Girl defies laws of thermodynamics: Why isn't this being touted as a huge medical breaktrough??

And journalists never, ever make mistakes, especially when reporting on medical or science issues.

I for one think that the laws of thermodynamics are very, very safe.

I really didn’t see anything wrong with the article. I don’t think the journalist could directly accuse the little girl of stealing food, whether she did or not. And nowhere did it say that the laws of thermodynamics were violated.

I think Doper’s reading comprehension is more at fault here then the journalist’s writing.

I was making a more general point, (adding to **Cognitive Dissonance’**s list) rather than critisizing this particular article. And the thread title did say: “Girl defies laws of thermodynamics”.

So in reply to the thread title, I would say “No. No she doesn’t”

Reading the article I increasingly don’t get the problem of the op.

Statement one: The girl had a brain tumor (crainopharyngioma) removed which has resulted in damage to her hypothalamus, causing hypothalamic obesity. As a result she

This is a well described condition and that amount of weight gain as a result of the condition is something that occurs.

Statement two. Even when on a restricted calorie diet she gains.

That is also well described, as noted above.

Does it somehow offend people here that the brain is involved in regulating metabolism itself? That damage to parts of the brain involved regulation of appetite and metabolism can cause a substantial decrease in BMR, in baseline activity (non-exercise activity thermogenesis - NEAT), in total calories needed a day, while also causing an intense drive to eat more with the brain convinced it is starving to death so much so that yes padlocks get broken? That bariatric surgery seems to work when other approaches fail, apparently bot only by reducing intake but by its neurohormonal effects?

What’s the problem here?

Could it be water retention? There’s no restriction on that, is there?

And is some of that “water weight?” I was a bit bloated and, using a prescription diuretic as indicated on the label, managed to fill a ten quart bucket to within two quarts of the top in about ten hours, peeing every seven minutes for five hours of that. That’s a loss of sixteen pounds of non-fat. (If you can’t experiment on yourself who can you experiment on?)

eta: Er, like the_diego said.

Because it’s impossible, and therefore someone’s either lying or mistaken. “Overweight person lies (or lies to themselves) about how much they’re eating” isn’t as good a story.

It’s only a $10 fine. You can just mail in a check, and no points will be added to your driving record.

But seriously, this story doesn’t really sound that crazy. It’s been proven that crash dieting is a very bad idea that can actually cause you to gain weight.

The problem is, if you didn’t get the snark of the op, is that the rate of weight gain and the rate of calorie consumption do not jive with each other, from a thermodynamics point of view. Both numbers are perfectly acceptable and realistic, but as long as they are independent of each other.

The other problem is that the family is demanding a gastric bypass surgery, which has not been shown to be safe or effective on children.

I got the snark of the op and it seems horribly misplaced to me, based on a very contrived read of the article that bespeaks of some issue the op has more than something of the article. I assumed that the hidden issue was the unspoken debate implied in the op, since this is GD and not The Pit.

A child has, as a result of surgery for a brain tumor, hypothalamic obesity, which causes massive weight gain (by significantly decreasing resting energy metabolism, decreasing other energy expended, and by increasing appetite). Even when put on a very restrictive diet she gains. There was no claim, other than by twisting your head out the window and looking thus so, cutting and pasting those two separate bits from their contexts next to each other, that she gains over 2 pounds a week even when successfully put on that restrictivie of a diet. The statements were in different sections of the article, one talking about how overall she has inexorbly gained at that rate and the second about how attempts at calorie restriction have not been effective. Even if there was that claim, that is, in this case, likely fairly mild hyperbole, much less than almost every news article indulges in.

Also your statement is untrue: bariatric surgery in severely obese adolescentshas a similar safety and efficacy profile as in adults.

Its role in standard issue adolescent obesity should be limited - as the first Pediatrics link suggests - to those who are very severely obese with multiple obesity related comorbidities who have failed other organized and supervised approaches. For those select cases it is very likely a life saving procedure. For this child, with the additional particulars of hypothalmic obesity as the cause, it does appear to be an indicated procedure. It should be covered and quite possibly will be on review.

To beat the dead horse, the whole THERMODYNAMICS!!! bit is usually bandied about in a whole mess of ignorance as well.

The 3500 calorie bit … that would only apply if the only factor in weight gain or loss was fat tissue. It is not. Weight gain and loss also consists of protein and carbohydrate stores, bone mass, and extra fluid. Protein and carbohydrate are less than half as calorie dense per unit weight as is fat and the extra fluid and bone mass are not calorie dense at all. The math that assumes that gaining two pounds a week equals 7000 calories is based on a faulty assumption. It is not so simple.

ISTM that we’re not really supposed to be discussing ways to break the law on this forum…

She should have a father like Homer Simpson:

“Lisa, get in here! In this house we obey the laws of thermodynamics!”

The problem is that when it comes to obesity, a significant subset of the population is loudly and willfully ignorant. But you already know that.

Does that mean a ban on performances of Paganini’s Moto Perpetuo?

The law is harsh!

May I point out that one reason the R-E-Y type of operation works is that it reduces the length of small intestine which effects the way the body absorbs nutrients from the digestive process? It isn’t rocket science [actually it is, there is some arcane calculation that matches up the remaining stomach pouch with small intestine length to determine the absorbtion, I can remember running across it mentioned in a study I was reading a couple years back] If they were to just pop in a lap band it would not have the same results - lap bands work on resticting the amount of food one can eat at a time, and she may well pop her stomach by continuing to pack the food in because her brain refuses to tell her to stop eating because she is full.

I really do believe that they need to do something, and that may well be admit her somewhere that they can make sure she really doesn’t keep eating, or the family need to lock her in a room she can’t get out of.

[Wasn’t this a CSI Las Vegas episode, some poor guy won a hot dog eating contest and was found dead from essentially eating until his stomach exploded?]

The Roux-N-Y surgery doesn’t by definition reduce the length of the small intesting. It drastically reduces the holding capacity of the stomach by removing everything (including the pyloric valve) but a pouch and connecting that directly to the small intestine.

Malabsorption is done with a BilioPancreatic Diversion with Duodenal Switch. First, the stomach is reattached to the small intestine past the duodenum, strictly limiting how much nutrition can be absorbed. Then, bile and pancreatic juices are diverted to an even further point of the small intestine so that there is less time for that specific digestive stage, and even fewer nutrients are absorbed.

I wouldn’t even say this child is sabotaging or cheating on her diet. Her brain is telling her that she is starving to death. After air and water, the drive for food is so strong, a person in those circumstances won’t have the opportunity to make a concious decision. They will simply do whatever they can to get their hands on any food at all.

It’s too bad there’s so little sympathy for her.

I have great sympathy for her, I just do not think that reducing the size of her stomach will help as much as the mother thinks it will if she can not control her eating. A friend of my father’s had the procedure done, lost weight for the first year and packed it back on and more in the next year because all he ate was junk foods all day long. He ended up dying as a result of the added stress on his heart of bumping from 400 to almost 600 pounds.

Now if there was some medical cocktail or new procedure that would restore her brain’s ability to properly control the hunger reflex, that would be fantastic. Until that time, physically controlling the access to food is probably the only way there is to deal with the situation.

I think she is just as disabled with respect to controlling her eating as I am with me telling my pancreas that it needs to pump out more insulin. It ain’t happening, and I can’t manage to get recreationally outraged by something that is totally out of my control.

You may be interested in reading the article that I linked to about bariatric surgery for this exact condition. Your concern is a reasonable one but the simple fact is that it does seem to work in that population when other approaches have failed. It may be that the neurohormonal effects of the procedure (which is why it is so effective in treating obesity associated diabetes, even before there is any substantial weight loss achieved), such as on gut hormones ghrelin, GLP-1 and PYY, may be a large part of the reason for its efficacy.

Admitting her to a lockdown facility for the rest of her life to control her food intake to match her reduced metabolism (or less than it to achieve loss), or otherwise imprisoning her, is obviously not a viable option.