Obesity(bariatric) surgery

Can you provide a link to your statistics that 2/3 of BMIs are innacurate Flick please.

I guess a doctor would look at the whole person. The BMI would be a statistical guideline for doctors
. NICE look at the big picture and this is a rather frightening scenario in which the number of people with Type 2 diabetes is going to rise very rapidly. You only have to look at the number of younger women who are seriously overweight - particularly in poorer areas. A % of overweight younger people will get Type 2 in early middle age and they will cost the NHS a fortune - drugs, staff, increased rate of other conditions such as heart disease and all the horrible specific effects of diabetes such as blindness and gangrene leading to amputation. With good care these patients could live for several decades after diagnosis. The cost of servicing these problems from the public purse will be astronomical. So NICE will have weighed up the risks of diabetes to the patient and the cost of treating it against the beneficial effects of bariatric surgery, the risks of bariatric surgery (all surgery has a % risk) and the cost of bariatric surgery.
Tegan I think dhal is a healthy food being made from lentils. Type 2 is on the rise in India as incomes rises.
Have you ever tried freshly made Indian sweets like julabees? (various spelling...)
We used to buy them in Walthamstow market 30 years ago - they put the sugar content of our cakes and pastries into the palest of shades. (well maybe not cup cakes)

Sorry*Aka*, if two thirds of the results are inaccurate it is no good as rule of thumb. If the result is that you are told that you are either overweight, when you or not, or like me told you are within the healthy body fat band when actually your body fat is heading for obese levels - and that will happen to two out of three people then that measurement should not be used.

There are many critical articles about it and it was never drawn up as a statistic to apply to individuals it was drawn up by an economist to measure populations where ON AVERAGE, the lower the population BMI was the poorer the country was.

It is like saying that because the average height of everybody in the country is, say, 5ft 6in anybody under 5ft 3in or over 5ft 9in has a height problem.

Most of the reason statistics get such a bad name is because people who do not understand them misuse them and BMI is a classic example of this.

That's a sweeping generalisation Flick to say that BMI doesn't count. As a general rule of thumb it's very useful.

BMI isn't a measure of fat (adipose tissue) it's a ratio between height and weight ie Body Mass Index. OK the higher your BMI the chances are the higher your body fat, but if you want an accurate measure of your % body fat then that's another issue altogether.

Rose is correct about BMI and very muscular people, and I think you'll find I mentioned athletes in my earlier post.

Has anyone tried the hypnotic virtual gastric band? I see that Paul McKenna has got in on the act. If it works, I'd prefer it to having to go under the knife.

I have heard that the 5:2 diet can help to alleviate and possibly get rid of type 2 diabetes.

The BMI measure has been found to be an ineffective way of measuring, as someone may have a high BMI but be very muscular and fit.

Very often the mind has to be in the right place before dieting can start; perhaps consideration could be given to clinics trying to help people to get themselves in the right mindset before they start trying to lose weight.

Right I am joining the GN diet group and aim to loose 5% of my weight to begin with and then another 5% etc until I am at my upper end weight of approx 11 st. I will do so by calorie counting as I think really this is much more realistic if this will be a lifetime change as otherwise it will all pile back on again. I will aim for approx 1400 cals a day.

Sorry to bore you all but I must do something!!!!

It's probably something else I'm thinking of, bags; it was the doctor who specialised in diabetes who mentioned it but it was a few years ago now. Whatever it was, it was very high in fat.

Sadly there seems to be a percentage of the population that believe they can eat anything they like and when they become obese the NHS will work their magic and make it go away. I have spoken to nurses working in bariatric medicine and their opinion is that it is better to fit a band than allow the patient to develop type2 diabetes. The cost of the operation is cheaper than medical care for the obese

BMIs don't count anyway. Two thirds of all BMI calculations are inaccurate. One third under estimate the individual's body fat and another third overestimate it.

I come in the first category. If I accepted the BMI figures I would be misled into thinking I had much less body fat than I actually do. Fortunately some years ago my body fat was measured using calipers and that showed that at several lbs below the 25% body fat BMI calculatione, my body fat level was higher than this. I work to the lower weight figure I was given then when watching my weight rather tyan the inaccurate BMI that could lull me into a sense of false security..

It has been suggested that waist/height ratios are a far better guide to an individual's probability of getting Type 2 diabetes than the BMI.

There are a number articles discussing the unreliability of BMI. This is one of them. www.medicalnewstoday.com/articles/265215.php

Why increase the use of this expensive and potentially dangerous major surgery when medical and nutritional experts have already said that drinks and processed foods are one the main reasons for obesity. Surely, part of the problem could be addressed by bringing in legislation to curb unhealthy ingredients in processed foods. It seems the government would rather burden the NHS than upset their friends in the food industry.

I thought dal was mainly lentils or split peas, tegan.

whitewave sorry, but at 5'7" and weighing 13st 4lbs your BMI is 29.1. As a reading of 30 and over is obese, I'm sorry, but you are very close to the limit. If you are only 5'6" then .......

Unless you are a world class athlete perhaps and carrying loads of muscle in which case BMIs don't count

Yes of course diet and exercise and therefore avoiding the need for the operation are the best things anyone can do. Surgery should be a last resort. Patients requesting the surgery on NHS have to undergo several tests including an endoscopy and are also required to have councelling prior to them agreeing to go ahead. I don't know if this applies to private medicine.
There is more than one method of surgery. My friend had a bypass not a balloon, this makes it virtually impossible to cheat. Not that she ever tried. She has dropped 6 dress sizes !!
I just don't see anyone with a weight problem 'letting rip food wise' as sue suggests in order to put themselves through a week of just liquids prior to the trauma of the actual surgery and baby food before you can even think about literally a couple of mouth fulls of food at a time for however long.

5ft 4in. You are well above average height whitewave so the 13st limit would not apply to you.

Tegan, you go to your GP now rather than your local authority, DH got a referral that way. If he had got a referral to the LA leisure centre his exercise activities would have been free. He only chose a subsidised referral to a private centre because it is convenient for home while the LA facilities are not.

I came in on this report on radio 4 this morning and what alarmed me was that the professor was asked what he would consider obese and a possible candidate for the operation in an average height woman and man the answer was 13 st for a woman and 17st for a man HELP!!! I am 13st 4lb and am sooooo not having the operation ---- dieting in full steam today.

But I am sure that 13st seems excessively too little I am about 5ft 6 or 7ins. Does anyone know what the average height of a woman is?

Local authorities [or it may have been the NHS] used to offer free membership at gyms for people that needed to loose weight. Probably stopped now due to cost cutting. The gym I go to has machines that you can use even if you have a mobility problem or are very overweight; if places like that were available for anyone to use it would probably save the NHS a fortune in the long term.

What a good example of supported weight loss, you have described FlicketyB.
Best wishes for you and your DH get to the goal you have set. X

Yes, but....

There have been a number of stories about people, who having had the surgery, find ways of circumventing the purpose of the balloon. One man was liquidizing all the high fat high sugar foods he ate before, like kebabs and doughnuts and despite the by pass was as fat as ever. And he is not the only person I have read about who has acted in a similar way. It is pointless to give this operation to someone who is not committed to making the necessary changes in their life style to maintain their weight loss and lead a healthy life

As several posters have already pointed out, surgery, any surgery, has its risks and bariatric surgery is major surgery and has higher risks, not only of side effects, but of permanently damaging your health.

I do not think anyone should be offered bariatric surgery who is not prepared to address the causes of their obesity and be willing to change these habits or has been diagnosed with a problem with obesity despite a good diet and exercise pattern. In which case they should be able to follow a diet and exercise programme.

I speak with some feeling DH is obese and has mild diabetes. Recently he has faced up to the problem and we have devised an eating pattern that is helping him lose weight. His GP has also given him a referral to a local sports centre, in his case a private one, for a three month course of monitored exercise. The centre is close to home and has a swimming pool, he has always enjoyed swimming but our Local Authority Leisure Centre is too far away to use conveniently, he also has a personalised exercise programme. In two months he has lost weight and is visibly fitter and healthier. At the end of the day this is by far the best and safest way to lose weight.

What is needed is not quick fix operations that don't address the cause of the problem but support to help people find the motivation to make the necessary changes in their lives and support them while they make them.

I feel for anyone who is facing such a overwhelming operation. I have only seen TV programmes about Bariatric surgery. Diets ( in the scientific sense ) are often just seen as a ' beauty, fad, money making ' topic. I feel that people who asks for support in losing weight/ changing lifestyle are just told to eat less, exercise more. I think that there is evidence to show that in many cases it's not just that easy. More support, investigation should be given at an earlier stage. X

telegraph today: www.telegraph.co.uk/news/matt/

Professor Mark Baker, director of the Centre for Clinical Practice at Nice, defended guidelines which recommended bariatric surgery to those with a BMI of 30 or above if they also had type 2 diabetes.

"Updated evidence suggests people who are obese and have been recently diagnosed with type 2 diabetes may benefit from weight loss surgery.

More than half of people who undergo surgery have more control over their diabetes following surgery and are less likely to have diabetes related illness; in some cases surgery can even reverse the diagnosis."

– PROFESSOR MARK BAKER

I hadn't realised about the problem with excess skin until I started watching repeats of Embarrassing Bodies. We just need to be more health conscious as a nation as the NHS just can't afford it. Surely you don't have to be fat to have diabetes [or is Type 2 more due to being overweight than Type 1?]. Then again I was told once that diabetes was prevalent in Asian communities; they weren't overweight but they ate a lot of 'dhal' [sp] which is presume is very fatty [?].

But it can JaneA - obviously not in every case.

My thoughts too, Sue.
This is being reported as a way of controlling the incidence of type 2 diabetes - but if, after surgery, people continue to eat a high-carb diet with lots of NMEs (non-milk extrinsic sugars), I don't see how the diabetes will be prevented or reversed.