Vox:Were barely using the best tool we have to fight obesity

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Vox:Were barely using the best tool we have to fight obesity

Postby dinska » Thu Dec 14, 2017 7:10 pm

I try to ignore all the bad health advice floating around the web, but this one really got me down today. Especially the use of the word "best". Considering the audience and the credentials of the author, there's no reason for this:


We’re barely using the best tool we have to fight obesity


Americans keep dieting to lose weight, but bariatric surgery is the most effective tool out there.

https://www.vox.com/science-and-health/ ... s-lap-band

There’s a surprisingly big disconnect between how obesity researchers think about the causes of and treatments for obesity and how the American public does.

Researchers think some people have genetic and hormonal traits that make them more susceptible to obesity. They view obesity as a complex, chronic disease, like cancer, with many causes and subtypes. They’re also losing faith in dieting and exercise, neither of which is very helpful for weight loss in the long term.

The public, on the other hand, generally believes obesity is caused by a lack of willpower, and that it can be fixed with gym memberships and trendy diets. In one 2016 survey of more than 1,500 Americans, 60 percent of the participants said dieting and exercise were even more effective than surgery for long-term weight loss.

Here’s the thing, though: Weight loss surgery is far and away medicine’s best treatment for severe obesity.
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Re: Vox:Were barely using the best tool we have to fight obe

Postby MINNIE » Fri Dec 15, 2017 8:30 am

UGH! I saw that story too. :mad:

Of course people are barely using the best tool for fighting obesity: real food.

DUH!
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Re: Vox:Were barely using the best tool we have to fight obe

Postby Roey » Fri Dec 15, 2017 10:42 am

I saw this article yesterday and was so itching to post it here :) What an ignorant article.
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Re: Vox:Were barely using the best tool we have to fight obe

Postby GlennR » Fri Dec 15, 2017 7:17 pm

Although I would never recommend this as a first line of defense, I do have a colleague who changed his whole life, and saved it, by getting a gastric sleeve. The results for him included improved health and a normal weight which he has maintained for over five years now. Not everyone manages to successfully change their eating habits to the McDougall plan and fewer still maintain it over the years. The statistics show dietary changes have poor long-term adherence and relapse is frequent.

If someone can manage to make the necessary lifestyle and dietary changes then there's no doubt Doc McDougall's way is best.
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Re: Vox:Were barely using the best tool we have to fight obe

Postby roundcoconut » Sat Dec 16, 2017 12:05 am

there is wonderful folk wisdom in the saying, “if you COULD’VE controlled it, you WOULD’VE controlled it”

this is used to try to persuade people alcoholics that they cannot continue lying to themselves about their drinking, and encourage them to believe that sobriety, rather than moderation or half-measures, is really the only way out for them.

when it comes to the predicament of the modern-day person living with an obese body weight in america, a similar argument seems to apply — if you COULD’VE controlled your weight, you WOULD’VE controlled your weight.

and as a result, people have begun to see that they must turn themselves over to a higher power, but actually, the new HP is the bariatric surgeon. isnt this worse than dystopian sci-fi???
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Re: Vox:Were barely using the best tool we have to fight obe

Postby veg tom » Sat Dec 16, 2017 6:17 am

My counter part at work just got off work to get the sleeve . He had to see a physiatrist for his mental state and a number of other of other people to get this done. I asked him what the physiatrist said about his state of mind and was told him he was normal. I said the guy should be fired because no one should be cut open for this type of surgery. Its not like he has been heavy his whole life,only the last few years. It looks like a money grab and every one wants their cut. He had to keep his lbs up so the insurance would cover it. I said, and you think I'm nuts for eating potatoes , I said having surgery is nuts. He does not have a clue. But he is happy because he wont have to work for a few months in the cold and snow in Michigan. :?: :?:
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Re: Vox:Were barely using the best tool we have to fight obe

Postby patty » Sat Dec 16, 2017 10:52 am

Then there is Dr Garth Davis who wrote “Proteinalohic”. Dr Kapler is leaving True North to start teaching doctors. It is just lack of education about what foods create long term satiety, body, mind and socially. We are a strange species that think cutting into ourselves solves our unrequited hunger of self-goverimg from a power greater than a human power.

Collectively we have sent people to college and given them the license to do this. It is like Dr McDougall was sharing his justified anger with his mentor, who said it is the i didn’t think of it syndrome.

Addiction is a thinking disease that tells the addict they don’t have a disease. Starch creates the satiety to think it through where we can stop to respond vs reacting. In AA they have a saying no one shoots off their foot. God is a idea. “me” is the the ultimate last addiction. No one gets thrown off the addiction bus. The zebra is the prey of the lion, and after out running the lion is still grazing in the same field. We are learning to be objective when subjective as it is not ether or but ether or and both who is the utitmate predator.

Aloha, patty
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Re: Vox:Were barely using the best tool we have to fight obe

Postby roundcoconut » Sat Dec 16, 2017 1:34 pm

The most appealing option when a person feels overwhelmed by their situation in life, is to ask someone else to fix it.

That is one reason why I believe people go to great efforts to get bariatric surgery — sure, they have to make it through many appointments and evaluations and pre-op “jumping-through-hoops”, but many people find themselves capable of doing a finite number of (administrative-ish) steps.

On the other hand, a person with over one hundred pounds to lose, who has not been able to lose one of those pounds over the last four months, often has no faith left in their own abilities to make any headway on their own problem.

The sitaution with junk foods and trigger foods in our society is pretty darn extreme. These foods are in every workplace. In every restaurant. At every gas station and every grocery store. At every party. At every meeting. In the early days of getting off of junk foods, there are easily dozens of triggers presented to you in an single afternoon.

You can control what is in your house, but you cannot do very much to change the grocery stores, gas stations, or pizza parties. The bank I go to, has lollipops in a candy dish. My car repair shop has tootie rolls in a candy dish. EVERYONE is eating these things, and everyone is offering them to you, dozens and dozens of times a day.

It is hell out there, for someone who feels they are weak in the face of junk food. True story, no?
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Re: Vox:Were barely using the best tool we have to fight obe

Postby Theswede » Tue Dec 19, 2017 7:07 am

True story roundcoconut.

It IS difficult out there, especially when you (like me some time ago) are not aware of the addiction these things causes. And that they are extremely comforting if you are in a bad place mentally.

I've only done WFPB eating for 9 weeks, but even though I am in a very rough and emotional situation since 7-8 weeks I've not been tempted one bit. I'd attribute that mainly to the information I've received and found.

More information for the masses, and so much pain and misery could be avoided.
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Re: Vox:Were barely using the best tool we have to fight obe

Postby f1jim » Tue Dec 19, 2017 8:20 am

It's hard to find fault with people that have tried "everything" to deal with obesity. The things that are recommended are usually poor choices for fixing the underlying problem. They usually involve portioning out smaller amounts of garbage food till caloric intake is low enough to lose weight. That doesn't stop the cravings for this stuff and probably, long term, makes things worse.
In desperation people seek out this intestinal tract meddling as their only hope.
We know there is a better way. Someday, perhaps everyone, including doctors will too.
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While adopting this diet and lifestyle program I have reversed my heart disease, high cholesterol, hypertension, and lost 54 lbs. You can follow my story at https://www.drmcdougall.com/james-brown/
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Re: Vox:Were barely using the best tool we have to fight obe

Postby Werner1950 » Tue Dec 19, 2017 8:30 am

Try to quit smoking in a smoking lounge. Try breaking free from alcoholism living in a pub.

I think we need to cut slack for some folks who, in spite of education and external support, cannot maintain consistency because they live in an environment that is everything but supportive. It is hard enough to get started on this for those who consider themselves well-balanced and educated.
"An ounce of evidence is worth a pound of presumption"
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Re: Vox:Were barely using the best tool we have to fight obe

Postby roundcoconut » Tue Dec 19, 2017 11:52 am

Werner1950 wrote:Try to quit smoking in a smoking lounge. Try breaking free from alcoholism living in a pub.


This is such a sad state of affairs — asking people to abstain from overly processed, calorie-rich foods, when there is hardly anywhere you can go where these things are not sprung on you regularly.

One time, about two years ago, I was at the DMV getting my car registered, and the wait time was at least 45 minutes. At one point, one of the ladies comes out from behind the counter, and goes around with a candy dish, going to each person and saying, “Here, I brought some Starbursts for you guys. Take a few. I know you’ve been waiting a long time!”

It’s a heck of an environment, when there are so few places where you will not offered the worst types of calories!

So far, there is not a candy dish at my gym. Oh, also my hairdresser does not offer me anything to eat, so I guess there are two places that I can name, that are not danger-zones for junk food.

It’s jungle out there, for someone who can’t string two days of good eating together.
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Re: Vox:Were barely using the best tool we have to fight obe

Postby Risto » Wed Dec 20, 2017 5:49 am

Yep, I was just thinking that the other day at a big-box electronics store. The place sold nothing but all kinds of electronic gadgets and home appliances, but once you got to the cash registers, there was a shelf of candy bars.

Here's a Cochrane Review from 2014 on bariatric surgery. Most of the follow-up in the studies is 36 months or less, and in that time frame, the surgery does work at reducing body weight, of course. What you'd want is a study of comparison to McDougall MWL type diet for that amount of time, and with regard to all aspects of health, but that's a tall order.

http://www.cochrane.org/CD003641/ENDOC_ ... or-obesity
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Re: Vox:Were barely using the best tool we have to fight obe

Postby roundcoconut » Wed Dec 20, 2017 12:21 pm

Risto wrote:Here's a Cochrane Review from 2014 on bariatric surgery. Most of the follow-up in the studies is 36 months or less, and in that time frame, the surgery does work at reducing body weight, of course. What you'd want is a study of comparison to McDougall MWL type diet for that amount of time, and with regard to all aspects of health, but that's a tall order.


It is such a predicament!

You can give people all KINDS of information about the McDougall plan, but in the end, information is just a tool. Tools only work if you use them!

The magic sauce of the McDougall plan is “time and adherence” — I think this will always be true. And guess what the biggest weaknesses of the average person are? Yep — time and adherence.

We seem to still struggle mightily with how to “implant” the McDougall diet into people. And it does no good to measure the results people DON’T get because they are unable to achieve the time and adherence. And it seems equally pointless to measure the awesome results people DO get when they able to achieve time and adherence in a controlled environment (like a live-in situation such as true north).

So in the end, we have an excellent tool, but few develop the skill and competence in using that tool. And the learning curve is so deep, that teaching people the implement that tool consistently is so massively time-intensive. Dr Esselstyn is a saint for being willing to sheperd some heart patients into excellent health, but I doubt if Dr Esselstyn’s results will be replicated by someone who’s not equally strong as an educator, as a persuader, as a source of inspiration, as a source of good will.

So many issues! My head starts to spin. :)
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Re: Vox:Were barely using the best tool we have to fight obe

Postby talkingmountain » Thu Jan 11, 2018 2:12 pm

As someone who's undergone gastric bypass AND who is in the uncommon position of having tried "McDougalling" multiple times prior to surgery, I felt it important to respond to some of the thoughts in this thread.

First, re the original post, I agree that it is a shame that the medical establishment in general still fails to recognize that there are "treatments" that may be as effective as bariatric surgery. There are hopeful signs that this is changing. With Medicare's 2016(?) approval for Dr. Ornish's "intensive cardiac rehabilitation" program, I think that we will see insurance companies start to cover lifestyle interventions, assuming Ornish is able to publish studies that document good success in the years to come.

I can also tell you that like many others, I wanted nothing more than to go to the McDougall 10-day or any other similar live-in program. I felt it was my best chance at getting away from hyperpalatable foods long enough to lessen their hold on me. Needless to say my insurance wouldn't cover it. Despite despite trying for several years, I couldn't save up the approximately $9,000 it would take to do that. I totally believe it would have been "worth" the money, but saving that amount wasn't possible.

Now to respond to some of the other thoughts expressed in this thread.

1. Taking the "easy way out." Let me tell you that, assuming you go to a reputable bariatric surgery program and are asking insurance to cover it, there is nothing "easy" about the preparation, recovery, or long-term maintenance. NOTHING.

You will first have to document that you've been trying dietary methods for many months. You can't just say it; you have to prove you've been on Weight Watchers or something (all of which cost boucoups $$).

You will then endure months of paperwork, interviews, psyche evaluations, training classes, etc. You will part with a lot of money before and after the surgery. You will get to "enjoy" a 10- to 30-day liquid fast before the surgery. Afterwards you will have gas pains that you think will kill you.

Once you are able to start eating "regular" food again, one bite of food that you "shouldn't" have can make you so sick you wish you could die. Going out to eat will never be fun again, because of the exhaustive list of things you have to avoid.

Beginning about 1 to 1.5 yrs after the surgery, you will have to be just as vigilant as before about what and how often and how much you eat. And for the rest of your life, any time you try a new food you will have to be prepared that it could make you ill.

And during all that, you will be reminded (rightfully so) by the staff and your family and friends that you could die, or be saddled with serious lifelong health problems, if you pursue this path. You will be reminded (rightfully so) almost daily that the path you are pursuing is no guarantee of success. At best you will end up losing 70-80% of your excess weight; at worst you could end up where you started. (I am the rarity in the bariatric surgery world, having has lost 100% of my excess weight; I attribute that to the fact that I follow a plant-centric rather than the meat- & dairy-centric diet prescribed by most bariatric surgeons).

And this is assuming everything goes "perfectly." If you end up with a serious complication (as I did, despite being very low risk), be prepared for missing even more weeks of work, $$thousands in hospital bills, painful tests, and lots of other fun things.

I'm sure there are people out there who've elected bariatric surgery because they thought it would be "easier" than dieting; but I guarantee you they are in for a very unpleasant surprise.

It was heartening to see that some of the posters on this thread "get" how strong the call of addiction is, and that food is, for some, an addiction. "Try to quit smoking in a smoking lounge" -- @Werner1950, that's a good analogy!

2. There's a common misconception that bariatric surgery is a "cure" for obesity. It is not. It is merely a tool. It also is a tool of (or should be) last resort.

For people with a food addiction, or an inability to sense fullness, bariatric surgery can be an incredibly valuable and effective tool because when you eat high fat, high sugar foods you will (if you are "lucky") experience immediate and terrible pain (called "dumping syndrome").

And for people who are so sick and in such physical or emotional pain that adopting a diet of any sort requires more energy than they can muster, it is a way to get the weight off fast enough to give them the energy & hope they need to adopt a healthy lifestyle.

Of course, only IF they are willing to do the work. For the rest of their lives.

Think of the "tool" of bariatric surgery like this. For someone who is addicted to heroin, methadone can be a life-saving tool to kick, or at least control, their habit. For someone who is addicted to alcohol, Antabuse can help them experience an immediate negative reaction that helps retrain their brain to associate alcohol with immediate pain. For someone who is addicted to food, bariatric surgery can serve to help them avoid addictive ("hyperpalatable" to use Dr. Kessler's term) foods long enough to break the addiction habit. In all 3 cases, the addiction is always lurking in the background, ready to roar into life if you start stoking its fire.

3. There really are people who have trouble sticking to the McDougall way, even though they believe in it wholeheartedly and try their darndest. I know because I am one. It's not a shortcoming of the diet; there is nothing more satisfying and healthy than Dr. McDougalls starch-based way of eating. It is by far the only diet I've ever had even a modicum of success at (Wt Watchers 7+ attempts, all fails; Nutrisystem, Jenny Craig, The Zone, Atkins, MediFast, Fuhrman, 7th Day Adventist... you name it I failed at it).

I'm sure there will be ignorant people on this board who tell me I just didn't try hard enough, but I am determined to ignore the haters. My family and doctor and therapist and I know all know the effort I put in and I'll draw consolation from that if needed.

The bottom line is, sometimes it's not "either/or." Sometimes it's "both." Some of Dr. McDougall's "100%-adherent" patients still need a statin to get their cholesterol into the ideal range, or a small amount of insulin to keep their diabetes at bay. Some chronic overeaters may need both the McDougall diet and bariatric surgery to adopt a healthy diet.

For me, gastric bypass has been the tool that has enabled me to finally adopt and stick to a whole-foods, no-oil, plant-centric diet for 2 years now. And that success has given me the confidence that I can go even further to improve my diet without falling into the "all-or-nothing" perfectionist trap that has tripped me up so many times. Not to mention given me the energy to implement those changes.
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