Worth the Weight? Part 3

This evening I attended one of the monthly Bariatric Support Groups organized by my attendings' practice. It's open to all of their post-op patients, whether two weeks out or two years out, as well as prospective patients who are considering the surgery. Ironically, it was held, of all places, in the conference room directly behind the hospital cafeteria, at the very time a Family Feud contestant would likely get the most points for naming as "a time to eat dinner" (6:00pm). Incidentally, I heard the other day that Max Taffel, the conference room's namesake, was a well respected surgeon who inexplicably did not believe in the utility of the bellybutton, and would therefore remove it whenever possible during abdominal surgeries on his patients. I can't quite put my finger on what feels so deeply wrong about bellybutton rejection; but I bet Freud would have a field day with that guy.

All anyone talked about was food. What they can eat, what they can't eat--what foods are tolerable, what makes them vomit or get "dumping syndrome". Listening to them all, there seem to be two types of people who undergo this surgery: first, there are those for whom it is truly a godsend, the very catalyst they need to enable them to stick to and maintain a healthy diet for the first time in their lives. They are the ones that adhere to every requirement, start exercising immediately, and just melt the fat off their body with astonishing speed. Then, there are the ones who will fail--from the very start, they find ways to tolerate the forbidden foods and eat more or quicker than the post-op regimen indicates. More importantly, although they may switch to a dramatically lower calorie diet, they still spend their evenings parked in front of the TV--only now it's with water bottle--not slurpee--in hand. For them, the surgery is, tragically, just another quick fix yo-yo (albeit an incredibly more expensive and higher risk one than, say, the cabbage soup diet).

A few women talked about their favorite moments since surgery. Among them: being able to get out of a car in under five seconds, without fanfare or a sweat-inducing battle with gravity and the steering wheel. Being able to buy a party dress that they actually like, rather than having to settle for whatever comes in a big enough size. Being able to walk 32 blocks in NYC, to go hiking and biking and enjoy the feeling of bodily movement and activity. Sitting in a chair along the wall of the conference room, scanning the several dozen participants, I felt a strange feeling: for possibly the first time in my life, I felt a murky mixture of embarrassment and pleasure at being among--if not the--most slender woman in the room. Aside from the guilty pleasure I took in this rare moment of superficial smuggery, I also had a feeling of guilty shame--and silliness, really--at the years and countless moments I have wasted feeling fat. Listening to one woman recount how she has gleefully returned to several former favorite restaurants, not to eat the food, but to slide triumphantly into a booth that used to be inaccessible to her--I felt a deep sense of patheticness at my sob stories hung like gaudy, disproportionately large earrings on the flimsy earlobes of an extra 10 pounds of flab. As the meeting was ending, I snuck out to the cafeteria, feeling hungry...and ended up buying a little bowl of jello and crystal light, which I guitily downed before heading back into the room to get my things.

Thinking more about the ease of eating healthier and maintaining weight loss following bariatric surgery, I realized something. We all, to some extent, believe that eating well requires some combination of willpower, determination, strength of psych--all characteristics presumably stemming from the brain. And as I mentioned earlier, the stomachs of obese people appears to be identical to those of non-obese people. Yet, in reference to yet another earlier posting, this supposed cure for obesity is not, either literally or figuratively, brain surgery. It is stomach surgery. Brain stays the same, stomach shrinks...and suddenly, weight loss. So maybe...the problem all along has not been that our eyes our bigger than our stomach--but that our stomachs were bigger than our eyes?