April 5, 2016

Weighing In on Bariatric Surgery

This is a wonderful documentary
that highlights the factors and
struggles of weight loss.
Check it out!
I have never been obese and can't even begin to imagine what it is like to live in a world that hates me as an obese person.  I can't imagine what it might be like trying to buy clothes that fit or constantly worried about sitting on a chair that may not hold me.  I can't imagine what it is like to have strangers call me names in public or suggest ways of eating and exercising that I haven't thought of yet.  The world is cruel for people of size (let alone those who are within the range of obese).  So, ya, I haven't felt that so who am I to talk.  I just wanted to put that out there because I do believe the drive for bariatric surgery is fueled by the desperation of living life in an obese body.

For anyone unaware of the term, bariatric surgery serves as the umbrella term for a wide variety of surgeries meant to reduce fat.  Surgeries can range from cutting and rearranging organs to placing a band around the stomach to reduce its' size.  There are huge line ups for such surgeries and from what I understand the percentage of those that achieve the desired weight loss is as low as 5%.  The aftermath of such surgeries can be somewhat drastic and embarrassing (like dumping syndrome...do I need to define it?). 

What confuses me the most about this process is what happens after the surgery.  The patient leaves the hospital with a list of lifestyle changes he/she must adhere to to ensure the success of the surgery.  Exercise and nutritional prescriptions must be adhered to along with taking a long list of supplements.  So if the person didn't adhere to this before the surgery...what is going to make them stick with it after? If there was a psychological cause for the weight gain, what makes this go away once the surgery is over? Time after time, I see post-bariatric clients to counselling them on eating behaviour...after the surgery.  Why can't I see them before? Perhaps there is a way to avoid surgery altogether if we could work on the psychology of eating before?

In most documentaries on obesity, we will hear the testimonials of those struggling with weight as they go through the long list of diets and exercise regimes that failed them.  What appears to be missing in everyone of these programs is gaining a deeper understanding of what may be the underlying influences of the weight gain (if any). While I realize there are many factors that influence obesity, I have yet to hear or read one nutritionist, personal trainer, or medical professional even hint that it could go deeper than just diet and exercise. Instead we apply a thin layer of a superficial weight loss treatment and then blame the person when it doesn't work.  It's not about will power or self control...it's about mental health (coupled with environment, social and cultural influences, and even biology). It's not about the person, it's about a medical system that fails to support them.
Probably one of the most honest books on
bariatric surgery told by a woman who went
through it.  She details the emotion and the
trauma before and after surgery.
Check it out!

Through my research as a graduate student in clinical psychology, I became aware that the only programs for weight loss are the typical diet and exercise programs (yawn). In fact, I was surprised to learn that there was no therapy-type program to help with weight reduction within any population (besides the usual cognitive behavioural stuff - change your thoughts will change your behaviours).  Cognitive Behavioural Therapy is good, but it ain't the answer to everything.

There's a gap in obesity care and it's starting to worry me a bit.  If we are unable to acknowledge the root cause of obesity (and this may be different for everyone) how the hell will we be able to reduce rates of it (without defaulting to surgery).  If bariatric surgeries become the norm, I am betting we will start seeing other health related issues due to those surgeries...and the cycle will continue.

Just something to consider.....

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