RE: Losing weight and binge eating

[Guest guest]

> I don't know if anyone lurks on the DS post op group, but

> there was a woman there who posted who was binge eating

> at night at 8 mos post op and was not losing -- obviously

> if she's binge eating. Has anyone else run into this

> problem?

I saw that post too, Chris. It's hard to know (obviously) what the real

problem is, but certainly if she is binge eating, that can't be helping

matters. I think it's important to be cognizant of the fact that, even

though it's uncommon, a few DS patients simply do not enjoy as much

success as others. Whether that's a failure of the procedure or of the

surgeon or of the patient is up for debate. But the statistics are what

they are. If you look at the Hess report, he breaks down his patients by

percentage of excess weight loss and kept off (see Table 6):

http://www.duodenalswitch.com/Procedure/1998Hess/1998hess.html

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Table 6. Composite grade and results for 361 primary cases.

Grade n Total (%)

Excellent 288 79.8

Good 47 13

Fair 25 6.9

Poor 1 0.3

Failure 0 0

Total Satisfactory 99.7

Total Unsatisfactory 0.3

Grade determinants (all minimum values): Excellent, 80% EWL;

Good, 60% EWL; Fair, 40% EWL; Poor, 20% EWL; Failure <2% EWL.

Satisfactory = excellent, good, fair; unsatisfactory = poor, failure.

Table 6 illustrates the number of patients in the different categories

and their results with follow-up to nine years. There are 335 patients

in the " good " and " excellent " categories for a total of 93%. The other

group falls into the " fair " category which is still satisfactory. Most

of these are considered successful, as they have had a stable weight for

a long time, but did not lose excess weight of more than 60%. In the

" fair " group there are 25 patients whose excess weight loss is from 40.2

to 59.8 percent with an average of 50.2% excess weight loss. When

comparing those to the determinates in Table 3, our total satisfactory

results is 99% with 1% unsatisfactory. Table 7 illustrates the total

patients counted in different years follow-up by number of patients,

number of satisfactory cases, and number in good and excellent

categories at that year. Of the long term results, there is a only

small amount of regain and we have never had a patient regain weight up

to their original weight. Our one patient in the " poor " category has a

weight loss of 35% of excess weight.

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So, while we all hope and pray for the best success possible, the fact

is that a few unlucky people will fall into the less successful ranks.

It's a bummer, and I feel horrible for anyone who undergoes WLS and

doesn't see their hope fulfilled. But ultimately, I think we do have to

remember that even the DS, as powerful as it is, can be weakened in

various ways, one of which undeniably would be binge eating of

highly-absorbable foods. I think in these cases, the best route is for

the patient to get psychological help in order to avoid the emotional

pitfalls that can undermine success after the DS.

M.

---

in Valrico, FL, age 39

Lap DGB/DS by Dr. Rabkin 10/19/99

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Starting size 26/28, now 10/12

http://www.duodenalswitch.com/Patients/_M_/melanie_m_.html

Direct replies: mailto:melanie@...

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