OKCPirate

@@BigViffer - Wow, well welcome to the big city Being from Indiana should have been considered a VERY good excuse BTW

Can't wait to here the great reports. Hope the other repairs go well.

@@Seahawkgirl - congrats, continued sucess

@@BLERDgirl - I wouldn't any more. They did a reformulation and it gets clumpy now. I found pipingrock.com. Their Protein powder is 1/3 the cost and dissolves well on everything as long as it's not too hot (my Kerug brews at 192 degrees, the powder clumps at that temp, but when allowed to cool for 3-5 minutes, it blends very well).

I think you just saved yourself some time on the other side. So be thankful. I have had run in's with people who I had met online before surgery, and they can eat their hearts out, they let me know who they really were on the other side.

I have been writing the studies author, here is his response: Thank you for the clarification. First of all, I share your concern that the overall benefits of this procedure should not be misinterpreted in media reports and we have tried our best in all interviews that we explain well that this (self-harm) problem concerns a small proportion of bariatric patients, and it can be addressed by a targeted, better follow-up of patients who may need them. Regarding the comparison, we did not compare the bariatric population (cohort) with any external general population. The statistics that you have mentioned is a descriptive one. It indicates a mental health diagnosis recorded in health databases in the five year prior to the surgery. Of note, up to 10 diagnosis can be recoded per patient, whenever, he or she contacts any provincially funded healthcare provider (mostly physicians). The most patients were diagnosed with anxiety disorder and a proportion with depression. What we did is that we repeat the analysis per stratum, i.e., by age, gender, income, and mental health strata. We observed similar trends as the main results though some strata showed more increase in events than others. We are aware of Cleveland clinic study as well as the fact that there are several groups in the US looking into long-term psychosocial consequences of this surgery. We tried our best to indicate the benefits of the surgery and the accompanied invited commentary from JAMA Surgery also seconds us on this. - We aim that our findings result in a better acknowledgement and awareness of this issue that touches a small proportion of bariatric patients Warmest regards, Junaid Subject: RE: Your JAMA article/editorial I saw the difficulty in doing the study. Without significant funding it would be really hard to get a real profile of those who are doing the self-harm. My concern is in the abstract you mentioned 93% of the self harm group already suffered from some form of mental illness. And when compared to the population at large was there a check to see if the populations were similar. Was there demographic analysis of the population that did self-harm besides location, age and sex? For instance income? My concern is that you are probably looking at a specific demographic sub-set which should be compared to a like sub-set, not the population at large. Without it you are creating a new stigma for those of us who have used these procedures. If the media is misinterpreting your study for a cheap headline, well that’s not your fault. Did you all check with the Cleveland Clinic who has been doing some fantastic research on long term results of bariatric surgery? I appreciate your attention.

@@goodnuff - yes it's a crooked game, but it's the only game in town...sigh

@@CowgirlJane - I think you are dead on right, goes along with Dr. Primack's comments: Craig Primack, MD, at the Scottsdale Weight Loss Center in Arizona, wrote in an email toMedPage Today that bariatric surgery should be considered a treatment, and not a cure. ADVERTISEMENT "In my practice, a subset of patients believe that many of their problems stem from their weight: (poor job, still single, bad marriage, no close friends, etc.) and when they get down to a specific weight then everything will be OK," he wrote. "When they get to that number (or close to it) and realize that they will not achieve the thing they thought their weight would fix, they stop losing weight to literally stall and not have to face the fact that when they are at their goal they still are single, still have a bad job, etc."

@@CowgirlJane - I'm sure the sun will continue to rise in the east despite your presence

@@James Marusek - thanks...the study was actually worse than I thought. This is a great summary: “A total of 147 events (93.0%) occurred in patients diagnosed as having a mental health disorder during the five years before the surgery.” Whoa! Did anyone in the news bother to read even the abstract?? Almost all of the suicide attempts occurred in people who had already suffered from some form of mental health issue. The two most common types are anxiety and depression (they frequently co-exist, and a common view is that they are actually two sides of the same coin). Here’s an alternative headline: “People who are depressed attempt suicide more often that those who are not.”

@@scubav85 now that is a bad date

it worked for me...thanks

@bellabloom...heathen;-)

@@gpmed - you are correct. But judging people going through a major life event, should be compared to everyone going through a major life event, not to the population at large. So I would conclude that doesn't make WLS patients more at risk than anyone else who has: Gone through a tough divorce Lost a spouse Lost a kid Yadayadayada Now does that mean I don't recommend to everyone who is new to this site and thinking about the surgery not get a counselor and work through the WLS Emotional First Aid Kit book? No, I do. But look at this guy's conclusion "you are 4 times more likely to kill yourself if you have WLS. And I think that is just blatantly stupid and poor science. Shame on JAMA for publishing and doing the editorial. The just gave an excuse to big insurance to deny more people.* *I'm not bitter, I self-paid for a reason. I didn't want to go through the insurance hoops and it was actually cheaper than all the co-pays.

This is the email I sent to the author's of the study: Dr. Ghaferi, I read about your study on bariatric surgery and self-harm with some alarm on http://www.medpagetoday.com/PrimaryCare/Obesity/54035. If I understand this, this is based off Canadian data? Was there demographic analysis of the population that did self-harm besides location, age and sex? For instance income? My concern is that you are probably looking at a specific demographic sub-set which should be compared to a like sub-set, not the population at large. Without it you are creating a new stigma for those of us who have used these procedures. If the media is misinterpreting your study for a cheap headline, well that’s not your fault. Did you all check with the Cleveland Clinic who has been doing some fantastic research on long term results of bariatric surgery? I appreciate your attention.

@@gowalking - When I dug deeper into the numbers, I think this is total crap. They are comparing apples and oranges. They were damn lazy. They have huge gaps. They don't know if the population of self pay (since this data from Canada where a very large segment of the population would rather self pay than wait for socialized medicine). If you add in the self pay WLS patients, that would lower the percentage of self-harm down to the population at large. There is no control for demographics. He's comparing unemployed self-soothing fat people to the total population and saying this proves the surgery will make you four times more likely to kill yourself. Sorry, total and complete BS. However on FOX news or CNN the headline will be "Have stomach surgery? You will probably kill yourself." Absolutely irresponsible.

@@bellabloom - Sounds about right. In short, be a dang gentleman and treat this as an opportunity to meet another human being.

@@gowalking - Thanks for pointing out this article. This actually tics me off. It stigmatizes all of us. But what they are pointing out the same results that happen to those few who win the lottery. They have problems too: http://www.thedailybeast.com/articles/2010/02/19/lotto-death-curse.html. Sudden good fortune is a blessing or a curse. It depends. And when I look at the whinny videos of people who have had WLS but eat crap and then bemoan their magic wand didn't work it really makes me mad. Well that's not completely true, I feel for them. But when people who self soothed through food are suddenly cut off of their only source of pleasure, what do you think is going to happen? You don't think anyone can see that? The morbidly obese are killing themselves. They don't have the coping skills, no support network what do you think is going to happen? But bunching me and the vast majority in that group with the crap stat "twice as likely to commit suicide" which is what everyone takes away from the story stigmatizes a potentially life saving procedure for many. If they broke it down into demographically true numbers you will find that those who are in the group that kill themselves are probably no more likely to hurt themselves as others in that demographic. So I'm ticked at JAMA again.

That's OK, we all talk about Babbs too and Elode

@@ladivaluz806 - While its important to learn from the past, it is vital to NOT project other people's failures on the new guy. Tough to do, but important. And it's only fair.

@@ItsTheNewMe - that is great, great for you, and a big high five to your husband for sharing

@@volsfan82 - it is, but respect the sleeve, take it slow and it will go well. Good luck, can't wait to hear about life on the other side.

@@ladivaluz806 - in Texas how can anything an hour a way be considered "long distance?" I get it, I live in a city and don't want to drive more than 25 minutes. It's tough. It's probably a test for the guy to keep making the haul. If he's not willing to do it, then throw in the towel sooner rather than later IMHO.

There were some really good slow cooker recipes in the myfitnesspal site: https://blog.myfitnesspal.com/15-slow-cooker-recipes-under-375-calories/?user_id=102838197669437&alt_source=mfp&alt_medium=email&alt_campaign=weekly20151012&utm_source=mfp&utm_medium=email&utm_campaign=weekly20151012&mkt_tok=3RkMMJWWfF9wsRoksq7LZKXonjHpfsX96O0pWKS1lMI%2F0ER3fOvrPUfGjI4DRcBiI%2BSLDwEYGJlv6SgFSrTFMblm0LgLXhM%3D

@@bellabloom - "It's hard to focus and know who to go out with. That's why I think it's a good idea to email a couple times on the guys side to let a woman know your really interested" @Daveo This is interesting. Good tip. HINT HINT SINGLE GUYS!!! You don't get this type of inside info very often.