Fat and Not Afraid

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Are Your Hero Days Over, Dr. Sharma?

May 26, 2011

Trigger Warning for Weight Loss & Weight Loss Surgery talk! (edited to fix title screw-up)


A four part series on why you support bariatric surgery? Really?

"So if risk of death is all that you care to consider, let us be clear that an obese patient with end-organ damage is over 10 times more likely to die within one year without surgery than from having surgery.

In contrast, an uncomplicated obese patient is just about as likely to die within one year without surgery as from surgery!"

Ok, I have to be honest; I wanted to hate this series. I really wanted to post up a scathing reply to his posts and point out how dishonest and full of assumptions and downright wrong they are.  But I can't.  I know the stories from people who've had bariatric surgery, people who've suffered from awful post-surgery symptoms, people who've lost their spouses to divorce, people who've died.  I've read about how bariatric surgery is being considered for teens and kids and it horrifies me.  Reading Dr. Sharma's post hasn't changed that. I'm still horrified and pissed off for those people who've had the surgery and are suffering.  But I can't hate what he's written because, as he's shown often in the past, Dr. Sharma isn't like other doctors.  In this series of posts he's taking a look at bariatric surgery in a way I don't normally see; for very fat folks who are actually quite sick.  Shocking, I know.  He provides actual data from credible sources as to why he will sometime recommend bariatric surgery to some of his patients.

The first post (linked above) is a discussion about the risks of bariatric surgery, having it vs. not having it.  It's very carefully framed in a non-theatrical way as an option only for those who are very fat AND in ill health.  The second discusses how we think about risks and benefits.  The third discusses the benefits of bariatric surgery in a realistic and again, non-sensational way.  (I see that Vesta44 has commented on this one and I highly recommend you read it!)  The fourth talks about why bariatric surgery works and what having it entails. There may be more posts coming on this and I'll let you know as I find them!

I don't know enough about surgery or the digestive system to say definitively "This is a Good Thing" or "This is a Bad Thing".  Like diets, I think there are way more risks than benefits to surgery of this kind.  We know diets don't work and people yo-yo in weight over the years and it wrecks their bodies.  We know that this kind of surgery rearranges our digestive track, on which Dr. Sharma says "It impacts dramatically on normal gut anatomy and function. Whether it just restricts normal passage of food through the gut (as in adjustable gastric banding), reduces the size of the stomach (as in sleeve gastrectomy), or additionally reroutes food through the gut (as in gastric bypass or biliopancreatic diversion), surgery has a profound, and in most cases, permanent impact on the anatomy and functioning of the digestive system. Tampering with an essentially ‘healthy’ gastro-intestinal system should never be considered trivial. This amazingly complex system has evolved through eons of human evolution to serve one of the most important biological functions - to digest and assimilate our food and drink - our only source of nutrients and calories. The expectation that this system can simply be surgically tampered with, without some very significant and sometimes dramatic consequences, is both naive and irresponsible."

For some people, however, this may be an option, and I have to say it's refreshing to see someone writing about it and talking about it directly and factually so people can make up their own minds about what they want to do with their own body.  Ultimately it's their choice and I have to respect that, even if I don't like it.

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