Thin is complicated

When obesity surgery first entered the public consciousness, it certainly sounded like a silver bullet. Certainly, there are risks associated with abdominal surgery, but imagine having a procedure which would alter how much you could eat and digest, thus instantly paving your path to thinness. For the chronically obese, surgeons argued, the procedure was a lifesaver. A few hours of surgery, a decrease in stomach size, and almost immediate weight loss results.

The use of bariatric surgery is on the rise in the United States in a big way, partially because it’s a medical fix to a growing issue. Many Americans who perceive an issue with their weight are unwilling or unable to stay the course of long term lifestyle changes such as altering their diet and exercise habits. Bariatric surgery forces the patient to change the way ou eats. Many more patients are coerced into the surgery by medical professionals, some of whom should know better.

Books and articles were written. Angry rants were posted. Satisfied surgical results were also written about.

But now it’s been a few years, and there’s been ample time to study the surgery, along with an expanding base of patients to examine. And the truth of bariatric surgery is emerging. It’s not a pretty one. It turns out that getting thin is complicated.

40% of patients develop complications within six months of the surgery, some of them fatal. That’s an alarmingly high complication rate. It’s also expensive–the average cost patients paid to deal with their complications was $36,542, and if readmitted to the hospital that price tag was a lot higher. Of course, somewhere between ten and twenty percent of patients don’t even get a chance to leave the hospital before complications set in. Surgery comes with complications: this is an unavoidable truth. But there is an acceptable complication rate, depending on the nature of the surgery and why the patient is receiving it. A 40% rate is extraordinarily high for a primarily elective procedure.

Weight is a fraught issue in the United States. The President of the American Society for Bariatric Surgery admits that probably less than 1% of patients who receive the surgery actually need it. In an age where doctors can’t spend enough time with their patients to address issues, and where being fat is tantamount to being a member of Hezbollah, there’s a great deal of pressure to fix the “problem,” and quickly. Preferably in such a way that you can convince your insurance to pay for it, also.

Those who are severely overweight are prone to health risks. This is something that cannot be argued. Whether or not they should be forced onto diets to normalize with society is a personal choice, likewise with those who are moderately overweight. While surgery looks like an “easy” solution to the problem, it’s not. Moderation and slow steps are in the long term a more healthy approach to weight loss.

All surgery is complicated, even “routine” procedures. There’s a certain amount of risk involved in being under anesthesia and being cut open. Medical professionals do their best to alleviate the risks for their patients, but a lot of the risks associated with surgery are complicated by weight. “Elective” surgery is something which should not be undertaken lightly and the patient should work closely with surgical staff to achieve the best result.

People have been dying to be thin for a long time. It doesn’t surprise me that the latest “quick” solution to unwanted weight comes with a heavy cost. As social pressures against the fat and happy (or not so happy) mount, how many more will go on the table to have their sins cut away?

[fat]