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You don’t say….device makers urge coverage of weight loss surgery

Why am I not surprised that the leading makers of the adjustable gastric band (AGB) for weight loss surgery are pushing for more coverage? Didn’t they appeal to the FDA to lower the qualifying BMI (body mass index)?  Do you REALLY think it is to help more people or perhaps to sell more devices…

I don’t know.  Regardless of motives I have the opportunity to meet with many individuals pre-operatively as they prepare for their weight loss surgery (WLS).  Fortunately it is a requirement of many insurance companies (at least in Texas) that they meet with a registered dietitian at least once.  Many insurance plans require a 3-month or 6-month “waiting” period as they undergo a supervised diet.

In my visit I make it a point to ask, who do you know that has had the surgery and what has their experience been?  Have they been successful?  WHY have they been successful?  If not, why have they NOT been successful?  Not ONCE in these conversations have I heard someone is not successful because they are following the guidelines and exercising.  Furthermore…every success story?  What are the secrets?  The patients are doing what they are instructed to do and 99.9% are exercising.

What I fail to see in the stories of promoting weight loss surgery is the importance of compliance.  I constantly hear (by promoters of WLS) how it’s the “cure” for diabetes, meds will be stopped, it gives a new lease on life, etc.  Perhaps it does (for some), BUT recognize that it is not a magic cure.  It is ONLY a tool that restricts the size of the stomach.  That’s it.  A tool.  There is no guarantee an individual will automatically eat less because if they really want to eat some food, they’ll find a way to eat it.  Ice cream and other “sliders” as we call them go down really easily.

Read the forums and you’ll see people who are wildly successful – yay!  Why?  Because they follow the rules and most importantly, exercise!  And then you’ll read all about ways to cheat the system and what we call “eat around the band”.  Seriously?  Why oh why go through this and not follow guidelines that will almost guarantee success?  I just don’t get it.  These are the people coming back years later because “the band did not work” and are now getting another weight loss surgery.  Which of course insurance is paying for.  Really?  The band (and other WLS) didn’t work?  The band works, IF it is made to work.

Just this week Dr. Oz had a show about weight loss surgery.  I don’t recall any discussion of the importance of compliance.  Tsk. Tsk.  WLS can be a wonderful tool – FOR the right person.  But, surgery is performed on the stomach, not the brain.

Registered dietitians want to help Paula Deen

Big news in the media last week – at least in the world of nutrition and healthcare – Paula Deen made public that she was diagnosed with type 2 diabetes three years ago.  Numerous people have blogged about it and rendered their opinions.  My colleague Angela Lemond, RD, CSP, LD and I had a chat about it. Tune in!

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