This is the first of a two-part commentary on the surgical procedure used to promote weight loss known as laparoscopic adjustable gastric banding, or lap band. -- Eds.
I had a bad dream the other night. In the dream world, it was forbidden to publicly oppose stomach binding (aka lap band surgery). I was under house arrest, waiting for my punishment: mandatory leg removal. I had failed to use my legs for the approved activity of running on treadmills to lose weight and had instead enjoyed walking, dancing, swimming, bicycling, doing yoga, gardening, having sex, and sitting cross-legged -- none of which made me thin. So I didn't deserve my lower extremities.
I don't think my dream was all that different from our current reality, where people of lesser and lesser weights (mostly women) are encouraged to sign up for surgeries to correct such problems as normal absorption of nutrients and failure to routinely regurgitate. It's the Victorian era all over again -- "Lie back and think of England (with every bite)."
In February, the U.S. Food and Drug Administration approved lap band surgery for average-height women who weigh as little as 174 pounds (206 pounds for average-height men), prompting get-thin-now billboards to spread across Bay Area scenery. Compare that with the average weight of American women (164 pounds) and men (191 pounds) according to a study from the U.S. Department of Health and Human Services.
The FDA approval not only creates 26 million new suckers -- er, potential customers -- it also paints a surgical target on more-or-less average-weight people. (Keep in mind I think it's a bad idea to do digestive bonsai on fat people, or people with health problems, too.)
Billboards touting the joys of stomach binding are ubiquitous in Los Angeles. According to reports from the Los Angeles Times, families of four people from the region who died after having lap band surgery (Tamara Walter, Ana Renteria, Willie Brooks Jr., and Laura Faitro) have filed lawsuits against surgeons, who argue the deaths were not related to the band or how it was implanted. Los Angeles Department of Public Health director Jonathan E. Fielding asked the FDA to investigate whether billboards carry sufficient warnings about potential complications.
Allergan, the company that makes 70 percent of the devices that borg-ify stomachs, also makes Latisse (Bigger Eyelashes Through Chemistry!), Botox (Poison Those Wrnkes Away!), and breast implants (Why Suffer from Small Boob Syndrome When You Could Roll Some Silicone Doilies?). This is a company that cares about your health.
The next thing that some stomach binders want is for the FDA to let them cinch healthy internal organs in teenagers.
All this leads me to love the obvious anagram: LAP BAND = BAD PLAN!
From the physicians' point of view, do stomach-binding surgeons imagine that millions of people eat excessively? Regardless, doesn't common sense suggest that other alternatives would be preferable? For example, if someone has the newly ratified psychological diagnosis of binge eating disorder, wouldn't that person benefit more from therapy than surgery? And if someone faces health problems such as diabetes or heart disease, wouldn't that person benefit more from eating nutritiously than risking malnutrition or other complications?
From the consumer's point of view, what sort of enjoyable, health-enhancing, body-loving endeavors could you buy with $12,000 to $20,000 (the price range for stomach binding)? Start with joining a gym that has a pool, hot tub, and sauna, or sessions with a Health At Every Size trainer, weekly massage or acupuncture, organic vegetables, a new wardrobe -- and there would still be money left over for kayaking and hiking tours.
Lap band surgery is the only noncosmetic surgery advertised on billboards. But is the procedure really about health if, as the New York Times reports, people are intentionally gaining weight (or wearing hidden weights -- let's not imagine where!) in order to qualify for it?
Next week: Studies, parodies, and a personal horror story of lap band surgery.
Marilyn Wann mourns Amy Winehouse's death and sings, in her honor, "They tried to make me get a lap band and I said, 'No! No! No!'"
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