African Americans lose less with RNY- anger

Here is the study I cited in my last post. It cites: The average long term weight loss for RNY is 50% of excess weight for all patients African Americans lose significantly less on average than Caucasians with this surgery Here are some other facts that I know. SMO people do not tend to succeed at a high rate with this surgery I am SMO. I guess I better not accept my insurance company's bull**** that the RNY is an equal option. Now, as I write, I am getting very angry at myself for even giving the RNY a drop of consideration- that was a wasted hour. I will either succeed at losing myself (highly doubtful) or have my DS. Bariatric surgery for severe obesity.Sugerman HJ. Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia 23298-0519, USA. [email protected] Severe obesity is associated with multiple comorbidities and is refractory to dietary management with or without behavioral or drug therapies. There are a number of surgical procedures for the treatment of morbid obesity, including purely gastric restrictive, a combination of malabsorption and gastric restriction or primary malabsorption. The purely gastric restrictive procedures, including vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding, do not provide adequate weight loss. African-American patients do especially poorly after the banding procedure with the loss of only 11% of excess weight in one study. Gastric bypass (GBP) is associated with the loss of 66% of excess weight at 1 to 2 years after surgery, 60% at 5 years and 50% at 10 years. For unknown reasons, African-American patients lose significantly less weight than Caucasians after GBP

Hey, don't get angry with *yourself*! You're in a vulnerable place, you were just disappointed by your flight situation, and a surgeon was trying to talk you into something that went against your best judgment and research! Hang tough for the DS, Kevin ... you can and will get it, and in the meantime, you're losing weight on your own which will put you in a healthier position for when your surgery comes. (Pretty interesting stats re: differences between whites and African-Americans with GBP --> wonder what that's about, what they attribute it to. Guess that's an unknown right now.) Sending you positive vibes. {{{HUGS}}} Alison

Wonder WHY African Americans lose less with the RNY? Care to speculate? LeaAnn Preebie

Hey Kevin - Do not berrate yourself - this is a very hard place to be!!! I am still pre-op like you trying to get the DS surgery and so many docs whip out the sentence "The RNY is the Gold Standard of WLS" which they do not understand is basically a non-sentence! It says NOTHING! I am sending you thoughts and prayers that you get your DS soon - I know in my soul (as it sounds as if you do) that the DS is the only option ... I am also SMO with about 215 to lose. The trouble is getting the surgery! As far as why African Americans lose fewer pounds with WLS - Perhaps African Americans' bodies are better at adapting to (compensating for) the surgery? Do AA's perhaps have fewer issues of vitamin deficiencies as well? Don't know just speculating? HUGS - Dia

I really do not know why this is. I am willing to acknowledge that it could be behavioral. The RNY is an intense form of behavior modification that has some basis in the body rejecting food and this provides a disincentive for eating sugary foods, etc.- for a while. When the body adapts to the changes and people begin to eat through their RNY, other things occur. Certain behaviors with food have a lot to do with culture. I work in a very diverse environment and often note that we as African Americans often have a drastically different diet. Marketing statistics show that we are much more likely to eat fast food. If those habits are not conquered, the RNY will probably eventually be defeated. This of course is just a guess.

This illustrates that African Americans recieve substandard health care in America! I believe it is the duty of every African American who has been denied this surgery should bring this study to the forfront of their insurers or employers who specifically exclude the ds. when the insureres reliaze that this discrimination must stop it will benefit all of us. I have not yet posted a picture so i will state for the record that i am not a African American, and there is no predudice in this proposed stratigy. ,

Walter you hit on a very important point here. I had to fight with my insurance company to change one of my blood pressure medications after I was told by 2 physicians that the results for the recommended drug were not optimal for African Americans. My insurance company didn't want to cover the suggested replacement prescription. So, is this another valid argument for insurers to pay for DS? Does ethnicity support DS approval? Robindaringtobelieveadifferentkindoflifeispossible

Wow, its interesting that the studies show AA loose less with rny....I wonder why that is...I do believe that it is probably b/c most of us do eat alot of fast food, simple sugars, and "soul food" does have alot of sugar, starch, fat, etc. when made the old fashion way. It is all about changing your mentality and sometimes its just hard to change the way you are use to eating all your life. Its something to consider, and it would be a great piece of info to add when one is putting together an appeal to have the ds in oppose to the rny. I personally do not have any problems eating "good" foods, I just eat too much and love food too much. Actually I'm a food addict, but thats another story....Thanks for providing that info, I was curious about it when you mentioned it in your earlier post. Good luck!!! Chi-Chi

I spent a lot of years in the south. I was fortunate to be invited home to dinner with AA friends quite a few times. I agree it's a cultural thing. The dinners were a real family affair with lots of people and multiple generations doing the cooking. More than once or twice I asked what was the occasion? Birthday celebration? I was always told it was just a normal dinner! These 'normal dinners' were better than what my family usually had for holidays. I can remember thinking I would be weighing 500lbs if I lived here! At my house, dinner was just another chore to be gotten through with as little hassle as possible. I was a guest the first time out. Then they started teaching me to cook. I was happy to learn. Over the years, I developed some serious skills. But it would be way too much work and calories for me to cook like that on a daily basis!

Patty, sadly that does happen a lot. Also, if you lose too much weight People will apply pressure to you to stay "thick" when you are from low and moderate income African American communities. I am 380 pounds and many people that I grew up with cannot relate to my desire to want to be a normal size. They think that because I am educated, I have it made, but there is actually more of a stigma from being overweight in my world. I am not lacking for female attention right now, despite being 180 pounds overweight. Guess the African American man shortage works to my benefit- or maybe it is because I am a rare BMW- Black Man Working Also, fresh fruit and vegetables can be missing from the diet of low income and poorly educated African Americans. It actually was a significant factor for the first 25 years of my life. I became overweight partially because my mother was forced to work three jobs to take care of me as a single parent of a child with an irresponsible father. I was left from 8 years old forward to make my own food choices. I made some bad ones and continued to make bad choices through my mid-20s. I am much better most of the time now, but can't shake the extra pounds. Thank God that more African American families have become better educated on proper nutrition and practice better habits. But in many urban communities, you cannot even find a grocery store that carries fresh fruit and vegetables and many people still hold on to habits of their youth. I bet if people were to study low income families in general, they would find that most of them fail the RNY based on another factor. The low income life is a higher stress, lower income and harder working life. Usually the families are broken. The mothers must work and the children are left to their own devices often to make food choices. It gives the low income working parent one more thing not to worry about.