Paul Mason was Britain’s fattest man. He weighed 980 pounds. He ate non-stop, even at night. As he said,
“You didn’t sleep a normal sleep. You’d be awake most of the night eating and snacking. You totally forgot about everything else. You lose all your dignity, all your self-respect. It all goes, and all you focus on is getting your next fix.”
Then Paul’s mother died, he reached bottom and he started seeing a therapist. He emerged from the nightmare. He developed a new outlook. And he began losing weight. He lost 70 pounds.
A Happy Ending Gone Wrong
At this point, Paul’s story goes horribly wrong. Already on the path to a healthier and happier life, already losing weight, already having changed the habits that made him so immense he literally could only be moved via a fork lift, he did something risky and unnecessary. He signed up for bariatric surgery.
I don’t blame Paul for this. If he wants to undergo risky surgery, he has that right. Surgery may have come to represent the Answer (with a capital “A”) to him in a way that it’s hard for someone who has never walked in his shoes to understand.
I blame his doctor. For harming his patient and risking his life for no benefit. Luckily, Paul was able to keep losing weight and rebuilding his life after the surgery, as he had been doing before it.
The American College of Physicians states that “Surgery should be considered as a treatment option for patients with a BMI of 40 kg/m2 or greater who instituted but failed an adequate exercise and diet program.” (emphasis mine) In the UK, Paul was given surgery despite successfully losing weight and being on the path to good health.
A doctor’s first commandment is to do no harm. The same guidelines from the College of Physicans state that as many as 1 in 50 patients die from their bariatric surgery. There is no excuse to run such a risk with patient’s lives when they have already achieved the goals of the surgery.
I have complained before about bariatric surgery. I believe it is a scandal that patients are advised to have their stomachs stapled, banded, sleeved, partially removed or bypassed. These are all dangerous operations with high rates of such side effects as being unable to keep from pooping in your pants. Other complications are more serious. They include malnutrition and the host of illnesses that can lead to. As many as one-third of patients suffer from protracted vomiting. You can also suffer from neurological complications such as behavioral abnormalities, cranial nerve palsies and even seizures.
Proper nutritional advice, psychological therapy and lifestyle changes can also help you lose weight — with none of the risks, side effects or complications of surgery. In a summary of obesity management, one researcher concludes:
“Diet, exercise and behavior modifications will remain the cornerstones of obesity treatment for the foreseeable future.”
Follow the Money
Of course, surgery earns much more revenue for the medical industry than counseling and nutrition advice. And surgeons want to feel like they are doing something useful. If you have a hammer, everything looks like a nail. If you have a scalpel, everyone looks like a candidate for surgery.
If you doubt that money is a motivator to doctors, you might be surprised that typing bariatric surgery into Google a moment ago delivered no less than 11 advertisements from doctors and medical centers. A quick peek into Google Adwords shows me that these advertisers are paying as much as $21 to Google for every person that clicks on their ad.
Why are doctors competing to get me to have surgery with them. In 2002, the last year for which I found records, patients spent nearly $1 billion on bariatric surgery, paying as much as $35,000 each. Doctors are only human. They want to be financially successful, just like bankers, mortgage brokers, politicians and everyone else.
Here’s the lowdown. It’s fantastic that Paul’s life has turned a corner. Sure he still has challenges, like the 100 pounds of excess skin that hangs from his thinner frame. But he is positive and can legitimately say that every day he is making his life a little bit better. He can look forward to a much better future. Formerly a laughingstock, he has become a model and an inspiration to others.
Even so, bariatric surgery does not appear justified in his case.
There is at least one bariatric surgeon who understands that healthy eating can save lives, and make life more enjoyable. He admitted in an interview the other day that he “loses money” when he prescribes healthy eating to his patients.
He’d earn tens of thousands more if he simply operated.
“As physicians, we perform surgery or prescribe medications to our patients to make them well. Why not also educate them on healthy eating, and make fresh fruits and vegetables readily available?”
But Dr. Davis prefers the satisfaction of seeing his patients get better over the financial rewards of operating when lifestyle changes are a better choice. Did I mention, he is also an Ironman triathlete?