Monday, February 2, 2015

If you've created a huge clusterfuck, commit more resources!

Further to Friday's post, Fairfax had an article in the SST (the second on this subject on Stuff in a week - here's the earlier one) which is apparently the latest instalment in the intensive lobbying efforts by bariatric surgeons to direct more taxpayers' money their way.

The spiel is that we have lots of fatties now, and they're so desperate they're travelling to Third-World countries to have bariatric (stomach-stapling) surgery, which puts them at risk of the foreseeable consequences of having your elective surgery in the Third World because it's so cheap.  Also, the costs of treating them for type-2 diabetes could be eliminated if we just spent a bit of money on publicly funding bariatric surgery for them. The grift is that the public funding would go to the surgeons carrying out stomach-stapling operations, who are the very people lobbying for this public funding.

Apparently, if you aren't keen on this grift, you're "fattist," an indulger in "prejudice against the obese." I guess the people pushing that bullshit haven't considered the analogy that this is like noticing that we have no end of people with fucked livers from sinking a couple of bottles of vodka a day, and berating the government for failing to fund enough liver transplants.  If that were the issue at hand, do you think we'd really be discussing why the government should fund more liver transplants, or would we instead be asking ourselves "Why the fuck are so many people sconning a couple of bottles of fucking vodka a day?" and doing something about that?

The vodka comparison is apt.  The most annoying thing about this is that "experts" have spent upwards of 40 years telling people they need to eat a low-fat, high-carb diet, with the predictable result that people keep getting fatter and type-2 diabetes is sky-rocketing.  Said experts' response to this is "Fuck, we need shitloads of stomach-stapling operations, right now!", thus doubling down on the expensive stupid.

One thing you notice about all these stories is that the surgery victims' type-2 diabetes symptoms disappear once their stomach capacity is 100 mls or less and they can't stuff themselves with carbs all day.  No fucking shit, Sherlock?  Here's a thought - maybe you could just recommend they stop stuffing themselves with carbs to start with, and skip the pointless, expensive waste of taxpayers' money.

NB: for anyone who believes to have found a correlation=causation error in the above paragraph, type-2 diabetes is an insulin-based disease.  Of the three food types, only one has a significant effect on insulin.  Anyone proposing that some dietary factor other than carbohydrate is implicated in type-2 diabetes has a major evidential hurdle to get over.

 A reader has supplied this this list of "some of the less well publicized effects of these procedures:" 

 Death – 1-2 % within 1 month of surgery, 5-13% at one year (depending on age and sex).  Somewhat higher than the chances of a morbidly obese person dying (about 0.5%).  Oh, and more likely to commit suicide than the general population.  (Information from US figures).

Malnutrition from the surgically enforced, very low-calorie, low-carbohydrate dietary intake.  Calorie intakes can average under 1,000 calories in the first year and after three years the average is still only 1,386 calories.  Adequate protein is needed and generally minerals and vitamins must be supplemented forever.  Even with supplementation, rapid neurological decline and aging are seen.  Common malnutrition problems include anemia, osteoporosis, loss of teeth, blindness and, in a reported 16% of cases, even neurological and brain damage.  Brain damage can be a result of beriberi, vitamin B1 (thiamin) deficiency.

And there’s the delightfully named Dumping Syndrome, which occurs as a result of “inappropriate eating”.  Basically, the body goes into shock when small, easily absorbed food particles rapidly dump into the digestive system. A cold clammy sweat, pallor, butterflies in the stomach and a pounding pulse may be followed by cramps and diarrhea.

Avoiding dumping syndrome can be done by eating protein first, making sure it comprises one-half of every meal. Snacking must be avoided along with all sources of simple sugar, including cookies, cakes, candy, sodas, ice cream and sorbet.

Finally, patients may lose significant weight but typically remain obese and start to regain weight.  And health indices like blood pressure, cholesterol rebound over the long-term, often to higher levels than they were prior to the weight loss.


The Veteran said...

PM ... final para ... do your mean that people should exercise personal responsibility over their dietary habits rather than expect Government (read the taxpayer) to pick up the pieces after having gorged themselves to near death?

Interesting proposition ... personal responsibility. Not loved by all in the body politik.

Psycho Milt said...

I wouldn't go that far. We're told from childhood by "experts" about the Food Pyramid and how most of what you eat should be carbs, and when we get fat the same "experts" tell us we need to eat fewer calories and exercise a lot, which has no effect other than to make you not only fat but also really-fucking-hungry all-the-fucking-time. So I think it's unfair to blame the people undergoing the surgery - if you don't know that what the experts are telling you is bullshit, how likely are you to ignore their advice?

Adolf Fiinkensein said...

'....if you don't know that what the experts are telling you is bullshit, how likely are you to ignore their advice? ....'

So true, Milt.

Do you remember a story in the media a few years a go about a Maori family up north who ate huge dollops of bacon and fried eggs every day?

Apparently their blood levels sugarlevelsand cholesterol did not go ballistic.

Somehow the story faded into oblivion. Must have been an anomaly which needed adjustment or something.

Noel said...

Given the last decades focus on obesity one had to wonder if this is not an unexpected reaction. Heading off overseas for a cheaper or only available alternative.

No longer is one "fat", larger people who in the past were not measured as obese have to feel guilty.

Recent research has shown that no diet is any better than another.

Interesting that we have taxpayer funded quit smoking initiatives but none for obesity.

Adolf Fiinkensein said...

Excellent call Noel

'Interesting that we have taxpayer funded quit smoking initiatives but none for obesity. '

Some slightly overwieght friends of mine frequently go to the local mall for lunch. They just look around and it makes them feel good about themselves.

Psycho Milt said...

The list of risk factors in the post update is eye-opening. It makes you wonder about the level of "informed consent" applying to this.

The Veteran said...

PM ... one might argue that 'informed consent' goes out the window when the person is faced with the societal pressures that go with being morbidly obese.