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Old 10-05-2008, 08:46 PM   #11
Patrick Donnelly
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For those who absolutely require some sort of surgery to save their lives, this is great. For those who simply want some sort of surgery to save their lives, this is better, however lamentable their need may be.


I wonder how any sort of volume-restriction surgery works. I remember a study citied in Good Calories, Bad Calories that involved rats eating several times the volume of their typical diet to simply get the same number of calories per day, eating much more diluted foods. Is it simply such an enormous reduction of volume that calories don't matter? What about nutrition? You're practically turning a morbidly obese person into an anorexic one by reducing their meals to just a few ounces each. That hardly seems healthy either.

Re: Derek
I hadn't heard about the testing period beforehand to determine discipline and eligibility. While it would be great if people could maintain the habits that get them through the trial period, I can't help but feel that some people have the discipline solely because they know they are being tested. As another example, take Alli. Taking the pill reduces your dietary fat intake by about 3/4's... Of that, 1/4 is the pill, and the other 1/2 is your own food choices. If people want to loose more weight, why don't they just cut the calories themselves without the pill? (Assuming low-fat diets lead to weight loss.) Because the pill offers the extra "incentive" to help keep you strictly on the diet.

Re: Chris
Good article. However, if the duodenum is supposedly partially responsible for diabetes, cancer, etc. why hasn't human evolution changed the way the digestive tract works?

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Originally Posted by George Mounce
Funny thing is you don't find many anorexic people in nation's plagued by starvation. So to me its another byproduct (like my lame video game addiction) of something in our "modern" society, fueled by the need of many to feel socially accepted to an extreme.
Interesting point.

Re: Phil
94kg is the top of the class, so you may want to avoid hitting 95.
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Old 10-05-2008, 09:49 PM   #12
Steven Low
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If morbid obesity is on the same level as anorexia or other similar conditions (aka both metabolic and psychological like you guys are saying) then riddle me this: why isn't it treated the same way? If someone admits they have anorexia or bulemia they would definitely be strongly encouraged to meet with a psychiatrist and a dietecian to make sure they aren't starving/harming themselves. Why not the same with the obese?

I mean, cost is definitely a factor along with some others... But can't people see they're ruining their lives (or at least shortening them and putting themselves at risk for tons of other diseases)? Shrug.

Yes, I can be insensitive at times (well, a lot of the time - working on it), but seriously.. obesity is one of the largest drains on healthcare, and it IS preventable. It is a HUGE problem especially here in the US and other first world countries. We need solutions. If you don't like the self control/personal responsibility option (which I do think can/should work in at least SOME cases) might I suggest coming up with a different one instead of just handily criticizing it as being insensitive or rude?


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Good article. However, if the duodenum is supposedly partially responsible for diabetes, cancer, etc. why hasn't human evolution changed the way the digestive tract works?
Uh, cause excessive food abundance has only really been around for the past say 50 or so years (maybe 100 if you wanted to be conservative)... I think that should cover it.
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Old 10-05-2008, 10:15 PM   #13
Blair Lowe
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My friend and roomate mom's just went through a gastric bypass. I don't know what her medical care company is but she had to go through a period of losing 50-60 pounds before she could get the surgery. I think this was to increase the odds of her not having any problem on the table but also put her on the road to eating better.

At first she wasn't happy about it. As well, she went on splenda, just as her two sons did ( my roomates, one of which is morbidly obese and the other overweight fat [ though he's lost some excess fluid and weight due to biking with no change in diet for him or his bro]).

I was given some weird looks when I said, " you lost that much weight on your own, why not keep going without the surgery. " As far as I know, she doesn't exercise either.

My roomate researched lap band a bit, and it turns out it is a safer surgery and was about 2/3rds of the cost between 10 and 15k maybe 12k.

Seeing my friends who are very into MMORPG has kept me away from them. I have played them my share, but sparingly because I tended to just have other interests and was always wary of something that would control my time ( I'm a control freak ).
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Old 10-06-2008, 12:02 AM   #14
Dave Van Skike
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Quote:
Originally Posted by Steven Low View Post
If morbid obesity is on the same level as anorexia or other similar conditions (aka both metabolic and psychological like you guys are saying) then riddle me this: why isn't it treated the same way? If someone admits they have anorexia or bulemia they would definitely be strongly encouraged to meet with a psychiatrist and a dietecian to make sure they aren't starving/harming themselves. Why not the same with the obese?
good question, Steven. The medical community may be missing the boat on this one.. I believe most of these types of disorders should start with a psychologist.

But here's a better question, if it's just so damn easy and a matter of willpower, how is it that so many people, stay morbidly or even mildly obese? they like it?, they're stupid? they're just weak? I mean, it's just calories in calories out right?

Yes, I am criticizing the rampant ignorance and stupidity of both ends of the spectrum, skinny bootstrappers who think it's just so simple and the Medical industry that is earnestly engineering invasive solutions.

I suggest fix what is broken. Someone who is on the verge of needing lap band surgery has serious psychological problems. Period. If you have spent any time around a victim of anorexia or a morbidly obese person, you'd note that the similarities are chilling.

Sorry if I come off as overly strident but the judgmental BS is a just a shade thick up in here and there is abundance of talking out of ass syndrome.
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Old 10-06-2008, 05:00 AM   #15
George Mounce
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As far as the duodenum procedure (which is another form of gastric bypass), it only then masks the problem (incorrect eating) and causes more down the road for those who get it done according to my mother who is a diabetic (Type I), diabetic educator and RNP. It isn't a fix by any means, its another lazy person's way out of bad food choices. My mother is against the procedure and would rather change someone's eating habits and educate them, than go for a permanent body-altering surgery.

I also agree with Steven - we don't cut things out of anorexics to make them better do we? Obese people need help with their head, not their small intestine.
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Old 10-06-2008, 09:56 AM   #16
Garrett Smith
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Messing with the digestive system = bad idea.

One patient I saw recently had violent bouts of dumping syndrome very soon after eating her meal. This was after having her gall bladder removed several decades ago--thing is, she started gaining weight right after that surgery--now she is 5'2" 260#. Last I heard, the digestive aid/enzyme formula I Rx'd her had already fixed most of the dumping issue and she was dropping weight (I gave NO dietary advice, she wasn't interested).

Another person, who I haven't seen yet, is a friend of the above person. She has a Lap-Band. I was told she is dealing with constantly vomiting up her food. Obviously a tightened ring around the top of the stomach can backfire--pun intended...

Self-control is not a natural instinct, it must be trained. We are simply wired for feast or famine. Put simply, just as modern medicine has yet to "cure" any disease that isn't nutritional in nature, the "cure" for obesity will never come from surgery. All surgery will do is set up the person for malnutrition in the future.
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Old 10-06-2008, 10:17 AM   #17
sarena kopciel
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Quote:
Originally Posted by Garrett Smith View Post
Messing with the digestive system = bad idea.



Self-control is not a natural instinct, it must be trained. We are simply wired for feast or famine. Put simply, just as modern medicine has yet to "cure" any disease that isn't nutritional in nature, the "cure" for obesity will never come from surgery. All surgery will do is set up the person for malnutrition in the future.

How true, but people today really just want a quick fix--not long term change. Who thinks down the line.....
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Old 10-06-2008, 12:52 PM   #18
Craig Loizides
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Quote:
Originally Posted by Patrick Donnelly View Post
I hadn't heard about the testing period beforehand to determine discipline and eligibility. While it would be great if people could maintain the habits that get them through the trial period, I can't help but feel that some people have the discipline solely because they know they are being tested. As another example, take Alli. Taking the pill reduces your dietary fat intake by about 3/4's... Of that, 1/4 is the pill, and the other 1/2 is your own food choices. If people want to loose more weight, why don't they just cut the calories themselves without the pill? (Assuming low-fat diets lead to weight loss.) Because the pill offers the extra "incentive" to help keep you strictly on the diet.
I've always thought the best way to get people to lose weight would be to sell them placebo pills for $100 a month and tell them it's guaranteed to work as long as they also eat well and exercise. Anybody want in on this with me?

Quote:
Good article. However, if the duodenum is supposedly partially responsible for diabetes, cancer, etc. why hasn't human evolution changed the way the digestive tract works?
The duodenum isn't responsible for diabetes, it's responsible for digestion. Digest too much of the wrong foods and you get diabetes. At least that's my interpretation of it.

Quote:
Originally Posted by Dave Van Skike
But here's a better question, if it's just so damn easy and a matter of willpower, how is it that so many people, stay morbidly or even mildly obese? they like it?, they're stupid? they're just weak? I mean, it's just calories in calories out right?
Good Calories, Bad Calories has a lot of interesting ideas on this. Taubes basically argues though that too much emphasis is made on the psychological and will power aspects and too little on hormonal and metabolic causes.
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Old 10-06-2008, 06:18 PM   #19
Derek Weaver
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Originally Posted by Dave Van Skike View Post
good question, Steven. The medical community may be missing the boat on this one.. I believe most of these types of disorders should start with a psychologist.

But here's a better question, if it's just so damn easy and a matter of willpower, how is it that so many people, stay morbidly or even mildly obese? they like it?, they're stupid? they're just weak? I mean, it's just calories in calories out right?

Yes, I am criticizing the rampant ignorance and stupidity of both ends of the spectrum, skinny bootstrappers who think it's just so simple and the Medical industry that is earnestly engineering invasive solutions.

I suggest fix what is broken. Someone who is on the verge of needing lap band surgery has serious psychological problems. Period. If you have spent any time around a victim of anorexia or a morbidly obese person, you'd note that the similarities are chilling.

Sorry if I come off as overly strident but the judgmental BS is a just a shade thick up in here and there is abundance of talking out of ass syndrome.
Fix what is broken? That only happens in systems where the point is for people to get legitimately better, our health care professionals tend to just look after the appearance of better.

I like your idea of required psychological analysis prior to invasive procedures.

In the end, just like Patrick pointed out with Alli, and Craig said with his placebo idea (I think you've stumbled onto a goldmine my friend) it is a matter of the mind. Whether is psychological addiction or a matter of having will power and discipline is an individual basis. I still feel like more people just don't care than don't have control, if they did, they would do something about it before they got to a point where surgery became a viable alternative.
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Old 10-07-2008, 09:56 AM   #20
Patrick Donnelly
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Originally Posted by George Mounce View Post
As far as the duodenum procedure (which is another form of gastric bypass), it only then masks the problem (incorrect eating) and causes more down the road for those who get it done...
What kind of side effects are these? The article from before only mentioned the numerous benefits, with no mention of negative consequences (not surprisingly).

Quote:
Originally Posted by Dave Van Skike View Post
But here's a better question, if it's just so damn easy and a matter of willpower, how is it that so many people, stay morbidly or even mildly obese? they like it?, they're stupid? they're just weak? I mean, it's just calories in calories out right?
From my experiences with obese family, it's a combination of them liking the food that causes it (not everyone thinks strawberries taste better than cake), misinformation (low-fat Yoplait, 100 calorie packs of junk food...), and then discouragement from failing so many times before.

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Originally Posted by Derek Weaver View Post
I still feel like more people just don't care than don't have control, if they did, they would do something about it before they got to a point where surgery became a viable alternative.
I am now considering the possibility that they just don't think they have the will power. If you had told me a few years ago that I would soon be eating, exercising, and living the way I do now, I would have thought you were f'ing crazy. Additionally, encouragement for the obese to loose weight from those who have already become healthy is ineffective and only further discouraging because those who are healthy are seen as "miracles."

Quote:
Originally Posted by Craig Loizides View Post
I've always thought the best way to get people to lose weight would be to sell them placebo pills for $100 a month and tell them it's guaranteed to work as long as they also eat well and exercise. Anybody want in on this with me?
Aren't placebos typically sugar-pills? The logistics may need a bit of ironing out, but count me in. Haha.
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