The Perils of Obesity

Now that's a daunting statistic.  One million Canadians meet the criteria for stomach bypass surgery to deal with their grossly morbid overweight status. Think about all that excess weight that people carry around with them, pressing on their viscera.  Something's got to give, and it does.  When all else fails, resort to surgery.

 All else is so utterly pedestrian; observing the Golden Mean.  Which is to say taking as one's life motto a respect for moderation in all things.  And when moderation is applied to energy intake in human beings, then people, ideally, do not become grossly, morbidly overweight.  But in our advanced societies of today food is plentiful and readily available and irresistible to those who without thinking simply eat not only what's available but choices that exemplify the worst possible decisions.

That would be, needless to say, processed foods that have been so altered from their original whole state as wholesome food that they bear little resemblance to what people normally ate before the advent of huge corporate interests devoted to the production of quasi-food.  Food that no one has to bother preparing to use in old-fashioned recipes; no cooking, it's all done by fast-food outlets and by supermarket-purchased short-cuts.

Heavily laden with all the dread ingredients that most people know they should be avoiding in excess; sugar, salt, and fat.  Our taste buds have been so degraded that without the addition of those seasonings and fat nothing tastes quite as we have become accustomed to and wish to continue consuming.  And in the process, we have passed on to children some very bad nutrition practices; what starts in the family stays in the family.

It's not the occasional trip to Kentucky Fried Chicken or McDonalds for their irresistible, cholesterol-loaded, artery-clogging, heart-stopping comestibles that will do us in; it's the ongoing devotion to make those items a mainstay of our inadequate diets.  And so was born bariatric surgery, the last defence of the otherwise-normal human being who tops out at 440 pounds.  Who long ago developed diabetes and heart problems, neuropathy and serious eye conditions.

And the creme de la creme, the gold standard of such procedures is something called Roux-en-Y, major abdominal surgery involving the building of a new stomach.  Or, perhaps more accurately, the bypassing of the old stomach.  Aside from reasons of physical comfort and mobility, there is the issue that gastric bypass surgery is effective at getting Type 2 diabetes - a chronic lifestyle disease, unlike Type 1 diabetes afflicting younger people with the destruction of the Islets of Langerhans in the pancreas that produce insulin - into complete remission.

To medically qualify for access to such surgery the qualifying BMI is currently 40 or over, associated with serious medical conditions such as diabetes or high blood pressure.  Doctors are contemplating lowering the qualifying BMI to 32 for people with serious "co-morbidities" such as diabetes.  Needless to say people with what used to be called adult-onset diabetes (Type 2) are capable, on their own, of sending their diabetic condition into remission by following a sensible diet and losing weight and remaining physically active.

"We don't even have the capacity to treat the one million Canadians who meet the current criteria - why would anyone want to expand these?
"Before you go out and offer this to patients with BMIs of 32 or 30, you better make sure you have a system in place that looks after these patients in the long term before you start thinking about 'Who else can we operate on?'"
Dr. Arya Sharma, medical director, Alberta Health Services provincial obesity program

With Roux-en-Y, a small part of the upper stomach is stapled or stitched closed to create a small pouch for food bypassing a large portion of the stomach, leaving people feeling fuller, faster.  Gastric banding is where a saline-filled band is looped around the upper part of the stomach.  That restricts the amount people can eat at a sitting.  Roux-en-Y is a permanent re-arrangement of the digestive tract, gastric banding is reversible

Montreal bariatric surgeon Dr. Nicolas Christou who is also a professor of surgery at McGill University remarks that the overall risk of death from Roux-en-Y "is equal to having your gallbladder removed.  If your (mortality rate) is above 0.5% you should stop doing this procedure."  Dr. Christou is aware of complications and deaths "that should not have happened had the team had proper training".