wrote:
On May 3, 5:30 pm, brigid nelson wrote:
wrote:
On May 3, 1:21 pm, brigid nelson wrote:
wrote:
Now, I'm not always a fan of60Minutes, but I don't see how
criticisms leveled by a blog run by a nurse equates to the60Minutes
story being untrue or unverified. Clearly that blog has it's own
agenda and false statements. Right out of the gate, this blog
accuses60Minutesof saying that gastric bypass cures cancer. I saw
the story, it's available online and no such thing was ever said.
What they did say was obesity raises the risk of several types of
cancer and that some studies have found that for people that have the
bypass surgery, the risk of cancer is cut in half.
The 'nurse' who writes this blog understands research methodology and
does an excellent job of de-bunking claims of weight-related morbidity.
Poke around her site some more and follow the links to the studies.
Here's another interesting article on Gastric Bypass:
http://junkfoodscience.blogspot.com/...ally-proof-tha...
Also, can you give me a cite for the study that shows the risk of cancer
decreasing with bypass surgery? I'm interested to see the sample size,
how long subjects were followed, and how these researchers decided they
could determine the causation of cancer to be fatness.
Sorry if you have a problem with me pointing out that the blog is run
by a nurse, but that is apparently her academic credentials related to
the discussion at hand. I didn't do the research for60Minutes. I
don't know what specific study they based the claim on. But a simple
google produced this, which says long term, the risk of dying from
cancer was cut by60% and is consistent with what60Minutesreported:
I detected a disparaging tone in your original post about the legitimacy
of the opinion of a *nurse*.

What I objected to was Hakans statement that the opinion of this nurse
on a blog means that the 60 Minutes Story is untrue.



Knowing a little something about
methodology myself, I find this nurse to be an good resource as she
carefully explains the methods and statistics used in these studies that
the media parade out in order to make us feel bad about ourselves and/or
buy expensive drugs and surgical treatments that may do more harm than
good. I think she performs a useful service as not everyone has taken a
class in research methods or statistical analysis. A nurse with a BSN
would have had at least one such class - and she obviously paid
attention. I just wish she'd read Taubes as I find her insistance that
carbs are harmless to be somewhat uninformed.

What I see is someone who has formed a opinion and is using FUD
tactics to hurl anything at all to try to paint gastric bypass in an
unfavorable light. Take this gem which leads off the blogs criticism
of the Swedish study:

"We’ll begin with one of the most common misconceptions: years of
follow-up. Since this study was examining the long-term effects of
bariatric surgery on mortality, it’s understandable you might think
that the average 10.9 years of follow-up reported meant the patients
were followed for 10.9 years after having surgery. Here is the first
example of not reading the study. The follow-up period — which
actually ranged from 4 to 18 years — began from the “matching date.”
That was the date that the study recruitment campaign ended and the
surgical candidates were chosen and matched with controls. This was
about 1 1/2 years before the surgeries were actually performed. So,
we’re down to just over an average 9 years of post-surgical follow-up.
"

This is the starting point, the best she can come up with to tear into
the Swedish study? Arguing a nit over whether the long term
measurement point is 9 years or 10.5 years? What critical difference
does that make in the grand scheme of things? If you want to start
attacking studies, you can tear any of them apart with such
critcisms. But IMO, it does show how biased she is.

If one wants to start with a critical analysis, why not start with her
own claim that 60 Minutes said gastric bypass cures cancer. That is
an outrageous falsehood. They clearly said studies showed it reduced
rates of cancer, not cured it.
You know what? I didn't see the show so I googled to see if I could find
a transcript. I found this:

http://www.cbsnews.com/stories/2008/...n4023451.shtml

Here's the first paragraph:

(CBS) It's pretty well known to doctors that the most successful
treatment for obesity is surgery, especially the gastric bypass
operation. But here's something the medical world is just realizing:
that the gastric bypass operation has other even more dramatic effects.
It can force type 2 diabetes into almost instant remission and it
appears to reduce the risk of cancer.

This is from the third page:

In addition to the operation reducing hypertension and coronary artery
disease, there appears to be an affect on cancer as well.

"Does being fat give you cancer?" Stahl asks Dr. Eugenia Calle, an
epidemiologist at the American Cancer Society.

"Being overweight or obese increases the likelihood that you'll get
several different types of cancer," Calle says.

Dr. Calle has been studying the link between cancer and obesity.

Asked what kinds of cancer, Calle gives Stahl a long list: "Breast
cancer, colon cancer, endometrial cancer, kidney cancer, cancer of the
esophagus, pancreatic cancer, liver cancer."

"I should have said what cancers don't, aren't affected by obesity,"
Stahl remarks.

"There are very few that aren't affected, yes," Calle says.

"Have you been able to calculate how many people die every year of
obesity-related cancers?" Stahl asks.

"We have. And our estimate is that about 100,000 individuals in the
U.S…,every year die of cancer, because of their weight," Calle says.

"So if you lose weight, you're fending off cancer?" Stahl asks.

"Well, that is and has been, up until now, sort of the piece of evidence
that hasn't been in place. People don’t really lose weight in this
country," Calle says. "They lose it and they gain it back."

***so sure, they didn't actually come out and say gastric bypass cures
cancer, however I'm sure many people who watched this didn't make that
distinction. It's very debatable whether cancer is caused by overweight
in any case, even though researchers continually claim it regardless of
what the study numbers show.

http://www.time.com/time/health/arti...655367,00.html
"The larger of the two studies — the largest of its kind — led by
researchers at the University of Utah School of Medicine, looked
specifically at gastric bypass surgery, also known as Roux-en-Y
gastric bypass, which accounts for 80% of all bariatric surgeries in
the U.S.
It's interesting to me that when I asked you for a cite for your data
you gave me a link to a press release/story in Time Magazine. Ironically
the very story that the link I gave you above does a good job of
debunking with the actual statistics from the actual study, not what was
presented in a current events magazine.

This would be the *actual* cite:

http://content.nejm.org/cgi/content/full/357/8/741

To properly evaluate the claims made by the researchers, you will have
to read beyond the abstract and look at the methods, especially how the
study group was not selected at random and how the 10 years were
measured not from the date of the procedures, but the date of the survey
mail out.


Yeah, here we go again. You asked if 60 Minutes interviewed any long
term gastric bypass patients, as if anecdotal evidence proves much of
anything. Here you have an actual study, and you want to rail against
it over what method is used as the starting point to measure whether
long term is 9 years or 10 years, as if that would make a critical
difference in the outcome. Unless you have evidence that it does,
then it's just attacking the study on any basis because you don't like
the results.

Interesting though that you have the link to the study, while asking
me for it.

Nope, I had no idea which study you were talking about. I found the cite
after following your link and reading the pr article. From there it was
relatively easy to find the actual study.

In the Utah study, researchers compiled data on 15,850 severely obese
people, half of whom had undergone gastric bypass surgery between 1984
and 2002, and half who were from the general population and had had no
surgical intervention for obesity. Overall, researchers found, the
surgery patients were 40% less likely to die from any cause during a
mean 7 years of follow-up, compared with the obese controls. What's
more, the mortality rate attributable to obesity-related disease was
52% lower on the whole in the surgery group: after gastric bypass,
patients were 92% less likely to die from diabetes, 59% less likely to
die from coronary artery disease, and60% less likely to be killed by
cancer."
and this:
http://www.cbsnews.com/stories/2007/...n3196880.shtml
Surprise! it's another press release of the same study.



I think some of the criticisms and questions raised are probably
valid, and others are likely not. For example, this blog raise the
possibility that the remission of diabetes type 2 in gastric bypass
could be due to the patients simply eating less food. Geez, I would
expect that researchers at a place like Cornell Medical center would
have the basic sense to test for this, which would be trivial. This
bypass effect results in remission within days. Surely they have data
and experience with other obese people with type 2 that have been on
severely restricted diets for a week to rule that effect out. As
well as the studies with rats. Are we to believe they are so stupid
as to not test this hypothesis on the rats, where they found the
bypass effect to work, and where they can clearly control the food
intake? So, when some blog starts hurling stuff like that around, my
BS detector goes off.
One aspect this blog focuses heavily on is the supposedly very
negative longer range effects. The60Minutesstory had a Dr with
4000 patients and 10-15 years worth of experience. I've also seen
other info from actual studies that suggest the long death rate in
gastric bypass patients from all causes is substantially less than
those that do not have the procedure.
You might want to look into that a little deeper. The net is becomming
increasingly crowded with blogs and support groups for people who have
had the surgery long enough for the serious side-effects to develop. Did
60minutesreally talk to long-term bypass patients? Those who are 7-10
years out to see how those people are living now?
60Minutesdid not show interviews with long term patients. They
did, as I pointed out above, interview a doctor with 4000 patients and
10-15 years experience.
Would that doctor perhaps, be wanting to sell his services to the
viewers of this program?


Yes, perhaps. But I could easily dismiss most studies, professional
opinions, etc on a similar basis. If gastric bypass is so damaging
and bad as you seem to believe it is, 60 Minutes could have done a
story on the irresponsible greed of doctors and medical
professionals. That would have been an even more sensational story.

Perhaps you haven't noticed, but it's really not fashionable these days
to question the rationale that fat will kill you. Why on earth would the
sponsors pay for a program that bashes a surgery that 'cures' fat people.



I looked at the60Minutesstory as a view into a curious side effect
of gastric bypass that no one expected, which is leading to more
research and COULD lead to treatment or cure for type 2 diabetes.
That could come from gastric bypass itself.. It could also come from
a better understanding of what goes on in the duodenum that causes
bypass to work, which in turn leads to a drug, etc. I guess you
could argue that the story was overly positive on gastric bypass, but
there certainly are studies that support it as a valid procedure for
some patients. And60Minutesclearly stated that patients typically
don't lose all their excess weight, but typically lose about 1/3 and
instead go from morbidly obese to just obese or overweight, etc.
Once again, I'd like a cite, with long-term data.
Try googling. I'm not claiming to be an expert on gastric bypass or
to have all the answers, long term data, etc. If you're so
familiar with the various aspects, pro and con, why do I have to be
the one to find the studies?
Because you're the one who said that you knew of studie(s) showing the
amazing benefits of gastric bypass surgeries.



Look, over the years, I've seen endless posts from many people here
talking about some new study, whether it be about LC, weight loss,
cholesterol, diabetes, etc. And in the majority of cases, all that
is provided is a link to the news story or perhaps an abstract of the
study, at best. I've never seen such hostility or demand for the
whole study, proof etc directed at them. And for good reason. Many
times these studies have been printed in medical journals and unless
you pay for access, you can't get the whole study.

I provided links that give the same sort of summary info for the 2
studies that directly support much of what 60 Minutes reported You
actually have one of the studies and the opening attack against it is
the silly 9 years vs 10.5 years argument. So, what's the point?




In short, you can draw your own conclusions. But I would look at
actual data from many sources before jumping to the conclusion that
the60Minutesstory is untrue because one blog says so.
Good idea. Let us know when you start.
Excuse me? Why the sarcasm?
Because while telling me to look at the actual data to form my own
conclusions, you are linking to ****ing press releases.


And now you interject profanity, which is never a good way to convince
people of your position. Why exactly are you so emotional over
this? I provided links to the news reports, exactly as many others
have done here over the years without being attacked. I've looked at
the nurses blog you provided and IMO it's clear that she has a very
biased approach to looking at this whole issue. Nothing there is even
close to being balanced and objective.

I understand that you think that she's not objective. What if the
studies are flawed? These studies have legitimate flaws that
delegitimize their reported claims. If gastric bypass (or bariatric
surgery, or lap banding) is safe and helpful in the long term than you
wouldn't have to play games with the methods and the reporting to sell
the procedure. How can you report good news if there isn't any.

On the other hand, despite all the time this thread has been going on,
it's quite obvious that you haven't even bothered to find out what 60
Minutes actually reported. If you had, you wouldn't be asking me
about what 60 Minutes did or did not say. If you're interested in
being fair and objective, that would seem to be a good place to start,
rather than demanding I provide full research studies.

As I said in this thread many times, I saw the 60 Minutes Story mostly
as opening a whole new avenue of potential treatments for type 2
diabetes and perhaps more. Researchers have found that bypassing the
duodenum reversed type 2 diabetes ina few days in humans. They
confirmed it with studies in rats. More studies are under way to
find out more about how this works and how it might be used. Exactly
the same process over the years has resulted in major medical
breakthroughs, which is a good thing and has saved lives. Bottom
line, are you against this research? Should this medical curiosity
just be ignored? What exactly do you want?

I want people to have access to information that will help them to make
good health care decisions. I don't think that's a bad thing. I doubt
that you will find unbiased health information from newsshows whose
advertising often comes from the heathcare conglomerates.

As to whether I want research, of course I do, but research is only as
good as the methodology. The criticisms in the pieces I linked to were
valid. You should know from hanging out in this group how often studies
are mis-reported or methodologically unsound. Just because it's been
published in a peer reviewed journal does not mean that all is right
with the paper. Especially currently in the medical journals. Want to
see just how bad it can be? Google 'Enhance Trial'.

The internets are increasingly home to blogs and support groups by and
for people who are past the honeymoon period and are starting to get
very sick, mostly from starvation-related diseases. So great, bariatric
surgery will cure my diabetes, I'll get nesidioblastosis and rotting
teeth instead. Sounds great, sign me up.

If you refuse to look critically at study data with an eye to the
methodology than no-one can help you.

good luck,
brigid