Bariatric Surgery

[JHAQ]

Oprah had a program on the aftermath of bariatric surgery for several women . The main point ( assumption ? ) raised was that being overweight is due to an ( eating ) addiction & if that addiction is frustrated by the surgery , then other addictions such as alcoholism , drugs , hyper sexuality etc may take over . Does any reader have any info on that --- is it a general phenomenom ? I am overweight ( 300 lbs ) but due to being on diabetic medications ( metformin & insulin ) & have been considering such surgery.

[Glider]

Disordered eating is not strictly an addiction. Whilst compulsive eating disorders are similar to addictions in that they are compulsive behaviours that are carried out in spite of the knowledge of subsequent harm, they do not fulfil the physiological criteria for addiction.

 

However, having said that, compulsive eating disorders are behavioural disorders, not anatomical ones. Therefore, surgery altering one's anatomy does not address the underlying problem, they only alleviate the symptom (obesity). So, to have bariatric surgery (which in itself is not without risk) might deal with the immediate problem of weight, but it ignores the underlying causal problem completely. In short, it is an example of the 'quick answer' that people have come to expect; an immediate solution that doesn't involve effort and doesn't really solve anything apart from the immediate physical symptom.

 

If the underlying compulsive behavioural issues are not addressed then these issues are likely to manifest in some other way.

 

People do underestimate the severity and long-term implications of bariatric surgery. A common form is some degree of gastric bypass, limiting the amount of food that can be absorbed. This allows the person to continue to indulge in their compulsive eating without gaining weight. However, should that person manage to deal with their compusive behaviour and return to a more moderate eating regime, they are faced with the problem of not being able to absorb sufficient nutrient from a moderate diet. Basically, the person has to remain a compulsive eater. There are other problems that can arise from such surgery, and all forms of surgery carry a degree of risk.

 

In my opinion, it is better in the long term to address the behavioural problem (i.e. the causal problem) and avoid 'quick-fix' surgery if possible. I think surgery should be considerd an absolute last resort to be considered only should all (more valid) interventions have failed (which is unlikely).