Karen's Blogs

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Weight-loss Surgery

I don’t think I’ve blogged about weight-loss surgery before, or at least not in a long while, and I’m not sure why. Perhaps because I don’t have extensive medical knowledge about it. What I do have is experience with clients who have had bariatric surgery, but who still sought me out to resolve post-surgery eating problems. Although I’m not totally against it, I believe it should be an intervention of final resort. Here’s why.

The post-surgery clients I’ve treated continued to have disregulated eating problems decades later. Some remained morbidly obese while others were some 20-50 pounds overweight. As one client said, “My stomach is still big enough to eat a Snickers bar, and ice cream slides down real easy.” Each was an emotional eater with a history of food problems dating back to childhood, and although they had been on many diets, none had ever really explored why they ate emotionally and compulsively.

With this (admittedly limited) experience, I was troubled by an article in the LA TIMES a few months ago by Shari Roan, The use of Weight-loss surgery may expand. What used to be a last-ditch effort to scale down weight, said the article, was now likely to become more commonplace, largely because of improvements in surgery technology. Making it less costly, time-consuming, and invasive would make it appeal to more people. Dr. Blandine Laferrere, a diabetes expert at Columbia University College of Physicians and Surgeons in New York expressed her fear, asking, “…But does that mean everyone who is overweight should have it? I don’t think so, because none of these procedures is benign.” The article went on to say that many nutritionists are not all that happy about the upswing in surgeries, citing side effects and potential risks such as nutritional deficiencies, diarrhea, regurgitation, and bowel obstructions; dumping syndrome, which is involuntary vomiting or defecation; and complications from ulcers, wound healing, hemorrhaging, deep-vein thrombosis, heart attacks, and strokes.

I doubt that the opinions of eating disorder therapists were solicited. My guess is that most of us would not be for expanding bariatric surgery because we end up seeing the people for whom it did not work, the clients who have the same eating problems they had before the operation. It saddens and frustrates me that our fat phobic, thin obsessed culture is adamantly hooked on the quick fix and refuses to take the long view of the causes of our dangerous, unhealthy relationship with food and our bodies. My advice: try therapy with an eating specialist before going under the knife. And be sure to check out this website on bariatric surgery: http://www.journeyintohunger.com/.

Fighting Food Compulsions
How Therapy Works

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