I notice in the WLS community there is so much denial that to me, it approaches schizophrenia at times. It seems that they deal with the announcement of someone's death always the same way...of course, this death couldn't be due to the WLS (even if the death is a result of something given as a complication of WLS).

To wit, the latest casualty of WLS (and she had a proximal RNY, supposedly the "safest" WLS), is a Brit named LB.

LB died on 3/30/01 at the age of 28, about 1 year after she had her WLS.

Since she died of meningitis (they think), the WLS community is saying that her death is not WLS related. But the chances of a young person getting that sick and going like right now, are very slim. Getting in an auto accident I can see but the fact that she got so ill and couldn't fight it, tells me her immune system was pretty much gone. Not surprising after major surgery to partially destroy the GI tract and then, starving for a year.

LB happily posted on a mailing list about going to get jeans and being thrilled to get a smaller size - this post was a week or so before her untimely death. Truly a model of "dying to stay thin", a title for a recent People Magazine article which is very unpopular in the WLS Community.

The post on the mailing list announcing her death was by her husband who said she died in his arms.

Today's RNYs are based on a surgery called the Billroth II. The Billroth II was done quite a bit until lately for ulcer patients. It's still being done for post gastric cancer patients. Edward Mason observed that his Billroth II patients had a difficult time keeping their weight in the normal range and figured out that a similar surgery would help the obese. At the time, the only surgery they had was the Intestinal bypass which more often than not, resulted in liver failure.

So Mason began doing a surgery which became known as the "loop gastric bypass" which was essentially a Billroth II with a smaller gastric (stomach) pouch. By the end of the 1960's he had refined this surgery to what is now called the RNY. This refinement was added to avoid the bile reflux of the loop gastric bypass.

So they have been doing Gastric bypasses (RNYs) regularly since 1980 and yet, no one can find the 15 and 20 year post ops. Excuses are made like it's just too difficult, people move too often etc. One clinic said they had done some 8000 RNYs since 1980. Even at a few hundred a year for that many years, there should be all kinds of folks with gastric bypasses walking around but they seemed to all have disappeared.

And now, an interesting development is that Mason who invented the thing, discarded it HIMSELF in 1980, advocating Vertical Gastric Banding instead. The procedure was questionable in the long run, he wrote. In an article in Fall 1999, he had this to say:

Bariatric surgery still does not have sufficient data from enough patients with any procedure to say which operation is best. I am concerned about the goals of surgeons and patients and their level of interest in what really goes on inside the body after alterations of the anatomy. I am concerned about the focus on the superficial and results from the first year with a lack of concern about how life will be affected when patients are 10 and 20 years older." - Edward Mason (MD, PhD - inventor of the gastric bypass)

Of course no one in the schizophrenic WLS community has ever questioned why the inventor of the RNY has been "pushing the VGB" since 1980.

Mason not advocating the surgery himself, explains why in May 2000, he sent out a letter of concern to all the surgeons who are members of the ASBS warning them that post op RNY patients may be leeching calcium from the bones and not absorbing it from what they eat (kind of a no brainer because calcium is absorbed in the part of the small gut they bypass and requires a fat soluble vitamin which post ops don't digest well either).

Will the craziness never end? In 1998, 20,000 WLS procedures were done but the estimate for this year with all the publicity they've had, is 45,000 WLS procedures.

It is an enlightening experience to mention the Billroth II (which is ESSENTIALLY what gastric bypasses ARE) to doctors not involved in selling WLS. A look of horror comes over their faces as they relate all the complications of this surgery. The longevity after a Billroth II is expected to be from 15 to 30 years. And although great lengths are gone to keep the RNY mortality stats from the public, I would suspect the longevity after the RNY is similar or less than the Billroth II.

The basic problems with the Billroth II are the malabsorption and the gastrectomy, not the bile reflux as some would have us believe.

Living 15 to 30 years after surgery is great for a post cancer patient. Not so great for a person in their twenties who gets this RNY surgery to "see their grandkids grow up". Not that many 40 and 50 year olds have grandkids.

Nurses who have worked with post ops in the hospital have many horror stories to tell. What Carnie Wilson calls "a bit of soreness after surgery" is excrutiating pain requiring morphene. Nurses have witnessed patients stay in the hospital for months after surgery and they have eased patients through parentinitis and being close to death. One surgeon who was described by one of his patients as a "saint" tells the nurses on his post op floor that because his WLS post ops are so large and the nurses might hurt their backs in lifting them, if one of these falls to the floor, leave them lying on the floor and call the paramedics. Some saint.

And a nurse friend of mine who worked ER for many years said that he saw WLS post ops come into the emergency room quite often with rather scary and painful complaints.

All of which we never read about in the popular media.

Criminal? Yes! Indeed.

Yes, there are always folks who would make the decision of WLS but in full consent, knowing that, for example a 20 year old might only have another 20 years to live whereas they could live 30 - 50 years as a fat person, that 20 year old might not want to choose this surgery.

Knowing that they will likely return to the hospital for repeat surgeries or that one piece of food, carelessly chewed could give them hours of excrutiating pain or even worse, knowing that osteoporosis is a probability with any mal absorptive surgery (and knowing how painful osteoporosis is), knowing that they might have to administer themselves B12 shots for the rest of their lives, knowing that an ulcer or adhesions can cause an excrutiating bowel obstruction at any time, necessitating emergency surgery. Knowing that their after surgery diet will be very restricted in both type of food and quantity and that in order to keep the weight off they need to exercise and knowing that following such a program consistantly long term would have the same effect without surgery (of making them leaner and fit). Knowing all of this begins to make many realize that the quality of life which they feel surgery will give them simply isn't there - it's a myth, an advertising ploy, a fantasy.

What is so sad is that most folks go into surgery because they are scared that they will die soon, a lie told them by the WLS business (and yes, it IS a business).

I have observed that my strongest argument against surgery is providing the ton of research which observed that there is no direct connection between obesity and morbidity, a result which came up in the 20,000 men of the Cooper Institute studies as well as the Met life insurance studies (the Met life had to draw up the charts using a mathematical formula since the results of their morbidity studies were all over the range. For example at age 40, the woman least likely to die at height 5'4" weighed 194 lbs!).

I provide them with a list of books which they cannot discredit... books which tell the truth about obesity and morbidity.

Because knowing that the surgery is very dangerous and that they WON'T die in five years, people often decide to not have surgery.

The surgeons don't want this kind of full knowledge consent because it would drastically cut down their business.

Follow the money trail...

- Sue