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Mache Seibel, MD

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Governor Christie's Lap Band May Be a Band-Aid

Posted: 06/03/2013 1:10 pm

A number of health issues have experienced increased awareness over the past decades because public figures were willing to talk publicly about their health conditions or treatments. For example, Ronald Reagan had a colonoscopy and make it much more public the need to investigate the possibility of colon cancer. Rudolph Giuliani had prostate cancer and discussed not only his problem, but also his treatment. And most recently, New Jersey Governor Chris Christie has had a lap-band operation to help control his weight.

I commend the governor for realizing that obesity is a potential health problem and committing to take a giant step in trying to change his health risk by lowering his weight surgically. I wish him well.

But what can we learn from his recent lap-band operation that may be helpful to the one-third of the United States who are overweight and the additional one-third of the country who are obese?

The first is the reality that being overweight is a major health hazard -- potentially the greatest one facing the country today. According to the Centers for Disease Control (CDC), being overweight or obese increases risks for coronary heart disease; Type 2 diabetes; uterine, breast and colon cancers; high blood pressure; high cholesterol; stroke; liver and gallbladder disease; sleep apnea; osteoarthritis and even infertility.

In addition, the CDC also estimates that one in three adults aged 20 years or older has prediabetes; that means their blood sugar is not yet high enough to be diabetic, but it is elevated above normal. That is about 79 million people. You can learn more about this below in the music video I created called "Diabetes."

The second point to make about Governor Christie's surgery is the fact that it is far from a given it will work. I have taken care of many patients over the past years for whom the operation is a failure. Here is why; the operation places an adjustable, inflatable ring around the upper one-third of the stomach to shrink its size. But many of my patients have learned that if they eat lots of liquid calories such as ice cream sodas, or eat calories from candy or other soft desserts, the band doesn't stop that from passing through. They literally eat their way through it.

This brings me to my third and final point: The lap band is really only a band-aid unless the person has come to grips with his or herself that to change one's weight, one has to change one's lifestyle. You have to change your habits.

As a child, I was front-page news in my county paper at age 2-and-a-half as the fattest kid in the county. The heading on the paper read "Mighty Might: The Fattest Kid in Galveston County." My current ideal weight isn't from surgery. It came from a desire to change my appearance and my risk for disease.

Weight loss is a very personal thing. Being overweight can cause us to feel poorly. It can lower self-esteem. It can lead to depression. It definitely does increase our risk for disease. But people are overweight for many different reasons.

Some are food-insecure and don't have access to good, whole foods that are high in nutrition. They eat what is available, and what is available is inexpensive junk food.

Some are overweight because they are emotional eaters. They are gratified by food and it provides comfort. That is a behavior problem that can be changed with behavioral therapy and new habits.

Some are overweight because it is socially-acceptable norm in their communities. This is major challenge because it requires educating entire communities about risks and benefits.

Some are overweight because they are sedentary and get no exercise. Added to that they eat high-sugar-content foods that drive up their blood sugar, which causes them to release insulin, which then drops their blood sugar and causes them to get hungry again in just a few hours.

Some people gain weight due to poor sleep. Too little sleep changes the hormones in your body so that you are less likely to get full and more likely to feel hungry.

Some are depressed. According to reports, obese people are 25 percent more likely to be depressed. People who are depressed often eat more and people who are overweight are more likely to be depressed. It's a vicious cycle.

Some just don't use portion control. The eat too fast and don't give their stomach enough time to tell their brain they are full and then they keep eating even after they are full until they feel stuffed.

Many don't realize they are overweight. When told by their doctor that they are overweight, they either don't believe it or deny it.

My point is this: There are a lot of reasons people are fat, and a lap band doesn't even begin to address all the issues. To really lose weight and keep it off, people have to first be ready to be different. They have to want to lose weight -- not just hope they can go in for a procedure and suddenly they are on the way to thin.

Second, you have to exercise regularly. Even standing while you talk on the phone or while you are having a meeting or parking your car further from the entrance of the store can help.

Finally, you have to change the food you eat. Avoid sodas and sweetened drinks, fast food, junk food, restaurant food and processed food (food that comes in a can, box or package). Instead, eat whole foods, lots of fresh fruits and vegetables, and drink at least eight glasses of water daily with one glass full before each meal. Don't go back for seconds. Keep desserts no larger than a deck of cards.

What is the motivation for the necessary changes a person has to make?

That depends. It could be your future health. But lots of people doubt they will lose their health until they have lost it.

Maybe it just realizing that if you want to be around for your family and to see your children grow up and be able to share in the joy the future brings, weight loss has to happen. One thing is clear; weight loss is doable if and when a person has come to the conclusion that they want to lose weight, are willing to make changes and change habits. Until that happens and a person includes regular exercise and eats primarily whole health foods that they prepare most of the time, a lap band is just a band-aid.



I have a wonderful article with a video that explains all the various weight loss surgeries in My Menopause Magazine Issue 2. It is in the Apple Newsstand formatted for the iPad. Download the free App and subscribe and in the popup for subscribers, type in BONUScode and get the issue free. It is a very clear explanation.

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For more by Mache Seibel, M.D., click here.

For more on weight loss, click here.

 

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