Stories of his death are greatly exaggerated

August 16, 2005 11:07 AM

A distant relative of mine recently died after undergoing a dramatic weight-loss treatment prescribed by his doctor. My family members claim it was not gastric bypass surgery, but rather a mysterious therapy his doctor called "the undertaker's friend."

"This will either save you or kill you," they claim his doctor said to him. They also swear he lost nearly 200 pounds in a matter of weeks, was looking incredibly healthy and fit, then suddenly keeled over and died. The fact that he's dead is true, but other than that the entire story sounds absurd.

I've argued with my family that 1) it's impossible to lose 200 pounds in a few weeks and 2) there are no "secret magic weight loss pills," that gastric bypass surgery is the only medically-approved way to treat morbid obesity so rapidly. They cling to their story and look at me like I'm the crazy one. (Treatment and death occured in Louisiana, if it matters. Resulting story naturally resembles pages from Midnight In the Garden of Good & Evil)

So what, besides gastric bypass surgery, are other ways doctors treat morbid obesity (besides, obviously, better diet and increased excercise). Are any of them known to have a high mortality rate? I realize that there are numerous risks associated with rapid weight-loss, and that there's no way we can know exactly what killed the guy; I'm just curious about the truth that must lie somewhere in the heart of this fantastic tale.

posted by junkbox to Health & Fitness (32 answers total)

Fen-Phen?
posted by Pollomacho at 11:09 AM on August 16, 2005

there's no way we can know exactly what killed the guy

Why hasn't an autopsy been done? If any of this story is true, it sounds like hideous negligence on the part of the doctor.
posted by Optimus Chyme at 11:18 AM on August 16, 2005

Quackery?

Sounds like a lawsuit to me. Heck, you will learn everything you want to know during the discovery phase of the legal proceeding.
posted by BeerGrin at 11:18 AM on August 16, 2005

Is it possible that it simply has nothing to do with weight loss at all? Maybe it was cancer. Cancer patients have been known to lose a lot of weight before dying. AIDS. Pretty much any terminal disease I can think of really.
posted by GuyZero at 11:19 AM on August 16, 2005

If any of this story is true, it sounds like hideous negligence on the part of the doctor.

Really? It sounds like the doctor told him that the diet had the distinct possibility of killing him. I believe that they tell you the same thing when you get gastric bypass surgery, and everyone who undergoes it is aware of the risk of death.
posted by billysumday at 11:21 AM on August 16, 2005

It sounds to me like something else is going on here. Something other than weight loss.
posted by 517 at 11:27 AM on August 16, 2005

200 pounds in a few weeks? This is on the order of 10 pounds a day. I can't imagine anything that would work that fast short of outright cutting off the weight. Even gastric bypass surgery would take a couple of years to take off that kind of weight: "[M]any patients los[e] over 100 pounds within the first 18 months following surgery," reports Wikipedia. I don't think even terminal diseases would take off weight that fast, and if they did the victim wouldn't be looking "incredibly healthy and fit."

Maybe it was a gypsy curse.
posted by DevilsAdvocate at 11:29 AM on August 16, 2005

Lap-band?
posted by tristeza at 11:33 AM on August 16, 2005

I couldn't imagine anything taking off that amount of weight save for liposuction.
posted by peacay at 11:34 AM on August 16, 2005

Although.."Reports of people removing 50 pounds (25 kg) of fat are highly exaggerated" - wiki
posted by peacay at 11:37 AM on August 16, 2005

The story just isn't true. I think it's simply not possible to lose 200 pounds in a few weeks unless a few weeks is in fact several months. Gastric bypass wouldn't provide those kind of results and there are hard limits on what human metabolism can do even if you're, say, Lance Armstrong. Even rapid weight loss due to out and out starvation wouldn't do this I think. I've heard of extreme cases of people using 30lbs in three weeks, but this is crazy...

This is one wierd AskMe. Doctor's providing pills called "the undertaker's pill'? What the hell are you guys doing down there in Louisana?
posted by nixerman at 11:43 AM on August 16, 2005

I would guess a combination of steroids and amphatemines would be the only chemical combination I can think of to lose weight and look fit on a rapid basis. Of course his heart would be that of a 100 year old man (you did say it killed him). Still even on a suicidal routine I would guess his organs would give out under stress rather quickly. 2 weeks would probably do it but I can't imagine losing that much weight. The 200lb claim seems unreliable. I would positive if he were on heavy dosages of tseterone and amphetamines he'd be exhibiting some "flags up" symptoms that your relatives would sure mention, such as the ability to control animals by mere thought.
posted by geoff. at 11:44 AM on August 16, 2005

Response by poster: It sounds to me like something else is going on here. Something other than weight loss.

What's happening is the story is passing through a family of overdramatic Southern storytellers like a bad game of telephone.

The story just isn't true.

My relatives' version is definitely not true, but I'm pretty sure he underwent treatment for obesity, lost at least some of the weight, and died suddenly soon after. Occam's Razor tells me that he probably had a perfectly good doctor who prescribed a life-saving but potentially dangerous treatment; I'd guess he actually lost a more reasonable (but still drastic) 40-50 pounds over the course of a few months, then succumbed to liver or kidney problems associated with his dramatic weight loss.

This relative is far enough over on the family tree (2nd cousin once removed) that I can't pick up the phone and call a reliable person for, say, autopsy results. I'm just hearing a story passed along 3rd hand and wondering what the truth might be.

Relatives swear he didn't have any kind of surgery like gastirc bypass or the lap-band, but I don't know if I believe them. I think they may be romantically enamored with the idea of a secret weight loss drug only doctors know about (you know, the same way drug companies have a cure for cancer they're withholding in order to make more money off less effective treatments), but IANAD and don't know what other treatments are actually available.
posted by junkbox at 11:54 AM on August 16, 2005

Whatever it turns out to be, don't let my dad get wind of it, or he'll be pestering me to do it. He's already informed me that there is a laser that can zap fat away and is unable to understand why I haven't had that done. My explanation, that there is in fact no such thing, while true, is insufficient, because he saw it on television.
posted by kindall at 12:10 PM on August 16, 2005

I can't think of any way to lose that much weight that quickly that doesn't involve a chainsaw.
posted by Civil_Disobedient at 12:18 PM on August 16, 2005

Being on a pretty strict but sensible regime* myself, losing 10 pounds a DAY is, as Ralph would say "UNPOSSIBLE".

A pound of fat is 3500 calories. An average (say, 160-170lb man) doing nothing all day burns about 2000 calories. So basically starving all for 2 weeks would result in 8lbs of weight loss not taking in account the lowering of metabolism due to starvation.

*a regime of 6 days at 1500cal intake + 4 days of weights and cardio (total workout 1.5 hours) and am LUCKY if I"m losing 2lbs a WEEK (the often touted theoretical, healthy maximum you can lose per week). This regime, btw, is pretty intense.
posted by eurasian at 12:28 PM on August 16, 2005

If he didn't have surgery, I think we're back to the the Fen-Phen hypothesis. It is, after all, known cause fatal episodes of heart-value disease, which is why it was pulled as a treatment in the first place. Presumably there are still stashes of it somewhere if you know that right pharmacist.
posted by desuetude at 12:35 PM on August 16, 2005

I'm not sure what happened here, but the death rate for gastric bypass surgery is actually quite high as these things go, although apparently (at least according to the folks at ThinnerTimes), not any greater than that for any major surgery performed on morbidly obese people:

The death rate (morality) from gastric bypass is about 1 out of 350 people (1/350)

The mortality rate for gastric bypass is similar to the mortality rate for other major general surgical procedures done on a group of patients who are obese and have multiple health problems. Risk of dying from any procedure depends on the general health, age, and weight of the individual. Clearly people who are older, have more severe comorbid problems, and are heavier are much higher risk than younger, healthier, less obese counterparts. The most common causes of death after gastric bypass include infection secondary to staple line or suture line leaks, pulmonary embolism, and respiratory problems.

posted by OmieWise at 12:49 PM on August 16, 2005

BTW, googling "Undertakers friend" comes up with this tin-foil hat site about "Murdering Blacks with Aspartame!"
posted by OmieWise at 12:52 PM on August 16, 2005

This story can't be true. No one can lose 10 pounds per day for weeks straight by any means. You could maybe lose 200 lbs all at once by liposuction, but even folks post gastric bypass rarely lose more than 5 lbs a week. You could maybe lose 10 lbs of water in a day - if you were a large indivudual - but you'd be close to death soon after from acute dehydration. You couldn't do this for weeks straight.

I also have doubts about a licensed medical doctor saying "This will either save you or kill you" when prescribing obesity treatment. Even if a doc was using something with a non-zero risk of mortality, like gastric bypass or amphetamines, no physician in his right mind would ever say something like that.

And finally, using a modality that had a significant risk of death, to where the physician found death unsurprising, would not be negligence, it would be straight open-and-closed malpractice. Sometimes physicians do kill their patients - during things like cancer chemotherapy, trauma surgery, and so on. In general the expected outcome of *not* giving the treatments is certain death. Physicians also risk their patients lives all the time, in small ways - we understand that people die from things like anaphylaxis and anesthesia risks - but routinely prescribing a fatal "treatment" for obesity? Just not done.

My guess is that whoever initially came up with this story was aware of the true story about your relative's death and found it somehow embarrassing or unfit for public consumption. This story was made up to take its place. This occurs frequently in, for example, death by stupidity (masturbation-related injuries, for instance) as well as suicide.
posted by ikkyu2 at 12:57 PM on August 16, 2005

Well, according to my calculations, in order to lose 50 pounds in one week, you'd need to burn 25,000 calories a day. For a week. Thats about 108 megajoules of energy, and that means burning caloires at 1255 watts constantly. I've read that lance armstrong outputs energy at 500 watts, and that most people can only sustain that kind of energy for a few minutes.

In order to get to lance armstrong teritory, we're talking about 10 weeks. I'd say it's still pretty unlikely.
posted by delmoi at 1:04 PM on August 16, 2005

The Undertaker's friend google results alternatively refers to somebody who kills lots of people (Asa Cain comes up), or Formaldehyde. I agree that it would be virtually impossible to metabolically loose that much weight over a matter of weeks. Surgery seems more likely, or possibly something non-metabological which would rid you of fat, such as a possibly non-leathal does of a poison.

Of course, this whole things is probably bunk.
posted by daver at 1:12 PM on August 16, 2005

Perhaps they drained a lot of water out of him? That seems like a possible way to lose a lot of wight and die.
posted by springload at 2:14 PM on August 16, 2005

I remember reading somewhere (mefi?) recently about dramatic weight loss in obese people treated with glucophage (the diabetes med). I don't remember the exact amounts lost but do remember them being much higher than I'd have thought physically possible with diet and/or exercise (as per delmoi's calculations).
posted by tiny purple fishes at 2:22 PM on August 16, 2005

In my AP biology class in highschool the instructor mentioned that there were appearantly drugs that disrupted the mitochondrial electron transport chain, which reduced the efficiency of respiration dramatically that were once thought to be promising weightloss drugs, until they tried them, and a lot of people died.

It sounds plausible, and dangerous even if it did work properly, but highly unlikely in this case, nevertheless, it is offered as a piece of dubious weightloss triva.
posted by Good Brain at 2:56 PM on August 16, 2005

This sounds so very fishy to me. I had gastric bypass surgery in June and when I went to the doctor for my monthly check up in July I had lost 40 pounds. Just thinking back on the 1st couple of weeks I was home from the surgery when the most I could eat was mashed potatoes, soup and sugar-free popsicles there is no way I could have lost 200 pounds. Even if I had not eaten anything that first month I would not have lost 200 pounds.
posted by govtdrone at 4:56 PM on August 16, 2005

Ingestible parasites. I'm not joking. This was very popular in the 80s (and eariler). Caused massive, rapid weight loss and lots of deaths for many people.

That said, I'm agreeing with the "something else was going on here" crowd.
posted by necessitas at 4:59 PM on August 16, 2005

A physician friend has offered that it might be a gastric stapling (as opposed to bypass).
posted by gsteff at 6:50 PM on August 16, 2005

I'd lost about 20 pounds if I amputated both my legs, and maybe 40 more if I chopped off my fat head. Who's got a meat saw?

(No, seriously, this dead-relative story does sound impossible on the face of it.)
posted by davy at 10:59 PM on August 16, 2005

I just thought of something: how could I find out what one of my legs weighs? (Just to know, I really plan to keep it.) I'm assuming draping it over a bathroom scale woudn't be very accurate, right?
posted by davy at 11:01 PM on August 16, 2005

In hospitals, pneumonia is known as "the sick man's friend" and perhaps "the undertaker's friend," too.

Dying can be a long process, even with an overwhelming disease. The heartbeat and breathing reflexes are in the "alligator brain" -- the most basic portion. You can't "will" them off.

Pneumonia, left untreated, produces quick and nearly painless death. In hospitals, staff frequently permit it to take its course, believe me for the good of the dying person and family much more than whether they need the bed.
posted by KRS at 3:20 PM on August 17, 2005

I don't think you're going to get a straight answer by talking to the family. It would require a serious outside investigation. It would not be out of line to make a call to the police and a complaint to the agency that licences physicians.
posted by winston at 4:57 PM on August 19, 2005