On Plastic and Bariatric Surgery

When people tell me they are considering plastic and bariatric surgeries including tummy tucks, lap-band and gastric bypass, they cringe and duck. They speak as if they are confessing a great, dark secret. I guess they expect me to denounce them publicly, to scream "You're a failure, fatso!" I know that in their own minds, the devil on their shoulder is saying just those things.

I am by no means opposed to surgical weight loss. Am I thrilled with it? No more than I am thrilled with CPR. In certain emergency cases, I know both are necessary and helpful. While it is easier to diagnose a heart attack in progress, it's a bit harder to predict the one coming in one hour or one day--but both require quick intervention. I also know that success breed success. When patients feel that initial burst of self-esteem, it often creates the momentum necessary to change their own lives.

The benefits to bariatric surgery are immediate and significant, and include a dramatic improvement in insulin resistance and the effects of diabetes. The costs and risks are dramatic and immediate as well--everything from the hit to the pocket book to risk of death during surgery. I've spoken to patients who told me, "I almost died because of this. It was the worst decision of my life." I've spoken to others who said, "I would have died, if it hadn't been for this. It was the best decision of my life."

If your doctor recommends it, bariatric surgery might be an option for you to investigate carefully. If your doctor simply says, "You need to lose weight," she means for you to try the old-fashioned way--eat less, move more.

But whether you choose surgical weight loss or "natural" weight loss, you must make healthy decisions after the fact. Plenty of people have gone "under the knife" and gone back to their old habits of eating too much and sitting, sitting, sitting. What happened? They gained the weight back. After all that pain, all that expense and all that progress, they found themselves obese once again.

No doctor on this earth can save us from ourselves. This week, let the angel on your shoulder make your choices for you. Be your own best friend. Got low self-esteem and serious lack of self-love? Then fake it. Let the angel on your OTHER shoulder help you make your decisions based on compassion for yourself. If one of those decisions involves calling a surgeon, dial away with my blessing.


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