Real Options Exist for Treating Obesity – Let’s Not Give Up So Soon
Is asking patients to lose weight a ‘sadistic’ act on the part of the doctor? Sounds extreme? In the current issue of Canadian Family Physician, associate scientific editor Dr. Roger Ladouceur makes just this argument.
“Why do we repeat, ‘You should lose weight’? What’s with that? Somewhat sadistic, don’t you think? Do we do this as a way of shifting the guilt and transferring the responsibility of the therapeutic failure?”
In the same issue Dr. Jana Havrankova of Quebec wrote, “There is very little evidence that the treatment of obesity works.”
She goes on to argue that prevention efforts in early childhood are the best way to combat obesity later in life.
It may be that Canadian doctors are becoming frustrated with conventional weight loss methods, such as medically supervised diets. It has been shown time and again that dieting is not the way to achieve long term weight loss. It shouldn’t surprise Canadian physicians when their overweight patients fail to keep extra weight off this way.
Giving up on overweight patients who are struggling to control their weight is not the way to go. 59 per cent of Canadian adults are either overweight or obese; unless trends change, by 2026 the proportion will reach 70 per cent, according to estimates presented in March at a federal-provincial summit on obesity.
“If there were ‘simple’ and effective ways to treat obese patients,” Havrankova wrote, “we would know it.”
Canadian doctors clearly haven’t explored all the options that exist for weight loss.
However, a counterargument by Dr. Dominique Garrel of the Universite de Montreal in Quebec, argues that obesity surgery, “is very popular and increasingly simple and safe,” given the consequences of carrying extra weight.
Weight loss surgery has been shown to help patients lose weight for the long term, which helps to improve the patient’s quality of life, something overlooked by many doctors. Quality of life implies a number of things about a person’s standard of living (accommodation, physical ability, etc.)
The two most popular weight loss procedures today are the Gastric Bypass procedure and Adjustable Gastric Banding. Gastric Bypass is the more invasive of the two – it involves the re-routing of the intestines and can cause nutritional deficiencies that last for the rest of the patient’s life. A Gastric Bypass operation is not reversible.
Adjustable Gastric Banding, on the other hand, is completely reversible, and does not require the cutting or stapling of the stomach. It involves the surgical placement of a silicone band around the upper part of the stomach. The band creates a second stomach pouch, or stoma. This allows the patient to feel full faster, and slows down digestion so the patient isn’t hungry between meals.
Canadian doctors need to inform themselves about surgical weight loss procedures so they can better assist their obese patients. Only then will we be able to make progress in the fight against Canada’s obesity epidemic.