Tuesday, June 14, 2011


AARP's June 1 news bulletin features an article, "Before and After Weight-Loss Surgery," which unabashedly recommends gastric bypasses as a corrective for obesity.

This operation is effective for its stated end, weight loss, which can help type 2 diabetes to disappear as well. The picture's not all rosy, though. At first, post-op patients can eat only small amounts of pureed foods. When they graduate to solids, they need to be carefully chewed or they don't go down. Some pills are too large to digest; alcohol, carbonated drinks and caffeine are verboten; protein, vitamin and mineral supplements are necessary. Some patients need to wait two hours after a meal to drink water or other liquid. But hey, they lose weight.


Obesity is epidemic in America. In 2004, the National Institutes of Health reported that nearly two-thirds of U.S. adults were overweight or obese. Over a million Americans have had a gastric bypass, which costs about $35,000 and, like other interventions, isn't getting any cheaper. Do the math.


Not everyone's wild about this tendency. Comments one surgeon, "When I put on my public health hat, I have to admit that it seems crazy. But I'm a clinician. I treat patients who have tried everything else, who have type 2 diabetes and other complications of obesity, and they're desperate. This is the only thing we can offer that allows for a cure."


The operative phrase here must be "…the only thing we can offer…" Why can't we offer anything else? Our ability to put people on the moon is, in my mind, totally useless except for the fact that it demonstrates the efficacy of American will. Why can't we offer anything else to the obese? How is it we can deftly rearrange people's insides but don't have a clue to helping them modify their behavior?

In addition, the expenditure feels unseemly, to put it mildly. The millions of people in the world who go to bed hungry could be nicely fed with this money we spend hopefully to correct our overeating .

Overuse of expensive interventions is a kind of selfishness, but there's something even more destructive at work: abdication of personal power, actually a reversal of the American "can-do" ethic. We're more and more assuming the role of "consumer" rather than doer. In my next blog entry, I'll make a case that consumerism may well be a form of mental illness.


  1. The food that the average American eats regularly is so full of addictive additives and chemicals that most of what we eat isn't food at all...but it stimulates our taste buds and certainly makes us want to eat more of it. Sugar and various forms of MSG are rampant in our foods and drinks. We eat and drink for so many reasons other than putting good fuel in our bodies. We eat/drink to socialize, to entertain ourselves, to repress feelings, to feel comfort, to catch a buzz. It is rare to meet a human whose primary reason for eating and drinking is to put appropriate and healthy fuel into their body. And it is a HUGE jump conceptually to move from 'food as entertainment' to a mindset of 'food as good fuel'. We promote unhealthy food addictions in our children right from the time we put formula we put in our babies' bottles. There are millions of high school kids addicted to caffeine, and millions more college kids who are alcoholics before they leave their institution of higher learning. In many cases, not all, gastric bypass is merely a continuation of the same mental/emotional/spiritual disease process that got those individuals into the mess in the first place. We seem to have developed a cultural myopic inability to defer gratification. We are encouraged to live a life made up in sound-byte mental processes, short term fixes, microwaveable instant everything. We have so much stimulation that we can't remember the last catastrophe because we just hear about the newest one. Katrina is a distant memory but New Orleans is still trashed. Fukushima's meltdown is hardly mentioned three months later and that mess is still getting worse as it brings a world industrial power to its knees.

    As we continue to eat based on convenience and as the quality of our food continues to decrease, I'm afraid that we'll see that we've only scratched the surface of the health care crisis.

  2. Hi, Dove,

    Thanks for your comment. You're certainly right that we eat for a variety of reasons in addition to fueling our bodies. For me, eating is necessary for survival, and it's also social, sensual, and comforting.

    But many folks eat mainly to fill the void they perceive inside themselves. As you state, they suffer the "mental/emotional/spiritual disease" of deficient inner life. Their senses of judgment and direction undeveloped, they are easy to sell to, primed for consumption. If you consume too much food, then consume surgery to fix it. To quote from a country song that's making the rounds, "No One Sells Love at the Mall,"

    I bought me an RV to travel, to seek what might comfort my soul,

    So I’d feel like I’m more than a food tube, an unfillable, bottomless hole.

    I parked in the lot of a Wal-Mart and with high hopes I entered the store,

    Bought an iPod and a drill and a George Foreman grill, but left as empty as I was before.

    - Jeff Kane MD