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Weight-Loss Surgeries: Does Success Offset Controversy?

Big Chris Christie, New Jersey governor, has had weight-loss surgery.  We’ll look at the buzz and controversy around gastric bypass surgery, lap bands and more.

This April 30, 2013 file photo shows New Jersey Gov. Chris Christie during a town hall meeting on Long Beach Island, in Long Beach Township, N.J. (Mel Evans/AP File)

This April 30, 2013 file photo shows New Jersey Gov. Chris Christie during a town hall meeting on Long Beach Island, in Long Beach Township, N.J. (Mel Evans/AP File)

New Jersey governor Chris Christie is a big guy.  Between 300 and 350 was the weight most people guessed, while he joked with a doughnut on David Letterman and told critics of his heavy poundage to back off.

But early this year, Chris Christie secretly did what a growing number of heavy Americans are doing these days.  The big governor had weight loss surgery.  Brought the doctors in to do it. Word is he’s lost forty pounds.

So, is it a good idea ? For him?  For the country? To be banding and stapling our stomachs for weight loss?

Up next On Point: Chris Christie, big America, and weight loss surgery.

– Tom Ashbrook

Guests

Dan Goldberg, health reporter for The Newark Star-Ledger. (@DanGoldbergSL)

Dr. Robin Blackstone, medical director and bariatric surgeon at the Scottsdale Healthcare Bariatric Center and former president of the American Society for Metabolic and Bariatric Surgery. (@rblackstonemd)

Diana Zuckerman, president of the National Research Center for Women and Families and author of the 2011 New York Times op-ed “Playing With The Band.”

Marion Nestle, professor in the Department of Nutrition, Food Studies, and Public Health at New York University. Author of “Food Politics” and “What To Eat.” Co-author of “Why Calories Count.” (@marionnestle)

Mark Ambinder, contributing editor at The Atlantic. He underwent gastric bypass surgery and wrote about his experience in the 2010 Atlantic piece “Beating Obesity.” (@marcambinder)

Show Highlights

Videos

Animation of lap band surgery:

Animation of gastric bypass surgery:

Chris Christie eats a doughnut on “The Late Show With David Letterman”:

Tweets From During The Show

From Tom’s Reading List

The Atlantic: Chris Christie: Fit To Be President? – “If Americans embrace Christie and his journey, the stigma around these procedures will become less of a barrier to participation. Few high-profile Americans, with the exception of Al Roker, have openly talked about gastric bypass. I understand why Christie would want to keep the fact of his surgery secret for a while, because medical procedures are private. But I applaud him for coming out, as it were, as the most famous American to discuss his weight loss surgery.”

The Los Angeles Times: Chris Christie’s Weight-Loss Surgery: How Does It Work? – “Banding procedures are less invasive than other types of bariatric surgeries. All of them ‘foster rapid weight loss by surgically reshaping the intestinal tract,’ as the Los Angeles Times reported in February. ‘To varying degrees, they aim to reduce the stomach’s capacity, decrease the calories and nutrients absorbed from food, and change the chemical signals of fullness that are passed between the brain, the gut and the endocrine system.’”

WBUR: Weight-Loss Surgeon: Christie-Style Secrecy Common, Stigma Lingers – “We don’t know the reason but we think there’s still sort of a stigma to having weight-loss surgery. So even though we’re doing 150,000 weight-loss operations a year [in the United States], there’s the idea that if you have a weight-loss operation you’re somehow ‘taking the easy way out.’ You’re kind of ‘cheating.’ You’re just not tough enough to do the diet and exercise required for weight loss. You’re somehow ‘weak,’ right?”

WBUR: After Losing 322 Pounds, One Man’s Thoughts On Christie Surgery – “We would love to sit down with him and talk with him about “The Good, The Bad, and The Ugly” of weight loss. I mention this because back in November of 2011 I weighed over 533 pounds. In a little over a year, I have lost 322 pounds. I now weigh 210. My goal weight is 200 pounds, so I am only 10 pounds away from reaching it. But it took a great deal of hard work to get to where I am now.”

Book Excerpts

Excerpted from “Food Politics: How the Food Industry Influences Nutrition and Health” by Marion Nestle (University of California Press, Revised and Expanded, 10th Anniversary Edition, 2013):

Excerpted from “Why Calories Count: From Science to Politics” by Marion Nestle (University of California Press, 2012):

Please follow our community rules when engaging in comment discussion on this site.
  • Phil McCoy

    The Best part of this story is that Christie stopped deluding himself into thinking he was a “healthy” fat person. are there occasionally obese people who may be very health and fit, of course there are (but most of them are playing football or sumo or something athletic). generrally speaking, most obese/very overweight people who say they are “fit” or “healthy” need to realize that it is a relative “fit” and “healthy.” being obese is never healthy.  I hope that he can serve as a role model for other obese and overweight americans and encourage others to try and loose weight.

    unfortunately people won’t talk about that and instead talkabout how many pounds he needs to loose to becmoe president. apparently these people, who think you need to be skinny or not overweight, have never heard of Howard Taft

    • teaforweightloss

      Good point Phil it should not be about societies perception its about being healthy, and eating right with regular exercise is where it begins.  

  • arydberg

    There is research that indicates that not only has the FDA made us fat by flooding the market with HFCS but that many of the so called  “diet” supplements do in fact cause people to increase weight.   

  • adks12020

    The lap band procedure can be very effective. I saw a friend’s sister lose half her body weight using it. The smaller stomach size forced her to learn to eat well and she is now very healthy.  As she lost weight she began to exercise more and more regularly and now goes to the gym or runs 5 times a week. She’s done so well that the band was gradually loosened and I believe she is considering having it removed.

    It won’t work for everyone because it requires extreme discipline but as a last resort it surely worked for her.

  • Jasoturner

    Not sure why surgery should be controversial.  I am going to speculate that it is treated as controversial because it is viewed as a “shortcut” to overcoming the moral failure of gluttony and the weakness of will associated with the inability to gain weight.

    I tend to agree with Taubes that much overweight is probably due to an energy partitioning dysfunction.  Basically, people overeat because their fat cells are stealing energy that other cells need.  Thus, the vital tissues are semi-starved and continue to cause hunger, even as sufficient calories (technically) are consumed but stored preferentially in the fat tissues rather than used for cellular function.

    While dietary intervention is probably a better solution, the state of dietary “science” is so preposterously bad that it merits little respect or attention (though I think Taubes is onto some good ideas.)  Thus, without a proven dietary intervention, safe surgical approaches should certainly be in the treatment toolkit.

    Nothing controversial about it.  And Christie has nothing to be defensive about in my opinion.

     

    • DWWalker

       If you’ve read Gary Taubs “Why we Get Fat” you might like to read “Wheat Belly”, Wm. Davis M.D.  Both of them really debunk the calories in calories out theories and talk about metabolism and true physical addiction. Gluttony and weakness are shaming viewpoints that really don’t help when folks are eating what the ‘market’ tells us is healthy and truly is NOT so!

      • Jasoturner

        Thanks, I will check that out.  By Taubes I’ve actually read Good Calories, Bad Calories more than once.  It’s a bit of a slog, but quite convincing.

  • J__o__h__n

    On Point, please stop posting Twitterings before the comments.  If I wanted to follow On Point on Twitter, I would.  If you must post them, post them at the end.

    And the popups are still annoying. 

    • Expanded_Consciousness

      Posted Twitterings? Where? I don’t see them.

      Yes, popups that you must close, annoy.

      • J__o__h__n

        They post them after the show.  Look at yesterday’s shows. 

        • Expanded_Consciousness

          Thanks, that is annoying. They should come after the comments, if at all. Wait, I have to close another popup before posting this.

  • sickofthechit

    I applaud Gov. Christie and his efforts.  It is time that he and others be treated more compassionately and encouraged in their efforts.  Bravo Chris!  charles a. bowsher

    • http://profile.yahoo.com/JXSANCUDPIKQSPID5KT2U4XK5Y TF

      I do also, and it takes a certain straight-shooter (which he has the rep of being) to say so bluntly. That makes it easier, methinks.

      However, I’m sorta holding my breath until someone else (on the right or in the ignorant middle) takes Christie’s personal decision, abetted by the top-flight insurance he has, and turns it into “Why can’t all fat Americans lose weight?”

      If it doesn’t happen I’ll buy you a beer.

  • X-Ray

    Weight loss is only one facet of this procedure. An overweight friend, who was taking drugs to control his Diabetes, was able to discontinue has medications immediately after surgery, before any weight loss had taken place. This effect has been noticed but not explained by the medical researchers. There is a lot we don’t know about this subject.

  • MarkVII88

    Despite his repeated comments to the effect that he doesn’t have any national political ambitions, I wholeheartedly believe that Chris Christie is prepping for a 2016 Presidential run.  His biggest disadvantage, aside from being a conservative Republican, was his size.  Not that large individuals can’t perform the duties of President, but his image as an obese person is a liability to getting votes.  People don’t like voting for someone who is not like “them” and being as big as he is, Christie would face an uphill battle to be our representative to the rest of the world. 

    • BHA_in_Vermont

      Given the percentage of Americans who are overweight or obese, isn’t he “like them” already?

      • http://profile.yahoo.com/JXSANCUDPIKQSPID5KT2U4XK5Y TF

        I don’t know, exactly.

        What income quintile is Christie in among Americans? Since nowadays “obese” often means “poor”, for a variety of medical and other reasons, what income quintile is he in among obese Americans?

        He’s rich enough of an obese man to do this about it, and that differs from many.

      • MarkVII88

        That may be the case, but you don’t see overweight fashion models on the covers of magazines…and on…and on.  Not that it isn’t hypocritical of Americans in general, but we simply don’t typically hold up overweight people as paragons of society or role models to follow.  And I know first-hand how overweight people are sometimes treated, for no good reason.

        • http://profile.yahoo.com/JXSANCUDPIKQSPID5KT2U4XK5Y TF

          Study exercise: Where (generally) do you live?

          I ask because surroundings matter. There are cliches that someone moves to Boulder CO and “becomes fat”, or to Cleveland, and “becomes hot”, versus “Anyburb USA”. Those cliches exist for a reason.

          (Disclaimer: I’m in no shape–ha!–to move to Boulder myself and feel less fit than I am.)

  • BHA_in_Vermont

    I am interested in Christie’s prior dietary and exercise changes to address his unhealthy weight. Was he a “try every diet” dieter? Has he ever seriously changed his eating and exercise habits?

  • http://profile.yahoo.com/JXSANCUDPIKQSPID5KT2U4XK5Y TF

    I’d like to suggest an addition to the reading list: “Fat Land” by Greg Critser. In the decade or so since it was published, it’s only become better and better.

  • http://www.facebook.com/estelle.paus Estelle Paus

    Instead of surgery, I think Americans need to start focusing on sugar in their diet.  There is too much hidden sugar in the American diet because food processing companies add high fructose corn syrup to almost everything.  I recently looked at a bottle of “low sugar” chocolate syrup.  Was this artificially sweetened to get a “low sugar” content?  No.  In fact it was sweetened with sugar.  It’s non low sugar counterpart, the regular one that people not concerned with sugar buy, was sweetened with high fructose corn syrup.  It had double the sugar content of the one sweetened with sugar.  If we are eating sweetened foods in America, it is more likely than not sweetened with high fructose corn syrup which contains twice the “sugars” as sugar.  If we want to lose weight as a country, we need to demand that manufactures stop using high fructose corn syrup to sweeten our food.  Start looking at labels.  You will be shocked at how much of your food contains high fructose corn syrup.  Instead of addressing the symptom by stapling our stomachs, let’s eliminate the root cause of our obesity – high fructose corn syrup. 

    • Jasoturner

      Most carbohydrates are converted to sugar.  What about them?

      • http://www.facebook.com/estelle.paus Estelle Paus

        Just like the diet for diabetes patients – Stay away from white foods – white rice, potatoes, white bread.  Apparently, fiber consumption is important for balancing the sugar in your body.  But all I’m saying is High Fructose Corn syrup is everywhere and we need to stop consuming it because it gives  twice the “sugars” as sugar.  It’s seems like a no brainer.  But it is hard to not consume high fructose corn syrup because it is so prevalent in our processed food.

        • Jasoturner

          And where does 18 year old scotch fit into the picture…?

      • Al_Kidder

         Carbohydrates are sugar polymers.
        What I find amusing is fat reduced foods. I used to work in a factory where we boiled up fats and oils with acid, splitting the triester of glycerol and fatty acids into a mixture of mono and di esters and glycerol. Same energy content, more or less, but it is no longer fat ie a triester, so you can pour it into your fat free product with gay abandon.

        • Jasoturner

          That is…kind of depressing…

    • Wm_James_from_Missouri

      Sugar has been implicated as the cause of other health related issues such as, memory loss, inflammation, advanced glycation end products that accelerate the ageing process, and heart attacks. Do you have any opinions on the sugar, “Ribose”? It may be a healthier form of sugar despite its’ high cost.

  • http://www.facebook.com/UnfoldingStoryPictures Zee Zarbock

    At the age of 54, I had gastric bypass (laparascopic RNY) 9/09 and it was the best thing I ever did for myself. My doctors had been pushing me to do it for 10 years, but as a single mom, I couldn’t justify the risk. By 2009, I found an awesome surgeon, Dr. Sheila Partridge, at NWH in MA, the procedure was much safer, and my daughter was old enough to take care of herself. After years of being unsuccessful in getting rid of 130 of my excess 200 pounds, I was hurting so bad, I had absolutely no fears when I got on that table. Dr. Partridge gave me my life back! I have had very little in the way of complication except for an adhesion, which could have happened with any abdominal surgery. That said, if you don’t have your head right and change your life forever, even gastric bypass won’t help. Many people who have had it have put a lot, if not all, of the weight back. It’s not a cure, but a tool.

  • Sarah-Wade Boatwright

    I am a medical student and just wanted to add one other aspect to the gastric surgery discussion.  In the course of my education, one of the GI surgeons who specializes in gastric surgery raised the point that for a lot of patients, food is an addiction.  After the weight-loss surgery, some patients find substitutes for food and end up with other addictions such as drugs, alcohol, or gambling.  For this reason, it is important that patients have a thorough work-up including psychiatric evaluation and/or treatment.  Weight-loss surgery, as you have mentioned on the show, is only part of a larger transformation.

    • yulaffin

       Agree with the need for a psych evaluation/treatment as part of the process.  I have a close friend who had gastric bypass surgery and initially did well in losing weight, over 150lbs.  But because he didn’t deal with the emotional/psychological issues he had, he ended up gaining back all he lost and then some.

  • DWWalker

    Great lineup for this topic. Please start to look at the real reasons we get fat: not how much we eat, but what we do eat.
    Resources: “Why we Get Fat” by Gary Taubs… excellent resource of historical and medical study and observations.
    “Wheat Belly” by Wm. Davis M.D. cardiologist.
    Reasons why obesity is so ubiquitous are entwined with what happens metabolically when we consume refined carbs especially containing Fructose… and what happens in the brain ‘addiction’ processes kick in! 

    High quality proteins and fats play an important nutritional role in maintaining healthy weight. Why are poorer populations struggling with obesity? 

    Our food industry is shamefully advancing ideas that non-fat is good while loading fructose for palatable appeal. Metabolism kicks in to store those fructose calories as fat.

    Surgery, for the well off maybe interesting but there are huge populations of people who need to learn what to eat and how to break the addiction to the carbo driven glucose/insulin cycle.

    • yulaffin

       I have been obese since childhood and in 2005, my doctor suggested I have bariatric surgery.  I ended up trying a low carb high fat diet instead and finally started losing the weight.  208lbs gone so far and another 90lbs or so to go.  I’m disabled as well so no exercise, just eliminating most sugar and grain products and processed foods and eating whole foods, good fats and proteins and low carb veggies instead.

      • StilllHere

        Great story!  Congrats!

  • gemli

    If the surgery makes eating large quantities of food uncomfortable, I have a much cheaper solution.  For a lot less money you could hire someone to follow you around and whack you with a stick if you overeat.  Surgery is no walk in the park, and if we put that much effort into management of diet and lifestyle we could have people gain control of their eating.

    • http://www.facebook.com/profile.php?id=100005439874554 Bob Patin

      What a stupid comment. If you understood anything about eating compulsions, you wouldn’t make such an asinine statement.

  • arydberg

    Lets face it there is a fat industry out there.    They own the government and the FDA.    People really don’t count.   If they did the idea of Monsanto selling GM corn with no disclosure would not be allowed, but it is.    Of all the basic rights people have the right to know what we eat is at the extreme top of the list.   Yet Monsanto does not tell us.     Shame on our government.  

  • Trond33

    The most unhealthy aspect is the addiction to weight-loss.  Each person has a natural weight that is healthy for them.  There are plenty of heavy people out there that are a lot healthier than the skinny as a rail weight obsessed person.  Bottom line, the goal should be to eat healthy, exercise and live a balanced life.  

    The media has no business touting around Governor Christie’s weight-loss efforts.  That is personal and should be left alone. 

    I do know people who have had surgery and others who have taken major weight off by changing lifestyle.  It does seem that the medical industry is pushing surgery, which is troubling.  

    Personally, I will gain 5-7 lbs in the winter months.  Then when hiking season hits again, I bounce right back.  I find that in the more sedentary winter months, I crave sugar more.  Guess I need to get into cross-country skiing.  Point is, get out there and figure out what works best for you.  

    • jomuir

       I had a roommate who also gained 5-10 pounds every winter, then in the spring she lost it easily. She wasn’t bothered by it at all. She also said she craved certain foods more in the winter, for her it was dairy and sweets IIRC.

  • http://www.CayerComputing.com/ Melissa A. Cayer

    Well, that Mother’s Day fattening food gift that I was planning on giving does not seem like a good idea, now.

  • dakaranani

    I listened to this broadcast today and Tom Asbrook TWICE said “geriatric bypass surgery” without even flinching– how could he make such a mistake, and twice, and not apologize for his mistake?  He didn’t even notice he had done it.

  • Dana Elliott

    While there are a lot of things that people as individuals can do to control their weight, I also think that there are a lot of systemic problems that at the best don’t help people, but at worst cause many of the problems.  Our society basically revolves around the auto industry.  Generally, the department of transportation is only worried about moving car traffic.  If our cities were such that it was safer to travel either by foot or bicycle, I think that more people would do it.  As it is, I think that it’s considered a success if 1% of the population uses a bike as transportation (compared to some European cities where the goal is 30ish%).  We don’t have a healthcare system that adequately supports people.  Insurance generally doesn’t cover nutrition education, which would be a big help.  There are food deserts where it’s cheaper to buy a cheeseburger from McDonald’s then it is to buy a banana.  Finally, we so heavily subsidize the corn industry that it’s so easy to make high fructose corn syrup.  The research on whether or not high fructose corn syrup itself causes problems is shaky, but the fact that it’s increasing how much sweet food we eat has to be problematic.  

  • 120down

    120down.com

    There is an alternative to lap band that is based completely on food. In fact eating large amounts of it.

    I lost an avg. of 5lbs./wk for a total of 120 lbs. in 6 months. No pills, shots, or surgeries. To find out more, visit

    http://www.120down.com

  • Stephen Valder

    Tom,
    I listen regularly to your show. Though I agree obesity is a major issue, I encourage you to avoid the demonization of obesity. According to the CDC smoking increases the risk of death for men by 22 times (2200%). Obesity increases the risk of death by 50-100%. Not insignificant, but not to where any doctor can predict Chris Christies death.

  • Stephen Valder

    Tom,
    I listen regularly to your show. Though I agree obesity is a major issue, I encourage you to avoid the demonization of obesity. According to the CDC smoking increases the risk of death for men by 22 times (2200%). Obesity increases the risk of death by 50-100%. Not insignificant, but not to where any doctor can predict Chris Christies death.

  • Qeana

    Looking for weight loss motivation? Find out how these people went from flab to fab: http://afterfat.com You can try too!

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