In “Emily’s Scars,” Frank cites a quote in Vogue from a woman who lamented the humiliation of burying her ugly toes in the sand at the beach. He went on to compare her terrible life to those people with actual deformities of note—namely people born with facial and physical deformities.
There are so many angles to the “possibility of fixing” and whether it is fair self-improvement or vain self-enhancement, and a lot of them were covered by the Frank article. Who’s to say that woman with the ugly toes wasn’t truly suffering daily at the sight of them? (Well, me, but it can be argued the other way.) As for Emily who underwent leg-stretching, was she ending her disability, or was she just failing to shake her own self-consciousness? Is it better to improve yourself with plastic surgery in this world full of unrealistic expectations and unshakeable norms, or would society benefit if there were more people out there willing to accept themselves as they are?
The article got me thinking about obesity and obesity control surgeries like gastric bypass. Perhaps I’m biased, but I would say obesity is a little more humiliating in day-to-day life—and especially at the beach—than ugly toes. It’s something that cannot be hidden, and perhaps worst of all, most people get themselves in that situation without help from a hereditary disorder. The shame only builds when overweight people find themselves unable to lose pounds. If their condition is bad enough, however, they have a surgical option.
I have two once-morbidly-obese friends who have undergone obesity control surgeries. The first continued to eat more than the tiny (seriously, miniscule) portions recommended by her doctor. Her stomach stretched out, and she has gone back to her pre-surgery weight. The second lost 70 pounds in her first year after the surgery, but has since then plateaued. After spending a lot of time with her while we studied abroad, it was pretty easy to see why. She cheats her shrunken stomach by stretching her abdomen at the table in order to fit down three courses per meal, and not only does she hate exercise, but she also 1) refused to take the Tube because she didn’t want to walk the stairs out of the station and 2) consistently used the elevator to get up to her second floor apartment.
When do you get the right to be surgically aided in your quest to be skinnier? Should gastric bypass even be an option for people who can’t demonstrate that they have made genuine attempts at diet and exercise? I wanted to tell myself that surgery is a last resort, but seeing my friend who refused to even consider walking two flights of stairs made me rethink that. Is gastric bypass just another example of a leg up for people with money to spare? If they get the procedure for superficial rather than health reasons, should their insurance cover it? Surely no insurance company would cover a follow-up surgery to get rid of excess skin.
In a world rife with surgical options, I can at least rejoice that there is occasional karmic backlash. Gaining back the weight due to laziness, freezing your face after plastic surgeries, suffering from blisters on your new designer feet—some force out there has a sense of humor I approve of.
Holly,
ReplyDeleteGreat post. In a sort of joking nature, this makes me think of the "handicap" tags given to obese people who can now park where disabled and elderly people can park. I think we should definitely make obese people who want those tags park in the back of the parking lot in order to help them. I mean, seriously, how did they get there in the first place!?
Ok, now on a serious note, I think gastric bypass is not as bad as permanently removing a limb. The person receiving the treatment should be advised/monitored what to do and what lifestyle changes need to be made BEFORE the surgery occurs, so that gastric bypass is a last ditch solution. In the case of your friend, who refused to walk two flights of stairs, shouldn't have considered the surgery if she wasn't willing to do a simple task of walking up stairs.
But for people who have done everything in their power to lose the weight or for people for which obesity is going to cause their death, then I am all for them considering or getting the procedure done.
A very thoughtful post. Not to be rude, but people like your friend who get gastric bypass and then refuse to walk up 2 flights of stairs anger me to no end. They obviously don't understand what it takes to truly change and just want a quick fix. They are doing nothing but wasting these doctors time and resources.
ReplyDeleteI actually also have 2 friends who have similar stories. One of them got gastric bypass, lost a little weight, and then went back to his old ways and gained it all back. The other decided that he was going to change his lifestyle. He started learning how to cook (because he used to eat EVERY meal out), and got a membership to the gym down the street. So far he has lost around 50 pounds and has no intention of stopping soon. So from what I've observed it seems like its all about self will. If you really want to change, you will. If you just want the easy solution and don't really want to change your lifestyle to fit, then you will fail.
@ Kevin. I actually think that gastric bypass and apotemnophilia are basically opposites. One is an attempt to become "normal" within society and the other basically achieves the opposite.
It is still amazing to me that obesity is now classified as an epidemic. I've always considered being overweight or obese was a problem that could be fixed through diet and exercise. This is an issue that has come up in many times in my classes due to the variety of ways that it negatively affects the body (CVD, diabetes, certain cancers, respiratory difficulties, musculoskeletal and skin problems, infertility, etc). With all of these problems that come with obesity, you would think (or at least I would) that people would be motivated to lose weight, yet the CDC predicts that obesity will soon become the number one underlying preventable cause of death in the US.
ReplyDeleteIn a cardiac class that I took recently, we were discussing the effects of obesity on hypertension. Many of us in the class got hung up on why more people don't just diet and exercise-it's less expensive than drugs or surgery and works better too. Our professor's response was that dieting just doesn't work. In an ideal world, dieting and exercise would be a perfect solution but it never works in reality. He said that the problem is that people just don't stick with it, even if they lose weight at first they give up within a few years.
Obviously, this situation and the one you pointed out with gastric surgery are both unfortunate and I think that they reflect a need for societal change. I think that having a good diet and exercising regularly should just be a normal part of everyone's lifestyle. I know that sounds obvious, but there are a lot of people who just don't know how to eat well and who haven't grown up with healthy habits so it's really hard for them to change their lifestyle. I personally believe that schools should teach kids these habits so that by the time they are adults it will be natural for them.
As for who gets gastric bypass: all patients who get gastric bypass are supposed to go through a screening process which requires them to be signed off as psychologically and medically ready for the procedure by a physician, dietitian, psychologist and surgeon. Of course, it is possible that there are cases where a patient can get through this screening from physicians who are lax or by lying during the screening. Technically, though, patients are supposed to start to change their lifestyle before they go through with the surgery.
I wonder what the screening process is. And I wonder, maybe the insurance companies do cover the removal of the excess skin, why wouldn't they if it is a natural result of the first surgery?
ReplyDeleteThis is a great example to add to the debate. Weight is such a trigger of personal and moral feelings. Is it the individuals responsibility to buck up and live a better life the way they are? Is being fat a moral failure? Is looking different from the accepted norm or ideal a reason for rescue?
These surgeries and clinics have been expanding like crazy (no pun intended)---what is the ethical responsibility of the doctors who are making money off these surgeries. Certainly surgery creates a much larger invoice than diet and exercise recommendations do.
And one more possible culprit> the people filling our food system with crap. But I guess we will get to that later in the class...
And lastly--how barbaric is it to try to solve the problem of eating too much (if that is indeed the problem for a patient) by just cutting out a chunk of someone's guts? An earlier version of the surgery involved installing a band around the organs so they couldn't expand. It just seems a bit medieval...
I'm sure we've all seen the documentaries on TLC, Discovery, or NatGeo depicting someone's life before and after their gastric bypass surgery. The shows make it seem as though it's as easy as just getting the surgery done and then watch the weight fall right off basically, when we all know it can and never will be as simple as that.
ReplyDeleteIt's not only frustrating hearing about people who undergo gastric bypass surgery expecting that to be the 'quick fix' and lose weight without any trouble, but it's equally as frustrating hearing people (cough*my roommates*cough) who are at a perfectly healthy and normal weight, talk continuously about eating less, working out more, and becoming SKINNY!
Of course their system fails every week, and I hear the same speech about how they'll start it up again on Monday. And I just think to myself each time that as long as they view losing weight in a superficial light (ie: to be skinny) rather than in a healthy light (ie: to be in shape) they'll be stuck in this cycle until they die. I think that people who are at any weight with mindsets like this will always be setting themselves up for disappointment, as long as they continue to think of losing weight as only for superficial reasons.
So, as much as I want to feel bad for your friends who have undergone gastric bypass surgery, and have gained most, if not all, of the weight back, I can't. Going along with what I have said, and with what has been commented already, it has to be part of their own mindset and motivation to lose weight and keep the weight off. We each have to be responsible for our own bodies, and having gastric bypass simply to lose weight FOR us, while not putting in any effort ourselves, is not being responsible.
It's a shame what some people have reduced gastric bypass to. Modern medicine provides the morbidly obese with a last resort surgery to aid in their weightloss goals, and it then becomes commonplace in the overweight community. The bioethical issue here is clear: where do we draw the line for people who need/require/want the surgery?
ReplyDeleteBeing the child of a dietician I am quite familiar with this area. I feel that two key issues are fueling this unethical practice. First, we as a society are constantly striving for the cure-all, quick fix. We desire so much but have lost the ability to work for it. Second, there are millions to be made by hospitals/insurance companies because this is a very safe procedure. With little risk involved many doctors have no problem putting a person 50lbs overweight under the knife.
Its appalling. People that show no signs of acheiving their weightloss goals other than dragging their ass to the doctor think they NEED this surgery to act as a stepping stone. Of course they are going to lose wieght at first--their stomach has been reduce to the size of a human thumb. but, as can be seen by the numerous examples already cited, these people often gain most of it back.
If it were up to me (say if i were the surgeon general). I would force anyone that thinks that gastric bypass is an option for them prove that they are already on the road to a healthier lifestyle. I mean, take some responsibility. If its shown that you're working hard, then you can be rewarded for your efforts with a little help...