Posts Tagged ‘ Obesity epidemic ’

Don’t play the weight blame game

July 28, 2011
By Mark Fusco MD

This is a reprinted blog post from the excellent blog called Weighty Matters. It is written  by a Canadian medical weight loss expert Dr. Yoni Freedhoff.  The post deals with the double standard in many circles, including the medical community, as it relates to access to surgical weight loss procedures.

Medicine isn’t about blame, it’s about treatment


Yesterday this blog saw a guest posting from Lillian, a Nova Scotian who fears she’ll likely die before she reaches the head of her province’s 10 year cue for bariatric surgery.

A great many folks left comments (both here and on my Facebook page). Some were supportive. Some were full of self-righteous indignation. Others I chose not to publish as they were incredibly rude and hurtful.

The bottom line for virtually all of the upset commentators was that Lillian just ought to do something. That she ought to fix this problem herself. That clearly she’d just given up. That she wasn’t trying hard enough.

It was the good ole, pull herself up by her bootstraps and take things into her own hands crap, or a variant of I did it, so so can she, and while I’m thrilled for the folks who’ve experienced their own successes, they don’t necessarily translate to others.

For readers who don’t know, I’m not a surgeon. I’m the medical director of a behavioural weight management program. And while I’ve seen with my own two eyes many a person lose enough weight to preclude surgery, I don’t delude myself into thinking that downloading the solution to extreme obesity onto personal responsibility is everyone’s answer.

If there were a non-surgical, reproducible and uniformly effective plan for the management of extreme obesity, I’d agree with you, but the fact is, there is no such plan.

Of course, even if you do want to embrace personal responsibility as the sole cause of obesity, medicine isn’t about blame. We patch up drunk drivers and folks who don’t wear seat belts. We offer smoking cessation programs. We treat asthmatics who don’t bother keeping up with their puffers, pneumonias exacerbated by the early discontinuation of antibiotics, and the psychotic breaks of folks who stop their antipsychotics.

Oh, you want surgical examples?

How about lung reduction surgeries in smoking induced emphysema; liver transplants in former alcoholics; or how about one that doesn’t involve a so-called vice at all – heart bypasses on folks who simply didn’t bother to take their blood pressure, cholesterol or diabetes medications?

We operate on them all in a timely manner, and so we should, and the public doesn’t generally say boo.

But yet in the case of bariatric surgery, many people are up in arms about its timely provision.

Why?

Because aside from obesity it would seem, medicine isn’t about blame, it’s about treatment, and if there’s a proven and viable treatment option, at least here in Canada, people believe it should be readily accessible by our heavily taxed population, regardless of how and why their conditions developed in the first place.

At the end of the day, Lillian rightly sees bariatric surgery as hope. Emotionally it would see her bolstered by a success which for whatever reason, and it’s not for anyone to judge, you haven’t walked in her shoes, has eluded her. Economically it would save Nova Scotia likely tens of thousands of dollars of care and may improve the Province’s GDP by increasing Lillian’s ability and duration for gainful employment. Statistically and medically, it will prolong her life, cure her diabetes and sleep apnea, and potentially provide her with a springboard to retool her world, meet her grandchildren, and enjoy a fuller life.

Can you think of any other area of medicine, with an equally dramatically effective treatment option, where people would feel comfortable preaching about personal responsibility trumping a patient’s desire or right to access said treatment?

I sure can’t.

Lillian shouldn’t have to wait 10 years on a wait list for a gastric bypass, and blame has no place in the ethical practice of medicine.

 

 

 

300 Pounds Just Ain’t What It Used To Be! Dr. Fusco shares Blog Post on Adjustable Gastric Band Surgery in the NFL

February 23, 2011
By Ashley

Earlier this month another super bowl has come and gone. Some say that the sports we watch are a microcosm of our society. I came across a very interesting blog post by Marty Hudson from the MedicalGPS blog and decided to share it with you…

Superbowl week.  My team’s not in it, but I still follow it pretty close because I just like football.  Something interesting I ran across is the number of men on both the Packers and the Steelers that weigh over 300 pounds.  There are 26 players on the two teams that weigh north of 300.  That’s amazing!  There are only 53 players on each team.  That’s nearly 25%! There are another 6 players over 300 on their reserve squads.

Some of these guys, I don’t know how they can play football.  B.J. “The Freezer” Raji for the Pack clocks in at 337, according to the roster.  He’s the guy that intercepted Chicago QB Hanie in the NFC Championship and ran for a touchdown.  How does someone that big play football and not drop dead of a heart attack.  With a dance to boot which, by the way, has become so popular, you too can learn how to “Raji”. Green Bay’s first Super Bowl team, 45 years ago, didn’t have a guy heavier than 265 pounds.  Mean Joe Greene, at 275 pounds, was the biggest player on the Steelers when they won their second championship in 1976.

How did these guys get so big, and could any of this really be good for them?  They eat tons of food.  I suppose that’s great when they are young and so very active.  But what are they going to do after football? 

Take the case of Jamie Dukes.  First Reggie White died, followed by Tory Epps and Mel Agee. By mid-2005, former NFL center Jamie Dukes was not only mourning his former teammates, but fearing that morbid obesity would leave his own three children without a father. When Dukes, 44, retired in 1996 his 6-1 frame carried a muscular 290 pounds. A decade later, over-eating and reduced exercise had left him at 385 pounds. The weight-related deaths of his friends and concern of his wife and children led Dukes to undergo gastric banding surgery. In fewer than six months he lost 85 pounds, and is a public face of an issue that has emerged as a silent killer of NFL retirees: obesity.

According to stats provided to The Associated Press by Stats LLC, there was one 300-pound player in the league in 1970, three in 1980, 94 in 1990, 301 in 2000 and 394 at the start of last season.

As guys get bigger, the pressure mounts from teams and the NFL to ‘keep up’.  Speaking of which, Packers nose tackle Howard Green spent the preseason with the Redskins, where they wanted him to play at about 360 pounds. They cut him and he eventually ended up with the Packers. In their media guide, they boasted that he “brings size and bulk to the interior of the defensive front at 6-foot-2, 340 pounds.” “That’s cool for right now,” Green said. “I could do better, but I’ve got to do what I do for right now. You can’t go into depletion mode in the middle of the season. You’ll be weak. You’ll get your butt kicked out here by these guys.”

The man who used to be the poster child for unhealthy NFL living in the Super Bowl city of Dallas is Nate Newton. Once a proud 400-pounder nicknamed “The Kitchen,” he’s now on billboards for gastric-sleeve surgery. The ads scream “Lose Weight Like Nate,” and indeed, Newton is a shell of his former self, weighing in at a svelte 215 pounds. He said all the weight-related health problems he had — diabetic conditions, sleep apnea and more — resolved themselves when he took off the pounds.

On the other end, there’s the story of his fellow Cowboys lineman, Erik Williams, who limped into the Super Bowl media hotel Tuesday on a cane. He recently was diagnosed with severe degenerative arthritis in his hip — a result, in part, of playing in the 300-plus range over 11 seasons. “I’m disabled right now,” he said. “I need two hip replacements. It’s definitely something to look out for.” And yet, he concedes, he wouldn’t change a thing. “If they lose weight, then they jeopardize their position,” Williams said. “Linemen have to be strong, have to be quick, have to be agile. It comes with the territory. They may need hip surgery, it might be toes or it might be knees. I’d just tell guys to just keep doing things you love and whatever consequences come with that, deal with it.”

Is it worth it?  I don’t know.  Depends on your priorities.  When I was 24 years old I probably would not make the same decision as I would today.  Of course, when I was 24 there were no 300 pounders.  One things for sure, 300 Pounds Just Ain’t What It Used To Be!”

—Marty Hudson

(Not mentioned in the blog post is the story of Eagles Max Jean-Gilles believed to be first NFL player to have weight loss surgery (Lap-Band) while still playing. He had surgery in the off-season and was able to start training camp on schedule. )