The Quest to be Slim: Is Surgery an Option?

Who hasn’t dreamed of losing weight without trying? Or eating all that you can and maintaining a perfect figure? Until recently, this seemed an impossible goal.

But medicine has caught up with the eternal quest for the perfect body. And in this new technological century, all things are possible.

Weight loss surgery, termed bariatric surgery to use its medical name, is more popular than ever before. But like any operation, there are risks involved.  Do these procedures work? And at what price?

Gifty Mane      Files  Health, Mental Health

Many folks want to look like fashion models, and dream that all it takes is a surgeon’s scalpel to get them to their desired goal. But doctors will tell you that weight reduction procedures are a last resort, usually reserved for those who have at least 60 pounds (28 kilos) to lose. Clinics will generally only use surgery to help patients with a body-mass index (BMI) of 35 or over.

Given how hazardous these procedures can be, the results can be dramatically awful.

Ann, 76, found that her obesity was a real handicap. Standing 5 foot 2 inches tall (1m 57), she weighed in at 200 pounds (91 kilos). A diabetic, she’d tried everything.

She turned to Slimband, an Ontario clinic specializing in gastroplasty. This procedure involves placing a small ring around the stomach, dividing it into two smaller compartments. In reducing the stomach’s size, the patient consumes less food. The patient’s metabolism is sped up and is less hungry.

Slimband’s aggressive marketing campaign promises rapid, effortless weight loss without dieting. Ads are jam-packed with wall-to-wall testimonials by smiling satisfied customers. Catchy slogans fill the airwaves and the web. The company has penetrated the Quebec market – 7% of its clientele come from this province.

Statistics tell us that 25% of Canada’s population is obese. We are one of the world’s fattest nations, just behind Great Britain and the United States. This has staggering health repercussions.

Given this national health crisis, many have tried to come up with workable solutions to get people to educe their weight. Montreal endocrinologist (gland specialist) Dr. Dominique Garrel recently dropped his regular practice to open a weight loss clinic.

Dr. Garrel offers a multi-disciplinary approach: “At this clinic, I work with a psychologist, a kinesiologist (exercise specialist) and a nutritionist We offer an intensive weekly follow-up program, to offer the most support,” he explains.

In Canada, public health authorities offer bariatric surgery as an option only to the most obese patients. To get the operation done for free there is a minimum 2-year waiting list. So for many, private clinics provide their only option.

Slimband will operate on you without delay, but at a cost of thousands of dollars.

Ann’s operation 4 years ago quickly became a nightmare. At first she lost lots of weight, as promised. But soon, she stopped losing weight and began to put on the pounds. She complains of a lack of follow-up from the company.

“They treated me shamefully! It’s a business,” she complains. “They lure you in, they seduce you. For someone with an eating disorder like me, they could’ve been nicer and treated me with a little more patience and dignity!”

Contrary to the impression jazzy ads may produce, gastroplasty isn’t the ideal solution for everyone. According to Dr. Nicolas Christou, bariatric surgeon, the procedure gained a great deal of popularity about 15 years ago. But it lost much of its luster starting in 2006, when it was observed to produce a number of negative side-effects.

“We noted that a lot of gastroplasty patients came back to have their rings removed,” Dr. Christou says. “Some were regaining weight, and some were experiencing pains. The problem is that if a patient doesn’t reduce their portions, the stomach can grow in size, and undigested food can accumulate in the esophagus, which will cause weight gain and pains.”

Dr. Christou sometimes recommends a vertical gastrectomy, which consists of removing part of the stomach. Another option he may suggest is gastric bypass surgery, in which the stomach is short-circuited. In all cases, an intensive medical follow-up is a must.

Both Dr. Garrel and Dr. Christou find the Slimband approach unethical. They find it unsettling that medical requirements take a back seat to improving one’s appearance. Inserting a stomach ring is seriously risky, requiring a rigorous medical follow-up, especially after surgery.

Ann confesses that she regrets having undergone the procedure, because it was costly and did not produce the desired result. “Slimband did help me,” she says. “But it cost me a lot of money, and I sacrificed my financial future. I lost weight, but I also put a lot of it back on.”

Attempts to contact Slimband for their views on gastroplasty proved futile. We hopefully await their reply.

Nonetheless Dr. Garrel defends gastroplasty as an effective weight-loss therapy – if well-managed and accompanied with a rigorous follow-up by a competent medical team. Without those qualifiers, gastroplasty poses grave health risks.

Dr. Christou never forgets to remind his patients that bariatric surgery is a major procedure. It should not be undertaken purely to improve one’s appearance, but for health reasons. As he says: “More than just losing weight, you’re regaining your health.”

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