Living in a culture that erroneously conflates health, value, and worth with body size, weight-based discrimination runs rampant. That patients seek treatments to shrink their bodies, often by any means necessary, is no surprise. Weight loss surgeries represent one such approach. Though increasing in popularity, steadily climbing from 158,000 in 2011 to 252,000 in 2018, weight loss surgeries remain under-studied and widely misunderstood when it comes to long-term impacts and outcomes.
Indeed, a 2015 article reviewed the body of literature published from 1946 to 2014 to better understand the effectiveness of weight loss surgery two years following the procedure. Of the 7,371 papers the authors identified, only 29 met their inclusion criteria…or, a grand total of 0.4%. In their words: “Very few bariatric surgery studies report long-term results with sufficient patient follow-up to minimize biased results.”
Despite this gaping information gap, we do know that weight stigma remains a primary driver for patients seeking weight loss surgery. Lisa DuBreuil, LICSW, guest expert for EDRDpro’s September 2019 members-only webinar, quoted a mental health clinician who worked in bariatrics: “For most patients, weight stigma was at the core of it. I did evaluations for two years, and only one person did not have body dissatisfaction that you would see in someone who met the criteria for an eating disorder. People would say, ‘Of course I hate my body.’ They were uncomfortable with themselves and their bodies, and there was this sense of desperation.” These realities play notable roles in many people’s decision to move forward with weight loss surgery.
Even with a rapid and significant reduction in body weight immediately following the procedure, Lisa noted that many patients do not experience the transformative positive changes they had envisioned. Many are not aware of the myriad of risks following weight loss surgery, including higher rates of self-harm and suicide, depression, weight regain, return of preoperative diseases, disordered eating and body image disturbances, metabolic changes, and alcohol or substance abuse. Sociocultural judgment that weight loss surgery represents the “easy way out” adds to these risks, leading many patients to feel disappointed and defeated.
As dietitians, keeping these considerations at the forefront of our minds is paramount. Navigating our work in a diet-and-weight-obsessed world is already challenging, and weight loss surgery often further complicates matters. In Clients and Weight Loss Surgeries: Considerations and Complications with guest expert Lisa DuBreuil, LICSW, we take a deep dive into these issues to answer the question: How can we, as Health at Every Size® professionals, best support our patients when it comes to weight loss surgery?
Like all of our monthly webinars, Lisa’s presentation is available for members to watch at their leisure. Head over to the webinar library to access, or learn more about EDRDpro membership here!