also agree that most of the time it's emotional issues that keep the weight on a person.

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  2. This is the BEST post I have read in a long time. I actually read it three times..
    This is my opinion..
    There is not a single person that I have ever met that has had the surgery done that did not regret it in some way. Every single one of them said that they wished they had learned to lose the weight on their own. That it was not a quick cure for a problem that so many americans live with.

    In my opinion after now trying to lose weight for 14 weeks and struggling at dropping the pounds.
    I have learned so much along the way. If I went in and had my stomach made smaller at this point with a BMI of 35. I would come out being the exact some person that I am with the same eating issues. But the only difference is that I put my life in jepordy for it.
    I think each case is as individual as we are and for them to make it available to just about everyone is a disater in the making!

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  3. I know people who haven't regretted it, but this surgery profoundly alters your physiology and chemical makeup in ways that forever alter you, make it more risky to have children and a host of other complications. I think it should be limited to people who might die if they don't lose weight. People profoundly obese. I was close at one point and opted for Weight Watchers and exercise instead after reading horror stories.

    I have a good friend who lost 80lbs but had to GAIN 5lbs to qualify to just be looked at for the surgery. She had to have high risk doctors for her pregnancy because of it. She can't eat certain things.

    I know another woman who has gastric fluid leaking into her system and has been very sick since losing her weight. She has no regrets. I would. She now needs to have corrective surgery to fix this issue of toxins leaking into her body.

    Again, great technology but should be limited to people for whom their obesity is immanently life threatening.

    But what do I know? lol

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  4. Frankly I would rather see people get the banding done because it is reversible. I would not want to have my plumbing rerouted and then gain the weight back or have other health issues like can happen with GBS.

    Having the band is just another tool in weight loss. It will work for some people and not others.

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  5. Right now, it's still just a recommendation to the FDA from one of its panels (though most places are reporting it as a done deal, since the FDA rarely bucks a panel recommendation).

    I think this is awful. The report from Allergan to the committee names no authors, takes no responsibility. The study that it's based on is nonrandom, has a very small sample size (150 people), and its incomplete. They've all had their surgeries, but follow-up is supposed to happen through 2012, when many of the participants, who are now in th honeymoon phase with weight loss, will have regained much of their lost weight and some, possibly, could suffer really grim side effects. Why are they rushing this before the study is even done? The chair of the FDA advisory committee, moreover, is an Allergan shareholder. This just stinks to high heaven.

    Philosophically, I have issues with gratuitous surgery, and lowering the BMI to open the door to more surgery is based in aesthetics more than health, IMHO. Grrrrrrr.

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  6. I had gastric bypass surgery. It is a quick fix with lifetime ramifications. After 3 1/2 years, 161 pounds lost. I wish I would have found a different way. Which I have now, but that is not why I posted here. If they lower the BMI, it... just means more people will try and take the "easy" way out. And it is NOT easy. Between surgery, loss of work time (then job), almost dying twice, the pain of the surgery, throwing up, stuff not settling correctly, over $120,000 worth of bills (some insurance, but it should count) it was not worth it. People that have the surgery still have to watch what they are eating, have control over their cravings, exercise.............I could go on and on, I just wish that wasn't such a wide used option. :-|

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  7. Holy Moly. That would put my old self right in the eligible range. I can't imagine ever seriously considering such drastic surgery to lose 30 pounds. Just craziness! So many side effects; so many unknowns about long term effects.

    I agree with Mari-Anne, surgery for weight loss should be reserved the morbidly obese. I just don't see how the risk-benefit profile makes sense otherwise.

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  8. I've never posted before, but I'll give it a go. I'm 35 and hit my highest weight last year at 269 pounds at 5'6". I tried and tried and tried to lose weight the "normal" way. I did WW, Atkins, South Beach, exercise, nutritionists, see a therapist. And still I couldn't lose more than 10 pounds. It took me 6 months to lose 10 pounds. I did have hormonal imbalances that contributed to difficulty loseing weight. After a year long process, I had the LapBand done in June. Since then, I've lost 35 pounds. It's still hard. It's not an easy out. My surgeon told me flat out that with my hormonal problems, it was still going to be difficult.

    Other than the hormonal issues, I have no other co-morbidities. I am a healthy person, but my weight was going to put a damper on that quickly.

    I've known people with the Band and with the bypass, and while they both have their pros and cons, they serve a purpose to those that can't otherwise, just "eat right" and get up off their butts.

    Having said all that, I don't think the lowering of the BMI should be the only caveat for having the surgery approved. I also think that bypass should be restricted to those that are super morbidly obese. Those whose lives are in immediate jeapordy because of their weight.

    I've heard people go round and round about how "hard" it is to get surgery. "Go to Mexico and you don't have to jump through all the hoops." Hoops are there for a reason. It's so someone that isn't 30 pounds over the max BMI can just walk in and get the surgery.

    It's a tough thing to say what is right or wrong in this circumstance, but you have to look at all the sides.

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  9. I predict that this will become the gold standard for weight loss within 10 years. Mark my words. Where there is desperation and money to be made, a market is created. It will be what teeth whitening has become...price will drop, people other than surgeons/physicians will be certified to perform the procedure, and the selection criteria for eligibility will be loose and open. I guarantee it. Keep this post and refer back to it in 10 years; you will see my prediction come true.

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  10. Interesting. We were just discussing this topic at work yesterday. It seems that anything which promotes significant 'quick' weight-loss without behavior modification (discovering what is behind the behavior and working on that, as you say, from the inside out)...seems merely to be a bandaid for the problem. Is there something more behind this purported attempt at resetting the standard? hm. (btw. love the comments, agree so much w/Renea..I too am going the long route--to lose twenty pounds--and finding out a significant amount of curious and telling information about why the weight gain (so, Yeah!Renea!)..also, per Alan's comment. Having worked post-surgically with the early VGB's and roux en y procedures, the male population (and this is not a comprehensive study at all, just an observation), seemed to have a higher mortality (3-1), than the female population following gastric surgeries.--oh the things I have seen....

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  11. p.s. I agree w/ emmabovary...keep this post and refer back to it...

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  12. For my height (5'4), my BMI would be 30 at 174 lbs. Are you kidding me?? At 174, I don't even know if I'd WANT to lose any more weight (considering muscle mass)! I think lowering the bmi limits will encourage people to look at this option more quickly than they would have otherwise.

    As Alan stated I surely don't think GBS is the "easy" way. I think people think it is, but there are far too many consequences for me to consider it. And that's coming from someone whose BMI is 60, but is busting out 50 minutes of cardio a day. =)

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  13. In Saturdays NYTimes this topic was one of 4 outrageous articles I noted in my blog!

    Regarding BMI, first problem is that it fails as a predictor of health in athletes, those with high muscle mass (most pro athletes come up obese, so don't feel bad!), and in shrinking women,because it is a calculation of wt/ht squared. So decreased height becomes pretty exaggerated in this calculation.
    You could be heavy, with high BMI and have a low percent body fat (and therefore qualify for surgery). It's a pity.
    Because surgery is not an easy way out. If you weren't very heavy from a young age (ie largely genetic obesity) surgery takes away your only way of coping. And most programs give lip service to their therapy component,leaving most people on their own to improve their relationship with food.

    I have seen my share of clients who reportly "failed" at bypass surgery. They only feel worse and more frustrated as they have expanded their small pouch and work the system, so to speak.

    Worst of all is the company's plan to ultimately have kids covered! Ughhh!

    I think I'd better do my own post on this subject as it makes me irate!
    Lori Lieberman, RD, CDE, MPH, LDN

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  14. I've also known people who've suffered devastating effects from various types of weight loss surgeries. Oddly, they thought it was worth it anyway because it helped them "get skinny." They didn't realize that they're just as unhealthy as before... just in a different way.

    I think the best weight loss method is one that deals with the CAUSE of the overeating and not with the SYMPTOM caused by the overeating.

    Unfortunately, people want things to happen quickly.

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  15. People kept telling me that I should do the lap band or whatever. Surgery. I hate surgery when it's necessary, so there's no way I'm gonna do it when it's "elective". Because it really is. I need to make a change in my head and then I'll get healthy. Even if I had the surgery, if I didn't change my head, I would change my eating and I still wouldn't get healthy. Thin, possibly, but not healthy. Anyway, just my thoughts. Vee at http://veegettinghealthy.blogspot.com

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  16. Keep the number high I say. I think its just one more ploy to get money into the medical coffers and I live off an income that comes from surgeries not this kind, but close enough. I also think that there is alot to do with weight and emotion too along with that there is cornstarch in almost everything we consume out of a box these days. But most people have forgotten how to eat from the raw state and work physically hard to keep the metabolism burning.

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  17. Those headlines are disturbing, especially when I came here expecting to think about something positive. One of the reasons I like this site is it doesn't (usually) involve gratuitous violence.

    ~Shelley

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  18. Thank you so much for your feedback everyone. I realize this is a hot-button subject with no easy answers.

    Alan, your writing about your experience is so heartbreakingly honest. Thank you for sharing it here.

    Noell, I really am in awe of your tenacity. Your desire to lose weight and not give up despite the odds is inspirational, even though it feels really frustrating to you.

    Shelley, I apologize if some of the headlines I used seemed like gratuitous violence. I would never use someone else's pain to gain readership here. I used those headlines to demonstrate what it takes sometimes to get people to read a story. If I offended you in any way, please know that was not my intent.

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  19. I don't think more gastric band surgeries are the answer -- but I think SOMETHING must be done to combat the obesity epidemic. What if the government poured its support behind gym and weight loss member ship? What if insurance companies were required to cover these expenses for weight loss? What if we came up with less risky solutions for the very obese? I agree something needs to be done but gastric band is an invasive and risky choice.

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  20. There is no easy way out, but unfortunately a whole segment of the population will be led to believe there is if this happens...

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  21. With a practically lifelong struggle around weight issues having lost and kept off over 100 lbs though choosing gastric bypass surgery this past June to "lose" the remainder, I'm all for surgery if it gets people off their butt. I have no regrets-- contrary to some of the people's opinions commented here. I *do* have a regret about not having the surgery sooner so I could have lived more of my life.

    Because cancer is practically a side effect of obesity (see http://www.cancer.gov)
    the two often go hand in hand. I am living proof of this though I do not have direct proof that the uterine cancer dx I received was directly caused by obesity, there is plenty of research to back up my statement. I know from research and professional opinions that I also ran a very high risk of cancer recurrence if I kept the extra weight on.

    I became so tired of saying to myself that I'd get on the weight-loss bandwagon again which you can read in numerous "weight-loss" blogs. The majority of these people who, week in and week out, beat themselves up over eating, and not being successful, are addicted to food and either don't realize it or they are unwilling to give up the pull of food. I had to make a decision for myself and it came after much soul searching. I am a food addict. I had to stop the madness. Just as if I were a boozer giving up the booze.

    But I feel if a person can't or won't do anything or feels helpless to do anything about their situation, you have to decide to quit singing the same song and play a different tune. This is where surgery can be helpful and with this announcement, choices can be made, choices other than to stuff themselves and stuff their feelings and stuff the horror of being obese and frowned upon.

    I enjoyed emmabovary's comment "Where there is desperation and money to be made, a market is created." The diet industry is no different than a "surgical" industry. And if everyone were to suddenly become healthy and fit, the dieting industry that would certainly suffer.

    There is far too much judgement of people who chose this surgery as a method of weight-loss. There is no "easy way out" with surgery except for speed of loss. Thank goodness for speed.

    Having walked in both the chronic dieter's and weight-loss surgery shoes now, my only regret is that I didn't have the surgery at a younger age preferably prior to a cancer diagnosis.

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