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Bariatric Surgery: Not the ‘Easy’ Way Out—the ‘Healthy’ Way Out

Bariatric surgery is often stigmatized as the “easy way out” for patients with morbid obesity. Numerous studies have confirmed the stigma’s existence among not only lay people but also among healthcare professionals. People with obesity are often viewed as lazy, unmotivated, lacking in self-discipline, and sloppy.

This societal attitude of blaming individuals for their obesity might lead further to the idea that people with obesity do not deserve what is perceived as an “easy fix.” Another possibility is that the speed of the resulting weight loss, rather than the rigors of surgery and subsequent lifestyle changes, makes the surgical approach seem “easy” in comparison to changing one’s diet, decreasing dietary intake, exercising, or struggling with a weight loss.

It presupposes that people who come to a decision to have bariatric surgery have never tried diet and exercise before – or even worse, they just didn’t try hard enough. It assumes that the need to have bariatric surgery is a terrible failing. This opinion – that bariatric surgery is the easy way out – is not only condescending and dismissive, but it’s completely inaccurate based on the current science.

We know that long-term weight loss in individuals who have obesity is difficult to achieve through diet and exercise alone. We also now know that is because obesity is a complex disease, made up of a combination of genetic, neurological, endocrine and lifestyle factors. Together they create critical biological imbalances that work against weight loss efforts and maintenance of a lower weight. Because the body sees weight loss, even desirable weight loss, as a stressor, this sets into motion a series of events that makes maintaining lost pounds highly unlikely. We eat less but feel more hungry, while at the same time our bodies burn fewer calories with each pound lost. Is this fair? Definitely not. But it is the reality in the majority of cases.

People that label bariatric surgery as the easy way out just don’t understand the disease process. Most of these patients have tried dozens of diets. They have lost hundreds of pounds through aggressive medical weight loss programs, only to gain all the weight back and then some. It’s not just a simple issue of discipline and a diet. Obesity is a disease, just like cancer, diabetes, heart disease, and stroke.

Now consider the thought process involved in undergoing surgery. Patients need to admit to themselves and their families that they have a disease that is so profound that they need to see a doctor to treat it. Next they have to see a dietitian for nutritional guidance pre and post-surgery. Then they have to have a major surgical procedure. Granted, it’s typically performed laparoscopically, but they still need to undergo general anesthesia, and have someone operate on them in order to help fight this disease. Does that sound like the easy way out?

Perhaps we should refocus, viewing it not as “weight loss surgery,” per se. For patients, it is the “healthy choice” rather than the “easy way out.” For them the surgery represented a dramatic approach to regaining their own health rather than a choice simply to help them lose weight. Viewing these patients as individuals who are taking responsibility for their own health by undergoing surgery is a useful paradigm shift for healthcare professionals and also the general public.

Surgery alone does not equal success. Creating good nutritional habits, exercising, having a positive relationship with food and developing a solid support system are all things that take time. But they will make or break success in the lifetime that follows the decision to have surgery. This is not a quick fix, or easy or a guarantee. But it is a chance. A really good chance, for someone willing to put in the work.

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