Weight Loss Medical Mayhem: Decades of Harm and Hype

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Americans are fat—and getting fatter. Ac­cording to national survey data, the first two decades of the twenty-first century saw levels of adult obesity rise from an already worrying 30.5 percent to more than four in ten American adults (42.4 percent), with the proportion of “severely obese” adults nearly doubling, going from 4.7 to 9.2 percent.¹ Since 1988, obesity prevalence in children and adolescents (ages two to nineteen years) also has roughly doubled.

In his 2005 book, A Life Unburdened: Get­ting Over Weight and Getting On With My Life,² author Richard Morris provides a powerful first-hand description of what “a day in the life of a fat man” is like. During the period described, Morris weighed over four hundred pounds and “was a dead man walking,” suffering “from a toxic mix of obesity-related ills that included shortness of breath, sleep apnea, hypertension, aches and pains in [his] joints, depression, a frail immune system, asthma and other ailments too numerous to list.” The details Morris shares about the daily grind in a four-hundred-pound body are not unlike the description of the obese offered by Galen, the second-century Roman philosopher-physician, who wrote that such a person “cannot walk without sweating, cannot reach when sitting at the table because of the mass of his stomach, cannot breathe easily. . . cannot clean himself.”³

In Galen’s time and up until the twentieth century, people in most places “would probably have experienced overweight and obesity as exceptional rather than normal.”³ When Mor­ris, in his early forties, embarked on a quest to understand the sudden normalization of obesity and how—as an exercise enthusiast and endless dieter—he had ended up not just overweight but morbidly obese, one of his most profound insights was to recognize “the folly of a medi­cal industry that expends immense resources on the treatment of obesity-related symptoms, but adopts a hands-off approach when it comes to treating the source of those symptoms: poor nutrition.” The National Institutes of Health (NIH) helped consolidate the myopic focus on aggressive medical intervention at “Consensus Development Conferences” held in 1985 and 1991, respectively, where the gathered experts not only solidified the view of obesity as a chronic disease⁴ but “concluded that surgery is the only effective treatment for severe obe­sity.”⁵ The Institute of Medicine followed up in 1994 with the suggestion “that the condition be treated as doctors treat other genetic and bio­logical diseases—with extended drug therapy or surgery.”⁶

Morris shares a sobering observation in that first chapter: “the reality of being fat is so unlike anything else that fat people live in an entirely different world.” That world, both he and the media tell us, is sometimes punctuated by desperation. Fortuitously for Morris, his investigations led him to the Weston A. Price Foundation and to other resources and authors willing to contradict standard nutrition dogma; these gave him the courage to “ignore the ex­perts” and return to eating the real and unpro­cessed foods of his childhood, whereupon he not only rapidly shed one hundred fifty pounds but regained his agility and zest for life.

Many other miserably overweight Ameri­cans take a different approach, however, lured by the promise of quick results from whatever weight loss gimmicks are in vogue at the time.⁷ As one writer puts it, “Being fat in America means you are a problem to be solved and a rich market to reap.”⁸ The fact that medical/pharma­ceutical weight loss interventions virtually never deliver on their long-term promises only makes the market that much more lucrative—what’s not to like about a business model in which the industry’s target audience is “losing and gain­ing the same pounds over and over”?⁸ As new generations of overweight adults and children succumb to the hype—perhaps oblivious to the fact that “the experience with obesity medica­tions is littered with many unintended adverse events that have resulted in the withdrawal of many drugs from the market”⁹—trade maga­zines are eagerly prophesying that obesity will be “the next blockbuster pharma category.”¹⁰

FROM DONKEY MILK TO RAINBOW-COLORED PILLS

In ancient Greek and Roman times, physi­cians’ weight loss recommendations revolved around moderating one’s eating, occasionally fasting, performing “regular” or even “strenu­ous” exercise and doing more physical work.³ If further intervention seemed necessary, ad­ditional recommendations might include taking substances designed to promote elimination, either through vomiting (emetics) or via the bowels (cathartics). Emetics of the era included “hellebore plants and honey water,” while cathartics might include “juice of scammony (bindweed), Cnidian berry and sea spurge” or laxatives such as “donkey milk with honey, wild parsley, dodder of thyme. . . and honey water or sweet wine.”³

Fast-forwarding through time to the late 1920s, the landscape for weight loss intervention changed dramatically when a biochemist named Gordon Alles discovered some interesting properties of beta-phenyl-isopropylamine—oth­erwise known as amphetamine.¹¹ Smith, Kline and French (SKF) (later, SmithKline Beecham, and still later, after numerous mergers and acquisitions, GlaxoSmithKline12) patented the chemical’s base form in 1933 and began making an amphetamine vapor product, Benzedrine, initially marketing it as a decongestant.¹¹ By 1937, the drug (in tablet form) had segued into becoming America’s first “antidepressant.”

During the war years, the pharmaceutical industry and consumers became enamored by another nifty amphetamine application—its use as a tool for weight loss. A 2008 discussion of “America’s first amphetamine epidemic” in the American Journal of Public Health estimates that by 1945, U.S. civilians’ consumption of am­phetamine products made by SKF (Benzedrine and also Dexedrine) and another manufacturer, often for weight loss, “conservatively” amounted to thirty million tablets per month—enough to supply the standard dosage of two tablets per day to half a million Americans.¹¹ Although the drugs’ easy availability soon began to lead to widespread “misuse and abuse,” these and other dangers—such as elevated blood pressure and stimulant-induced psy­chosis¹³—received little attention.^11,14

In 1947, the American Medical Association (AMA) formally green-lighted the advertising of amphetamine drugs for weight loss, and in the early 1950s, sales of amphetamine (as well as methamphetamine) products skyrocketed to new heights. However, because amphetamines caused many users to experience “unpleasant agitation,” companies introduced a “simple and terrifying” solution: combination diet pills that included “amphetamines, diuretics, laxatives and thyroid hormones to send the body into weight-loss overdrive, as well as benzodiazepines, barbiturates, corticosteroids and antidepressants to deal with nuances like insom­nia and anxiety.”¹⁵ These untested combination products “proliferated throughout the 1950s,”¹¹ and by the 1960s, thousands of “fly-by-night” clinics across America were peddling fancy new iterations of the diet pills—rainbow-colored stimulants “combined with other medications to counteract the side effects of stimulants”—that promised a “pleasingly uniform reduction in weight.”¹⁴

As Erin Blakemore wrote in Smithsonian Magazine in 2017, the pills’ colorfulness was a con—and a deception in which doctors willingly participated. Blakemore explains:

“For decades, diet pill companies marketed their wares directly to doctors—and told them that by prescribing a rainbow of pills, they could sell the illusion of personalization. ‘You should have more than one color of every medication,’ said one brochure, warning doctors never to prescribe the same combination twice. ‘That’s a little psy­chology and is well worth it.’”¹⁴

The diet pills were highly profitable. One doctor, Blakemore recounts, purchased a lot of one hundred thousand pills for $0.00071 apiece and sold them for $0.12 each—a one hundred sixty-nine-fold markup.

Eventually, the potentially fatal “side effects” and frank addictive­ness of amphetamine-based weight-loss drugs began to tarnish the drugs’ innocuous reputation, forcing complacent regulators to take action. After the Food and Drug Administration (FDA) restricted “all approved amphetamine-derived anti-obesity drugs. . . to short-term use” and made the drugs “subject to label warnings regarding the risk of addiction” in 1977,³ pharmaceutical companies slacked off for a while on developing new amphetamine drugs for weight loss, but in the early 1990s, Wyeth (then American Home Products) launched a new boom with a widely prescribed and immediately disastrous product popularly known as “fen-phen,” which combined serotonin-boosting fenfluramine with the “mother’s little helper” stimulant phentermine.⁶ Soon, researchers were reporting serious heart-valve disease in people who had taken fen-phen for as little as one month,^16,17 and—two hundred million dollars in profits later—Wyeth withdrew both fenfluramine and fen-phen from the market.⁶

THE NEW CASH COWS

Ever in search of cash cows in the weight loss space, drug companies have, in recent years, discovered new chemical pathways for suppressing appetite. The latest wonder drug on the U.S. market, as of 2021, is semaglutide, the “foundational molecule” (in the words of its manufacturer, the Danish multinational Novo Nordisk) of Wegovy,¹⁸ an FDA-approved, pre­scription-only injectable medication for “chron­ic weight management” in adults. Semaglutide is a “GLP-1 agonist,” meaning that it mimics “the action of GLP-1, a naturally occurring [gut] hormone that helps to regulate blood glucose levels.”¹⁹ Simply stated, semaglutide results in “dramatically slowed digestion” and thereby reduces “hunger, appetite and cravings.”^20,21

Novo Nordisk also makes an injectable drug for “long-term weight loss” in individuals as young as twelve (“Saxenda for teens”), featur­ing another GLP-1 agonist called liraglutide.²² And, as it happens, three other similar Novo Nordisk drugs—FDA-approved for type 2 diabetes—also result in weight loss: Ozempic (a semaglutide injectable for adults), Rybelsus (semaglutide tablets for adults) and Victoza (a liraglutide injectable for anyone age ten years and up).^23,24 Wegovy contains a somewhat higher dose of semaglutide than Ozempic, but other than that, there is little difference between the two drugs.

Despite uncertainty about insurance cover­age and a monthly cost of one thousand to fifteen hundred dollars,²⁵ Wegovy came out of the gate with a bang, with the co-director of NIH’s of­fice of obesity research telling the press that it is “a very exciting time in the field.”²⁶ In 2022, Novo Nordisk experienced some temporary “supply stumbles,” but it was able to relaunch Wegovy in the U.S. in 2023, and as of the first quarter, the company was happily giving credit to Wegovy for a meteoric 124 percent year-over-year increase in “obesity care sales.”²⁷ By the second quarter, Wegovy sales were up 543 percent, prompting Novo to upgrade its profit expectations for 2023.²⁸ Describing the situation as “Wegovy takes all,” the trade rag FiercePh­arma dubbed Novo the king of “the burgeoning obesity scene.”¹⁰

Wegovy is far from the whole story for Novo, however. Even with the supply reset, “huge demand” for the drug reportedly made it difficult for the company to keep up, with Novo even putting its Wegovy advertising “on hold” while a company spokeswoman complained, “We can’t make enough.”²⁶ Fortunately (and probably not coincidentally), Novo had Ozempic waiting in the wings. In a February 2023 blog titled “What happens when a drug goes viral?”, Harvard professor Robert H. Shmerling, MD, described how social media posts by influencers and celebrities sharing their successful weight loss with Ozempic turned “a side effect into a selling point,” triggering an explosion in off-label prescribing,²³ notably via telehealth.²⁹ By March, CNN reported, sales of Ozempic were at “an all-time high,” and Novo was recording the same magnitude of sales spike for Ozempic (a year-over-year increase of 111 percent) as for Wegovy.²⁹

Both sales surges ended up in the same place—with shortages—leading Shmerling to scold health care practitioners sternly about “priorities” and “irresponsible prescribing.” He also pointed out, however, that Novo’s ad­vertising for Ozempic had not been shy about publicizing the drug’s supposedly inadvertent impact on weight. In fact, using the marketing phrase “the Ozempic ‘Tri-Zone,’” Novo openly touts its drug’s triple benefits of “improved blood sugar control, lower cardiovascular risk, and weight loss”; moreover, the company does not list weight loss as a possible side effect but instead relegates the statement “Ozempic is not a weight loss drug” to easy-to-miss fine print.²³ At the same time, the company virtuously as­serts that its products “are not interchangeable and should not be used outside of their FDA-approved indications.”³⁰

Nonetheless, the media routinely refer to Ozempic as a “weight loss drug,” without undue protest from Novo. In July 2023, the public radio station WBUR reported that “Novo Nordisk spent millions for doctors to promote Ozempic [and] other weight loss drugs”; in 2022 alone, the company shelled out eleven million dollars on “travel and meals for thousands of doctors,” with WBUR querying the ethics and legality of the company “spending so much to talk to doctors about this type of drug.”³¹ An endocri nologist interviewed by CNN, who agreed that “advertising around Ozempic took off in 2022,” likewise commented, “I think we really need to start questioning our ethics around this.”²⁹

LIFE-CHANGING “SIDE EFFECTS”

According to an obesity medicine specialist interviewed by Forbes, semaglutide and liraglu­tide drugs “are designed to be taken long-term”; in fact, when individuals stop taking the drugs, they typically—and rapidly—regain most or all of the lost weight.²¹ However, an insurance in­dustry analysis of U.S. pharmacy claims showed that only one-third of those who started taking one of Novo’s semaglutide or liraglutide drugs for weight loss were still taking it a year later, representing “a substantial drop in adherence compared to what was reported in clinical tri­als.”³² A clinical trial of Saxenda in obese teens (ages twelve to seventeen) found that one in ten adolescents taking liraglutide dropped out of the study due to adverse events (versus zero discon­tinuations in the placebo group); two-thirds of the liraglutide group versus roughly one-third of the placebo group (65 vs. 36 percent) reported gastrointestinal adverse events.³³

Indeed, the insurance analyst who ex­amined pharmacy claims speculated that one reason for the dropoff in adherence at one year might be the severity of side effects. The list ad­mitted to by Novo for semaglutide is daunting; it includes nausea, low blood sugar, dizziness, flu symptoms, a pounding heartbeat, vision changes, mood changes (including thoughts of self-harm), gallbladder and kidney problems, symptoms of pancreatitis and serious thyroid problems.³⁴ Ozempic has a “boxed warning” (formerly known as a “black box warning”) about thyroid tumor and thyroid cancer risks.³⁵ The liraglutide drugs come with similar risks.³⁶

Anecdotal information is starting to seep out about other serious life-changing effects from both short-term and longer-term use. Dis­illusioned consumers report dramatic impacts from both Wegovy and Ozempic, including a side effect not specifically mentioned in the drugs’ inserts: severe gastroparesis. Popularly referred to as “stomach paralysis,” severe gastroparesis is defined as 35 percent or more of food still being present in the stomach four hours after a meal, when ordinar­ily, less than 10 percent should remain by then. The FDA concedes that the agency has received reports of gastroparesis associated with both semaglutide and liraglutide, “some of which documented the adverse event as not recovered after discontinuation of the respective product at the time of the report.”²⁰

In a July news account, a thirty-seven year-old woman suffering from severe gastroparesis stated that she “stayed nauseated all the time, no matter how little she ate,” and had resorted to taking a prescription anti-nausea drug “like it was candy.”²⁰ When her stomach problems first surfaced, it took months for doctors to connect the discomfort to Ozempic and take her off the medication. She lamented:

“I wish I never touched it. I wish I’d never heard of it in my life. This medicine made my life hell. . . . It has cost me money. It cost me a lot of stress; it cost me days and nights and trips with my family. It’s cost me a lot, and it’s not worth it. The price is too high.”²⁰

Even a year after discontinution, another woman described how she now vomits multiple times a day (so-called “cyclic vomiting syndrome”), a condition so uncomfortable that she had to take a hiatus from her job.²⁰

According to some reports, anesthesiologists are concerned about the rise in stomach paralysis because it can increase the risk of regurgi­tation during surgery, even if the patient has fasted according to pre-op instructions. This, in turn, can send stomach acid into fragile lung tissue, which is not designed to handle acidic digestic juices. In one instance, an anesthesiologist discovered “a ‘massive amount’ of undigested food in [the] stomach” of a forty-two year-old who had had nothing to eat for eighteen hours but who had started taking Ozempic two months earlier.³⁷ According to the alarmed physician: “We had to stop the procedure, put a breathing tube in and another instrument into his lungs to clean the lungs from the food that he inhaled and aspirated. . . . [T]his was a potentially serious, potentially fatal complication.”

For its part, the FDA maintains that the drugs’ benefits generally outweigh the risks, while a gastroenterologist funded by NIH to study liraglutide unsympathetically suggests that the women experiencing severe gastroparesis “may just be really unlucky.”²⁰

As bad as gastroparesis is, suicidal ideation may lead to an even worse outcome. Reuters reported in July 2023 that the European Medi­cines Agency (EMA) is investigating both Ozempic and Saxenda due to “reported thoughts of self-injury.”³⁸ Although the EU product inserts do not list suicidal thoughts as a possible side effect, the U.S. insert for the similar drug Wegovy includes instructions to prescribers to keep an eye out for such thoughts. The FDA’s adverse event reporting system includes, according to Reuters, at least sixty semaglutide-related reports of sui­cidal ideation since 2018 and at least seventy liraglutide-related reports since 2010. A portfolio manager and Novo Nordisk shareholder quoted by Reuters comments, “a low incidence of suicidal thoughts might be acceptable for a drug against Type 2 diabetes but not for a weight-loss drug.” The Saxenda clinical trial with teens (published by a group of authors with significant Novo Nordisk conflicts of interest) reported one suicide in the liraglutide group but assessed it “as unlikely to be related” to the drug.³³

Other slightly more humorous—but not really—side effects reported for Ozempic (and also Wegovy) are “Ozempic face”³⁹ (described as a “gaunt and skeletonized” face that can “make someone look older than they are”), “Ozempic finger” (shrinking fingers that no lon­ger hold rings) and “Ozempic butt” (a “saggier-than-normal” rear end). A news story notes that “when weight loss is fast, it can make it tough for your skin to keep up”; a dermatologist explains, “Rapid weight loss does not allow collagen and elastic fibers to adjust to this lack of support and results in severely sagging skin.”⁴⁰ As a Forbes writer flippantly puts it, “such rapid weight loss can throw you a curve ball of sorts by making you lose some of your curves.”³⁰ The medical community’s recommendations to deal with the embarrassing sagginess include skin-tightening procedures and plastic surgery.

WHAT’S NEXT?

Recognizing that the nausea experienced by 44 percent of Wegovy users deters many from sticking with the drug on a long-term basis, biotech firms are hot to develop a “Wegovy-like” drug “without the downside of nausea.”⁴¹ One firm is tinkering with an approach that would disrupt the body’s mitochondria. (What could possibly go wrong?) As various companies indicated to Reuters, “the huge amount of at­tention the obesity market is receiving due to Wegovy’s success could be a game-changer for their own drug development prospects,” including opening the door to massive infu­sions of venture capital.⁴¹ An investment banker excitedly stated, “It’s absolutely possible that in 5 to 10 years we’ll see over a hundred biotechs working in this area.”

Nothing daunted, Novo Nordisk is now plugging the cardiovascular benefits of sema­glutide and liraglutide. The announcement of “positive data” from a clinical trial triggered a 17 percent jump in Novo’s share price, with the financial press explicitly attributing this “upside” to Wegovy.²⁸ Novo and its fleet of be­holden researchers are also enthusiastic about other potential applications of the drugs for conditions ranging from polycystic ovary syn­drome to addiction and dementia, and numerous clinical trials are underway.⁴² One researcher states, “In some ways there is a sense that some of this might be too good to be true. But. . . any potential benefits should be investigated.”⁴²

Lost in all the excitement about “game-changers” and “drug development prospects” is (as Morris noted in his 2005 book) any mean­ingful discussion of food and nutrition. This was not always so. Historians observe that the famed Banting Diet⁴³ conceived of by William Banting (1796–1878) was the first high-fat, low-carb diet, with a booklet that was “so popular” it went through ten editions over four decades.⁹ However, when contemporary South African scientist Tim Noakes updated the Banting Diet in his book The Real Meal Revolution, his coun­try’s “diet dictocrats” persecuted him for his common-sense (but to them, contrarian) view that “what you eat has a bigger impact on your weight than how much you eat.”^44,45

On the Wise Traditions Podcast, Dr. Guill­ermo Navarrete has argued for the importance of context when educating people about weight and nutrition, stating: “The only way to get people to a safe place where they lose that weight and keep that weight out forever is that you teach them first what’s the problem and why it is a problem. . . . If you identify that whole industry, not just that food or the cookie. . . and why is that industry powerful, you will understand why.”⁴⁶ He emphasizes, “Modern diseases are caused by modern food and modern habits.” Over the years, the Weston A. Price Foun­dation has often adopted a similar big-picture lens when discussing the food industry favorites that are contributing to weight gain in America and around the world: monosodium glutamate (MSG),⁴⁷ soy (used to “fatten fish, poultry and animals quickly and profitably for market”),⁴⁸ sodas (including “diet” sodas),⁴⁹ reduced-fat milk⁵⁰ and industrial seed oils.⁵¹

Discussing her weight-loss “formula” (“Purge, Splurge, Fast and Last”), Sally Fallon Morell also emphasizes personal responsibility:

“Long-term, permanent weight loss requires a complete change in lifestyle, including rejection of all processed foods, adopting a schedule of regular meals and, above all, dedication to nutrient-dense foods. If your diet is not supplying all the vitamins and minerals your body needs, the urge to eat will eventually overcome the best of intentions and the strongest willpower.”⁵²

Real, nutrient-dense foods include healthy fats like butter, olive oil, lard, coconut oil and duck fat; pastured meats, organ meats and eggs, fish and artisan cured meat products such as bacon, salami and paté; bone broth; raw milk and other high-quality dairy products such as raw aged cheese, kefir and yogurt; whole grains (properly soaked, sprouted or fermented); genuine sourdough bread; natural sweeteners; and fermented vegetables, condiments and beverages. Ultimately, one of the strongest advantages of this type of diet is that it is satisfying. Bone broth, for example, “improves the digestibility and assimilation of food, giving the body the critical message that it is deeply nourished, happy and full.”⁵³ As Navarrete observes, “When you do the right thing, what the body needs, deserves and is willing to absorb and use, the body will say ‘thank you.’ The way your body says ‘thank you’ is by getting healed from diseases or getting to the right weight.”⁴⁶

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SIDEBAR

BUMMER BARIATRIC SURGERY

Although drugs like Wegovy have been hogging the weight loss headlines, many overweight individuals choose to go the bariatric surgery route. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), there are a lot of weight-loss surgery options to choose from! The most common (59 percent of all weight-loss surgeries)⁵⁴ is the gastric sleeve procedure (“sleeve gastrectomy”), which permanently removes about 80 percent of the stomach, “leaving a tube-shaped stomach about the size and shape of a banana”⁵⁵ so the person can only eat one-half cup of food at a time.⁵⁶ According to the ASMBS, five and a half times more gastric sleeve procedures were performed in 2021 versus 2011.⁵⁷

Other less sought-after procedures include Roux-en-Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB), single anastomosis duodenal switch (SADI), biliopancreatic diversion with duodenal switch (BPD/DS), endoscopic sleeve gastroplasty (ESG), gastric band surgery, gastric balloons and finally, revisional bariatric surgery (RBS) to “repair or change a previous weight loss surgery.”⁵⁸ RBS—representing about 11 percent of bariatric surgeries⁵⁴—itself is increasingly com­mon but introduces further complications in at least one in ten patients; researchers also report that the “durability” of its effects “remains questionable.”⁵⁹

Gastric sleeve surgery is associated with a high rate of “recidivism” (weight regain).⁶⁰ It’s estimated that 20 percent of sleeve recipients also experience other long-term complications, including ongoing nausea and indigestion, “food intoler­ance,” gallstones, stomach ulcers, acid reflux, sagging skin, abdominal scarring and malnutrition resulting from a reduced ability to absorb nutrients and calories. Some of these problems then require additional interventions.⁶¹ Evidence points to other alarming long-term or fatal outcomes from various types of bariatric surgery⁶²: gut leakage⁶³ and fistulas⁶⁴ that can lead to sepsis⁶⁵; permanent colostomy (an opening in the abdominal wall “for poop to come out”⁶⁶); dependence on daily intravenous nutrition⁶⁷; liver damage⁶⁸; and premature death.⁶⁹

Interestingly, studies also point to a higher risk of new-onset substance use or abuse (both alcohol and other sub­stances) in those who have undergone bariatric surgery, with researchers describing it as an “overlooked” iatrogenic (doctor-caused) complication.⁷⁰ They point out that gastric bypass alters the way the body absorbs substances like alcohol, and some suggest that some form of “addiction transfer” may also be occurring.⁷¹

Worryingly, bariatric surgeries have also trended upward in the teen and young adult population, and a recent study suggests that they can end up with weakened bones.⁷² As reported by Children’s Health Defense (CHD), the researchers found that the young people had “reduced vertebral bone strength and density.”⁷³ Integrative pediatrician Dr. Michelle Perro told CHD that the research constitutes “yet another reason to call for an immediate cessation of barbaric bariatric surgery in children and address the real root causes of childhood obesity, and abandon Band-Aid solutions.”

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SIDEBAR

BUMMER BARIATRIC SURGERY
Although drugs like Wegovy have been hogging the weight loss headlines, many overweight individuals choose to go the bariatric surgery route. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), there are a lot of weight-loss surgery options to choose from! The most common (59 percent of all weight-loss surgeries)⁵⁴ is the gastric sleeve procedure (“sleeve gastrectomy”), which permanently removes about 80 percent of the stomach, “leaving a tube-shaped stomach about the size and shape of a banana”⁵⁵ so the person can only eat one-half cup of food at a time.⁵⁶ According to the ASMBS, five and a half times more gastric sleeve procedures were performed in 2021 versus 2011.⁵⁷

Other less sought-after procedures include Roux-en-Y gastric bypass (RYGB), one anastomosis gastric bypass (OAGB), single anastomosis duodenal switch (SADI), biliopancreatic diversion with duodenal switch (BPD/DS), endoscopic sleeve gastroplasty (ESG), gastric band surgery, gastric balloons and finally, revisional bariatric surgery (RBS) to “repair or change a previous weight loss surgery.”⁵⁸ RBS—representing about 11 percent of bariatric surgeries⁵⁴—itself is increasingly common but introduces further complications in at least one in ten patients; researchers also report that the “durability” of its effects “remains questionable.”⁵⁹

Gastric sleeve surgery is associated with a high rate of “recidivism” (weight regain).⁶⁰ It’s estimated that 20 percent of sleeve recipients also experience other long-term complications, including ongoing nausea and indigestion, “food intolerance,” gallstones, stomach ulcers, acid reflux, sagging skin, abdominal scarring and malnutrition resulting from a reduced ability to absorb nutrients and calories. Some of these problems then require additional interventions.⁶¹ Evidence points to other alarming long-term or fatal outcomes from various types of bariatric surgery⁶²: gut leakage⁶³ and fistulas⁶⁴ that can lead to sepsis⁶⁵; permanent colostomy (an opening in the abdominal wall “for poop to come out”⁶⁶); dependence on daily intravenous nutrition⁶⁷; liver damage⁶⁸; and premature death.⁶⁹

Interestingly, studies also point to a higher risk of new-onset substance use or abuse (both alcohol and other substances) in those who have undergone bariatric surgery, with researchers describing it as an “overlooked” iatrogenic (doctor-caused) complication.⁷⁰ They point out that gastric bypass alters the way the body absorbs substances like alcohol, and some suggest that some form of “addiction transfer” may also be occurring.⁷¹

Worryingly, bariatric surgeries have also trended upward in the teen and young adult population, and a recent study suggests that they can end up with weakened bones.⁷² As reported by Children’s Health Defense (CHD), the researchers found that the young people had “reduced vertebral bone strength and density.”⁷³ Integrative pediatrician Dr. Michelle Perro told CHD that the research constitutes “yet another reason to call for an immediate cessation of barbaric bariatric surgery in children and address the real root causes of childhood obesity, and abandon Band-Aid solutions.”

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REFERENCES

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20. Goodman B. They took blockbuster drugs for weight loss and diabetes. Now their stomachs are paralyzed. CNN, Jul. 25, 2023.
21. Northrop A. Ozempic for weight loss: side effects, risks and more. Forbes, updated Aug. 22, 2023.
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This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Fall  2023

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