UNPOPULAR OPINION: I Don't Support Weight Loss Surgery
Having been fat since at least the fifth grade, I’ve done a lot of ridiculous things in pursuit of being not-fat. I’ve taken prescription diet pills in dangerous doses, non-FDA approved supplements with no actual proof of their efficacy, and even tried good old-fashioned starvation.
Of course, none of them worked. Almost all of us fat people who try to lose weight by dieting will not sustain long-term weight loss. But thanks to the wonders of modern medicine, you can rapidly lose as much weight as your heart desires, so long as you commit to a risky surgery that reduces the function of a healthy organ and comes with a laundry list of complications, side effects, and restrictions.
Weight loss surgery has been increasing in popularity since the first roux-en-y procedure was performed in 1967. According to the U.S. National Library of Medicine, roux-en-y surgery involves “creating a stomach pouch out of a small portion of the stomach and attaching it directly to the small intestine, bypassing a large part of the stomach and duodenum. Not only is the stomach pouch too small to hold large amounts of food, but by skipping the duodenum, fat absorption is substantially reduced.”
Roux-en-y procedures come with extensive short and long-term risks, even if they promise substantial weight loss. Up front, the surgery causes malnutrition if an extensive regimen of vitamins and minerals aren’t taken every day. Not only is the body less likely to absorb fat, it also won’t be able to take in the external substances it needs to survive, like calcium. Osteoporosis and anemia are common long-term side effects, along with intestinal hernias.
Then there’s “dumping” syndrome, or why you’ll be eating off the kids’ menu for the rest of your life. If you eat too much food or make the mistake of drinking during a meal, you’ll probably experience shaking, nausea, and diarrhea.
Or you could be one of the 4.6% of bariatric surgery patients who die after surgery.
Then there’s always the possibility that the procedure will fail, probably because you failed to get your fat, donut-eating ass up off the couch and do some cardio. Or at least that’s what they’ll tell you. Twenty percent of patients don’t meet the standards of “successful weight loss” after bariatric surgery, meaning that they’ve stretched out the stomach “pouch” and will require another costly reversal procedure if they want to lose the weight again.
Gastric banding procedures, known as the LapBand, may be less dangerous, but many of these complications still apply to that surgery. All of the risks, combined with the fact that I could just end up fat again, have completely taken weight loss surgery off the table for me. And don’t think I haven’t strongly considered it before. Many times, I have Googled surgeons who performed the procedure while dreaming of shopping at places like Anthropologie. I’ve talked to my doctor about it. He, of course, was supportive of that decision.
When I express my distaste for weight loss surgery on Twitter, or amongst a group of friends, I'm almost always met with strong disagreement, usually along the lines of: “If people want to improve themselves, why not let them be happy?” “Getting healthy is a goal that everyone should have!” “But it’s a choice. You’re a feminist. You have to support people’s choices.”
It is beyond clear to me why people choose to have weight loss surgery. I’m not going to suggest that there aren’t some people who medically need to have the procedure, because I know that there are. And I don’t begrudge anyone a medical procedure that improves their quality of life or keeps them alive. Some people undergo weight loss surgery to treat diagnosed medical conditions, like type 2 diabetes.
And I do support people’s choices. But I don’t support weight loss surgery as a treatment for fat. If you aren’t at risk of imminent death, your fat is just another part of the body, not a disease to be cured. Diabetes, high blood pressure, cancer, those are things that can be diagnosed and treated according to established medical protocols. And, by the way, they’re all diseases that thin people can develop.
A 2012 study published in the European Heart Journal found that fat people who were metabolically healthy had no significantly higher risk of developing or dying from cancer or heart disease than “normal” weight people. Close to half of the obese people studied fell into the metabolically fit category, and they were much less likely to become sick or die than people who were underweight.
I don’t assume that all fat people are healthy. I have no doubt that weight loss surgery has helped people lose weight and work toward a healthier lifestyle. But for the most part, the bariatric surgery industry makes fat, and not disease, the enemy. Those photos of women standing in one leg of their former fat pants send a distinct message –- your fat body is not good enough.
It is just easier to live in a thin body than it is to live in a fat body. It’s also much easier to shake the stigma associated with fatness when the whole world can see that you’re the “good fatty” who finally got her shit together and lost the weight.
But that’s something society needs to fix, it’s not up to our individual bodies. If thin people need barbaric procedures like weight loss surgery to convince them that people who were once or are currently fat are deserving of respect, love, and accommodation in this world, that’s their problem. The internalized self-hate that comes along with the bullying and shaming of fat people shouldn’t be the impetus for a surgery that will dramatically alter the rest of your life.
When fat is the enemy, so are fat people. Weight loss surgery does nothing to address the root of fat discrimination, and there are one million ways to make your body healthier without going under the knife. Eating vegetables and exercising in a way that is fun and works for your body isn’t necessarily a formula for losing weight, but it can make you healthier.
So I’m out on weight loss surgery. I won’t be having it, and I won’t be telling anyone “congratulations” when they announce their decision to have the surgery. I won’t shame anyone for their choices, but I’m not going to be complicit in encouraging a mostly-healthy person to have a surgery that could seriously endanger their lives.
If someone really close to me told me that they planned to have the procedure, I would try to raise my concerns in a non-pushy way, but I would probably fail, and try to convince them to not go through with it.
I would also be incredibly sad. I don’t want anyone I know, fat or thin, to reach a point where surgery feels like the only option. If you’re currently considering weight loss surgery, please look into the Health At Every Size® principles developed by Dr. Linda Bacon, and take a little trip into the fat acceptance movement. It might be the best thing that’s ever happened to you.