I previously worked as the nutritionist for a gastric bypass surgeon.  I can certainly see the merits of this surgery.  I saw it affect the lives of hundreds of patients while I was there. 

I know that the hope of losing weight with diet and exercise is pretty slim.  In fact, I disagree with the fundamentals of the diet and exercise mantra of the health industry.  I realize, in some cases, drastic measures are necessary.

The problem I see with bariatric surgery is the notion of it being a total solution.  The problem people have is an abnormal relationship with food.  Until this is addressed, the problem has not been solved.

People use food for reasons other than hunger.  Most people eat emotionally without realizing it.  Emotional eating is not the typical scenario of crying over a pint of haagen dazs.  People don’t feel an emotion — there is just a sudden urge to eat.

When you take away a person’s ability to regulate their emotions with food, what do they have left?  Oftentimes you see people who have had the surgery switch addictions to drinking or even drugs.  I have seen several cases myself where people have developed anorexia or bulimia after bypass surgery.

The key to success with weight loss surgery is to give people the tools to handle what they were not handling before the surgery.  People need to do the hard psychological work in order to really see a change in their lives.  Working with a nutritionist who understands binge eating or compulsive overeating is key as well.

Gastric bypass surgery is a tool.  It should be one tool of many to be used in regulation of weight, not the only tool.  It should also be clear that weight loss surgery, and the resulting weight loss, will not solve all of the individual’s issues.  It is easy to get sucked into the culturally propagated idea that if you lose weight, your life will be perfect.

If you are thinking of having bariatric surgery, do so responsibly.  There is a palpable fear among the patients I’ve worked with, and that is the fear it won’t work for them.  This is definitely a possibility if it is not done correctly.  I’ve seen people stretch to the point of being able to overeat again.  I’ve seen people graze throughout the day in order to keep themselves numb.  The reason this continues to be a problem for these people is they allow themselves to be blind to reality.  The reality is the issue is far deeper than food.