Public Perceptions on Obesity & Weight Loss Surgery

Obesity is one of the most significant health problems we face today.  Nearly one third of the world’s population and about 40% of the U.S. adult population is overweight or obese. Obesity has become “the new smoking” and is a leading cause of premature death due to noncommunicable disease.

Bariatric Surgery Being Underutilized

Doctors and scientists who research diseases provide these statistics on obesity and warn us of the dangers to our health if we fail to take action.  And yet we see that obesity rates have not declined and our most effective treatments, gastric bypass and gastric sleeve, are being used by less than .5% of the people who could benefit from them.  Why is this?

Some people fear surgery and resulting complications.  And while it is true that a very small percentage of bariatric surgery patients do experience complications, this risk is much lower that an obese individual’s risk of developing a life-threatening condition due to their failure to take action.

Stigma Attached to Obesity & Weight Loss Surgery

A report in the Journal of the American Medical Association (JAMA) says that many obese people don’t seek treatment because of the stigma attached to the condition and bariatric surgery. Unfortunately, this attitude is prevalent not just among the general population but among those in the medical profession as well.

Researchers at New York-Presbyterian/Weill Cornell Medicine in New York, NY added some obesity related questions to the Cornell National Social Survey, a telephone survey conducted among randomly dialed English-speaking adults.  These questions were:

  • “Do you think people mostly have weight loss surgery for cosmetic or for health reasons?”
  • “Do you think weight loss surgery is usually an ‘easy way out’?”
  • “Should health insurance cover medical procedures to help people lose weight?”

A group of 948 people were surveyed.  The surprising results revealed the following:

  • 49.4% think weight loss surgery is mostly for cosmetic reasons
  • 39.1% say the surgery is chosen as an “easy way out”
  • Only 19.2% said insurance should always pay for it.

Health Benefits of Weight Loss Surgery

The health benefits of losing weight for the morbidly obese have been well documented.  Those who are able to lose a significant amount of weight after weight loss surgery lower their risk for heart disease, stroke, many types of cancer, sleep apnea, arthritis, and many more conditions. Many obese patients find their type II diabetes is either greatly improved or cured after bariatric surgery.  Cosmetic benefits are just one of the benefits of weight loss surgery.

Let’s look at the notion that weight loss surgery is the “easy way out.”  Despite its higher rates of effectiveness for long-term weight loss versus traditional diet/exercise, most Americans think that obese people lack the willpower to lose weight through diet and exercise.  This is simply not the case.  Many who eventually turn to bariatric surgery have lost substantial amounts of weight with traditional methods, many more than once.  Keeping the weight off is the larger problem.  Weight loss surgery solves this problem in that the gastric sleeve and the gastric bypass procedures physically reduce the size of the stomach and also suppress the hormone responsible for feelings of hunger.

So, is weight loss surgery “easy”? I don’t think many bariatric surgery patients would describe it that way.  It is surgery, and there is some discomfort and at least a week or two of recovery time at home.  After this, there is still work to be done.  The patient must adopt a new way of eating to accommodate their new digestive system.  Exercise is also an important part of the equation.  Bariatric surgeons like Dr. Preeti Malladi will continue to follow the patient to ensure that they are managing well and sticking with these new diet and exercise routines.  With surgery, the weight loss happens faster, but it is certainly not the easy way out.

It’s difficult to understand why a rational person would argue insurance should not pay for weight loss surgery when the health benefits are so clear and well documented.  The fact that Medicare and Medicaid (in 48 states) cover bariatric surgery is a pretty strong indication that these procedures are considered valuable medical treatments, rather than elective cosmetic procedures.