Wednesday 9 June 2010

Bariatric Surgery - Is it the answer?

I have just come home from a BOSPA meeting. BOSPA is an organisation that provides support to people who are thinking about or have undergone bariatric surgery; gastric bands, bypasses or sleeves (and other less common procedures). I was invited as a guest speaker this evening and it was real privilege.

I am aware, as I write, that before tonight I had lots of judgments about people who choose to have surgery to lose weight. Actually no, that's not true. I didn't, I had judgments about the doctors who offer the surgery. I felt angry that people are being put under the knife before being offered tools and support to change their relationship with food (other than diets!) which might mean they could avoid such major invasive surgery. How many people I wonder, who opt for bariatric surgery, have been offered the opportunity to work on their overeating in a supportive and positive way? How many of them have talked to other people who understand and hear them with compassion about what it's like to live with body hatred, feeling bad about themselves and stuffing those feelings down with yet another pack of crisps? How many of them really know, before they change their digestive system, sometimes irreversibly, that with support and care and encouragement, they could transform their relationship with food and stop overeating...

And this evening I saw things in a different light. Whatever my views about surgery and the alternatives, I met people who have been thrown a life raft. Their stories moved me and I felt a huge amount of respect and admiration for every one of them. They know, as I know, that the surgery offers them a tool, one way to manage their eating and they also know that there's lots of work to do to change their relationship with food once they've undergone the procedure. That the surgery alone is not enough. Without making changes the weight comes back on, just like it always does. When we don't know how to manage the reasons we overeat, when we don't know how to deal with it when every bone in our body wants to eat, when the urge to fill ourselves up with something, anything, is so great, so overwhelming, that it feels as if it controls every fibre of our being, then even a gastric bypass cannot keep the pounds at bay.

The surgery is not THE answer and it does make an enormous difference to some people's lives. It is so easy to judge, to think that people who opt for surgery are taking the easy option. That is definitely not the case. Only those who have been there understand the utter desperation, misery and anguish that accompanies being overweight and/or yoyoing up and down year after year, for decades. The diets fail us, the dietitians, nutritionists, doctors, therapists... they all fail us. None of them offer a realistic, lifelong solution. So where do we go when we reach the end of the road? With stone upon stone to lose?

Beyond Chocolate offers people hope, not just because we look at our relationship with food from every angle; what we eat, how we eat, why we eat... we look at emotional eating and body image, we deal with exercise and healthy eating. And we do all that with kindness and compassion. We don't patronise people - we know that they know everything there is to know about food and diets what they 'should' or shouldn't eat. They could probably write a book about it! We don't just offer a one dimensional fix. We show people exactly how to change the way they eat in a way that is sustainable and real. Gradually, one step at a time. And sadly Beyond Chocolate and it's cousins (the few that exist out there) are not offered to people by GPs because we have not yet had the financial good fortune to invest in research to 'prove' that what we do works. While GPs reluctantly or happily refer people to the good old slimming clubs (who can afford the glossy brochures and so called research showing how much weight people lose - but not how much they invariably regain!), we remain the prerogative of those who can afford to pay and have the good fortune to come across us or hear about us through word of mouth or on the internet. We're working on it! Slowly but surely we are gaining ground. We'll get there.

We are committed and passionate about empowering women (and men) to know and trust their bodies and to taste the freedom that comes from a healthy balanced relationship with food. And that means anyone, however they choose to support themselves, including bariatric surgery.

I am so grateful to have been invited to speak at the BOSPA meeting tonight. I left feeling moved, honored and much better informed and with huge admiration for all the participants and Georgina, the woman who runs such a supportive and encouraging group.


  1. Fantastic post!

  2. Striking article Sophie - very interesting. love Lucy

  3. Sophie, it was a real pleasure to meet you and I am delighted to read on your post this morning your very positive comments about weight-loss surgery and the fact that it is just a tool and not an easy way out. We will all benefit from the some of the ideas, tips and ways in which we can address those overeating problems which never really go away until you deal with the underlying causes. I, for one, felt moved enough last night, to start that journey of discovery and will be looking at your workshops. Carol

  4. I have been on one of your courses which I found usueful, interesting and certainely believe in the ethitcs of it,however after being over weight for most of my adult life I am now 47, and doing every diet under the sun and teeth wiring twice, along with many hours if therapy I decided to opt for by pass surgery on the NHS under the Whittington Hospital in Highgate.
    It took 10 months for me to get to the surgery stage after undergoing different health and phsylogical tests and attending their monthly support group and I eventually had my op in April 2009.
    I have lost 9 stone and feel much healthier, confident, womanly and more able to manage my food choices. I no longer eat bread, drink fizzy drinks (as this can apparently swell the pouch )and I dont drink alchol although I am able to eat everything else. I now chew my food and eat much slower. All this has brought up other issues for me . I believe over eating is very much in the head and just because my stomach is smaller it does not mean I do not get cravings , because beliver me I do, its just how to manage them!
    So for me it has given me a huge tool to help change my mind set, some days are easier than others and overall I am very pleased that I had the op as basically, I according to the surgeon have added 30 + years on to my life which I am looking forard too.
    I wish anyone who is contemplating the surgery good luck , its not the full answer, it is another tool in the big box of life.

  5. am due for a gastric bypass and I do have a bad realtionship with food. Please understand, some of our minds are with 30 years of overeating broken. Some of us need to sever all ties with food in any sort of way just like an alcoholic or heroine addict. My body is all stretched out, my joints and knees ache and i barely leave the house out of the misery of my size. Thinking about it, doesn't always work. Thinking is what made me eat in the first place.

  6. You've written a sensitive piece and I speak from a posito of someone whose mother had bariatric surgery. I felt very strongly at the time and still do that bariatric surgery was not a positive step forward because I doubted my mother would take the steps needed to make the surgery work. She has always looked for shortcuts and this was yet another shortcut. She didn't do the 'follow-up' care just like she never stayed for the pep talks at Weight Watchers (just went for the weigh in). In short she put her life at risk to do something to change the problems that existed in her head and it didn't work. I was phoned this morning by my mother's partner telling me she's been admitted to hospital with severe alcohol induced cirrhosis of the liver and the prognosis isn't good. I wish options like Beyond Chocolate were there for GPs to prescribe to women like my mother because what she needed was internal change (and by that I don't mean her bowels and stomach). Of course in her case she also needs much more then B/C but it would have been a step in the right direction. I salute your work with women.

  7. This wouldn't be posted any better! @Jess: Sorry about what happened to your mom. If she just been monitored and she's willing and disciplined with her habits. It should be a better one. That's is the thing with gastric bypass surgery, you are given a chance to lose some weight with a great prize.


Note: only a member of this blog may post a comment.