Residents of Southern California have spent several years being inundated by 1-800-GET-THIN billboards (and radio jingles) advertising the Lap-Band, one of a growing array of weight loss surgeries. The signs assure motorists zooming by that the “safe” procedure lasts only an hour1, and is of course available with financing for those who have concerns about the cost.
The Los Angeles Times has been crusading against the dubious billboards for over two years, as have fat activists and others concerned by the idea of advertising a potentially dangerous surgery to unwary members of the public.
I’ve followed the Lap-Band case because it intersects with a number of issues dear to me, starting, of course, with weight loss surgery itself, which is touted as a solution to the terrible tragedy of being fat.
Since being fat is the worst thing ever, radical surgeries are of course a completely reasonable thing to consider to fix it. Fatties are simultaneously shamed for not getting surgery and shamed for getting it; either you won’t take a simple step to “save your life2,” or you’re taking the lazy way out3 instead of working to lose the weight on your own4.
And of course there are the issues bound up in direct-to-consumer advertising of treatments and procedures. The risks of the Lap-Band were cleverly hidden in tiny print on the signs, and the FDA only bothered to take regulatory action about that last month, after considerable agitation in the media. Other regulators have been slow to follow suit: Agencies designed to protect consumers from misleading and dubious advertising aren’t doing their job.
The billboards are also part of the growing medical credit industry, which exploits low-income people with low financial literacy. People who don’t have a lot of money but are desperate not to be fat anymore sign contracts with high interest rates and unfavorable terms, not understanding that they probably won’t be able to pay off the debt. And then it becomes a black mark on their credit records, and a source of denied opportunities in the future.
Behind the Lap-Band billboards lies a sinister and sad tale of people exploiting fat hatred and fear of fatness for cash. A lot of it. Bariatric surgery is a booming industry in the United States and the idea of a safe, one-hour procedure with minimal complications is appealing to a lot of people who shy away from more radical procedures like gastric bypass.
Earlier this month, former employees of surgery centers affiliated with the 1-800-GET-THIN campaign alleged “gruesome conditions” at clinics, including conditions that got patients killed:
At least five patients have died since 2009 after Lap-Band procedures at clinics in Beverly Hills and West Hills that are affiliated with the 1-800-GET-THIN marketing campaign, according to autopsy reports, lawsuits and other public records.
When they reported the conditions, they were subjected to retaliation. Because nobody likes a
tattletale medical professional concerned with the safety of patients.
The Times has historically been pretty ferocious on the investigative journalism front, and journalist Michael Hiltzik has been doggedly pursuing this case for years now.
A snowball of revelatory stories in the last few months may ultimately be what leads to the downfall of this particular Lap-Band advertising campaign, and perhaps tighter monitoring from government regulators. Members of California's legislature just called for an investigation into the marketing campaign, and the safety of Lap-Band procedures in general.
Vindication in this case still leaves me with a sense of sadness, though. These campaigns are predicated on the idea that fatness is a state so awful that people will do anything to get un-fat, and they exploit people who may have limited education and income.
As a shaming tactic, they are dangerously effective; when you’re surrounded by messaging that your body is disgusting, it’s hard not to feel the pressure to pick up the phone and call a surgeon.
When you're told that the key to happiness lies in not being fat, that you will be able to take charge of your life and be a new person and get rid of sadness by getting surgery, you're willing to pay almost any amount.
The fact that it took years to get any kind of meaningful action is deeply telling. Other aggressive campaigns for treatments and procedures are monitored much more closely, and regulators are much more willing to take rapid action to shut down campaigns that are obviously dangerous. In this case, the sluggishness is rather reflective of an endemic attitude that fat people are less than human, so they don’t deserve the same care and consideration that everyone else is entitled to.
Five patients died because of unsafe conditions at these clinics. Five fat people who put their lives and bodies on the line, and trusted medial professionals to take care of them while they were under anesthesia. Five fat people who thought they were doing the right thing because the people around them encouraged them to get surgery. Five fat people who had families and loved ones and dreamed of something better for themselves.
(Additional note: After I submitted this for publication, Allergan suspended Lap-Band sales to this family of clinics.)
1. In news that I am sure will astonish you, it turns out that when you undergo a procedure requiring general anesthesia, you actually need to spend several hours in recovery afterwards. Lap-Band surgery is not the sort of thing you can get on your lunch break, kids! Return
2. Fatness is deadly, as we all know, yes? Other things that are deadly: being alive. Return
3. Because nothing says “lazy” like invasive surgical procedures that permanently reroute your digestive tract, alter your metabolism so significantly that you need to eat a special diet, and, oh yeah, require weeks of careful recovery. Return
4. Diets are highly effective! You just need a little willpower, because fatness has nothing to do with complex factors including genetics or, you know, social shaming that makes it difficult to do things like going to the gym while fat. Return