Weight Loss Surgery is Not a Quick Fix

In the United States today, more than 44 million individuals are obese. Our lifestyles are sedentary; our portions are out of control. Oddly enough, even though more than half of the nation is, in layman's terms, fat, this situation is not embraced. Rather, we are constantly reminded in one way or another that being overweight is wrong. Not only do news reports warn us of the health problems linked to obesity, but celebrities, fashion magazines, and the media equate thinness with success and happiness.

Health risks combined with pressure to conform are sometimes too much for the obese to tolerate. Some of these people feel that they need to correct their flaws immediately. Individuals who feel a traditional diet program is too difficult or lengthy often opt for a gastric bypass, which surgically reduces the size of the stomach. However, those who elect to have this procedure are often shunned by thin individuals who imply that this surgery is an effortless escape from morbid obesity. On the contrary, as will be discussed in the context of this paper, bariatric surgery is anything but an "easy way out" (Bailey). Gastric bypass surgery is a life-altering, potentially life-threatening decision and those have such an operation demonstrate great discipline and sacrifice.

First it is important to realize how detrimental obesity really is. For starters, the health risks associated with carrying extra weight are countless. Statistics show that over 80% of obese adults have been diagnosed with heart disease, high blood pressure, high cholesterol, diabetes, or gallbladder disease. 40% of these adults have two or more of these conditions (Spake 467). All body organs are somehow negatively affected by obesity. Regrettably, obesity related disorders account for more than 300,000 deaths each year in the United States (The Cleveland Clinic). We cannot forget the shame brought on by being overweight, either. For instance, obese individuals struggle with simple activities that thin people take for granted, like biking, swimming, and horseback riding. The obese find themselves short of breath when attempting to walk up the stairs or tie their shoes. Some obese individuals become burdens to themselves and their families when they cannot fit into the seats on airplanes or roller coasters. In addition, weight discrimination is a serious issue in our society. Whispers of fatso, slob, and blimp escape from the mouths of complete strangers, damaging the self-esteem of the insulter's targets. Similarly is the unethical issue of workplace discrimination, in which obese workers are placed at the back of the office so that they are not seen (Spake 467). Equally important is the negative reaction from the media in response to the obesity epidemic. Instead of embracing curvy, voluptuous individuals, fashion magazines imply that one must be slender in order to be trendy. It is difficult for the obese to look stylish, since the plus-size clothing selections available are not flattering and do not compare to the fashions of Hollywood. Finally, even the Church criticizes obesity, saying that it represents the sins of overindulgence and gluttony (467). All of these factors cause the obese to feel depressed, isolated, and self-conscious (Sugerman 183).

Obese individuals, seeking societal acceptance and optimal health, see a glimmer of hope in gastric bypass surgery. This risky procedure involves the surgical reconstruction of the patient's intestines so that his stomach will be able to hold only a few tablespoons of food. To begin this two hour operation, the surgeons first convert the upper portion of the stomach into an egg-sized pouch. Next they cut the small intestine, connecting one end to this stomach pouch and reattaching the other end to the small intestine ("Weight-loss surgery" 7). This newly formed stomach pouch is so small, that the patients are unable to eat large portions without experiencing painful symptoms. These symptoms, including severe abdominal pressure and cramping, serve as a physical reminder that the stomach is full, and therefore, change the patient's eating habits so that he rapidly loses weight. This surgery is a lifelong commitment, being reversed only in the case of an emergency (Hochstrasser 156).

Surprisingly, the general public does not feel that this surgery is a lifelong commitment. Their general reaction is that a two hour operation is an easy price to pay for continuous, guaranteed weight loss. Thin individuals often scoff, saying that those who elect to have a gastric bypass are weak and powerless. On the contrary, those who have weight loss surgery demonstrate a great deal of strength in overcoming the multitude of challenges they face. These challenges begin before the patients even step foot in the operating room and continue for the rest of their lives. Since this procedure is so risky, individuals must meet a list of qualifications before they are even considered. Generally a good candidate is at least 100 pounds overweight, has failed at traditional diet programs in the past, and has obesity related health problems. The mindset of the patient must be that the negative effects that he is currently struggling with as an obese individual are worse than the challenges that will occur after surgery. To ensure that the patient will be able to adequately handle the lifestyle changes, he must receive psychiatric counseling (Lucero). As with all surgeries, the operation itself has risks. For the morbidly obese, general anesthesia is quite dangerous. Getting the heavy patient onto the table is hard, and the patient may have a difficult time breathing while lying down (Gawande 521). Tragically, 1 out of every 200 gastric bypass patients dies in the operating room (524).

Those who survive the surgery are now faced with the daunting task of adjusting to a strict, unpleasant diet. Immediately after surgery, the individual can have only clear liquids, like water, decaffeinated tea, or chicken broth. When released from the hospital, the patient gains full liquid privileges. However, he can still not have very hot, very cold, or carbonated liquids, because they cause pressure and discomfort. The patients must not sip beverages through straws, either, because the sucking action bloats the stomach pouch. About two weeks after the surgery, the patient advances to a pureed food stage, in which he can eat foods of mashed potato consistency. About 2 weeks after this, the patient progresses to eating only soft, moist foods, like bananas or scrambled eggs. A regular diet can be resumed after 1 to 2 months (McGowan and McGowan Chopra 90-7). However, the term regular is quite the exaggeration. Those who have gastric bypass surgery must forever follow a high protein, low-sugar, low-fat diet. High-carbohydrate foods like sweets and starches often trigger a reaction called dumping syndrome, which consists of heart palpitations, nausea, vomiting, and diarrhea (Hochstrasser 232). Carlos Lucero, who had a gastric bypass surgery three years ago, describes his unpleasant dumping syndrome experiences:

It feels as if someone is twisting your insides. I feel sweaty and clammy, hot and cold, all at the same time. The pressure on my stomach is so great, I feel as though my intestines could tear open. I have cramps so bad that I cannot stand up straight. Sometimes, I must force myself to vomit up the food I just ate in order to relieve the pressure and pain. (Personal interview)

Obese patients may become cured of serious diseases like diabetes following a gastric bypass surgery, but that does not mean that they will receive a clean bill of health. The patients may experience a number of dangerous side effects months or even years after the surgery. First of all, the individuals do not readily absorb certain nutrients since the small intestine was re-routed during surgery. The nutritional deficiencies of calcium, B vitamins, and iron can lead to hair loss, osteoporosis, and beriberi. It is essential that these individuals take a vitamin supplement every day for the rest of their lives in order to stay healthy (Hochstrasser 228). In addition, the gastric bypass patients are at high risks for blood clots, pulmonary embolisms, staple line tearing, leaking, and bleeding out of the stomach. Up to 30% of individuals having weight loss surgery end up with a stomach ulcer; others are faced with infected incisions or hernias at the incision site (204). Also, many individuals who have the bypass surgery discover they have more frequent bowel movements, diarrhea, and bad gas on a regular basis (232). Since an individual's health "will never be normal after weight loss surgery", he must have yearly doctor examinations and blood work in order to best prevent serious complications from occurring (228).

Finally, it is important to recognize that low self-esteem is still a problem for many bariatric patients, even after their weight becomes normal. Since a patient loses such a great deal of weight, his entire appearance changes and he must learn to adjust to his brand new body. Lucero admits that "it feels awkward to say the least" when he runs into an old friend who does not recognize him (Personal interview). Sometimes individuals become even more self-conscious after weight loss surgery, because they are left with excess draping skin and a large abdominal scar (Sugerman 184). Many patients find themselves having a second, body contouring, surgery (The Cleveland Clinic).

The American public has been fooled into thinking that gastric bypass surgery is a lazy person's cure for obesity. Our society has been taught to believe that this surgery is "easy, painless and without sacrifice" (Bailey). However, that is not the case at all. Those who survive the operation must adhere to a specific diet and suffer painful side effects for the rest of their lives. They must take vitamins daily to protect against damaging conditions resulting from nutritional deficiencies. In addition, these individuals must adjust to brand new bodies and work hard to gain self-confidence. Those who have had weight loss surgery have more determination and willpower than the average person realizes. Desperate to fit into society and aspiring to live healthy, normal lives, obese individuals see a gastric bypass as their last resort. Weight loss surgery is not a quick fix; it is the ultimate sacrifice. Works Cited

Bailey, Kaye. Home page. 2006. 27 July 2006 .

Bariatric Weight Loss Surgery. The Cleveland Clinic. 2006. 18 Jul. 2006 http://cms.clevelandclinic.org/bariatricsurgery/>.

Behrens, Laurence, and Rosen, Leonard J., eds. Writing and Reading Across the Curriculum. New York: Pearson Longman, 2005.

Gawande, Atul. "The Man Who Couldn't Stop Eating." Behrens and Rosen 520-533.

Hochstrasser, April. The Patient's Guide to Weight Loss Surgery. New York: Hatherleigh Press, 2004.

Lucero, Carlos. Personal interview. 18 July 2006.

McGowan, Mary P., and Jo McGowan Chopra. Gastric Bypass Surgery. New York: McGraw Hill, 2004.

Spake, Amanda. "Rethinking Weight." Behrens and Rosen 465-471.

Sugerman, Harvey. "Surgical Management of Morbid Obesity: Benefits, Techniques, Complications, and Considerations." Contemporary Surgery 20 Mar. 2005. 18 Jul. 2006 .

"Weight-loss surgery is an option for many." Harvard Women's Health Watch June 2006: 6-7.