Blog | Thursday, October 2, 2014

Pulling the gastric bypass trigger too soon


If losing weight were easy, we’d all be skinny. If exercise were fun, we’d all be doing it. If quitting cigarettes were effortless …

What should our response be toward rising societal tonnage?

Pass laws restricting access to the wrong type of food. Former Mayor Bloomberg got stiff-armed on this approach by the courts. It’s also always fun to watch folks argue over the definition of a “wrong food.” The debate on which foods warrant prohibition at least brings some entertainment into the public square. Imagine trying to achieve consensus over 20 or so food items that should be banned. If this task were actually accomplished, cigarettes and alcohol would still be legal. Make sense?

Initiate a massive public education campaign to scare us skinny. Show ads of scary pictures with scary music reminiscent of an iconic anti-drug ad (This is your brain on drugs …. ) from a few decades ago.

“This is your heart.” (Screen shows cartoon of a happy and vigorously beating heart.) “This is heart on ice cream.” (Screen shows depiction of gasping and quivering organ, coughing up fat globules.)

How would we fund this effort? Simple. Tax the manufacturers of “wrong food.” Allow individuals to choose their food and beverages freely and to accept any health consequences of their decisions. (LOL on steroids here.) Give tax breaks for every 5% loss of excess body weight. Interesting concept. Might thin folks file a discrimination lawsuit here?

Most folks who are overweight want to be thinner. The reasons why folks carry extra weight are complex and are not simply because they eat too much. There is a powerful mental component that for many people is part of the problem and must be part of the solution. Sure, caloric control is fundamental, but many overweight people do not eat just to satisfy hunger. They do so for other reasons which must be attacked directly if a successful outcome is to be achieved and sustained.

The quick fix has been luring folks with false promises for generations. Infomercials on the air every day hawk agents that will melt fat away, although there always appears a disclaimer in a font size too small for the human retina to discern that states that “results not typical.” The threshold for recommending bariatric surgery is getting progressively lower, and it has not hit bottom yet. My sense is that this treatment is becoming regarded as a routine remedy, rather than a last resort measure after multiple other attempts have failed. I suggest that many dieters may not be as disciplined and determined with conventional weight loss programs knowing that a bariatric rescue is available.

Obesity is a serious health issue without an easy external cure. Weight loss medicines are either ineffective or dangerous. Fad diets don’t work. Gastric bypass surgery is a serious operation that profoundly changes every day of your life by design when it is working properly.

Weight loss can be viewed as two distinct tasks. Losing weight and maintaining the loss.

Success, in my view, will come from within.

Weight loss is not a sprint, but is a long distance run. Consider this point. Very modest lifestyle changes over time can deliver big results. Lose a pound per month, for example. Do the math and calculate your new weight 2 years later. This cold math works the same way if we gain a pound each month.

Write down your reasons why you are overweight. Are these reasons stronger than you’re desire and commitment to change? If not, then get yourself to the starting gate. Your marathon run is about to commence.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.