A Note To Al Roher

Last evening I sent the message below to Mr. Roker. I am posting part of it here. Steven Walfish, Ph.D. Could you please forward this e-mail to Mr. Roker. Mr. Roker, As a clinical psychologist who works with gastric by-pass patients I watched your Dateline piece with great interest. In addition, for the past six-eight months I have worked with Dr. Procter's patients. As such the story was of even more significance to me. I think it is important that patients understand the risks of surgery. I especially appreciated you highlighting that Dr. Procter: (a) warns patients of the risks of surgery; (b) has them sign a form and write a statement that they understand the risks, and (c) has such a low mortality rate, significantly lower than the 1 in 200 that you cited on the show, with 4 deaths out of thousands of patients. I believe when patients see statistics such as these they never believe they could wind up being the statistic themselves. I think this is a generalized phenomenon in that people always think bad things happen to other people and not themselves. For example, I recently reviewed research on the incidence of serious motor vehicle accidents. During a given year one in fifty people can expect to be involved in a serious MVA. This number increases to one in four over the course of a lifetime. I would bet that if you went into a room of 100 people and asked, "How many of you will be in a serious motor vehicle accident over the course of your lifetime"? I am doubtful that more than a handful of people (if that many) would raise their hand, let alone 25%. I have no doubt that the same holds true for gastric by-pass patients. I especially appreciated your discussion of the need to identify and address the emotional factors related to eating in this patient population. As a patient once said in a support group, "This is gastric by-pass surgery, and not brain surgery." Without addressing the issues that led to abusive eating I believe patients are high-risk to regain the weight or not lose the optimal amount of weight. For your review I have attached to this e-mail a copy of a paper that will appear in the next issue (Nov/Dec) of the journal Obesity Surgery titled, "Self-Assessed Emotional Factors Contributing To Increased Weight Gains in Presurgical Bariatric Patients." In the study at least 40% of the sample could be identified as emotional eaters. Let me also say that I have known Dr. Procter, his associate Dr. Richard, and their staff to be extraordinarily caring and responsible people. For example, not all surgeons require a psychological evaluation prior to the surgery. Some will only ask for it if the insurance company requires it. Obesity Solutions requires it of all of their patients. They want to be sure that patients can fully emotionally participate in the surgery and the (as you know rigorous and structured) requirements of continued weight loss. Based on my recommendation I know they have "held back" on doing surgery with patients pending their doing prepatory work (e.g., stabilized on antidepressant medications, participate in counseling to reduce anxiety/depression/stress). Please also know that the initial reactions of patients to this are usually negative because they want the surgery NOW! However, Drs. Procter and Richard want to optimize the likelihood of a positive outcome and require patients to follow these recommendations before they will do weight loss surgery. I appreciate your willingness to share your personal story. While it may be hard for you to grasp from afar your story is an inspiration to many. Sincerely, Steven Walfish Ph.D. Visiting Lecturer Atlanta Center For Cognitive Therapy Department of Psychology 1772 Century Blvd. Georgia State University Atlanta, 30345 Atlanta, GA 30302 404 248-1159

Dr. Walfish, Great facts, well written. To bad NBC doesn't have all the real facts to base the stories they want to tell. They just want you to hear and see what they think might make an interesting dramatic story. To help boost their ratings. I didn't personally know the patient. But, I'm very saddened by his death and my heart goes out to the family. Dr. Proctor performed my gastric-bypass 3 years ago, and I had a 3rd leak test. So I know he always checks for leaks. My 2 sisters, and daughter have all had gastric-bypass, performed through this practice. No problems with any of us, I would recommend him before any other practice. Because, I know Dr. Proctor and Dr. Richards has the skills and the compassion for all of his patients. NBC needs to state all the facts and not just what they want you to believe. Proud Patient, Lynn Bennett

Bravo!

Every response I've read to the NBC show on Friday night that supported Al Roker basically attacking a surgeon for the death of one of his patients was a poor attempt to show the "bad" side of the surgery. Everyone who has supported that part of the show has said, "I'm glad that people are able to see both sides of the picture." Well what about the "good" part and those patients whose lives he has changed for the better. I sure didn't see them getting interviewed for that segment. If we are going to report, let's be fair. And I disagree, I think most gastric bypass patients go into their first consultation with having researched to the highest and lowest depths the things that could happen to them- the risk factors involved with weight loss surgery. It's a reality, people die everyday from different things. Most people decide to have this surgery because they feel they would die without it. So, on that note. I have to say I didn't agree with them just picking some surgeon out of the blue to criticize. Yes, he might should have said this..done that. We are all human. He is not God. He is a surgeon whom God has blessed with certain abilities. That's just my view, though. Hope no one wants to jump down my throat for sharing it. Sincerely Jamie L. Miller/Holman

Good job ( as always) Dr. Walfish Maureen