So, you say I took the easy way out. A surgeon's perspective on Bariatric Surgery.

Obesity has genetic components, well documented in the medical literature. There are socio-economic factors involved. Many of our patients have an abuse history, and sub-consciously shroud themselves from unwanted physical attention through their weight; hence, obesity has a psychological component. There are numerous metabolic issues at play, such as diabetes, hypo-thyroid issues, poly-cystic ovarian syndrome, and leptin insensitivity.

Now consider the thought process involved in undergoing surgery. Patients need to admit to themselves and their families that they have a disease that is so profound that they need to see a doctor to treat it. Then they have to see a mental health provider, to evaluate them for untreated mental illness and coping skills. Next they have to see a dietitian, and may need to undergo 6 months of medically supervised weight loss, depending on their insurance. Then they have to have a major surgical procedure. Granted, it’s typically performed laparoscopically, but they still need to undergo general anesthesia, and have someone operate on them in order to help fight this disease. They may incur significant expense, loss of time from work, and/or time away from school. Finally, they have to take vitamins for the rest of their lives, and they have to follow up with a mean surgeon (me) forever!

Does that sound like the easy way out? How do I explain to a woman at a party that, without surgical intervention, only 30% of my patients would live to see their 65th birthday? How do I explain the humiliation involved in asking for a seat belt extender on an airplane? To not be able to go to a movie, or an amusement park. To have to have a family member do your toilet care because you simply cannot reach? To not be able to run after your child when he or she is in danger? To have people judge you as lazy and slovenly before even shaking your hand? To be discriminated against when applying for a job, just because of the way you look?

Obese people are the last population that folks think of as socially acceptable to ridicule. Yet, over 30% of Americans are considered overweight. While I’m thrilled that the AMA has declared obesity a disease, how long until the rest of society recognizes that ruling and stops discriminating?