Fat chance
Sunday, July 25, 2004
Here's a startling fact: one in 10 of the world's school children is overweight — that's 45 million kids with a problem, possibly for life. And if that's not bad enough, obesity is about to become the major cause of death in the US. And here in Australia, we're not far behind. So what are we doing about this deadly serious health crisis? Well, more and more we're resorting to the knife. It's hard to believe, but kids as young as 12 are giving up their diets and exercise for the quick-fix. Radical surgery that's guaranteed to stop them over-eating.
INTRO — LIZ HAYES: Here's a startling fact, frightening too — one in 10 of the world's school children is overweight. That's 45 million kids with a problem, possibly for life. And if that's not bad enough, obesity is about to become the major cause of death in the US. And here in Australia we're not far behind. So, what are we doing about this deadly serious health crisis? Well, more and more we're resorting to the knife. It's hard to believe, but kids as young as 12 are giving up their diets and exercise for the quick fix — radical surgery that's guaranteed to stop them overeating.
STORY — LIZ HAYES: Seventeen-year-old Brianne Herr is about to undergo life threatening surgery, an operation that kills one in every 1000 patients each year. She's doing this to lose weight.
BRIANNE HERR: I'm going to have the stomach that's the size of a cup. It's weird going from a stomach that's the size of a football.
LIZ HAYES: Brianne is one of hundreds of young people resorting to radical surgery in a last-ditch effort to beat obesity, an epidemic that doctors believe has become our greatest health threat.
DR GEORGE FIELDING: We are not even on the tip of the iceberg. We're right up. But this is a cultural catastrophe.
LIZ HAYES: Australian Dr George Fielding is at the front line of the battle. He's operating on obese kids, both here at home and in America.
DR GEORGE FIELDING: These kids live in a world of fast life, fast food, high-energy food, and to tell a kid who's gigantic that you've just got to eat like a little rabbit, you've got to resist McDonald's, you've got to resist Coke you've got to resist Microsoft and you've got to resist the 5000 ads you see a year about food and somehow you've got to lose 200lb.
LIZ HAYES: And they just can't do it?
DR GEORGE FIELDING: They can't do it.
LIZ HAYES: The statistics are frightening. In Australia and America, 60 percent of all children are overweight. Twenty percent are obese, five percent are classified as morbidly obese. And by next year, obesity will become the leading cause of death in the US.
DR GEORGE FIELDING: So are you nervous about the possibility of surgery?
GIRL: No. I'm anticipating it because I wanna ... because I want to be healthier.
LIZ HAYES: And right now, it's those kids who are 40kg or 100lb overweight who are looking for surgical solutions. In America, the surgery of choice is a gastric bypass operation. It's irreversible, it's dangerous and involves the stomach being reduced in size and the intestines rearranged to limit the absorption of calories. Here in Australia, George Fielding and his colleagues perform a different operation. It's called lap band surgery, where a belt is used to restrict the amount the stomach can hold. This procedure is reversible, but, like all operations, involves some risk.
DR GEORGE FIELDING: Honestly, it's the most satisfying thing I've ever done because you take these humungous, sad kids and you give them a shot at a normal life. That's all it boils down to.
LIZ HAYES: Is it the last roll of the dice for them?
DR GEORGE FIELDING: Yes, it is. And if I achieve anything in my life doing this, and this has become my life now, it's to make people realise that fat people are sick people as well.
AMY TOPPEL: I'm really glad I went through with it.
LIZ HAYES: Are there no regrets of any kind?
AMY TOPPEL: None, none at all.
LIZ HAYES: If there was a pin-up girl for gastric bypass surgery, Amy Toppel would be it. Twelve months ago, this was her — 120kg and climbing.
AMY TOPPEL: It was hell. It was just miserable. I would pretty much just be by myself. I would, you know, sit in the cafeteria by myself because nobody would really want to sit and talk to me. I just wasn't popular and just never was happy.
LIZ HAYES: Since the operation, Amy's lost 45kg. Today, she has a few tiny scars as a reminder. But she also has a whole new wardrobe.
AMY TOPPEL: I'm more popular, I'm more outgoing, I'm not afraid to talk to people. I have a great job. I have a wonderful boyfriend. I'm much happier. I've never smiled this much in my life.
DR GARRY EGGER: It's saying to people, "Well, you can't control your behaviour so we'll try and control it artificially." But in the long run, it has a negative effect because they still have to change their lifestyle.
LIZ HAYES: Dr Garry Egger is an obesity specialist. As the man who founded Gut Busters, he believes surgery for fat children is not only dangerous but a cop-out. Dr Egger says the solution is simple - parents must make their kids exercise more and eat less.
DR GARRY EGGER: There's no treatment that works without a lifestyle change. There is no magic fix, there is no drug, there is no surgery where you don't have to change your lifestyle. By suggesting that all overweight or obese children need to be operated on, I think, is throwing up our arms and saying, "This is useless. We can't do anything about it."
LIZ HAYES: How young is too young for this operation or for surgical intervention?
DR GEORGE FIELDING: Well, yeah, at the moment, it's 12 is where we sort of cut it off.
LIZ HAYES: 12?
DR GEORGE FIELDING: Well, we've done 12-year-olds.
LIZ HAYES: You've operated on 12-year-olds?
DR GEORGE FIELDING: Sure. 400lb 12-year-olds. If you met these kids … you'd...see, it's incomprehensible. It's a really scary notion. It's like, this is just so weird that you would do this, but it's also really weird that you're that big.
LIZ HAYES: Was it just too much food?
CHARLIE FABRICANT: Um, I think so. I think it was too much food, eating too much and often...
SAM FABRICANT: I eat a lot of chocolate and sweets and obviously, there's no real good health thing with that, and that's my downfall — sweets.
LIZ HAYES: Twins Charlie and Sam Fabricant at their heaviest weighed in at a combined 630lb, nearly 286kg. That was until six months ago, when Charlie, at the age of 15, decided on surgery. After that, his appetite changed forever.
WENDY FABRICANT: One piece of pizza could last him three days.
MR FABRICANT: One slice.
LIZ HAYES: Since the surgery, Charlie has lost 45kg, nearly a third of his old weight.
CHARLIE FABRICANT: I can't see a downside from where I'm sitting because, of course, there was the pain at first, but I mean, I just had to do it and so I think it was well worth it.
LIZ HAYES: Over the same period, Sam, who has not had the operation, has been dieting and exercising. He's lost just 4.5kg.
SAM FABRICANT: I'm envious of him. I know, you know, this is a drastic step but obviously, if you want a quick solution right now, that's what is happening right now.
LIZ HAYES: This is a family who has always battled the bulge, sometimes in the most bizarre ways.
WENDY FABRICANT: I got shots from a doctor of the urine from a pregnant woman and supposedly that would help your metabolism. That was the most bizarre diet.
LIZ HAYES: The boys' mum, Wendy, has had the controversial gastric bypass surgery herself and believes it's only a matter of time before Sam has the operation.
WENDY FABRICANT: I don't care what anybody else says … that we've put them, or put Charlie, you know, in a dangerous situation having surgery. But it was the only choice.
LIZ HAYES: And Charlie's surgeon, Dr Chris Salvino, agrees. He controversially believes that diet and exercise have little to do with our growing obesity epidemic.
DR CHRIS SALVINO: Heavy people do not cause the weight problem.
LIZ HAYES: They ate too much.
DR CHRIS SALVINO: Their genes have caused this to happen. Most heavy people, if you actually sat down and talked to them, are not eating much more than you or I. So many heavy people …
LIZ HAYES: Is that true, though?
DR CHRIS SALVINO: That's true.
LIZ HAYES: Really?
DR CHRIS SALVINO: That's true. Many people have tried regular diets. Their metabolism is just different. So it's really a disease state. It's a disease state like bad eyesight.
LIZ HAYES: But aren't you almost giving people an excuse to accept their obesity?
DR CHRIS SALVINO: We're not giving them an excuse. We're giving them a chance at a second life.
DR GARRY EGGER: Genetics loads the gun and environment pulls the trigger. If you think it's genes that is causing the problem, have a look at mum and dad and the kids and then you have a look at the family dog or cat. And if the family dog or cat are obese, then it's not a genetic problem, it is an environmental problem.
LIZ HAYES: Everybody is eating too much?
DR GARRY EGGER: Exactly.
DR GEORGE FIELDING: At the end of the day, fat people are fat, I believe, because they have uncontrollable hunger. It all manifests itself all different ways, but they're just hungry all the time.
LIZ HAYES: And George should know. He's battled obesity himself. And it wasn't until he had lap band surgery, the very same operation he now performs, that he gained control of his weight.
DR GEORGE FIELDING: I didn't want to die. I really thought I was going to die. I was on 11 tablets and medicines. I'm really bright, I'm really aggressive, I'm smart, I can do just about anything but I could not stop eating.
LIZ HAYES: Remember Brianne Herr. As she sat down to her last meal before her gastric bypass operation, she weighed 290lb. That's more than 130kg. Four weeks later, we met up with her again. She's lost 18kg, but is still in pain from the operation and has not yet been able to eat solid food.
BRIANNE HERR: I kept asking, "Mum, why did you let me do this?" She was just like, "It was your choice and you made the decisions."
LIZ HAYES: And remember, the surgery is irreversible.
BRIANNE HERR: It was really horrible because I kept going back in my mind, "Was it really worth it?" So I would just go on crying and then couldn't stop crying.
LIZ HAYES: For the rest of her life, she must supplement her diet with a cocktail of vitamins and minerals.
There is a major adjustment that has to be made to your lifestyle. Is that hard to do?
BRIANNE HERR: Yeah. It's very hard. Um, before, you know, I'd go out with my friends and, like, we'd get a hamburger and some french fries and drink, and now I can't even eat, you know, five french fries without feeling full.
LIZ HAYES: Five french fries?
BRIANNE HERR: Well, I haven't tried french fries yet, but, you know...
LIZ HAYES: That's all it would take?
BRIANNE HERR: Yeah, that's all it would take and I would be, like, "I can't do it any more."
DR GARRY EGGER: It's not an easy solution. It works very effectively in the right hands but it's not an easy solution. People do have to still change their lifestyle and it remains a problem for the rest of their lives. If somebody is obese, they remain potentially obese for the rest of their lives.
LIZ HAYES: Are you comfortable as a doctor doing this?
DR GEORGE FIELDING: I am now. I was scared, you know, scared … I was also scared about how I'd be perceived, but I tell you — you take one of these kids and they lose the 200lb and they come off all their pills and they bring in their girlfriend … it's cool.
LIZ HAYES: That's when you know...
DR GEORGE FIELDING: I've done good for them. I genuinely have.
LIZ HAYES: George Fielding believes he's fighting a life-and-death battle, one we can't afford to lose.
DR GEORGE FIELDING: The thing is, we all love kids and the notion that our kids are going to die before we do is the great horror that everyone has. And that's going to happen.
LIZ HAYES: That our own children could die before we do?
DR GEORGE FIELDING: We will be burying our kids because they are going to get diabetes. And when you get diabetes, you go blind, you get kidney failure, you get heart attacks and your legs drop off and it's going to happen.
LIZ HAYES: Just because we got fat?
DR GEORGE FIELDING: Correct. It's a nightmare.
Reporter: Liz Hayes
Producer: Lincoln Howes, Julia Timms
