Day 171 – A lap band article in today’s The Age.

My brother handed me an article today from the M magazine, which is out of The Age (Melbourne Newspaper) on lap band surgery. So I thought I would transcribe and post it on my blog for you guys to have a read.

Okay so here it is…

DIMINISHING RETURNS
Lap-band surgery is in demand, but its not the easy way out for the overweight. Bernadette Clohesy talks to those who’ve had it done.


Real estate agent Paul Dines 40, says he’s always been “heavy-set”. But when you are 183 centimeters (six feet) tall, you can get away with some extra weight (especially if you have a big personality to go with it). However, three years ago many of Dines’ peers were coming down with health problems and he wondered if he’d be next. “I felt like a child playing on the highway,” he says ruefully. “I hadn’t been hit by a bus yet but I was just waiting for it to happen.” He tried all the fad diets and diet medications but none of them worked. His GP had mentioned gastric-banding surgery a few years earlier but it sounded a bit drastic to a man who’d never had surgery before. But when his weight ballooned to 150 kilos, he put his fears aside and had the surgery in 2004. Three years down the track, he’s down to 100 kilos and feels much happier and healthier.

With obesity blamed for the growing incidence of diabetes, heart disease and sleep apnoea, anything that gets results is worth considering. But surgery? Whatever happened to willpower and a sensible diet?

Demand for gastric banding has soared in the past four years, according to the nation’s insurance companies. Last month, health fund MBF reported that the number of claims for obesity surgery had more than doubled between 2002 and 2006 – from 459 claims to 1102 Medibank Private reported steeper figures: claims jumping from 641 in 2001 to 1521 last year.

High profile patients such as comedian Mikey Robbins, who lost 65 kilos after surgery, have only increased interest in it.

“I think there is a certain stigma still attached to weight-loss surgery,” Robbins told ABC-TV’s Australian Story in July. “In my case, there was nothing genetic, there was nothing glandular, there was nothing hormonal. I just never had a sense of feeling full. That stop button wasn’t there. I could never put the fork down.”

Ian Michell, a Melbourne consultant general surgeon who focuses on laparoscopic surgery said, “sadly, for some people, the reality of willpower and dieting is that they don’t actually make a difference. The majority, if not almost all of the people I see, would have tried other things and they haven’t worked.” Michell performed his first gastric banding operation in 1994 and now does about 150 a year.

The procedure is often referred to as lap-band surgery, named for the band wrapped around the upper part of the stomach, dividing the space into two pats. The small upper stomach can only hold a small amount of food. A small opening created by the band allows food to pass very slowly through to the lower section, so the patient feels full for longer.

In the past, gastric banding was more invasive and less successful. The operation is usually performed now by laparoscopy (using very small incisions and long instruments). A two-night stay in hospital is the norm and most patients are back to work within a fortnight. The biggest improvement is that the lap band can be adjusted without further surgery. The hard part is adapting to a new diet, one that, for most patients, is drastically different.

Before the surgery, Dines would start dinner with an entrée, followed by a main, which would often include 2 steaks, and a dessert. Now, he says, if he eats a whole piece of fish he feels really full – and he can eat only a slither of steak. But he still eats out often and enjoys food now for its taste – not quantity. But he hasn’t become a saint: he had some choclate last night while watching TV.

All of us, including surgeon Michell, have heard about people who’ve had their stomach banded but still cheat by pureeing “bad” foods such as choclate bars or eating a lot of ice-cream or milkshakes that can be sucked though a straw. “There are ways of getting around the band,” Michell concedes, “but if you do that you won’t get the results. There are rules: you need to eat solid food; you need to cut it up well; you need to eat slowly; you have to chew it well; and, as soon as you feel full, stop.”

If you follow the rules, the results can be dramatic. According to Michell, the weight loss over two years works out to be a little more than half the patient’s theoretical overweight – after that it stays pretty constant. But that doesn’t mean that anyone who is unhappy with their weight can have the operation. Michell runs seminars through his practice that explain the stringent criteria. You have to have a body mass index of around 40, or have one of the illnesses that go along with obesity; have been overweight for more than five years; and have already made serious attempts to lose weight. Clients are then required to consult a psychiatrist, a dietician and a physiotherapist.

Training consultant Judy Brooks, 62, says she’s been big since puberty, but it wasn’t until she was 60 that she decided surgery was the only answer. She had three children in close succession in her early 20’s and says that she didn’t lose any weight in between. “I was an emotional eater,” she says. “I went through a bad first marriage so I ate to console myself.” Always a yoyo dieter, she’d lose five kilos, then put on 10.

Brooks was not what’s considered obese when she had lap-band surgery in August 2005, but she did have health concerns. She once played a lot of sport, but she then had trouble with her knees. When an orthopedic surgeon told her that if she didn’t lose weight she’d need two knee replacements – she was then 110 kilos and only 167cm tall – she became really concerned. “I also had a couple of scares with high blood pressure and chest pains,” Brooks says. “I turned 60 and thought if I don’t do something about my weight soon I’m going to die.”

Two years after the operation, Brooks says she feels (and looks) like a completely different person. She’s now down to 66 kilos. “I was always hampered in the kind of clothes I could buy,” she says. “One of the things I did go out and shout myself, when I got down to a reasonable size, was a Carla Zampatti pant suit in a size 12 (she used to wear a size 22). That was my reward: I’ve never spent that much money on clothes in m y life.”

It hasn’t been all smooth sailing though, “The first month is the hardest,” she says. “Everything you eat you have to be able to suck through a straw. It can get very monotonous. But f if you can get through that then you’re right. The diet plan they give you then is very sensible; it has all the food groups.”

Now Brooks cooks the same food for her family as she does for herself. But her portion is very, very small. When they have a stir-fry with rice, her serving is just three-quarters of a cup. There are some things she just can’t eat (such as bread and chicken) because they won’t stay down, but she’s never resorted to eating pureed or soft food. “Some people do cheat,” she says, “But I never have. It’s no magical cure; it’s a tool that will assist you but you still have to help yourself.”



What an amazing article!!!

Reney