I don’t see that he’s advocating making gastric bypass for children the norm. This kid isn’t the norm. Brain tumors aren’t the norm. Damage to the parts of your brain that control hunger and metabolism, while normal for the sort of surgery she had, aren’t the norm. Having a metabolism so slow you can gain weight on what is normally considered a starvation diet isn’t the norm.
And frankly, you seem to be far more focused on addressing the symptoms than the cause. Her increased appetite and lowered metabolism are the symptoms–the cause is that the hormones that regulate those things are fucked up. If gastric bypass can reduce how fucked up her hormones are (this isn’t an effect I was previously aware of, though it makes sense once I stop and think about it), maybe it ought to be the norm for this sort of situation.
You have GOT to be joking! DSeid is a licensed pediatrician who specializes in pediatric obesity. As your posts have made abundantly clear, you have no training in the subject at all. Look in the mirror is you want to see who’s out of their depth.
Oh, and FYI, to my knowledge DSeid is not obese. He’s also a regular participant in the exercise and weightlifting threads on this board.
I’ll take your concern about my depth under advisement. Thank you for the concern.
I completely understood that your belief was that bariatric surgery was, in this case, unnecessary. Since you are still confused, that was what I was referencing as
No not the removal of the tumor.
Bariatric surgery has been demonstrated to be effective in treating the severely disabling and life-threatening obesity that results from the hypothalamic damage that removal of a craniophyngioma causes in cases in which other approaches (including supervised diet and exercise programs and medications) have failed. Really. The cites have been provided. I appreciate that the actual articles are possibly a bit medical and scientific jargonish for you but reasonable reading level summaries have been offered as well. Maybe I overestimate your reading level but you should have been able to understand the clear language presented.
As artemis notes, I am not obese. Fitness and nutrition are strong interests of mine both professionally and in personal practice. I’ve done a marathon and a half-Ironman. At 54 I feel I am in as good of condition as I’ve been in my life. But really, so what if I was obese? You are attempting an ad hominem fallacy. My being fit and not obese matters as little to this discussion as my professional status. What matters on this board are the arguments and evidence you bring. I could be fat High School drop-out and it would be of no difference. You could be an MD/PhD actively involved in the research in the field and you still present only vacuous arguments and zero evidence.
To be precise, btw, I do not specialize in pediatric obesity. I am a general pediatrician who is strongly interested in it and have participated at a leadership level in developing the programs that work towards preventing and treating it. The basic science research on obesity also fascinates me.
Still wondering how you would address the cause of this girl’s problem: the hypothalamic damage. But you’ve gone bye bye I guess so we’ll never be able to share your approach with medical science. Such a shame!
It seems that L4L is not understanding the point that DSeid is making. Let me see if I can make it simpler to explain.
-The child had a brain tumor that required surgery.
-The surgery caused damage to the brain causing the girl to have a lower metabolism than normal and trouble regulating her appetite.
-This is partially because that part of the brain releases hormones that affect metabolism and feeling full partially by acting on other hormones in the stomach.
-Even if she restricts her diet she will gain weight because of the low metabolism.
-We don’t know how to repair the brain damage caused by the surgery.
-Dieting won’t change her metabolism.
Doing a surgery that just limits the size of the stomach (like gastric banding) may make her feel physically full but won’t solve the problem because it won’t increase her metabolism or give her brain the feeling that she is psychologically full (satiated) so she may continue to overeat and gain weight.
-Gastric bypass reroutes the intestines and therefore alters how hormones in the stomach are released and absorbed which then signal back to the brain which can increase metabolism and also give her brain the feeling of fullness.
-Yes it is surgery, but it is the only way we know to fix the hormonal feedback loop.
-Studies have shown that this surgery does work in this particular condition.
-If the child does not have this surgery which is the only recognized effective treatment for her condition she could die.
-Therefore, the surgery is necessary.
Indeed - IANAD/N, but I recently worked on a study where patients with various autoimmune diseases were on prednisone long-term, and the study was trying a particular medication to get them off the prednisone and still treat their disease. (There are plenty of alternatives but each has its own side effects, levels of effectiveness vs various ailments, etc.) Prednisone has lots of side effects, but the patients all wanted to get rid of the crazy level of insatiable hunger. Most said their families and friends just couldn’t imagine what it was like, told them to just not think about it, etc., when it was more like trying to ignore a migraine or something similar. The level of relief when you can get someone off of their long-term prednisone is amazing.
From me as well, thanks to DSeid for the level of expertise in this area.
Thank you for the thanks. And twickster my apologies for being unable to more completely contain the tone of my responses … I must say I did not quite get why it got moved here instead of The Pit though based on the op alone … but I am no mod.
This thread is a really amazing, perfect example against the nasty prejudice that exists against overweight people, even if the weight gain is provably not their fault. For that, I thank L4L for what will no doubt be a great cite in the future.
Example 1 (paraphrasing for those who didn’t get it the first time)- Hey, Doctor who’s specialty encompasses exactly the issue we are discussing, my uninformed lay opinion carries more weight (see what I did there? My own amateurish attempt at the craft) than yours which is drawn merely from years of study and experience.
Example 2 (parphrasing again) - Hey, you whom I have never seen and only know exists via electrons on a computer screen, you are defensive and pig headed because you are a fatty mcfatfat.
I really thought Dopers were more in tune with the comedic arts than this.
[sub] Please tell me this was absurdist humor…please?[/sub]
