This episode of The Oprah Winfrey Show aired a while back, but it’s a classic. Oprah invited some formerly obese teens, a couple of parents, and a couple of doctors — including Dr. Mehmet Oz, who hangs out in the audience contributing medical illumination when needed. The show also features some very useful animated graphics demonstrating the difference between Lap-Band® and gastric bypass surgery.
It includes a statement from Dr. Diana Farmer, who is not in favor of the idea of grownups making the bariatric surgery choice on behalf of obese children. She has a healthy respect for the potentially serious long-term problems. If there is no other reasonable choice, she prefers to see the Lap-Band® method used. Here is what WebMD says about this type of surgery:
Gastric banding is among the least invasive weight loss treatments. This surgery uses an inflatable band to squeeze the stomach into two sections… Most people can only eat a half to one cup of food before feeling too full or sick.
One of Oprah’s guests is a mother who took her daughter to Mexico because American doctors wouldn’t do her weight-loss surgery, which is not surprising because in the “before” picture she’s not that hefty. (A skeptic can’t help thinking of the TV series Weeds, where the mother of a chubby girl laced her secret stash of candy with laxatives and caused her an embarrassing incident at school.) Then, there is a young man named McGregor who topped out at 360 pounds and found fat camp ineffective. His mother compares Lap-Band® surgery to “eye glasses for his body,” to which Dr. Robert Pretlow responds, “Comparing gastric banding to glasses is appalling.”
Another guest is Kylie, a 17-year-old girl who had a gastric bypass.
***Update: We are delighted to include here an update, sent in May of 2016, from Kylie’s mom, who writes: “It’s been 9 years since she’s had her surgery, the weight remains off and she now has a happy, healthy life and family.” Oprah, who knows that obesity is more about the head than the stomach, asks Dr. Oz how people learn to readdress what made them fat in the first place.
Dr. Oz says 80% of obese people are eating to fill emotional need, and notes that eating is a socially acceptable addiction. One of the dangers of bariatric surgery is the tendency of patients to find other substances or processes to replace their food addiction. To demonstrate, we meet a 21-year-old who had gastric bypass four years ago, and transferred her addiction from food to alcohol. Dr. Oz explains how these patients are much more vulnerable to the effects of alcohol, since it goes directly to the small intestine and gets mainlined directly to the liver. It’s a very efficient way to get drunk and black out.
Dr. Oz is a big believer in dealing with the real causes of emotional distress, and not rushing into surgery. Young people need the chance to develop their coping mechanisms and figure out how to face life. And we are totally in the dark about the consequences these kids will face 20 years down the road, as a result of surgical intervention. He says, “Anything that’s strong enough to help you is strong enough to hurt you also.”
We see film of Nathaniel, a 340-pound high school senior who had gastric bypass surgery because of back and knee problems, sleep apnea, acid reflux, the danger of diabetes, and other considerations. His mom and dad are fairly large people. There is an interview with Dr. Mary Brandt who did the surgery, and who believed Nathaniel had the kind of co-morbidities that cry out for treatment. She says the good thing about the surgery is you can’t cheat. But others say that isn’t so, that anybody can eat their way around the surgery.
One question Oprah asks all the kids is “How much can you eat?” and the typical answer is a couple bites of hamburger and a few fries. Wait a minute. We’re getting the impressions that the entire object of this surgery is to allow kids to continue eating burgers and fries. Wouldn’t a more nutritious menu be appropriate, especially since they can hardly eat anything at all?
It’s an approach that worked for Whitney, who went from “an obese little girl to the pages of Seventeen magazine without surgery.” She joined a gym, got on a treadmill every day, and started running, and lost 100 pounds within a year. Whitney also studied up on nutrition and eventually convinced her parents to keep unhealthy foods out of their home. This family support issue can be very crucial, and promises to become more prominent in the future. Here is a sample from Marshall L. Wilde, in an article called “Bioethical and Legal Implications of Pediatric Gastric Bypass,” originally published in the Willamette Law Review:
Parents of morbidly obese children face a Hobson’s choice between losing custody of their child for medical neglect and subjecting their child to a regimen of increasingly dangerous interventions to control the child’s weight… Because of the gravity of the procedure and the potential ethical conflicts between the interests of the parent and those of the child, preoperative preparation should include extensive attempts towards medical weight loss.
Your responses and feedback are welcome!
Source: The Oprah Winfrey Show via YouTube, Parts 1, 2, and 3
Source: “ Choosing a Type of Weight Loss Surgery,” WebMD
Source: “Bioethical and Legal Implications of Pediatric Gastric Bypass,” Willamette Law Review via LexisNexis, Summer 2004
Image by colros (Sandra Cohen-Rose and Colin Rose), used under its Creative Commons license.