Is The Gastric Bypass ALTERNATIVE better than any of the bariatric surgeries?
Sep 2017 V1.0
By: Marcus K. Free, MD (bariatric surgeon, board certified surgeon)
My research is based on my 17 years experience as a bariatric surgeon and an extensive review of ~1,200 posts on the Facebook.com/groups/LOST100 of users of the Gastric Bypass ALTERNATIVE regimen (GBA). I also communicated with dozens of users of the (GBA) to check validity of their success, weight reduction rate, side effects and health benefits.
My research concludes:
1. It’s possible to achieve a healthy weight without surgery and avoid the complications associated with the bariatric surgeries
2. The likelihood of achieving a healthy weight is directly linked to the determination of the GBA user
3. My observation is that the GBA is a lifestyle change and has a higher likelihood of being a long term change resulting in a higher likelihood of maintaining the lower weight achieved. That, as opposed to the perceived quick fix of any of the bariatric surgeries: gastric bypass, gastric sleeve, weight loss surgery, LapBand.
4. The cost per lbs lost with a gastric sleeve is about $80 while GBA users pay only $10
5. Weight loss rate observed in the group was about 2.5 times faster than that known with gastric sleeve (most popular weight loss surgery today) patients
Bariatric surgery is performed for morbid obesity (BMI>40) and for severe obesity (BMI>35) with obesity-related complications. Roux-en Y gastric bypass and sleeve gastrectomy are the most common procedures currently performed and typically result in loss of more than 50% of excess weight. However, these procedures are costly, severe complications can and do occur, troubling side effects are common, and weight regain often causes long-term failure. Medical weight loss methods offer lower risk but poor results. A novel non-surgical weight loss regimen, the Gastric Bypass ALTERNATIVE, is described along with initial data showing a much lower incidence of severe side effects, a minimal risk of complications, better effectiveness at weight loss, and a much lower cost when compared to bariatric surgical procedures. The GBA is better, safer, and cheaper than bariatric surgery.
Bariatric surgery is risky, has frequent and troubling side effects, has severe complications, and often results in long-term failure from weight regain. A large segment of the U.S. population suffers from the disease of obesity and the rate appears to be increasing. Many patients are seeking bariatric surgery to achieve significant weight loss with exposure to significant risks of perioperative complications, long-term complications often requiring reoperation, bothersome and troubling side effects, and long-term failure from significant weight regain. Medical options are typically exhausted prior to bariatric surgery due to inadequate weight loss effectiveness in the morbidly obese patient. A better solution is needed that can provide effective weight loss for the morbidly obese with an acceptable level of complications and side effects. In this paper, we describe a non-surgical weight loss regimen, the Gastric Bypass ALTERNATIVE,® that is as effective as bariatric surgery for significant weight loss yet free of the many and frequent complications and severe side effects common to surgical weight loss.
Obesity in the U.S.
In the 1960s, about 30% of the U.S. population was considered overweight and approximately 10% met the current criteria for a diagnosis of obesity. Currently, approximately the same percentage of the population is overweight but the prevalence of obesity has tripled to nearly 30%. Instead of an increase mostly in the overweight category and a smaller increase in the more severe condition of obesity, our population has swollen the ranks of the most severe end of this disease spectrum. Interestingly, what many consider our most powerful treatment for obesity, bariatric surgery, although developed in the 1950s, has apparently done nothing to slow our conversion to a mostly sedentary, food-centric, unhealthy population.
Untreated, the costs of obesity-related disease are high. As this epidemic has raged on, we’ve had to coin new descriptions of diseases, including obesity hypoventilation syndrome, non-alcoholic hepatosteatosis, and metabolic syndrome—a collection of metabolic disorders caused by obesity. Current estimates of the costs for treatment of obesity-related disease in the United States are $190.2 billion, or nearly 21% of our total healthcare spending. Obesity-related absenteeism costs the U.S. another $4.3 billion per year in lost productivity. Together, obesity-related costs each year are equal to approximately one-half of the entire U.S. military budget, or nearly 25% of the entire U.S. government budget. Unchecked, the rising costs of obesity could threaten our safety and security as individuals and as a nation. The yearly cost of treating diabetes, one of the most common diseases associated with overweight status and obesity, has now risen to $825 billion per year in the U.S.
Currently available treatments for obesity and overweight status include medical weight loss and surgical weight loss. In addition, many non-medically related “programs,” such as diet supplements and fad or non-scientific diets, are also promulgated as weight loss solutions. Medical weight loss methods, including dietary counseling, behavioral therapy, exercise programs, and prescription weight loss medications, are frequently utilized after personal dieting has been tried. Surgical weight loss treatments, initially started in the 1950s by Drs. Mason, Sugarman, and others, have included a wide variety of approaches that can be categorized into gastric restrictive, malabsorptive, and combination gastric restrictive-malabsorptive. Early procedures were the vertical-banded gastroplasty (gastric restrictive) and the jejunal-ileal bypass (malabsorptive) which was also called the “J-I-B.” Later procedures have included the Roux-en-Y gastric (a combination procedure and still considered the “gold standard” bariatric procedure), and the gastric banding (gastric restrictive and no longer supported). Newer procedures include the sleeve gastrectomy (gastric restrictive) and the duodenal switch (a combination of the sleeve gastrectomy and a small intestine bypass procedure). Unfortunately, these methods for attempting weight loss are often costly, risky, and ineffective. Surgical weight loss procedures, may be effective in terms of eventual weight loss, but has serious complications and frequent weight regain. Medical weight loss methods are rarely effective at achieving significant weight loss of more than 10-15% of excess body weight although have a lower risk of serious complications.
In the U.S., bariatric surgery is indicated for patients with body mass index (BMI) of 40 or greater (morbid obesity), or 35 or higher (severe obesity) if accompanied by obesity-related diseases. Current surgical procedures being offered include the sleeve gastrectomy and the Roux-en Y gastric bypass. The American Society of Bariatric Surgery estimates that there were 196,000 bariatric surgeries performed in 2015, consisting mostly of gastric bypass (23%), sleeve gastrectomy (54%), and revisions (14%) (www.asmbs.org/resources). According to an Obesity Coverage report from August 10, 2017, the average cash price of a sleeve gastrectomy surgery (hospital, surgeon, and anesthesia) in the U.S. is $16,800. The average cash price for a gastric bypass is $24,000. However, most patients now seeking bariatric surgery are covered by insurance, so the actual charges paid for surgery are much higher. Industry sources report major commercial health insurance carriers typically pay in excess of $50,000 for a sleeve gastrectomy. Commercial insurance payments for gastric bypass procedures are in the range of $70,000 to $100,000. Costs and benefit analyses of bariatric surgery typically compare the costs of the procedure against the costs of untreated obesity-related diseases. Such analyses assume the procedure will successfully resolve such disease processes. We question the validity of such analyses and propose a different measure of cost-effectiveness of weight loss methods: the cost per percent of excess weight lost, or $ per %EWL. The sleeve gastrectomy and gastric bypass procedures result in approximately 70-75% excess weight loss. Using the cash price gives an approximate cost per each percent of excess weight loss of $224 for the sleeve gastrectomy and $320 for the gastric bypass.
Which procedure to recommend?
An additional concern regarding bariatric procedures is the longterm viability of individual procedures. The jejunal-ileal bypass was promised to result in superior weight loss without restrictions on the type or amount of food consumed. However, late deaths and severe neurologic disorders ended this procedure due to the operation’s severe interference with micronutrient and vitamin/mineral absorption. Vertical-banded gastroplasty, a popular procedure during the 1970s and 1980s that was also known as “stomach stapling,” was eventually discontinued due to poor long-term results. As the stomach was simply partitioned but not divided, connections inevitably developed through the staple line (fistulas) and caused failure of the procedure several years later. A bariatric surgery that received wide-spread attention through heavy marketing efforts, the Lap-Band® procedure, was promoted as a better option than the vertical-banded gastroplasty without the higher risks of the gastric bypass procedure. Starting in 2001, many patients who were seeking a safer surgery underwent the adjustable gastric banding procedure. Unfortunately, just like other surgeries that have come and gone, this procedure has been largely abandoned due to weak weight loss effects and a very high reoperation rate (as high as 20%, including band removal and conversion to other bariatric surgeries). Currently, the sleeve gastrectomy is the increasingly popular choice of bariatric surgeries. Recent studies are now showing an alarming incidence in the appearance of gastroesophageal reflux after the procedure and worsening of reflux if present preoperatively. Already, another procedure (the gastric plication) has been developed to address some of the shortcomings of the sleeve gastrectomy. The one procedure that continues to be offered over a number of years is the gastric bypass. This procedure has good weight loss results but the tradeoff is a higher risk of serious early and late complications. An often quoted medical maxum is “if there are many treatments for a single disease, it’s because none are very good at treating the disease.” The litany of bariatric surgery procedures over the last 50 years seems to fit this rule. Perhaps the real reason that the surgical community continues to develop new procedures is because bariatric surgery is not the best way to cure obesity.
Troubling side effects
In general, all bariatric surgeries cause significant side effects. Nausea, vomiting, and chronic abdominal pain are the most frequent side effects encountered after bariatric surgery. The gastric bypass and other procedures that involve bypassing a portion of the small intestine frequently cause “dumping syndrome” that can be early (within minutes of a meal) or late (hours after a meal). Increased flatus, or gas, that is often very smelly is common, as is chronic intermittent diarrhea with loss of bowel control (such as the famous “Al Roker incident”). Dry and sagging skin, chronic halitosis, and loss of hair and teeth are also commonly in patients who have undergone bariatric surgery.
Bariatric surgeries are high-risk major intra-abdominal procedures that require general anesthesia and hospitalization. Accordingly, patients undergo major cardiovascular stress with risks of heart attack, pulmonary embolism, stroke. Specific surgical risks are also involved and include intraoperative bleeding and surgical injuries to the stomach, esophagus, spleen, liver, and intestine. Wound infections are also a significant risk, particularly in patients with diabetes and morbid obesity. For the gastric bypass, leaks can develop at the stomach-intestine connection (the gastrojejunal anastomosis) resulting in intra-abdominal abscess, sepsis, shock, and even death. The sleeve gastrectomy has a very long staple line where the stomach is divided and leaks similar to those observed in the gastric bypass can develop anywhere along this staple line. Leaks require reoperation with even higher risks than the initial surgery.
Late (delayed) weight loss surgery complications
Complications can also develop months or years after bariatric surgery and may result in severe weight regain and/or need for additional surgery. Fistulas (an abnormal connection) can develop between the stomach and the abdominal cavity, other organs, or to the skin and require a surgical or endoscopic procedure to correct. Nutrients and electrolytes can be lost through the fistula resulting in worsened malnutrition. In the case of the vertical-banded gastroplasty, fistulas frequently connected the small stomach pouch to the rest of the stomach. Food would pass through the fistulas instead of just the intended pathway, allowing patients to consume a much larger meal and regain their weight. Hernias can develop in the incisions for this surgery, often requiring surgery to prevent bowel obstruction from the hernia. Bowel obstructions from intra-abdominal postoperative scar tissue (adhesions) require surgical correction when the vomiting and severe abdominal pain doesn’t improve within 24-48 hours. The gastric bypass has two intestinal connections that can cause an “internal hernia” where the bowel gets trapped by itself. This type of bowel obstruction is difficult to diagnose but can lead to bowel strangulation and even death if not treated promptly. Malnutrition is a major complication seen with virtually every type of bariatric surgery. A bariatric procedure will cause severe restriction in the amount of nutrients that can be ingested (LapBand®, gastric bypass, sleeve gastrectomy, vertical-banded gastroplasty), malabsorption of ingested nutrients (gastric bypass, bilio-pancreatic diversion, duodenal switch, jejunal-ileal bypass), or both (gastric bypass, bilio-pancreatic diversion). Severe deficiencies are seen with protein, iron, B vitamins, vitamin D, calcium, copper, and zinc. Patients who experience bariatric surgical complications are likely to have ongoing problems with abdominal pain, unsightly surgical scars, intolerance to many types of foods, severe hair loss, gum disease, tooth loss, neurologic diseases including numbness and weakness, permanently altered taste and smell perception, frequent nausea and vomiting, foul-smelling flatus and diarrhea, severe skin dryness, major weight regain, and an immunosuppressed state.
Weight regain after bariatric surgery
In addition to the early and late complications from surgery, there are a significant portion of bariatric surgery patients who either will have poor weight loss or will experience significant weight regain within several years of the procedure. The factors contributing to poor initial weight loss include improper patient selection and/or poor surgical procedure choice, inadequate mental/emotional preparation of the patient for the surgery, early postoperative complications, poor or inadequate postoperative follow up, poor dietary training, and pregnancy during the first year after surgery. Those same factors, along with late complications, revisional surgeries, severe nutrient deficiencies, and recurrence of preoperative dietary behaviors are major causes of weight regain years after surgery. However, the one common cause of poor weight loss and later weight regain may be the most important factor of all: the persistence of food cravings after bariatric surgery. Several studies have examined the impact of bariatric surgery on cravings and found mixed improvements; however, the cravings remained well above the levels of cravings seen in non-obese, non-bariatric patients.
Non-surgical weight loss
Most common is the Gastric Bypass ALTERNATIVE regimen invented by Don Karl Juravin.
The other general type of weight loss available is loosely described as “medical weight loss” and includes dietary and behavioral counseling, exercise programs, and prescription weight loss medications. In the U.S., prescription weight loss medications include appetite suppressants (phentermine, diethylpropion, phendimetrazine), satiety stimulants (lorcaserin), pancreatic suppressants (Orlistat), binge-eating suppression (topiramate), and combination medications (phentermine/topiramate, naltrexone/bupropion). Several medications have an unclear mechanism of action for weight loss and are actually diabetic medications (metformin, liraglutide, exenatide, canaflozin, empagliflozin, dapagliflozin). For those with obesity or morbid obesity, the overall success of weight loss medications ranges between 3% and 14% of excess body weight. To put these results in perspective, a 250 pound person with 100 excess pounds (based on a calculated ideal body weight of 150 pounds) would likely only lose up to 14 pounds in a successful medical weight loss program. For an overweight individual needing to lose 30 pounds, the loss of 14 pounds would be significant, but for our hypothetical morbidly obese patient, this miniscule amount of weight loss is unlikely to achieve any noticeable or lasting health benefits. In fact, many bariatric physicians consider the loss of 50% of excess weight to be a measure of the success of a bariatric surgery. The LapBand® procedure has been largely abandoned in large part due to an average excess weight loss of only 40% (in addition to an excessive frequency of reoperation). If such results are unacceptable for a surgical weight loss procedure, one would question why other treatments continue to be prescribed despite very low weight loss effects. The likely answer is that overweight and obese patients are so averse to the major risks of more effective forms of weight loss (gastric bypass, for instance) that they are willing to accept even small amounts of weight loss if accompanied by low risk. However, prescription weight loss medications have a long list of known complications, including cardiovascular, renal, gastrointestinal, and neuropsychiatric. Unfortunately, some of these complications may not be uncovered for years, such as the now well-known cardiac valve damage caused by the combination diet drug phen-fen. Non-medical weight loss programs, including many dietary supplements, may not have the risk of frequent severe complications found with more aggressive weight loss treatments such as bariatric surgery, but also have poor weight loss results and frequent weight regain. Clearly, a need exists for a weight loss method that is both effective and safe. Until now, this holy grail of obesity treatment has been unattainable.
Clearly, there exists a need for weight loss therapies that have acceptable levels of risk and are highly effective at both weight loss and prevention of weight regain. In our opinion, the missing element is the ability of weight loss methods to successfully address the issue of cravings. A craving is a seemingly inexplicable desire for a specific food or non-food item to eat or consume. A common feature of cravings is that the person experiencing the craving can’t rationally describe why that particular item is desirous other than consuming or eating the item reduces the desire. However, a craving has a biological or physiological basis: a significant deficit in a particular nutrient is the causative factor of most cravings. For instance, craving and eating ice on a regular basis is highly suggestive of iron deficiency and craving burnt toast is linked to low potassium (and to obsessive-compulsive disorder as well). A craving for potato chips or French fries may be from too little consumption of omega-3 and other “healthy, non-saturated” fatty acids of which, ironically, potatoes have low amounts. Without anticipating and addressing the cravings that often accompany weight-loss attempts, many weight loss programs can’t prevent the self-sabotage that occurs is patients with unresolved cravings.
Another mechanism which many weight loss methods do not take acknowledge is the impact of altered gut flora on metabolism. A change in the makeup of the many types of bacteria found in the small and large intestine accompanies most weight loss attempts. The change may be simply due to a major change in the types of nutrients available to the bacteria such as what occurs with a low-carb, high protein diet. Or the change may be more forceful, such as the alteration in bile chemistry following a gastric bypass. In both cases, certain bacteria suddenly flourish and others—that were previously dominant in the gut—are greatly reduced in number. An increasing number of basic science and medical research is now showing the incredible importance of the balance of gut flora in both preventing disease and causing disease. And new research is showing that one particular pattern of intestinal bacteria is associated with and may even cause obesity, while a different pattern promotes normal weight or weight loss in obese test subjects. Without an understanding of these alterations, both surgical and medical weight loss methods may be missing an important aspect of metabolism and weight homeostasis.
The Gastric Bypass ALTERNATIVE
A new non-surgical, non-medical weight loss regimen, the Gastric Bypass ALTERNATIVE, was developed by Don Karl Juravin, its inventor, several years ago and can provide highly effective weight loss with a low risk of side effects and complications. This regimen inherently provides a multi-faceted approach to weight loss:
- Reduces or eliminates cravings
- Addresses the behavioral and motivational aspects of weight loss
- Safely produces satiety with decreased gut motility
- Slows the absorption of micro and macro nutrients
- Stabilizes insulin release and promotes lipolysis not fat storage
- Provides a rapid loss of excess body weight with a low risk of complications
The Gastric Bypass ALTERNATIVE, or GBA, consists of several proprietary preparations. The morning dose is a special, optimal mixture of non-digestible fibers that promote satiety and decreased gut mobility. An anti-cravings pill eliminates or reduces food cravings throughout the day. A metabolism booster helps the body to shift into fat breakdown (lipolysis) without promoting insulin production. The effects of these oral components are further amplified through a strict behavioral element, the Boot Camp. This vigorous tutorial strongly encourages the successful use of the GBA regimen and improves user’s results dramatically.
Intended use of the Gastric Bypass ALTERNATIVE regimen
The GBA regimen is primarily intended for use in adults who have obesity or morbid obesity (BMI 30 or higher), can comprehend instructions for use, and exhibit a clear understanding of the severity and seriousness of their disease. Although we are not aware of any evidence suggesting a reason not to use the regimen or its ingredients during pregnancy, in nursing mothers, or in children, we recommend against such use. Potential users seek out the GBA regimen and there are no targeted or directed marketing efforts currently underway. Participants are given a customized set of instructions and a supply of the components.
Results with successful users
Successful use of the GBA regimen is defined as consistent, daily use of the GBA regimen as instructed until at least “goal 1” is reached. This initial goal is when the user reaches a weight loss of at least 25% excess weight loss and demonstrates that the user has properly used the GBA regimen for enough time to significantly increase the likelihood of continued use. Because there is a wide range of starting body weights, we feel that the most appropriate measure of effectiveness is the percentage of excess body weight that is lost over a period of time. Excess weight is defined as the user’s initial (starting) weight minus a healthy body weight at a BMI of 24.0 (adjusted for sex). Users are encouraged to enter their current weight and duration of use into an online weight loss calculator, from which daily %EWL (percent excess weight loss) is calculated. Successful users maintain at least 0.6% excess weight loss per day with some reporting up to 1.0-1.2% excess weight loss per day. To illustrate, a 250 pound female with a starting BMI of 41.6 has an ideal body weight of 145 and has an excess weight of 105 pounds. A weight loss of 0.63 pounds per day, on average, on the GBA regimen would help this person reach a healthy body weight (loss of 50% of excess weight) in 83 days. Based on our observations, successful users of the GBA regimen are achieving excess weight loss in the range of 45-65% over an approximate duration of use of 3 months.
Complications, side effects, and cost
We have not identified any serious complications or severe side effects that have been associated with use of the GBA regimen. Initially, some users may feel mild side effects, including bloating, change in bowel habits, abdominal cramps, and mild headaches. These side effects are self-limited and resolve with a temporary adjustment with one or another components of the GBA regimen. No severe allergic reactions have occurred from use of the GBA regimen to our knowledge. Additionally, we have not found weight regain to be a significant issue for users who have completed their weight loss and are no longer actively losing weight through use of the GBA regimen. The costs for a typical 3 month use of the GBA regimen is approximately $840, which is offset significantly by the savings from decreased high-calorie food intake while on the regimen. This cost of the regimen equates to a cost per %EWL of $12.92 to $18.67, based on a range of total excess weight loss of 45-65% in successful users.
Source of GBA research data
The results from use of the Gastric Bypass ALTERNATIVE was obtained through direct interview with current and past users of the GBA regimen. From a pool of over 80,000 past and current users, approximately 1200 social media posts were reviewed and followed over approximately three months. From those posts, 85 users of the GBA regimen were contacted for further information. Of those 85 contacted, 69 responded and agreed to provide further information through an online interview. The authenticity and identity of each person as a user of the GBA regimen was verified along with their medical conditions, starting weight, ending weight, amount of time using the GBA regimen, and improvement in their health after using the GBA regimen. None of the users who were contacted were found to be fictitious, and those who did not respond to the request for further information will be contacted again in the future for verification. Of the 69 users who responded and agreed to be interviewed, each was contacted and interviewed; individual results were not separately reported but included in the overall weight loss calculations.
The Gastric Bypass ALTERNATIVE regimen is more effective, safer, and cheaper than bariatric surgery. Our review of current and past users of the GBA regimen confirms that use of this novel method of weight loss is strong and effective without the costs and risks of bariatric surgery.
The GBA regimen is more effective than bariatric surgery
The Gastric Bypass ALTERNATIVE is more effective at weight loss than bariatric surgery. The two most common bariatric procedures performed in the U.S., the sleeve gastrectomy and the gastric bypass, may produce an excess weight loss of up to 65-75% over 18 months to 2 years. By comparison, the Gastric Bypass ALTERNATIVE is capable of producing similar weight loss but over a much shorter period of time, approximately 3 months. On average, bariatric surgery results in 0.10% to 0.14% excess weight loss per day, compared to 0.59% to 0.65% excess weight loss with the GBA regimen. This analysis highlights a rate of weight loss with the GBA regimen that is more than four times that of bariatric surgery. Clearly, the Gastric Bypass ALTERNATIVE is more effective at weight loss than bariatric surgery.
The GBA regimen is far safer than bariatric surgery
The Gastric Bypass ALTERNATIVE is far safer that bariatric surgery. There have been no reports that we are aware of serious side effects or complications resulting from use of the Gastric Bypass ALTERNATIVE. By comparison, bariatric surgery has a major complication rate, including need for additional surgery, of up to 20% of all patients.
The GBA regimen is far cheaper than bariatric surgery
The Gastric Bypass ALTERNATIVE is far cheaper than bariatric surgery. A sleeve gastrectomy, now the most common bariatric surgical procedure in the U.S., costs approximately $224 per percent excess weight loss. The Gastric Bypass ALTERNATIVE is 12 to 17 times cheaper when compared to a sleeve gastrectomy. When compared to a gastric bypass, with an average cost of $24,000, the Gastric Bypass ALTERNATIVE is 16 to 24 times cheaper.
Obesity is an ugly disease that brings to its victim a number of other diseases, including diabetes, hypertension, degenerative joint disease, obstructive sleep apnea, and heart disease, among others. The incidence and prevalence of obesity is rising unabated, despite widespread education, physician and patient awareness, and aggressive treatments, including high-risk bariatric surgery. Non-medical weight loss efforts fail almost uniformly for those who are obese, medical weight loss methods have measurable but mild weight loss effects, and bariatric surgery produces significant weight loss at high cost and high risk of major, life-threatening complications and prolonged serious side effects. According to the American Society for Metabolic and Bariatric Surgery, less than 4% of patients who appear to qualify actually undergo bariatric surgery. Insurance coverage may have played a role in the past, but most commercial healthcare insurance plans now cover bariatric surgery, as do Medicare and Medicaid. We believe that the more important reason is fear—fear of severe side effects, complications, and the weight regain that many post-bariatric patients experience and are no longer silent about. The obesity epidemic is unlikely to improve with the current approach to treatment in the U.S. A clear need exists for an effective, low-risk, reasonable cost weight loss method that can utilized safely and without fear of a “bad outcome.” We believe the answer to that need is the Gastric Bypass ALTERNATIVE and we believe that the initial results reported here justify a serious, comprehensive consideration of this novel weight loss method by both patients with obesity and those who pay for obesity treatment.
Limitations of this report and need for future studies
This article represents a sampling of many users of the Gastric Bypass ALTERNATIVE and is not a formal statistical analysis or study. Additionally, the individual results were as reported by users and not independently verified. However, based on the promising initial results discussed in this article, we feel strongly that a more rigorous review of the Gastric Bypass ALTERNATIVE should be conducted and the results reported for commentary and outside review. A final limitation that we feel exists with this report, and likely with future studies of the GBA regimen, is an inability of statistical analysis to account for the motivational aspects of the program, including the boot camp directed by Mr. Juravin and the user-to-user coaching and instruction on the member-based social media site (Facebook/LOST100). From our careful discussion with users of the GBA regimen, we estimate that perhaps 80% of the improvement in overall health and well-being of GBA users is a result of their weight loss and the remaining 20% is likely related to non-measurable aspects of participating in the regimen, including improvements in self-discipline, self-image, and self-awareness. Future studies should acknowledge this non-tangible contribution to the GBA users’ experiences as separate from their weight loss results.
The author had a unique opportunity to compare the GBA to the top 4 weight loss surgeries as he is a bariatric surgeon with 17 years experience and the Medical Director in the Must Cure Obesity CO. marketer of the GBA regimen.
((PENDING – STILL ORGANIZING THE SOURCES))