It profoundly reroutes the guts and changes every day of your life. This is not like undergoing a heart bypass surgery when after a period of recovery you resume your normal life. After GIB, there is no normal life afterwards. Your life is irrevocably altered. Meals are such a significant and personal part of our lives. Think of all of life's celebrations and you will recognize that food is a part of them.
I point out these strong caveats to remind folks that the decision to proceed with GIB is not a casual one. It requires careful deliberation and an understanding of the lifelong changes that one is committing to. In addition, this operation is no quick-fix cure. A patient who is a food addict, for example, will regain the lost weight after surgery, a sad and predictable outcome. This is why high quality bariatric programs screen patients very carefully psychologically. If a program accepts nearly all applicants, then one must wonder about the quality of the institution.
Personally, I feel that bariatric programs pull the trigger too quickly and that the public is too willing to serve as targets. These surgeries, which should be regarded as last resort rescues are increasingly offered as front line therapies. Eligible patients are rightfully told that GIB weight loss can melt away diabetes, sleep apnea and hypertension.
Before consenting or seeking GIB, have all other methods of weight loss been exhausted? Has the individual received intensive dietary and nutritional counseling from weight loss professionals? Has there been an adequate system of coaching and accountability? Quitting a diet or two after a few weeks does not constitute exhausting all efforts. I think that the existence and marketing of bariatric programs has influenced patients to leapfrog over conventional weight loss programs directly to the operating table.
I absolutely believe there is an important role for bariatric surgeries. I am less sure that we are performing these surgeries only when they are the most appropriate option. It's weighty issue for sure. Feel free to weigh in yourself.
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.
