To be frank, I was kind of horrified that my amazing and beautiful friend would put herself through it and I believe I used the phrase, "Cutting out her guts and hauling them away in a bucket," but I supported her decision once it was made and have loved being a part of her weight-loss surgery journey, to use a sappy WLS blog term.
However, because I was concerned for her health and because I wanted to understand what my friend would be going through, I did extensive research on the subject and the surgery in general. Culturally, I was amazed by the obvious double standard: if someone were to exist on 500 calories per day for an extended period of time without having had a surgery, they would be considered an anorexic and doctors would tell them to seek treatment...but if they had weight-loss surgery, then suddenly they are making a "decision to improve their health."
The lack of solid statistical analysis on the long-term effects and the efficacy of the surgeries was kind of shocking, but what was more shocking was the willful blinders worn by post-op patients on forums--they would talk about the debilitating side effects, they would post memorials to people who died during or of complications from the surgery at ratios that were much MUCH higher than described on the surgeons' websites. (Folks, I work with statistics for a living and there are SO many ways that you can justify manipulating data to look like it's reasonable, you would not believe it. One word: outlier.) And then they would insist that they were reborn the moment they woke up from the anesthesia and started dropping poundage. In some ways, it reminded me of the Christian concept of the mortification of the flesh, a physical apology and paying back for the hedonism of weight gain.
Self's August issue contains a very though-provoking article titled, "The Weight Loss Miracle That Isn't." The whole thing is gold, but here's a bit that gave me pause:
"But a new theory might provide some answers about post-op weight gain, and prove that willpower has little to do with it. Researchers are now theorizing that the reason patients lose a certain amount of weight in the first place is because gastric bypass, in part by toying with hormones, somehow lowers the body's natural set point, the weight your system is most comfortable maintaining. A patient's hunger returns, because the body has achieved that lower set point. 'The surgery changes our physiology, the way the body responds to food. It makes heavy people more like people who are naturally thin,' enthuses Dr. Kaplan, who is conducting cutting-edge research on the topic. 'Understanding this as a set-point issue allows us to stop blaming the patient who doesn't do as well, because they were just built that way. What they lose is what they lose, and they can't expect to lose any more.'"Quite honestly, the article is so full of excellent points and more issues than can be covered in a single blog post, but the snippet above really stuck out at me. If willpower has little to do with post-operative weight gain, then it would follow that willpower has little to do with a body's ability to lose weight or maintain weight loss through diet alone too. Suddenly, fat doesn't have quite the moral judgment that it did when you read about the fat people ruining the environment through their uncontrollable love of Ding Dongs.
And what kind of raw deal is it if these people go through all of that soul-searching and physical pain, all in the name of health, when really, you have the potential of not even losing all of the excess weight that is supposedly so much more unhealthy than cutting up one's internal organs. And I keep thinking of one poster who said that she had weight loss surgery because she needed to lose significant weight and after a ton of side effects, she's now living on 700 calories a day and is only ten pounds smaller than she was pre-op. I have to give that commenter a heck of a lot of credit, because I would be in jail right now from going postal, but the creepy thing is that everyone on the WLS forums told her that she wasn't using her "tool" correctly and that it was weight-loss surgery and not brain surgery and a bunch of other sanctimonious crap. And it makes me thankful that Anne has a place to talk about what really sucks about her process without anyone giving her pushback or making her feel like she's violating the Masonic Code of Shiny Happy Thin People, but it makes me really said for the rest of the people who played Let's Make A WLS Deal and ended up with the goat behind door number three, because their concerns are getting shushed as a buzzkill.
What do you guys think? Is WLS the answer for the obesity epidemic? Should all the fatties just go in for the slice and dice and then hit the ground running (and shrinking)? Do you get the sense that the picture isn't quite as rosy as the Lap Band and Gastric Bypass advertisements would have you believe?
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