From Edible Geography: Photo of a lap-band and how it fits around the stomach.
Long time reader Michelle sent this one in. Consider it presented with absolutely no comment:
At 202 pounds, Steffany Sears knew she was fat, but not fat enough to qualify for traditional weight-loss surgery.
Desperate for help, the Gold Bar, Wash., woman did what seemed the only logical thing: She gorged herself on chips and cookies, pizza and fried chicken so she’d gain at least eight pounds more.
“I would have eaten myself stupid,” recalled Sears, 34, who was turned down by her insurance company for the $20,000 procedure. “I know friends who would have done that, too.”
In the end, she actually qualified to participate in a clinical trial that led the federal Food and Drug Administration this spring to lower the bar for obesity in people eligible for one form of weight-loss surgery, Allergan’s Lap-Band stomach-shrinking device. Because she had a body mass index, or BMI, of between 30 and 35, the target range of the new rule, she even got the treatment for free, instead of having to take out a second mortgage on her house.
Today, at 5-foot-6, she weighs 143 pounds. “I felt like I’d won the lottery, really, with my life,” said Sears, a native of England.
But Sears’ experience highlights what dieters and doctors alike say is a growing dilemma. Spurred by strict insurance policies that limit surgery to high BMIs of 35 or 40, some obese people are actually striving to gain weight — in order to lose it.
Web sites devoted to weight-loss surgery are full of advice and anecdotes from would-be losers who claim they ate piles of bananas, chowed down on burgers and curly fries or swilled gallons of water to nudge the scale to the correct heights.
“That happens all the time,” said Dr. Robert Michaelson of Northwest Weight Loss Surgery in Everett, Wash., who was a clinical investigator for the FDA trial. “I’ve seen people come in with ankle weights on.”
Sometimes, it works. Elizabeth Marks, 32, of San Diego, Calif., was turned down for surgery once by her insurance company for being less than 100 pounds overweight, but accepted after she gained more.
“I just had two weeks of eating all the junk I could,” Mark said.
In general, a person who is 5-foot-6 and weighs 220 pounds has a BMI of 35. At 250, the BMI climbs to 40.
Weight-loss doctors definitely discourage patients from gaining more and instead urge them to pursue non-surgical options, or to find other ways to pay for the surgery. One good reason? Some insurers regard the practice as fraud.
“I tell them go home. You don’t qualify,” said Dr. Namir Katkhouda, a bariatric surgeon at the University of Southern California who has performed 2,000 procedures. “They come back six months later and their problems are much worse.”
Actually, I take that back. I have two thoughts:
1) Is THIS why the FDA considered altering the weight requirement a while back? To prevent people from doing this?
2) Here’s hoping “two weeks of eating all the junk I could” isn’t enough time to cultivate an emotional eating habit in someone.
Thoughts?
30 comments
This pattern of abuse on our bodies have to stop! People will gain weight for this “solution” to their PHYSICAL obesity, but they are still MENTALLY obese. The problem starts in the mind, and if you don’t change those unhealthy cravings you can lapband your brain for all I care…you’ll STILL BE UNHEALTHY.
Has* darn mobile internet. Lol
I have a sister who at one point considered this surgery. She actually was over 250 at 5′ 3″ so I think she technically could qualify. I am so thankful that instead she is choosing to workout and eat healthy. I can only imagine how much better she will feel, how much healthier once she gets the weight off. I won’t say it’s more valuable to do it the hard way…I know the morbidly obese may need emergency surgery. But if you’re NOT morbidly obese, it’s sad that as a culture we would rather get worse to get better. We must not realize that weight loss IS possible with some consistent work. I lost 35 lbs, going from overweight to fit, and have maintained for 2 years. I know it’s hard, it’s a lifestyle change. I’m glad my sister is dedicating her life to change how she thinks of food instead of waiting until she can barely walk to get surgery. Note: I’m not judging those who get surgery, just applauding those who take the difficult route.
Congratulations on your weightloss. And I hope your sister continues on her journey so that she can show others it can be done. Hard work, consistency, and dedication are the keys to accomplishing everything in life. It shouldn’t be any different when it comes to your health.
Correction, technically have been maintaining for a year. Have been focused on my weight for 2 years. It’s a lifestyle change that a band can’t make for you!
When a person is desparate to lose weight, they will go to drastic measures; this I do understand and I empathize with these people. We know it is not smart eat loads of junk food to qualify for a life changing high risk surgery that will cut you stomach to the size of a grape, only to eat a fist worth of food in hope that you don’t vomit if you somehow eat more. I considered the lap band at one point in time; but I’m glad my insurance did not cover it because it was not the best option for me. Some people are good candidates for the weight loss surgery I believe. Most of us are able bodied enough to put one foot in front of the other and make some moves. So, with that said, for those of us who do not believe in the weight loss surgery, we should encourage those who want to do the surgery (but really don’t need it) by making sure we are making healther choices in our own lives so they can see that making good choices will be rewarding for our bodies and the rest of our lives.
i get that, but 202lbs?? There are ppl out there that really need this, they can’t walk, they can’t so anything in some cases. At the end of the day the risk is too great for what 40lbs possibly? maybe 55? 20K when she probably could have lost it for not even 10% of that with a gym membership and a couple of meal plans. So what happens when she gets thin, then she goes back to eating how she wants. These things are perm fixes to be healthy. The only think that i saw from researching this is that, once you get the surgery your risk for type two diabetes is non-exsistant if you suffer from it and I think that has a lot to do with that wierd fat web crap you get in your stomach as you get older but these people would quickly waste this by going back to their old ways, never working out, and still not understanding the art of eating right.
I agree 100%. I’m 200 lbs now (down from 215). The only way I could get surgey if I gained about 50-100lbs. I’d rather work on losing the weight. Surgery is a quick fix not a resolution. It makes you lose the weight but not the habits that got you there. And this surgery comes with its on set of issues depending on your health.
I’m torn on this article. Intellectually, it is stupid to GAIN weight to qualify for a surgery, but I would have done the same as the first woman mentioned in the article. Either gain eight pounds and IMPROVE my health for FREE or mortgage my house and possibly WORSEN my financial future to improve my health … it’s a no brainer to me.
But honestly, these folks hovering at the 200 lb mark should have just buckled down, bought some running shoes and cleaned up their diet. At most heights, 200 lbs is certainly in the obese range, but it is not impossibly large. Most people at average height only need to loose 40-50 lbs to be in a healthy BMI. Loosing that can be done in 12-18 months by sticking to a sensible low carb diet and walking for 30-60 minutes a day.
Mmmm why did i get excited to see my name in this. Hi Michelle here, my friends are I are still commenting on this via FB. It’s pretty sad basically…god forbid they get this surgery on the tax payers dollar. at 202 lbs, she could have considered going to the gym …these surgeries have risk, and when did eating a veggie pose a risk? It’s pathetic and I’m still just disgusted by it.
I think it’s ridiculous that people will gain weight to be able to qualify for a surgery instead of learning to eat properly and work out. They are further endangering their health. You need to change all of you in order to be a success story not just take off the pounds. I am sure this also contributes to the fact that there is a high percentage of people that regain weight after surgery since they have not properly learned to care for their body. On a positive note I love your blog discovered it a few weeks ago. Keep up the great blogging!!!!
Just ridiculous! I weigh 214 lbs. I can’t imagine gaining weight on purpose to get weight loss surgery. I have been running and working out since July. I love the feeling that I’m getting healthy and strong – losing weight along the way. Too bad they are missing out on the personal satisfaction of losing weight on their own.
This is crazy! As much as I would love a quick weight loss solution I can not imagine doing this too myself. I know some patients who use bariatric surgery, but those gluttons who are gorging themselves should be a shame. In my opinion, some people choose bariatric surgery not because they can’t lose the weight, but because they choose not to let go of the habits that got them there. People think that once they get these procedures done they’re cured, but that’s so far from the truth. There is no gurantee that you’re going to be skinny or that your issues will be resolved.On this episode of True Life, this young guy had a gastric bypass. He went to a restaurant ate about five different entrees, went to the bathroom to vomit, and out and ate some more. My advice: solve your food addiction first before undergoing these procedures.
Wow. When did the influx of judgmental commenters happen? There’s a TON of that going on here. @ Tremilla – “those gluttons who are gorging themselves should be a shame.” Seriously though? Those gluttons? Did people mistake this for a fat-shaming blog? Did some people lose weight and are now itching to dehumanize the overweight/obese like they were? Newsflash: fat is fat. We all have it. If you zoom in on the fat cells of an overweight or obese person, it’s going to look EXACTLY THE SAME as the fat cells on your own body. Some of us have more/larger fat cells than others. Sometimes, this creates unhealthy physical conditions. And in NO WHERE of that circumstance does that person’s humanity disappear. Okay? Many of the comments thus far are appalling. It doesn’t kill anyone to display empathy.
On to the article – I would have gained 8 pounds for free surgery as well. And while I agree that it’s healthier and more rational for people who aren’t morbidly obese to lose weight naturally, in the end it is always going to be that person’s choice to make. If they get surgery and lose weight, only to gain it all back because their eating habits didn’t change, they will have to realize for themselves what is causing them to overeat and they will have to find the motivation within themselves to take action about it. Sitting here from afar and pointing fingers, telling them that they need to move their lazy fat behinds and eat less instead of taking shortcuts? REALLY ISN’T GOING TO HELP THEM. Chances are they’ve been fat-shamed their entire lives, and it’s been proven over and over again that not only does fat shaming not work, it tends to exacerbate the problem because the victim will eat to soothe the pain or develop an eating disorder in their struggle to just be respected as a human being, regardless of their size. Maybe instead of pointing fingers, we should be encouraging a more comprehensive support system for those who get the survey. Maybe instead of name calling, we should be leading by example and being supportive. Change starts with us, and if you’re not overweight but know someone who is and is struggling, nothing is stopping you from asking them to go out with you for some physically rigorous entertainment, like DDR, or organizing a healthy potluck dinner, or taking one of a number of actions Erika has written about on this very blog.
Maybe some people just need a hug.
**meant to say “those who get the surgery.
Dehumanized??? LOL. Now that’s a new one. I guess after you read the line about gorging you didn’t care to read anything else that I wrote. Other then that comment, what else about my comment was negative? Nothing! And for your information I’m still overweight. I can empathize with some weight loss struggles but not with this one. I’ve never been that size or don’t know anyone (personally) who has. Like I said in my previous comment they should try to resolve the underlying issue first before considering surgery. And BTW have you noticed they’re overeating to qualify for surgery. Isn’t that the reason why some (not all) are in their current condition?
What kind of logic is “because I had an opinion about your word choice, I must not have read anything else in the comment?” I seriously do not get the connection. I read the entire comment. I also included that line as one example of the number of judgmental comments and attitudes on this post. If you were trying to be helpful to people who are in a similar boat to the ones mentioned in the article, I think you went about it in a really ridiculous manner. Did you read MY entire comment? Because my whole point was that it’s usually ineffective to help people by demeaning and disrespecting them. Calling someone a “fat glutton” because they struggle with weight issue IS dehumanizing. That’s not hyperbolic. If you claim to understand the struggle, why would you call them names? That woman who eats to console her inner pain may have been sexually abused (as many with eating disorders are). That child may have grown up with obese parents who never taught them anything different, and is now an obese adult trying to break the cycle.
But if you seriously think calling obese people “fat gluttons” is healthy and encouraging, you’re more than entitled to that opinion. I’ll stand by my opinion that people struggling with weight need compassion and support.
Intentionally letting this play out…. but I’m going to co-sign the following:
“I’ll stand by my opinion that people struggling with weight need compassion and support.”
It’s not about being a “fat glutton,” it’s about understanding why you got to where you are (to the point where you are unhappy), and getting away from that.. Surgery or not.
Just clear this up I did not call anyone fat. That word was not used in either of my comments. And honestly my comment wasn’t meant to encourage anyone. I just wanted to state my opinion on the matter. I stand by what I said.
I sat thinking about this debate between you & I. I’ll stop being insensitive for the moment and give you a genuine response. I’m 5’2″ and 198lbs (was 215). Compared to the woman in the article she is actually smaller than me. Now I wear this weight well. People are shocked when I tell them the #. That being said that’s my main reason for finding this idea crazy! With her being smaller than me and considering bariatric is something I can’t not comprehend. Throughout my struggle have I considered lipo? Yes. Diet pills? Of course! What has stopped me? Me! I know why I’m overweight and what has to be done to get fit. It’s not that I have no compassion or cannot be supportive. I can not support individuals gaining weight for weight loss surgery. And no I don’t know her reasons for choosing to do so and neither do you (the article does not state that fact). I only know my reasons for being against it. I really didn’t forsee my comment bringing on such an outburst. Could i have dissected your comments about how you came at me?Yes.But I’m not the type of person to take everything to heart. Youre entitled to your opinion as am i. I stand by my opinion and you can stand by yours. People agree and disagree every day. It’s about of life. Arguing a point will let the other person see where you’re coming from but it won’t change how they feel.
*bariatric surgery, *apart of life
Wow. So much judgment going on here. If you are one of those people who ‘never have and never would consider’ weight-loss surgery, chances are you’re not educated on it. People who have wls are counseled on what they need to do in order to lose the weight. It is repeated often, to candidates, that wls is NOT a magic pill, easy way out or shortcut. With the surgery, one STILL has to learn, develop and maintain healthy eating habits and a regular exercise program…..or else (they are warned) the weight, along with a slew of other problems, are likely to come back. Gaining 8lbs to qualify for surgery is not a big deal, in my opinion; esecially when one thinks of the alternative (financial) decision this woman was faced with. You (the collective) don’t know what people’s motivations are to have ‘wls’ and for many people, it is their last resort. Those of you who are struggling or have struggled with losing a great amount of weight know that (doing so) is not as simple as ‘put the food down, put on your running shoes and get off the couch.’ That’s like telling a person, who is unhappy, being mistreated, used or abused etc. but still deeply in love, to just get up, walk out the door and leave their spouse/significant other behind and don’t look back. I’m sure every commenter on here has been in that situation….and remained ‘stuck’ in it much longer than they should’ve.
Actually I started my journey at 264 pounds and it is as simple as track your food and move. I am now 220.These simple things can be challenging and are a battle daily but I think it is ridiculous that this person put on weight on purpose just to have surgery. I think she could have done it on her own considering she did not weight that much and I doubt that this was her last resort.
Maybe I am judgmental but I don’t agree with this method. Have I ever wished that I could just have a procedure or take a pill that would make it all go away? Yes!!! I am the same weight as this woman and shorter so I probably qualify. What stops me from going there is that I know that I have what it takes to reach my goal. I don’t want a quick fix. I want a lifestyle change.It starts and ends with me. With some hard work and
dedication I will get there. Can’t say that I know why people agree to this method. No I do not know their reasons for it. All I know is that I’m against it.
Has anyone stopped to think that, regardless of our opinion of the efficacy of weight loss surgery, that the minimum weight to qualify for it is arbitrary anyway (especially as evidenced by the fact that the article states that the bar for qualifying has been lowered)? Who is to say that one woman at 202 lbs isn’t as much in need of the surgery as if she were the full 210? And, don’t we all know that if she’s so desperate for the surgery – because she feels unable to make the lifestyle changes necessary to lose weight without it – that eventually she WILL qualify anyway because she will likely continue to gain weight?
I’ve considered and dismissed the idea of weight loss surgery for myself even after watching EVERY person I know whose had it keep the weight off and thrive. Believe me, I’m with most of you – it still does not seem like a good permanent solution and I can’t imagine taking that physical risk. But that we or I believe that doesn’t change the fact of the matter for many of the people who feel that they DO need it, choose to have it done, lose the weight they need to, and save their lives in the process.
Think about it. Consider that the insurance/medical community is in essence nickel-and-diming (ounce-and-pounding?) patients instead of doing enough to make “the hard way” more appealing than “the quick way.”
“Consider that the insurance/medical community is in essence nickel-and-diming (ounce-and-pounding?) patients instead of doing enough to make “the hard way” more appealing than “the quick way.””
*whistles*
This reminds me of a friend who is obese and was trying to get on the television show the Biggest Loser. He actually ate a whole sheet cake in one sitting and a “ton” of other junk food to gain weight to have more of a chance to get on the show.
i too say wow what assumptions have been made about overweight people and how they got there, omg. i didnt have wls but i have learned alot about it. one of the problems is it is referred to as “the easy way” by people who have not had wls. it has its own risks and diets that are not easy. see that from the regains. it’s a reroute of your inside body. is that easy? well maybe easier than some “other” ways to lose weight. oh wait, those “other” ways haven’t worked…sure if i ate 800 cals a day my body would be skinny. wls changes your hunger hormone so that you don’t have to fight the same things the same way as well as some immediate effect on diabetes. if my body didn’t have whatever issues it has, then maybe i wouldn’t have eaten so much ever, huh…guess your bodies don’t have any issues. the one thing that can be said about wls pretty consistently is that it is much much quicker than non-wls ways of losing weight. i am jealous of that. and, nowadays insurance pays for the loose skin to be removed alot of the time, and who’s going to pay for mine if i ever lose my stomach even with lipo????
“wls changes your hunger hormone so that you don’t have to fight the same things the same way as well as some immediate effect on diabetes.”
The “immediate effect on diabetes” comes from the physical restriction in not being able to eat as much sugar/blood sugar raising foods.
WLS doesn’t actually change your hunger hormone, it changes your physical capabilities. THAT forces the body to adapt. I don’t know how you adapt to the malnutrition, but hey. YOLO.
I see the information out there still hasn’t become clearer. That’s not good.
I just want to say to Erika that I love what you do and how you do it. Thank you for your blog and for the discussions it generates. Obviously people have strong opinions on these subjects and discussions are needed.
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