10-May-02 - 01:56 PM
Dear Expert on Obesity, I am a female in good health age 31, with too little time to exercise. I eat too much too often and have 75 lbs overweight and anxious, I have been unable to adhere to any dicipline of dieting. I have tried many methods of weight loss including RX drugs. I have heard about Jaw wiring for weight loss. Is it safe and is it effective. If it is harmful, in what ways is it harmful, if it is safe and effective why is it so difficult to find a provider for this service how can I find a provider for this service. If you do not recommend jaw wiring why not?
Specialty: Obesity , ExrID State Genr
6059 CA
10-May-02 07:56 PM
Specialist 1 wrote:
Jaw wiring, or maxillomandibular fixation, is rarely done today for obesity, which is why you're having problems finding out about it. The most important problem with it is that it is temporary and that when the jaw is released the patient gains the weight back. For example, Dr Cannell from London did a series of 11 patients, who tolerated the wiring for 3 months; after that, most of them tried to interfere with the linkage or detached the splints. Only 2 were successful in stabilizing their weight after its removal, one after losing 35 lbs & the other after only 5 lbs. lost. I agree with Dr Cannell as he concluded that jaw wiring is unsuitable for the majority of obese patients. Another study compared jaw wiring for 6 months with intensive behavior therapy. During the wiring period, patients lost about 50% of their excess weight, compared to those in the behavior group, which lost 40%. After the wires were removed and behavior therapy initiated in the ex-wired group, weight loss in that group converged with that of the other group, both ending up losing 30% of their excess weight. This study was reported in the British Medical Journal in 1985. As far as safety is concerned, the fixation could be a problem if one were to get sick and have to vomit. Also gums and teeth are affected; in another series 40% developed periodontal problems, including periodontal pain, and of these about 1/4 continued with problems after the jaw was freed. The fixation can also cause muscle spasms around the jaw joint, and some find limitation of jaw movement after removal. As far as who would do such a procedure, those most qualified would be maxillofacial surgeons, but you'd have to find one with a special interest in obesity. The website of their organization is http://www.aaoms.org. Other doctors to check out would be Bariatric surgeons, who do surgical procedures specifically for obesity: http://www.obesityhelp.com/abs and http://www.asbs.org.

Specialist 2 wrote:
I wouldn't recommend jw wiring because, unless you plan to make it a permanent
wiring, it doesn't work. The weight you lose will come back as soon as you take away the wires and it's been shown that "roller coaster" weight gain and loss is detrimental to your health.
The way to lose weight is through a healthy lifestyle including regular exercise and good nutrition with plenty of fruits and vegetables and limited fat intake with moderate carbohydrates.

Specialist 3 wrote: Jaw wiring is not considered an appropriate or preferable way, even for "forced" weight loss, which is what you are requesting. This would be a relatively invasive procedure. A better surgical solution is stomach stapling; consult a qualified surgeon for more information on this. No matter which procedure you may try, most important is establishing the personal and professional support and structure to live a healthier lifestyle, and to deal with your anxiousness and compulsive eating with counseling and/or medication.

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