For a growing number of severely obese individuals bariatric surgery is the solution to shedding excess weight when diet and exercise have not succeeded, but it is definitely not an easy choice and produces a wide range of outcomes in different patients.
There are a number of different surgical procedures offered today from gastric bypass surgery involving the decrease of the volume of the stomach and bypassing a section of the intestine to both restrict the amount of food eaten and the absorption of calories from that food to lap band surgery which merely reduces the volume of the stomach to once more restrict the amount of food that can be consumed.
Whatever form of surgery is done the basic principle is to make the body burn off a greater number of calories than can be ingested and so reduce weight by using up the body’s fat reserves.
The true problem with obesity surgery however is not to be found in the surgery itself but is seen in the weeks and months following the operation when individuals discover that their lifestyle has to alter dramatically and that they must adjust to a whole new method of eating. For most people this is hard work but for a few it can bring severe difficulties that are simply too much to cope with.
There are a variety of different reasons for obesity but two commonly seen problems illustrate this point.
The first problem is that of those individuals whose obesity has resulted from, or been exacerbated by, emotional eating. Here individuals resort to eating whenever they find themselves under stress or when their emotions are particularly low. Emotional or comfort eating is an extremely strong habit that is difficult to break and the psychological pressures that normally follow obesity surgery are just the kind of pressures that can trigger the desire for comfort eating in people who suffer from this problem.
The second problem is that of those individuals who are prone to binge-eating and the uncontrollable disgust, depression and guilt that frequently follow binge-eating episodes. It is only too easy to visualize the great difficulty which such individuals will experience in attempting to cope with the significant lifestyle changes following gastric bypass surgery.
Taking all of these and other factors into account it is perhaps not too surprising to learn that approximately 20% of people being considered for obesity surgery are not suitable, or more correctly not ready, for surgery which is when psychological obesity treatments come into their own.
A great deal of attention is paid to the requirement for individuals to meet certain physical requirements for surgery (in terms of things like their BMI and the existence of other medical conditions linked to the fact that they are severely overweight) but all too frequently only lip service is paid to very real psychological problems that are associated with surgery. For surgery to be given the best possible chance for success then it is critically important to pay close attention to the psychological needs of individuals and then provide them with pre-surgical assessment, counseling and, most important of all, treatment.
