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Et Tu, BBC?

Yesterday, the BBC woke me up with this news: Only a tiny fraction of the people who could "benefit" from lapbands are having them installed by Britain's National Health Service (NHS). Apparently, it would save the government billions of pounds if everyone in a particular BMI range (not specified) would do their patriotic duty and get their digestive systems butchered in order to look more acceptable put themselves into a lower risk category for some diseases of old age. Did I mention that this was reported on the BBC with no critical analysis whatsoever?

I heard this on the radio and I thought "does anyone take this shit seriously?" Then I read the related article on the BBC website (thanks Charlotte) and noticed that this study was funded by "two firms involved in making equipment used in obesity surgery" and performed by the Office of Health Economics (?!). A privately funded study performed by a government agency? I haven't had a chance to read it yet, but this appears to be it.

There's precious little information in the article about the study itself; its methodology, its assumptions... However, the article does hint at some things:

  • First, it seems very likely that the study assumed obesity is always the cause of (not a side effect of) disability. In reality, that is not necessarily the case.
  • Secondly, it hints that obese people are automatically unable to work. We all know that most obese people are able and willing to work, and that most work full time and pay taxes. Most people who are eligible for the surgery are already fully productive citizens.
  • Third, it assumes that obese people always cost the health system extra money. In reality, we do not necessarily cost the health service more than other people do. In fact, we're probably less likely to overuse healthcare, since we tend to have unpleasant experiences with it.
  • Finally, and most strikingly, it appears to neglect the costs associated with weight loss surgery, other than the cost of the surgery itself. This is an elective surgery with a considerable risk of death that often has chronic, serious side effects that are expensive to treat. Even the "successful" surgeries almost always result in nutritional deficiencies that require regular doctor's visits to treat with injections; frankly, a similar level of care to insulin dependent diabetes. In more extreme cases, this surgery can take a healthy, productive person and give them health problems that make them unable to work. The study evidently assumes that the opposite is always the case.

If the NHS encouraged everyone who is eligible for this surgery to have it, then I suspect that it would cost them millions of pounds in treating side effects, redoing and undoing failed surgeries, and treating nutritional deficiencies. I suspect that, on average, people who have had weight loss surgery cost more to treat than BMI-matched people who haven't and that doing more of these surgeries would increase demands on the NHS. I suspect if you looked at every recipient of the surgery ten years later, then for every person who became more productive because of the surgery, there'd by one who became less productive.

The article notes "the government says the treatment should always be a 'last resort'," implying that the government is mistaken. In fact, the government is right. Suggesting that productive people with high BMIs undertake risky surgery with dangerous side effects because it may lower their risk of diseases that are unlikely to affect their productivity before retirement age is absurd. It would injure and kill people needlessly, it would not save the NHS any money, and who would it benefit? Manufacturers of lap bands. Oh, and bariatric surgeons, who are probably nodding in agreement with the article as I type.

The fat people who would "benefit?" Unfortunately, they'd benefit mostly from an improvement in social standing. They'd suffer less weight-based discrimination, at least while the effects of the surgery lasted (assuming it resulted in weight loss in the first place). Even though they might not be able to eat normally and they might suffer from inconvenient, painful and even life-threatening side effects, they might be happy with the results. It makes me incredibly sad that we think it's okay to hurt people so that others will stop mistreating them. It's adding injury to insult.

I plan to read the study within the few days to see if any of the issues I raised above were adequately addressed. I'd invite other BFBers to do the same.

Ten years, baby! | Fat & Health Rebuttal on Feministe

vesta44's picture
September 9th, 2010 | Link | From what I've heard of the

From what I've heard of the lapband, it may not be as dangerous as other WLS, but it still has its full share of complications and drawbacks. And people who aren't suited to the lapband are going to be recommended to have other versions of WLS that are more dangerous, deadly, and have much more severe complications.
The problem with those complications is that some of them don't show up until years after one has had the surgery. I had my VBG 13 years ago this month, and just last year found out that there are some small lesions on my brain that could be indicative of MS - just what I need to go along with all the other complications I'm already dealing with. And yes, the MS is a complication of WLS, they're just now admitting that - it's not normally diagnosed in people my age (I'll be 57 in November) with no family history of it.
Just what a government-funded health care plan needs, people that were fat and healthy and employed made ill and unemployable by their health care plan. Take people who are working and paying taxes to support the health care plan, alter their health so much that they can't work and pay taxes and have to be supported by said plan, all because you don't like looking at fat people. Makes perfect sense......NOT (but then, government intelligence is an oxymoron, and common sense has flown the government coop).

WLS - Sorry, not my preferred way of dying. *glares at doctor recommending it*

richie79's picture
September 9th, 2010 | Link | This 'debate' (if you can

This 'debate' (if you can refer to the constant one-sided promotion of WLS by pretty much every outlet irrespective of political standpoint as such) has been ongoing in the UK media for about three weeks now and what has struck me most has been the complete and utter lack of any mention of the risks, side-effects and long-term complications of WLS. People die from this, face a lifetime of malabsorption, adhesions, the possibility of osteopathic and neurological issues and yet the assertion (made by groups such as the NOF which claim to be independent but are in fact part-funded by the weight-loss / gastric surgery industry) that the cost of WLS is outweighed by the much higher long-term costs of treating 'obesity-related conditions' seems to be taken as read and entirely beyond challenge.

So rather than discussing whether a) WLS is a safe, effective and permanent method of obtaining a socially acceptable BMI and b) the much more fundamental issues of why it is now accepted that all fat people should strive toward being thin and whether it is should be the role of Govt to force / bully / 'encourage' them to do so, the discussion has skipped over these questions entirely and focused instead on whether fat people 'deserve' to have surgery, setting up yet another an artificial 'us vs them' dichotomy against the backdrop of a nation in the grip of austerity measures and generating some truly vicious commentary from a vox populi who seem to be perennially filled with outrage and vim at the mere knowledge that we still dare draw breath.

For what it's worth I've attempted to present a FA viewpoint on a number of forums, highlighting the dangers of WLS, questioning whether so many fat people would be in favour if they had a full appreciation of the risks involved, or if society could evolve to a point where fat was as accepted as many other forms of human diversity and difference. Just one was published, having been held in a BBC moderation queue until after the debate had closed. What on earth is the point in spending time putting together arguments more cogent than any that see the light of day, when the mass media with their complete hegemonic control over the opinions and pet hates of the sheeplike masses refuse to allow any alternate viewpoints through their wall of censorship?

Honestly, I feel thoroughly defeated by the whole thing. But most depressing are the huge numbers of fat people who've posted on message boards and comment threads almost begging to be given access to this surgery at any cost as their apparent last hope of a 'normal' life. This I take to mean one free from bullying, discrimination, victimisation by the media and all the other external factors which if we could just get our message out there people would realise there is an alternative approach to starvation, drastic mutilation and all the rest, but which at the moment we seem further from achieving than ever.

"What is right is not always popular and what is popular is not always right" - Albert Einstein

girlalive September 11th, 2010 | Link | My NHS endocrinologist...

I'm living in the UK (against my will) and I can't believe the treatment I'm getting from my endocrinologist. I have PCOS, so I'm fat. I went in a year ago and I was diagnosed with a large ovarian dermoid cyst, which has a 2% chance of turning into cancer. The doctor insisted on "just waiting" on it.

Then he started in on trying to talk me into gastric bypass or lap band surgery. I refused. I'm not a good candidate because of a history of mental illness.

A year later I went in and demanded to be put on the waiting list for surgery to get the big tumor that is pressing against my sciatic nerve removed. He didn't want to put me on the list because "It's risky to undergo surgery when you're so heavy." So surgery to remove a tumor is too risky, but surgery to remove my stomach is just fine? He's basically trying to punish me for being fat by making me live with a painful and potentially deadly tumor. (I insisted and yelled until he put me on the list for surgery, by the way.)

I kind of hope it ends up being cancerous just to I can sue him until he bleeds.

DeeLeigh's picture
September 30th, 2010 | Link | girlalive - if you're living

girlalive - if you're living in a country against your will, then I hope it's because you're under 18 and your parents moved the family there...?

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