There's nothing new about bariatric surgery, even in the midwestern outpost I live in (once a New Yorker, always a New Yorker!), but this front-page story in this morning's paper made me see just how mainstream it's becoming--so mainstream that health insurers here are beginning to cover it.
The good news is that the story focuses on the risks of weight-loss surgery: internal bleeding, bowel obstructions, leaks in the new pipeline, blood clots, and cardiac complications. The local hospitals that do the procedures have complication rates about the national average--between 8 and 11 percent. (I wonder how this compares with complications rates of other kinds of surgery; anyone out there know?)
What made me sick was not just the literal description of the surgery, though that was graphic and disturbing. It was the curiously familiar rhetoric that accompanied the story's generally positive view of these procedures:
". . . some doctors [say] patients are looking at the surgery as an easy solution.
'I see a lot of people who are in a miserable situation, and they 're looking for a solution, and surgery seems like an easy solution,' said Dr. Edward Livingston, a bariatric surgeon at the University of Texas Southwestern Medical School in Dallas.
'But this is a big life change. It requires a great deal of investment on the patient 's part to make it work.'"
Sound familiar? It should. Like so many other diet pills and weight-loss plans, it comes with a heaping helping of guilt and blame: You say people are miserable and are just looking for an easy solution? How dare they! They should be made to suffer.
And suffer they will, if they have bariatric surgery. If they're lucky, like the woman profiled at the top of this story, they will get to go off their meds for diabetes, sleep apnea, etc. Assuming, of course, they were on them in the first place. If they're lucky, they won't die as a result of the surgery or have complications that cause them long-term pain and disability.
And even if they are lucky, they're still likely to face buyer's remorse. "This is a lifelong commitment, and there are going to be days when you're sorry you've made this commitment," says the woman profiled in the story.
I bet. I find the word commitment to be an odd one here. What we're really talking about is a procedure that mutilates the human body, with long-term consequences like absorbing 77 percent fewer nutrients from food--for the rest of your life. That's not a commitment; it's something you endure.
But the underlying assumption, here as elsewhere, is that there's an element of choice about being obese. And that's what I find frustrating and upsetting, that our culture assumes that whenever you deviate from the cultural norms around weight, it's your fault. Whether you're obese or anorexic, you are to blame, and you are to be punished.
If I were a therapist, I'd have to ask: How does this help us? What's the secondary gain of seeing weight as a reflection of intention, behavior, and responsibility?
These are the kinds of questions that stories like this one should be asking.