Welcome to the ranks of the “Pre-approved”

Well I was just clued in by a short post over at Big Fat Blog that the request put in for the FDA to lower the weight limits for people to be approved for Lap Band surgeries, was just approved.

Yes, now we can open our arms to welcome in all of those who are “less than severely obese” to the ranks of those who doctors can now gleefully recommend surgically altering the way the human body is allowed to process food.  Allergan is certainly going to be one happy company if this move does indeed “Pave the way to double the number of Americans who qualify for weight-loss surgery.”

Says the NY Times article of this FDA move:

Current guidelines say weight-loss surgery is appropriate for people who have failed to lose weight through diet and exercise and have a body mass index of 40 and above — or 35 and above if they have diabetes, hypertension or another severe health problem associated with diabetes.

Allergan wants to lower the threshold to a B.M.I. of 35 for people without health complications, and to 30 for people with health problems, which also would no longer have to be severe. (Emphasis mine)

I just want to point out the bold up there.  Did you catch that bit about how you could now be approved for a Lap Band simply by merit of being fat (over 35 BMI) WITHOUT HAVING ANY PRIOR HEALTH COMPLICATIONS.  I mean, do the people writing this crap even take a moment to wrap their brains around how INSANE this is??  How disingenuous to be offering a surgical procedure to physically alter the way your stomach is able to process food simply because you’re fat, BUT STILL HEALTH-PROBLEM FREE!?!

A little red flag to me is that this comes at at time when people are being booted from the military because they don’t fit the already outrageous BMI standards and can’t manage to trim their bodies to acceptable sizes; a topic excellently covered by Lesely over at Two Whole Cakes.  How many of those folks at the edge of being fired for their BMI, are going to sign right up in order to keep their jobs and continue to serve our country?  Probably more than I’d care to find out.

*sad sigh*

The article does indicate that there was some push back to Allergan’s proposed new lower limits:

But some committee members said the study was too small and too short, especially since people might have the band inside them for decades. Some wanted more evidence that the operation resolved diabetes or other health problems. Most panel members said the study included too few men, blacks and Hispanics.

Yet even those were apparently pushed aside because 2 of the 149 people in Allergan’s apparently nearly definitive little “study” told personal stories about how getting this surgery “Changed Their LivesTM”.  Read on:

Two participants in Allergan’s study, whose transportation to the meeting was paid for by the company, testified that the surgery had changed their lives.

“I couldn’t walk up a flight of stairs or even take a shower without taking a rest,” said one of them, Brandi Jirka of Nashville, who did not specify how much weight she lost. “Now I can run and play with my children, I do yoga and can shop at regular stores in the mall. I’ve even been snorkeling while wearing a bikini.”

Tell me again that this is all about health, okay?  The part that sways the committee to approve this lower BMI, is that two people are all excited that they can now “Shop at regular mall stores” and “Wear a bikini”? Yeah, I know those two ticket items are huge on my OWN personal health check-list, what about you?

There was a moment in the reading of that NY Times article where I cheered, but then cried at the same time. There was a call to remove the idiotic use of BMI (yay!) but only because it put limits on how many people we could call fat and push towards these lap band devices and bariatric surgeries (wtf!?)

Some also said that B.M.I. was too crude a measure of how much a person needs surgery. (YAY! Right on: BMI is badly flawed. Emphasis mine)“The B.M.I. criterion is so seriously flawed,” said Dr. John G. Kral, professor of surgery and medicine at SUNY Downstate Medical Center in Brooklyn. “Removing this barrier of this idiotic number in itself would be an important step.”

Allergan, which is known mostly for Botox, hopes that expanding use of the Lap-Band to less obese adults — and also eventually to teenagers — will spur sales. Sales of its obesity products, mostly Lap-Band, fell 4 percent to $182.4 million in the first nine months of this year, a decline the company attributed to the weak economy.  (Emphasis mine)

Are you kidding me??  We’re worried about this only because the damn company isn’t SELLING ENOUGH LAP BANDS?!?! Boo fucking-hoo!!  All of this push to make the range of people we’re allowed to call fat (which happened big time back in 1998, remember?); because poor Allergan wants to bump up its numbers for the range of “obesity products” which makes up a measly 5% of its overall sales.  AND did you catch how they hope to next push this crap on teenagers??

I just….this is why I’ve been trying to stick with the more positive posts lately.  How can such moves make sense to people?? I know that we all have been force-fed the idea that people only get Unforgivably Fat because they overeat but when will we raise our hands, stamp our feet and say “NO! Enough is enough!!  Leave my fat body alone!”?

In case  you’re more of a visual person, take a look at this slide show for the BMI Project.  THESE are the many people that Allergan wants to be able to slice into and make smaller. All the folks labeled as “overweight” “obese” and beyond.  And is anyone else beginning to feel the strain of the potential for them to ask for the high-end “normal” folks to get under that knife too next?

Do you think all those headless fatty photos that accompany such calls for stringent anti-fat measures make you safe?  Do you look at them and think “well, I’m still fine, sheesh, I don’t look like THAT”  Yeah, well Allergan thinks you DO look like that.  And it’s coming for you next with a scalpel in one hand and the other outstretched for its monetary recompense.

So, welcome to the ranks of the pre-approved.  Welcome to the ranks of the medically fat.  I’ve been here for quite some time.  You can submit your indignant rage here….


17 thoughts on “Welcome to the ranks of the “Pre-approved”

  1. My weight is just below the cut off 30. Let’s say that I went to a less than professional doctor. I ate pancakes and syrups before getting a fasting blood sugar so I could claim to have a comorbidity. I could slouch to make myself appear a little shorter and be over the 30 BMI cutoff plus weigh heavy clothes. I’m not recommended that healthy overweight people do this, but it could be done.

    So someone that it only fifteen pounds overweight by BMI could have this surgery without any real health problems. I’m using the pancakes scenario because I forgot that I ate before a blood test and had a high fasting blood sugar when it turned out that I ate. The stupid tech when I told him that I may have ate that morning said that it wouldn’t matter. A fasting and postprandia glucose level can be quite different.

  2. I’m within the new cut-off, health problems or not. (I have had high cholesterol, but I’m hoping that treating my thyroid issues is dealing with that.) That scares me.

  3. In case you’re more of a visual person, take a look at this slide show for the BMI Project. THESE are the many people that Allergan wants to be able to slice into and make smaller. All the folks labeled as “overweight” and beyond.

    FYI, BMI of 30+ is “Obese” per the CDC / WHO definitions. “Overweight” is a BMI of 25+. So this proposal affects those who are at 30 and above.

    Note, MOST of those who are officially classified as “Obese” have a BMI below 35. So this would definitely increase the potential market.

    • Living 400lbs; thanks for the clarification! Though I imagine it won’t be long if this sets a precedence before such companies are pushing for that overweight category too….

  4. Awesome post!

    I once had an argument with a woman who could not believe that medical studies and requirements could be fudged and skewed. WOULD NOT BELIEVE IT. and here we have right here – more people are now “dangerously obese” because a company wants to make more money.

    • Anna: yeah, it’s actually pretty frightening to me how easily this company has been able to push the idea that was basically founded on them wanting more money. A sad look into commercialism/consumerism/capitalism (one of those C-isms) and how it really ISN’T about the consumer…it’s about the company/corporation and their profit margin.

  5. It scares me how many people that will do anything to be thin will be sucked into this. When I was a young adult, I would have slouched, got a comorbidity ( like my false positive glucose test or white coat syndrome) to no longer be fat. I thought I was horribly fat although my BMI was in the overweight range closer to normal than obese.

    I can see many more people dying from the complications. I could see a thinner person, somebody with an original weight barely over 30 easily starving to death since they couldn’t get the added nutrition that they need if injured or sick.

    With our cultures fear of fat, many people that can afford this surgery will have it. Many will regain the weight. They will be the lucky ones.

    • Lillian, I know this really triggers my fear-bells too and I don’t know what it will take for people to look up from their head-in-the-sand mentalities and go “Hey! Hey, this isn’t RIGHT!”

  6. Allergan make me physically sick to the stomach. All they want is money. They don’t care how many people they have to kill and/or maim to do it. The fact that this is all sold to the general population in the name of “health” is the most offensive thing of all.

  7. Of course, these things are NEVER about our health. Look at any given “health” magazine (especially ones aimed at women…) at the grocery store or newstand, what are the headlines on the cover blaring? Stupid dieting BS. Do this X times of day and don’t eat Y to lose 20 pounds in two weeks! (Which is medically unsound.)

    Fuck, I’m more physically fit, stronger, and faster than a lot of people half my size. But because I wasn’t born with a fast metabolism, assholes just assume I’m lazy and/or have no willpower.

    But no, I apparently need a Lap band to make my life complete! Fuck these stupid companies that just want to make money off the weight-shaming culture this country is drenched in.

    • Rachel I think it’s pretty insidious how EASY these corporations and companies find it to market materials, services, etc to a population drenched in self-loathing. And it’s also frustrating in that such highly promoted self-hatred schemes end up hurting everyone by assuming that one “look” is somehow the model to strive for; which means their well-being is pushed under the rug too! *sigh*

      • It IS so sick and sad. I mean, the Lap band isn’t as drastic as say, other WLS such as gastric bypass surgery– death rates with gastric bypass are pretty common because it’s a lot of organs being messed and literally cut down from their natural size while the Lap band just compresses the stomach and there has only been a miniscule amount of deaths caused by the surgery.

        But fact of the matter is you get this “For your health!” crap shouted in your ears but how healthy is dumping syndrome where you don’t get nutrition from the food you eat anymore?! And hell, it’s other approaches too…like calorie restriction to the point that you’re tired all the time, exercising to the point that you’re vomiting/fainting?

        You’re absolutely right, it’s from the self-loathing that just gets ENCOURAGED…I thank the fuckin stars I’m not in that school of thought anymore. I have awesome friends, a loving family, a long trail of lovers, a great career and education, and all that’s been there at 300 pounds and still is at 225 (where I haven’t been able to get any lower from and no longer give a shit.) I think at 120 or 400 I’d still have those things because I only embraced them after I learned to stop hating myself!

  8. The increasing association between diabetes and WLS terrifies me. There’s even a push among certain doctors to rename WLS to “diabetes surgery”. What I fear is that, by changing the labeling, something that should be a last resort (at best) may become a standard treatment.

    This may sound far fetched but really isn’t. Diabetes is a serious condition, and managing it takes a lot of time and effort, and even then there’s no guarantee of achieving good control. If you happen to be also fat, there’s a good chance you’ll be pressured to lose weight. It doesn’t matter if you try to explain that you’ve been trying to do that for most of your life, without much success – since your health is really at stake, you’re expected to somehow react and summon the necessary willpower to finally lose the weight.

    But if there’s a “diabetes surgery” option, and a relatively safe at that, things suddenly become so much simpler. You only have to pass a certain BMI threshold and suddenly you’re entitled to the magic cure. It doesn’t matter that things aren’t really so simple – once the treatment is approved or even sanctioned by the competent authorities, which doctor will question it? Which patient will refuse a cure for a lifelong condition?

    • Fat and diabetic: Those are some excellent and compelling questions; to which I have no good answers. I’m not sure that many would fight against the flow to question things approved higher up and that just scares the bejeezus out of me.

    • That IS a totally scary question. Diabetes can be brought on by unhealthy lifestyles (but of course weight gets blamed…) but is also hereditary– unfortunately both Type I and II run in my family, my paternal grandfather was very sick with diabetes in his final years and was how he lost his life. Both my parents had Type II.

      In this day and age where weight loss is touted as this miracle cure (and if losing weight doesn’t cure your ills, now you’re suddenly worthy to have your problems examined by these bigoted overcompensated d-bags!)…it makes me wonder what they would’ve said to my grandfather had be around in this decade because while both my parents were fat, he wasn’t. Would a “normal” person be directed to this “diabetes surgery”? There are so many thin diabetics out there but diabetes is totally labelled a fat disease.

      What about that at least for Type I diabetes, even after this miracle band does its thing, you will still have an insulin imbalance? You’ll still need to test your blood and be mindful of what you eat to keep this condition under control? Diabetes is NOT the same thing as a strep throat or ruptured appendix that be cured with a short-term drug and routine surgery! When will this insanity stop?

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