Bariatric surgery likened to any surgery that remedies disease, expert says

Four women sit in a restaurant booth under the glow of hanging incandescent lights. They are at one of those all-day breakfast joints, and this is a special occasion: the monthly meeting of their weight-loss support group.

 To an outsider, though, this hardly looks like a group whose main concern is food addiction. For the most part, they are an average-sized bunch — one in particular is even bordering on skinny.

“Pre-surgery, no exaggeration, I could go to McDonalds and order two combos upsized and a couple pies, eat it all myself, and an hour later be hungry again,” says Denise Burton, a thirty-something blonde with a strikingly pretty face.

“Anything to numb my pain.”

By pre-surgery, Burton is referring to a form of a bariatric procedure — a controversial weight-loss surgery that is now covered entirely under Alberta Health Care.

The website, obesityhelp.com says the restrictive form of the surgery limits the patient’s food intake by “creating a narrow passage from the upper part of the stomach into the larger, lower part,” effectively reducing the amount of food that the stomach can hold.Timi Davis, Denise Burton, Gemma Philp, and Vicki Lee say fat can no longer dictate their lives.

Photo by: Melissa Molloy

To contextualize the type of morbid obesity Burton was living with before undergoing the major procedure, one must understand that any person is technically considered overweight with a body mass index, or BMI, of 30 and above. Burton’s BMI was a deadly 71.

“I was 472 pounds,” Burton says, her stern hand gestures and unwavering eye contact emphasize the desperation of her former situation.

“That’s almost 500 pounds — in my twenties. How much of my life did I waste? Where could I have been if I didn’t carry that?”

And where could she have been? Someone trapped within a morbidly obese body faces severe limitations for even seemingly mundane daily activities.

“As an obese person in this world you go to a doctor’s office and you can’t fit in the seat,” Burton describes. “You have to buy a vehicle that will accommodate your ass and your stomach. You can’t go on rides at the park, and you can’t take your kid out and play. You are stuck in your body.”

“I was 472lbs. How much of my life did I waste? Where could I have been if I didn’t carry that?” – Denise Burton

Vicki Lee, the only person at the gathering who still awaits the drastic surgery, is eager to pipe into the conversation.

“We didn’t go from being 125 pounds in our twenties and packing on a 100 pounds in a year. It didn’t happen that way,” she says. “It’s been a life-long struggle.”

The battle with fat

The struggle, as these ladies describe it, is one riddled with complexities — and food is only a small piece of an ever-evolving puzzle.

“It had nothing to do with the food,” Burton says. “It had everything to do with everything else that made me eat. I looked at the food for love and acceptance and friendship. It was everything.

“As long as I had food I didn’t need anything else.”

Most emphatically, the ladies cite bullying in childhood from both parents and peers as a main instigator in the vicious cycle that creates extreme obesity.

“What people don’t understand is that I may be fat, but that fat isn’t in my ears, and I still hear and feel everything,” Burton says.

“The comments and the hurtful remarks – they don’t help. They hurt and they sit with you on a really deep level.

“It’s taken me five years of intensive counseling to get over that.”

The pain endured from the taunts and stares that were commonplace for Burton and her weight-loss companions could only be satiated with food.

And after a great binge on potato chips or cheesecake, the ladies say the guilt over another failure set in just as soon the food settled in their digestive tracts.

The guilt led to more binging, the binging to more guilt and so on.

“People just say, ‘quit eating,’” Burton says. “But it’s not that. It is years of people telling you that you are nothing, and ugly and disgusting.”

“And what’s really sad is that for a lot of us who are overweight, we actually believe those things.”

The surgical side

Dr. David Lau, a University of Calgary medical professor, surgeon and the vice-president of the Canadian Association of Bariatric Physicians and Surgeons, says access to bariatric surgeries by the obese should be likened to medical treatments for sufferers of other diseases.

“When a person reaches a certain level of obesity, you can’t change back. You can’t turn the clock back. And that’s something that a lot of people don’t understand,” Lau explains.

“An overweight or obese person is not just a normal person that has visibly expanded in size. The physiology has changed. The metabolism has changed, and the person is no longer who he or she was.”

An easy way out?

For any skeptics who might deem these surgeries as an easy way to get rid of the fat, there is much more to the story. The surgeries are merely one step in a long physical and psychological healing journey from obesity.

Lau reiterates that the post-obese person is not the same as the pre-obese person. The body and mind have undergone a transformative experience — one that has left scars on the flesh and on the heart.

Along with intensive post-surgical counseling of the new mind, the weight-loss support group also has a plethora of side effects to deal with inside their new bodies.

Burton, for example, says she might vomit three or four times a day depending on new sensitivities she has developed for certain foods. She also doesn’t know which foods will bother her stomach on which days, making the issue difficult to manage.

Still, the women around the table seem to zone in on one consequence of the surgery of which they are not proud — the layers upon layers of loose, hanging skin, representing the remnants of a body much too large to maintain the organ’s elasticity.

“Now I’ve done all this work, I’ve lost all this weight,” Burton says. “And now the government won’t help me to get rid of all of this extra skin. And by far, this extra skin mentally does more to me than my weight ever did.”

Removal of this excessive skin is considered to be a cosmetic-procedure, and therefore not covered by Alberta Health Care. The cost of body-contouring plastic surgeries is in the tens of thousands of dollars.

Still, the ladies of the weight-loss support group say they are happy with their decision to go through with the procedure.

Today, it’s the little things that bring the biggest joy.

Perhaps Burton sums it up the best.

“I couldn’t walk a quarter of a block without stopping to take a breath. Now I can walk five miles. I can go to the gym, I can run, I can play with my daughter. I can go shopping at a regular store.”

“I can live my life, and fat can’t dictate what kind of a life I’m going to have anymore.”

mmolloy@cjournal.ca