Health At Every Size: The Surprising Truth About Your Weight (13 page)

Most environmental toxins are fat-soluble compounds that resist breakdown. Once they’re absorbed into your body, they get stored in fat tissue, and fatter people have been observed to have higher concentrations than leaner people.
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That may not be a problem when the toxins are locked into fat tissue, which is relatively inert. However, think about what happens during repeated cycles of weight loss: Those toxins get released into the bloodstream where they have another opportunity to do damage.
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Makes you question whether weight loss is a positive goal, doesn’t it? No doubt part of the reason why studies show higher incidence of certain diseases in larger people can be explained by the damage caused by repeated dieting.
 
Looking For a Shortcut?
 
Perhaps by now you got the message that dieting and exercise haven’t been proven to support sustained weight loss and that many factors beyond your control contribute to your weight. Maybe you’re considering outside help?
 
Weight-Loss Drugs, Supplements, Surgery, or Other “Aids”
 
It’s easy to get caught up in the fantasy that a pill or a scalpel can give you what you want. Advertising for weight-loss “aids,” whether supplements, drugs, surgery, acupuncture, or metals that change your body’s polarity, manipulates your emotions and reinforces and exploits your insecurities. Fearmongering about the dangers posed by “excess” weight and false promises of benefits allow you to rationalize these weight-loss aids as promoting good health and increased longevity. Inspirational success stories and celebrity testimonials lead you on. That physicians, dietiticans, and other “experts” back the aid provides added permission to buy in to the fantasy.
 
But do weight-loss dreams really come true? Has anyone figured out how to effectively short-circuit setpoint mechanisms? Of course not. If something seems too good to be true, it is. While numerous “aids” may support short-term weight loss, there is no convincing evidence that anything can help you maintain weight loss over the long run without the risk of seriously compromising your health. Here’s a quick look.
 
Selling Hope in a Pill Bottle
 
That there are pharmaceutical weight-loss treatments on the market is more about the pharmaceutical industry’s power to persuade regulators to obliterate barriers intended to keep consumers safe, than about their success in generating maintained weight loss.
 
Yes, you can temporarily curb your appetite or boost your metabolism with an amphetamine or similar supplements, but you may also be nervous, jumpy, and subject to insomnia and addiction and a host of other problems. Plus, once you stop taking the supplement, your lost weight comes right back, if not more.
 
Then there’s Alli, the FDA-approved, over-the-counter weight-loss drug, designed to keep your body from absorbing fat. The problem is you also miss out on absorbing many fat-soluble nutrients essential for good health.
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You are also unlikely to lose much weight.
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Plus, soon after taking Alli, your weight may ratchet back to where it started, if not higher.
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And let’s get graphic about what blocking fat absorption means: Instead of entering your body where it might actually be useful, that fat dribbles out the end of your digestive tract. Alli-oops, as some people say. “Anal leakage” and “dumping syndrome” are the official medical terms. The drug company that makes Alli even issued an advisory: “You may feel an urgent need to go to the bathroom. . . . It’s probably a smart idea to wear dark pants, and bring a change of clothes with you to work.”
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The two Food and Drug Administration-approved prescription drugs, orlistat (which is prescription-strength Alli) and sibutramine, are not showing exciting results,
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even though almost all the testing has been industry-funded. First, 30 to 40 percent of the research participants drop out of the studies (presumably because they are not successful?) and are not included in the final analysis. Of the remaining subjects who do complete the trials, weight loss is small: on average between 6 and 10 pounds. And each drug carries adverse cardiovascular effects.
 
The fact that such supplements are useless over the long run makes sense. First, your body systems are intricately entwined. Upset one and it has multiple reverberating effects on others. We may call the unwanted effects “side effects” but they are no less a part of the mechanisms of action than the effect we are looking for.
 
But more importantly, all supplements work on changing one aspect of your weight-regulatory system. If the principal effect of a drug is to suppress your appetite and reduce the amount you eat, then your body will perceive the caloric deprivation and compensate accordingly. For instance, it will slow your metabolism so you expend less energy, and any weight loss will be temporary at best.
 
A supplement that works in the brain to increase metabolism will be similarly ineffective, since your body will eventually turn up your hunger signals to compensate. Just as we see long-term weight regain result from diet and exercise, expect the same from supplements. You can’t trick your body for too long.
 
So don’t fall for the hype. There is no “magic pill” that will melt the pounds away. No doubt by the time this is published there will be new drugs and supplements on the market. But I’m not optimistic that we can expect anything different in the near future. It is unlikely that thin bodies will ever come from a bottle.
 
Dreams on the Operating Room Table (Bariatric Surgery)
 
Bariatric surgery refers to operations that help promote weight loss. It’s among the highest-paying surgical specialties, which perhaps partially explains why accuracy and integrity in research and reporting go by the wayside. Combine that with our vulnerability—desperation to lose weight is not conducive to good judgment—and it’s a setup for disaster.
 
People are misled about the extent and severity of the health risks associated with being fat and told that bariatric surgery is a solution. It’s not. It would be more appropriately labeled high-risk disease-inducing cosmetic surgery than a health-enhancing procedure. And unlike a diet, you usually can’t abandon it when you realize you made a mistake.
 
The ads for bariatric surgery make it sound so easy. Go to the hospital, gently breathe into a mask until you are lulled into unconsciousness, wake up thinner, and watch the pounds continue to drop off over time.
 
What’s the other side to the story?
 
Bariatric surgery is nothing more than a forced diet: The various techniques reduce your stomach’s capacity to hold food and/or damage your organs so that they can’t absorb as many nutrients. The goal is to intentionally induce malnutrition, and post-surgical nutrition deficiencies are the norm.
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Dying is a distinct possibility.
One study published in the
Journal of the American Medical Association
followed more than 16,000 people who underwent bariatric surgery and found that 4.6 percent died within a year.
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(Men had higher death rates than women: 7.5 percent versus 3.7 percent.)
 
Other sources indicate lower mortality rates, but even the American Society for Metabolic and Bariatric Surgery, which presents the most optimistic picture, indicates that two to five out of every thousand individuals die within a month of gastric bypass, the most commonly conducted surgery.
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Reported results are likely to be deceptively low: One investigative report found that deaths directly attributable to gastric bypass surgery were recorded as deaths from other causes, resulting in many never being accounted for.
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The largest examination of mortality rates
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following bariatric surgery found chilling results: nearly 3% of the patients died after the first year and 6.4% at the end of the fourth year. Of those who had surgery in 1995 and had at least 9 years of follow-up, 13.0% had died. Of those who had the surgery in 1996 and 8 years of follow-up, 15.8% had died, and of those who had surgery in 1997 with 7 years of follow-up, 10.5% had died. Sandy Swarzc, on the Junkfood Science blog, compared these rates to the U.S. National Center for Health Statistics of the Centers for Disease Control and Prevention data, matching Americans of the same age and BMI and concludes: “By best estimates, bariatric surgeries likely increase the actual mortality risks for these patients by 7-fold in the first year and by 363% to 250% the first four years.”
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“Complications” are likely.
A few other possible complications that the ads usually forget to mention, as compiled by Dr. Paul Ernsberger and Sandy Swarzc: adhesions and polyps, massive scar tissue, advanced aging, anemia, arthritis, blackouts/fainting, bloating, body secretions (odor like rotten meat), bowel/fecal impaction, cancer (of the stomach, esophagus, pancreas, and bowel), chest pain from vomiting, circulation impairment, cold intolerance, constipation, depression, diarrhea, digestive impairment due to heavy mucus, digestive irregularities, diverticulitis, drainage problems at incision, early onset of diabetes, early onset of hypertension, electrolyte imbalance, erosion of tooth enamel, excessive dry skin, excessive stomach acid, esophageal contractions, esophageal erosion and scarring, feeling ill, gallbladder distress, gynecological complications, hair loss, hemorrhoids, hernia, hormone imbalances, impaired mobility, infection from leakage into body cavities (peritonitis), infertility, intestinal atrophy, intestinal gas, involuntary anorexia, irregular body fat distribution (lumpy body), iron deficiency, kidney impairment and failure, liver impairment and failure, loss of energy, loss of muscle control, loss of skin integrity, low hemoglobin, lowered immunity and increased susceptibility to illnesses, malfunction of the pituitary gland, muscle cramps, nausea, neural tube defects in your children, neurological impairment (nerve and brain damage), osteoporosis, pancreas impairment, pain along the left side, pain on digestion, pain on evacuation, peeling of fingernails, potassium loss, pulmonary embolus, putrid breath and stomach odor, rectal bleeding, shrinking of intestines, stomach pain, sleep irregularities, suicidal thoughts, thyroid malfunction, urinary tract infection, vitamin and mineral deficiency, vitamin and mineral malabsorption, violent hiccups that persist daily, vomiting from blockage, vomiting from drinking too fast, vomiting from eating too fast, vomiting from eating too much (more than 2 ounces) . . . and best of all—weight regain.
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It’s hard to understand the justification for intentionally damaging healthy, functioning organs and voluntarily assuming the risk of death and “complications.” Apparently, the rationalization is that the dangers of carrying “excess” weight are much worse than the dangers posed by the treatment. Yet the evidence just isn’t convincing. Even the American Medical Association has raised serious doubts about bariatric surgery’s effectiveness and safety, noting that ethical and scientific questions abound and that the long-term consequences of these surgeries remain uncertain, both in terms of health outcomes and whether significant weight loss is maintained.
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The developer of gastric bypass, Dr. Edward Mason, also voices concern: “For the vast majority of patients today, there is no operation that will control weight to a ‘normal’ level without introducing risks and side effects that over a lifetime may raise questions about its use for surgical treatment of obesity.”
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The most comprehensive independent review of bariatric surgery, conducted by the Emergency Care Research Institute, a nonprofit health services research agency, examined evidence from seventy studies.
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The investigators reported that while significant weight loss occurred, patients still remain obese. However, they noted that the evidence demonstrating that associated diseases improved was weak, and it was not evident that surgery resolved heart disease or extended life span. They report that claims of improved “quality of life and long-term health impacts are less conclusive.”
 
There is a remarkable paucity of long-term data, but emerging data suggests gradual weight regain and return of co-morbidities during the long term.
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It is also logical to expect that because the post-surgery weight loss occurs quickly, most of the weight loss is valuable muscle tissue, not fat, which typically occurs in other weight-loss studies in which the type of weight lost is monitored.
 
Following surgery, patients are still fat, though less so, and may not have improved prospects for health or longevity. Some may never be able to eat normally again, and may be limited to eating small amounts (about 1,300 calories per day) and forever avoiding certain foods, like milk and sweets. Even if they follow their post-surgery diet, they are still likely to experience pain, vomiting, and an inability to control stool (“dumping”). The American Society for Metabolic and Bariatric Surgery reports that 85 percent of patients experience dumping
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while a study conducted by Brazilian surgeons found 64 percent experience vomiting five to nine years after their surgery.
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Research also shows a high rate of depression and suicides among those who have undergone the surgery.
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