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Let Them Eat Cake: Weight-loss doctors push Lap-Band surgery risk-free

Let Them Eat Cake: Weight-loss doctors push Lap-Band surgery risk-free

Picture of William Heisel

Dieting Sucks billboard

When I wrote about the "Dieting Sucks" campaign two years ago, I predicted that similarly unscrupulous plastic surgeons would join the race to the bottom.

They did.

They blanketed Southern California with advertisements saying, "Diets Fail! The Lap-Band Works!" The ads tell people they should call "1-800-GET-THIN" or "1-800-GET-SLIM" and sign up to have a Lap-Band device implanted that restricts the size of the stomach. Michael Hiltzik and Stuart Pfeifer at the Los Angeles Times have been doing a great job documenting these sleazy campaigns.

At least with "Dieting Sucks," the message seemed to be that dieting is hard work, which it is. With the "Diets Fail!" campaign, weight loss clinics are telling patients that they should not even bother trying to eat less. They make the Lap-Band surgery sound like a cake walk. That's dangerous for three reasons.

First, the main way people become overweight is by eating too much – regardless of the psychological or physiological problems that may contribute to the weight gain. By telling people to use surgery as an alternative to watching what they eat, the doctors involved in these campaigns are acting against their patients' best interests. Surgery is not an alternative to a healthy lifestyle. The Lancet published a study last week that showed how a worldwide epidemic of people being overweight and obese is leading to a surge in cardiovascular disease. Responsible clinicians counsel their patients about modifying their diet and getting regular exercise – even if it's only a walk around the neighborhood. They do not send them straight to the surgical suite.

Second, even though more people are gaining weight, the Lap-Band is not suitable for the vast majority of people. The company that makes the Lap-Band, Allergan in Irvine, Calif., notes on its website that the Lap-Band should be implanted only in people in very specific categories, including:

Your BMI is 40 or greater, or you weigh at least twice your ideal weight, or you weigh at least 100 pounds (45 kilos) more than your ideal weight, or you have a BMI greater than 35 with at least one obesity-related health condition.

You have been overweight for more than 5 years.

Your serious attempts to lose weight have had only short-term success.

You do not have any other disease that may have caused you to be overweight.

As The Lancet study showed, the average BMI in North American men and women is about 28. This is considered too high, but it is nowhere near 40.

Third, for people who do receive Lap-Band surgery, dieting is a requirement. Because the stomach is essentially shrunk through the surgery, Lap-Band patients are no longer able to eat large amounts of food or to eat food as quickly as they used to. Immediately after the surgery, patients are supposed to eat nothing but liquid foods for four weeks, and they have to stay away from sodas, coffee and anything with caffeine.Binge eating, in fact, is a major risk factor for post-surgical complications. As Allergan says on its site, people should not even consider having Lap-Band surgery unless, "you are prepared to make major changes in your eating habits and lifestyle."

Next: Irresponsible marketing for Lap-Bands may have deadly consequences

Photo: Pete Kraynak via Flickr


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Bariatric surgery, excepting small intestinal bypass, is a scam. See blog for details.

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This is just another bashing of the LAP BAND which helps so many people.... writers like this do no justice and ultimately instill fear into people who have no outlet or choice. Instead, Mr. Heisel, and his obvious friends at the LA TIMES want to make it seem that obesity is not a real disease and patients undergo surgery to fit in better clothes.  The decision to have weight loss surgery happens as a last resort, not a first option.


Morbid obesity is by definition ,the cause of much morbidity and mortality in Los Angeles and around the world.   If the LA Times, and Mr. Heisel, is to care about the health of its community, why would they not give fair and balanced stories when it comes to weight loss surgery? The Los Angeles community needs a newspaper not like LA times and writers not like Mr. Heise but, newspapers and writers that will provide news with fairness.

Now i ask, Mr. Heisel how could you not care about the people you write to,but instead directly instill fear and divert them from possibly saving their life ,and go write slanderous articles like this? Surgeries like this save peoples lives, who are you to judge them, and tell them how to live their life.

Picture of William Heisel

Thank you for your comment. I think if you read this post again you will see that I describe the requirements for people to qualify for Lap-Band surgery. I'm not sure how marketing campaigns that say "Dieting Sucks!" or "Diets Fail!" present Lap-Bands as a last resort. 


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