By now, whether overweight or not, most Americans with some sort of media access have heard of the wonders of bariatric surgery. Examples of the benefits attributed to the procedure include fast and drastic weight loss, substantial improvements in physical health including the resolution of chronic health conditions such as diabetes, hyperlipidemia, hypertension, and obstructive sleep apnea, and reduced risk for all-cause mortality. While such findings make it difficult to argue against the value of such a surgery, particularly among the morbid obese, there remains many dangers associated with viewing bariatric surgery as a quick fix for obesity.
First, the procedure itself is highly invasive and associated with substantial risks inherent in any major surgery. Second, it is by no means a 100% effective solution. In fact, regardless of the type of bariatric surgery chosen, it is always possible to regain the weight lost. Weight regain is particularly common among individuals with binge eating disorder and other physical and mental health conditions that may impact their adherence to post-surgery nutritional and physical activity recommendations. Finally, there is some evidence to suggest that a phenomenon called “transfer addiction” may occur among individuals who undergo bariatric surgery where one unhealthy behavior (e.g., overeating) is replaced with another, and often equally as harmful, behavior such as alcohol abuse.
Given the aforementioned facts, should people stop undergoing the procedure? No. What this means is that more efforts are needed in regards to educating prospective surgery candidates about the limitations of the procedure and the importance of developing the skills necessary for success prior to undergoing surgery. Such skills include the identification of underlying emotional issues that may be driving unhealthy eating patterns and in turn the development of healthier coping mechanism, as well as the acquisition of both the knowledge and skills necessary to adhere to nutritional and physical activity recommendations. In essence, instead of viewing bariatric surgery as a quick fix that will cure obesity in the way that an antibiotic cures an infection, individuals need to start seeing it for what it really is: a tool. In being viewed as a single component of an overall treatment, when combined with the right level of motivation, knowledge, and skills, bariatric surgery can result in vast improvements in the health of individuals who have reached a point where weight loss via conventional means is highly unlikely.
