Not much on the telly tonight, so I ended up watching "My 600 lb. Life" --- the show where folks go to Houston for bariatric surgery… some successful, some not so much.
After watching a couple episodes, I'm left with some mixed feelings.
Is super morbid obesity:
1) a disease along the same lines as alcoholism and drug addiction?
2) a lifestyle issue (poor food choices, lack of exercise, laziness)?
3) a mental health issue (poor self esteem, depression, etc.)?
What have you seen in your practice re: number of super morbidly obese admissions, bariatric surgeries, disease processes related to super morbid obesity, difficulty caring for super morbidly obese patients.
Not much on the telly tonight, so I ended up watching "My 600 lb. Life" --- the show where folks go to Houston for bariatric surgery… some successful, some not so much.
After watching a couple episodes, I'm left with some mixed feelings.
Is super morbid obesity:
1) a disease along the same lines as alcoholism and drug addiction?
2) a lifestyle issue (poor food choices, lack of exercise, laziness)?
3) a mental health issue (poor self esteem, depression, etc.)?
What have you seen in your practice re: number of super morbidly obese admissions, bariatric surgeries, disease processes related to super morbid obesity, difficulty caring for super morbidly obese patients.
I see 500 lb plus patients every day of my career.
I'm watching the Discovery health channel and they have a marathon of shows that deal with obesity and weight loss surgery on. Now it's the one about the fattest man in the world-almost 1000 pounds.
Kalycat-I love it that someone else is talking about the microbiome. The bugs in our gut serve a purpose. I think it is the most exciting new research out there. They have taken feces from lean people transplanted it into obese people and they lost weight. Farmers give animals antibiotics to cause them to gain weight. Fecal transplants have been shown so superior to vancomycin for c-diff treatment, yet people can't access treatment. I am disappointed with the FDAs flip flopping about fecal transplants being a drug or a tissue three times in the last year. People are turning to DIY on you tube. The implications that this treatment show it may be helpful in DM, metabolic syndrome, heart disease, Parkinson's, Multiple sclerosis, autism, obesity, sepsis etc means in the future we may be giving a lot more enemas. I used to think obesity was a matter of self discipline. Not any more. If you have more firmicutes than bactiodetes in your gut you will absorb 150 more calories per day. That antibiotic you took ten years ago may still haunt you. It plowed under your bacterial diversity. Autopsies of people who died of sepsis have shown that the only bacteria left in their gut was one antibiotic resistant type.
Kalycat-I love it that someone else is talking about the microbiome. The bugs in our gut serve a purpose. I think it is the most exciting new research out there. They have taken feces from lean people transplanted it into obese people and they lost weight. Farmers give animals antibiotics to cause them to gain weight. Fecal transplants have been shown so superior to vancomycin for c-diff treatment, yet people can't access treatment. I am disappointed with the FDAs flip flopping about fecal transplants being a drug or a tissue three times in the last year. People are turning to DIY on you tube. The implications that this treatment show it may be helpful in DM, metabolic syndrome, heart disease, Parkinson's, Multiple sclerosis, autism, obesity, sepsis etc means in the future we may be giving a lot more enemas. I used to think obesity was a matter of self discipline. Not any more. If you have more firmicutes than bactiodetes in your gut you will absorb 150 more calories per day. That antibiotic you took ten years ago may still haunt you. It plowed under your bacterial diversity. Autopsies of people who died of sepsis have shown that the only bacteria left in their gut was one antibiotic resistant type.
The microbiome research being done will revolutionize health care as we know it, including diabetes care. It is the most fascinating thing right now- talk about a paradigm shift.
I am rather confused why those with this issue is thought less of then those with Anorexia nervous or Bulimia nervous. Or even those with binge eating disorder that can toss it back up, over those that do NOT toss it back up.
Fiona, how do drug addicts get money for their drug? Alcoholics spend money from the family budget at the expense of the family to the point that they are homeless or without food for their drug of choice. It is a reshuffling of priorities. That drug becomes your priority.
I believe it is all three factors involved. I have observed from watching that most not all of the people are from lower socioeconomic backgrounds. One family member is an enabler and others may resent them for their size and all of the attention they receive.
I often wonder myself how the surgery is paid for. I think most of the obese people shown get some kind of disability whether it is dtate or federal. If they are receiving disability, they maybe receiving SNAP benefits. I highly doubt Medicaid is paying for the surgery. I would besurprised it it was!
I am rather confused why those with this issue is thought less of then those with Anorexia nervous or Bulimia nervous. Or even those with binge eating disorder that can toss it back up, over those that do NOT toss it back up.
I'm guessing it's because obesity is so rampant in this country while the other things you mentioned, although still too common, are not as prominent or as obvious. I mean over one third of this country is obese, and obesity and related health issues weigh on our health system more than any other single health problem. Not to mention it is one of the most preventable problems too.
I think it's multifactorial. You can't just pinpoint one thing, and the contributing factors are different for different people.
I also think that most people who are in the morbidly obese category already feel shame about their bodies, and further attempts to "educate" them with thinly concealed judgment does absolutely nothing constructive.
Well, I don't know for sure, but I suspect it's a combination.
As far as personal experience, I have four siblings who range from overweight to morbidly obese. The most I've ever weighed in my life is 135. I can tell you that I see a whoole lot of lifestyle choices in my family that I don't participate in, including overeating, unhealthy food choices, putting cheese on d*** near everything, and indulging in far too many "treats" like alcoholic cocktails, desserts, and the like. Where I drink almost nothing but water, they go through cases of soda.
It's caused a lot of resentment for me because my family constantly makes fun of my choices ("you don't eat anything", "you only eat rabbit food", "you're afraid of things that taste good", etc, etc.) I don't diet, I simply make conscious choices about what I eat. You'd be surprised how many people enjoy making fun of that and trying to make it seem like something is wrong with healthy eating. Just start a post about how healthy eating and exercise are great and watch people lash out.
trinitymaster
360 Posts
I see 500 lb plus patients every day of my career.
Their causative factors are all of the above.