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Weighing The Business Of Bariatrics

Fri, 01/08/2010 - 7:01am
Jeff Reinke, editorial director

While numbers can be twisted to mean almost anything a user wants them to, those relating to obesity and the general overweight condition of the U.S. population are tough to ignore. What I find interesting is that while some organizations – political and charitable alike – have established programs aimed at promoting exercise and healthier eating in combating this situation, it’s tough to ignore that a fair amount of resources have also been used to assimilate these conditions into our society.

Don’t get me wrong – the advancements in bariatric surgeries and the quality of life these procedures can help provide is tremendous and deserving of all its accolades. However, at what point are we allowing procedures like the more and more popular gastric bypass, for example, to be used as a crutch to combat poor personal health care decisions? I can appreciate the psychological and in some cases meta-physical dynamics that make these procedures necessary, but in too many cases neither is the problem.

This topic came to mind after watching a show on the Discovery Health channel called Big Medicine. The doctors on the show specialize in bariatric procedures, and the episode that I caught profiled a man so overweight that he needed a team of EMTs just to transport him to the hospital. Then, due to insurance complications, he had to be discharged. It took another large crew of individuals 12 hours just to get him back home. He said the cause of his addiction to food stemmed from kids picking on him as a child.

The next clip, however, shows him one year after his eventual bypass. He’s dropped hundreds of pounds and is actually able to get around by himself, drive a car and function as a normal member of society. Heck, he’s even engaged to the nurse who cared for him after his surgery.

Again, I’m not unsympathetic to this patient and hope he takes full advantage of this opportunity to get healthy and enjoy his life to the fullest, but in watching the show I was also struck with a couple of other thoughts.

  1. On a very selfish level I have to admit feeling a lot better about my own health, even though neither my diet nor level of physical fitness is where it should be. I wouldn’t characterize this false sense of assurance as a positive takeaway for me or anyone else watching the show.
  1. How could anyone watch and allow their child, friend or brother to eat themselves into this state of atrophy? As much as is being done to encourage kids to put down the video game controller and get some exercise, we also need to educate the enablers in our society to stop allowing their loved ones to do this to themselves. There are drug and alcohol interventions – one should also be developed for those developing these types of self-destructive behaviors.
  1. When we talk about health care reform, what about the costs associated simply with transporting the patient mentioned above  –  that was 72 man hours just to get him home after the first discharge from the hospital. Then he also required follow-up plastic surgery to remove nearly 50 pounds of excess skin after the weight loss. Even after insurance covers its portion, this man probably has medical bills in the tens of thousands of dollars that he’ll be paying off for a very long time – at the detriment of the hospital and healthcare providers who took care of him.
  1. As intriguing as I found this show, as well as others that profile the half-ton man in Mexico and other extreme cases of this type, it seems as though the more we’re exposed to these types of situations, the more we as a society become desensitized to them. We end up not talking about solutions, but simply elements of the problem. Instead of discussing how to prevent these types of unfortunate circumstances, we celebrate the medical marvels that allow these patients to regain a somewhat normal life. The kicker here, however, is that we’re still talking about a man hovering around the 400-lb. mark, placing increased stress on his heart, back and other internal systems. He may have gotten a big part of his life back, but his struggles and healthcare concerns are far from over – regardless of the closing video showing him walking hand-in-hand with his fiancée into the sunset.

So I’m torn.

On one hand I marvel at the technological developments that have made these surgical solutions possible and in restoring these patients’ quality of life. On the other I wonder if developing more advanced procedures for these types of bariatric issues simply enables our society to continue down a very self-destructive path.

Granted, the example I used here is an extreme, and I do see where these procedures have their place in helping “normal” folks. However, I get concerned when the obstacles of an incredibly obese patient are glamorized when the situation could have greater impact if positioned as a worst case scenario that our population should work to avoid.

What's your take? E-mail jeff.reinke@advantagemedia.com

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