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Mar. 24th, 2005

"Weighing the risks" is a report on the risks and side effects of WLS, by Todd C. Frankel.

It seems well-researched and more honest than many articles about the 30-day-post-surgery death rates and the long-term complication rates of WLS, especially emerging knowledge of the serious nutritional deficiencies it can cause.

However, it sends a mixed message about whether the nutritional deficiencies occur because patients "don't take their vitamin pills" or whether they can occur even when patients do take their vitamin pills. (In some cases, they need vitamin injections.)

My concern about the nutritional deficiency side effect is one of my major reasons for staying away from the surgery. I have an idea what the health risks are of being the size I am with the chronic illnesses I have, but I don't know what the effects of nutritional deficiency might be, and I suspect that as I age and become less able to absorb nutrition anyway, they may become significant. I guess I figure that if I'm going to become very sick, I'd rather it be from a relatively well-known condition than a less-well-known one.

Frankel interviewed a woman who had the surgery in 2001 and lost 175 pounds. She is 41 years old. But to my eyes, in small photograph of her in the article, she looks much older.

Excerpt from the article:
One of the most thorough surgery shake-ups occurred in Washington state.

It was set off by Dr. Jeffery Thompson, chief medical officer for state Medicare, who was shocked by mortality statistics he received in the summer of 2003.

The 30-day death rate for obesity surgery ranged from zero to 40 percent.

In other words, some surgeons were losing four out of every 10 patients.

In August 2003, Thompson ordered an emergency halt to the surgery for his agency's clients. State Medicare then asked for an in-depth analysis of Washington's obesity surgeries. A clear relationship emerged between the number of surgeries a hospital performed and results: Hospitals that did fewer than 10 operations a year had a 12 percent death rate, while hospitals that did more than 100 had a rate of 2 percent.


( 7 comments — Leave a comment )
Mar. 24th, 2005 10:53 pm (UTC)
It sounds scary as fuck. Urgh.
Mar. 25th, 2005 01:09 am (UTC)

Thanks for the pointer to the article.

Taking vitamin pills is tricky enough when you have a normal diet, they can make me throw up if I don't take them with food. Also, I wonder if the thinking behind Chinese medicine might be relevant here, that is, you can put something apparently beneficial into your body but you can't assume your body will metabolise it as you intend if there are other things wrong.

Mar. 25th, 2005 01:20 am (UTC)
Since metabolising nutrients is specifically what's being limited in WLS, the Chinese medicine notion seems very relevant.
Mar. 25th, 2005 01:24 am (UTC)
I'm really stressed about WLS. I've got a friend who had it at the beginning of this year, and things are going well so far. But I believe it was her personal decision to make, and she did make it - became informed, weighed up the risks, and made her choice.

I don't like the general social attitude that fat is bad in and of itself, and the resulting pressure for things like WLS. I think it's good there's more articles like this, and I hope it means each person can make zir individual decision.
Mar. 25th, 2005 03:50 pm (UTC)
Thanks for the article.

I actually found myself thinking of WLS for, oh, about 30 seconds some time last year. The nutritional stuff is just part of it. The immediate death rate, you betcha. But also I've heard and read too many first-person stories of diarrhea, even incontinence, sutures or staples bursting--horrible, horrible. It's a clumsy, clumsy way of messing with a delicate system. Which is also how I feel about appetite-adjustment pills.

If something not horribly clumsy came along, I might take it, for the diabetes. On the other hand, I've been slowly working on getting that back under control, and diabetic meds are gettign better, so by the time something effective and safe comes along, I might not need it anymore. Wouldn't that be nice?
Mar. 25th, 2005 06:29 pm (UTC)
That is a horrifying, horrifying article. *shudder*

Mar. 25th, 2005 10:27 pm (UTC)
WLS just squicks the hell out of me. I have friends who are looking into getting it, and I just can't even trust myself to talk rationally to them about it.
( 7 comments — Leave a comment )

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