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Is SEO Hiding the Truth About Lap Bands?

Imagine that you're thinking about getting a lap band. Where would you go to get information about the side effects and the long term prognosis? Of course, you'd ask your doctors for advice. However, GPs might not be well informed and baratric specialists might be biased. It would probably be best to go to a university library and ask a medical librarian for help finding relevant journal articles. However, I think it's fair to say that most lap band candidates would research the procedure using Google.

How do people use Google? A study found that a third of users will only click the first link that comes up, another third will click within the first five links, and almost no one checks the second page of results or beyond. Because of this, Search Engine Optimization (SEO), which attempts to place sites at the top of search results, has become an important marketing tool.

Squeegeelicious, a BFB member, tried using a few search terms that a lap band candidate might employ to search the web for information on lap band risks, side effects and long term effectiveness using Google: "lap band surgery," "lap band side effects," and ""lap band long term." Here's a summary of her forum post (accessible to BFB members) on the topic:

Search Phrase: lap band surgery

Three paid slots came up at the start of the search, all trying to sell me the surgery. The top ten results included the Allergan home page and seven marketing sites for weight loss surgeons and industry organizations. The Wikipedia entry on the lapband, which lists risks and side effects but doesn't explain them or discuss how common they are (and is probably policed by Allergen and bariatric surgeons), was in the top five. The Wikipedia entry also fails to mention how common it is for lap band recipients to regain the weight they lost. The tenth site was Lap-Band Surgery talk, apparently the largest Lap-Band forum on the web. It's a bit more of a wild card, because it allows users to post about their experiences. A positive news article on the lap band also appeared on the first page.

Search Phrase: lap band side effects

Again, there were paid results at the top. Most of the results on the first page were industry sites - either overt or not - that minimized the side effects and blamed the patients for problems resulting from the surgery. The most authoritative-sounding results in the top ten were Allergen's lap band page and the UC San Diego Center for the Treatment of Obesity, which lists risks and side effects but does not explain them or discuss the prevalence. The UCSD page follows quickly with the 'risks' of being obese. There were also a few poorly maintained forums and blogs. The risk of weight regain was seldom mentioned, and when it was, patients were blamed. Rounding out the first page of results and providing the only real dissenting voice was a 2003 BFB article. None of the hits above mentioned the effects of the surgery after six months except in the vaguest of terms.

Search Phrase: lap band long term

The first page included (again) the Wikipedia lap band article and an Allergan page that cites a three year study with 299 subjects. The Allergan article does list all reported side effects, and a few I hadn’t heard of before. A second Allergen page lists the effects that one might expect in the first weeks after implantation. Not exactly long term, but it provides a link to ‘6 months & beyond.’ Clicking on that link, it’s really just fluff about adjusting to your new thinner body and diet. Then there is a link for Google news, with 14 results. To sum it up, there were 12 positive articles, one reserved and questioning article about the FDA’s approval of the BMI lowering, and one result about banking.

A few other notes

I checked to see how far down I would have to go before finding a link to a negative review of the Lap-Band. For the ‘lap band’ search, the 19th result was an LA times article about a wrongful death suit connected to the surgery. It is decidedly anti-Lap-Band. For the search ‘lap band side effects,’ the last result on the second page is an article with stories of the suffering that people have gone through with the Lap-Band. For the search ‘lap band long term,’ there is a link to the same BFB article mentioned earlier at result 58, then a Women's E-news article that criticizes the FDA's move to lower the BMI recommendations and cites long-term European studies buried at result 74. It’s a good article, and points out the conflicts of interest of the panel that made the recommendation to the FDA.

While the majority of the sites gave accurate information on risks and side effects, most did not explain them or give information on their prevalence. When they did, they cited short term studies. When voices outside of funded sites surfaced, they were overwhelmingly positive about the surgery, and the few questioners were nearly drowned out. The one long term study that I did find was overwhelmingly positive towards Lap-Band, which made sense when I dug a little deeper and found that the first author of the study helped develop the technique and is one of its biggest proponents.

Summary

If someone uses Google to search for information on Lap-Band surgery, they will overwhelmingly be given Lap-Band positive information. It's likely that the person conducting the search will be hearing the same biased information from their doctors, from T.V. news stations, and from popular newspapers, and there's very little here that will change their minds once the initial hook is set. If by chance they do come across a dissenting voice, it will be so much in the minority that it will be easy to dismiss as ‘fringe’ information.

As Dr. Linda Bacon is fond of pointing out, "follow the money." I’ve followed the money, and it all flows back to people who have a vested interest in selling this product.

(by Squeegeelicious; edited and summarized by deeleigh. Thanks so much for doing this work and writing it up, Squeegeelicious)

Keeping in mind that Google's search results are dynamic and optimized based on personal information - they change day to day and they're different for everyone - I repeated Squeegeelicious's searches. I'm sorry to say that the information that came up for me was even more disturbing. Allergen's pages detailing the risks of the surgeries had disappeared. I had to hunt them down in order to link to them, and I couldn't find the one that talks about a 3-year study with 299 subjects. If anyone has a link to that, please share it in the comments.

Anyway, this made me wonder if Allergen is updating their pages following the FDA ruling - or more disturbingly, if they're deliberately making their pages on the risks and side effects of lap bands difficult to find. Are other people getting Allergen's pages on the risks and side effects of lap bands?

In conclusion, reasonably savvy people should be able to get to a list of lap band side effects and risks using Google. However, the risks and side effects - the meanings of the medical terms - will not be explained, and it will be difficult to find out the truth about how common they are. Information about the high rate of regain after lap band surgery is even more difficult to find.

Are there any medical professionals out there who would be willing to add details about the meaning and prevalence of lap band risks and side effects and the rate of weight regain to the Wikipedia article, and check up on it regularly to make sure the information stays put?

WLS: more barriers to rational decision making | Teens are Next on Allergan's List

vesta44's picture
vesta44
March 7th, 2011 | Link | I used Yahoo's search to

I used Yahoo's search to look for that Allergen study, and the only thing I could find in 9 pages of search was an article in Consumer Reports Health Blog, here, that refers to the study on Allergen's site. I couldn't find anything in that first 9 pages from Allergen at all on risks of lap band surgery. The same search on side effects of lap band surgery didn't turn up anything by Allergen either, but this post about hiding the truth about lap bands from Big Fat Blog was on page seven of the search results.

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

DeeLeigh's picture
DeeLeigh
March 8th, 2011 | Link | Squeegeelicious, I'm so

Squeegeelicious, I'm so happy that you decided to do the leg work on this and invest time into writing a very comprehensive post about it. I'd noticed the same thing, but I hadn't dug into it or written about it.

And, I should probably note that the front page post I put together is a complete mash-up of Squeegeelicious's work and ideas and my own (with the majority of the credit going to Squeegeelicious). Some of the stuff I talk about in the main parts of the post were mentioned by her in her forum post, and I also added content to the "summary" part in the blockquote.

DeeLeigh's picture
DeeLeigh
March 8th, 2011 | Link | You're right, Debra. We

You're right, Debra. We need to take a closer look at this. Anyone want to volunteer for a Skype study group?

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