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Some options, we can do without

I posted a few days ago about the FDA officially approving gastric banding for healthy people with a 35-40 BMI. And, you may ask:

"Why would you be against that? Shouldn't people be allowed to do what they want with their own bodies? It's just a new choice that people are being allowed to make. Nobody is forcing anyone to get a gastric band."

Unfortunately, it isn't as simple as that. Here's why.

First, there's what amounts to medical blackmail; doctors withholding treatment until a patient loses a large amount of weight. How can anyone be expected to do that with an efficient metabolism forged by yo-yo dieting and health concerns that may prevent strenuous exercise? WLS, of course! This effectively forces people into weight loss surgery, and it's unconscionable.

However, even people who clearly want WLS aren't on anything like a level playing field.

Living in this society, we learn to have a violent type of hatred toward our fat bodies. I understand the impulse. I've been there. Who among us has not at one time or another felt complete and utter despair about his or her body? "This isn't what I'm supposed to be like! Why do I have this horrible, disgusting body? This can't be me." To someone in that state of mind, their body is separate and despised, unruly and out of control, something to fight and force into submission. When you're at odds with your body, hating it doesn't feel like self hatred and self harm feels like fighting the good fight.

Why do so many people feel this way?

We're told over and over again that the substance and appearance of fat bodies - any softness or fullness, really - is something to be ashamed of and evidence of weakness and inferiority. We're also told that it's all our fault, all due to eating too much. If you're thinking about your body this way, you just want to be able to stop eating. You think that you deserve to starve, whether by will power or failing that, by brute force. You really do want to hurt your body; to force complience. And the people in authority agree. Doctors, reporters, the media: they cheer and facilitate any self-destructive action taken in the name of weight loss, because weight loss can never be a bad thing! Why, it's the silver lining on the dark cloud of depression and even cancer! This is in spite of the fact that the widely accepted assumption that fat people eat more than thin people has no evidence behind it.

And I should probably note that yes, these primitive bludgeons surgeries can sometimes help people who are very, very heavy, with compromised mobility, who just can't see any other way forward. But there should be a better way!

The question for fat people who aren't disabled by their size: Is the possibility of putting diabetes into remission (for the 8% of 30+ BMI Americans who have been diagnosed with it) enough to make up for vitamin deficiencies, brittle bones, neuropathy(!) and a heightened risk of suicide - not to mention the suffering related to the surgery and its intended effects?

It takes a special kind of blindness to disregard the problems with the evidence in favor of WLS: the short followups when the most widespread problem with the surgeries are nutritional deficiencies that become more and more harmful over the years; the high dropout rates, which are generally ignored (and I doubt the subjects who finish the studies are representative); the lack of meaningful control groups; the failure to acknowledge related deaths that occur more than a month or two after the surgery. (For examples, go to Junkfood Science and scroll down to the Bariatric Series on the right.) This shit is dodgy.

Gastric bypass has been around for 40 years and the lap band has been in use for almost 20. Why isn't the research on the long term effects of weight loss surgery more detailed and comprehensive?

Is it because the cost/benefit analyses being made by both doctors and potential WLS candidates are so loaded with societal baggage and negative emotion - not to mention profit motive - that the costs don't matter and any hint of a real health benefit is blown completely out of proportion? Is it because neither doctors nor surgery candidates really want to know the truth? Is it because the drive to make fat people thin actually has little to do with health and a lot to do with imposed and internalized hatred?

A Non-Dieting Vignette | WLS: more barriers to rational decision making

moxie3's picture
moxie3
March 1st, 2011 | Link | As someone who has

As someone who has experienced both surgeries first hand I can tell you that they either may not work or are only a temp fix besides the obvious health risks. I think the first issue to be dealt with is getting people to stop hating others and/or themselves for their body types no matter what they are. Many of us have had it ingrained in our heads for so long that it's very difficult to not think that way. Getting out more positive messages to people to love themselves is the best thing we can do as a society! Moxie

lilacsigil March 1st, 2011 | Link | I had to have major surgery

I had to have major surgery in 2010, and my first and most intense worry was that the surgeon would insist that I lose weight first, despite the fact that the condition being treated was thyroid cancer (major symptom: extreme rapid weight gain). This "lose weight THEN we'll treat you" idea is hardly new to me - the whole cancer saga began that way.

Fortunately, the surgeon was not only fat-friendly but entirely understanding of why I would be stressed about this issue, and was reassuring about his extensive experience operating on fat people. The anaesthetist was also awesome (and an in-betweenie herself). He is, though, the only surgeon in my half of the state that could have done that operation - if he'd refused or put on conditions, that would have been it. No cancer surgery. Weight-loss surgery (and ordering seriously ill people to lose weight) is a bludgeon used against those who have no way (and no option) to say no.

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