Thursday, October 25, 2007

Gastric Bypass? Are you CRAZY? . . .

I'm behind by about ten days on this release but a co-worker just sent me this story from WebMD and CBS News that finds 20% of all gastric bypass candidates are eliminated from eligibility for the procedure through psychological screening.

Now, 1 in 5 is a considerable number. To put it in perspective - only 9% of all first time drivers license applicants were denied permission to drive, in Utah, according to a 2002 review and only 14% of all Americans believe that Double Stuf Oreos are better than the original sandwich cookie.

BUT that number, to me, seems about right. I've been around the GB block, yo. I've known many a candidate, many a patient, many a happy success story and many a person who had the surgery and is not doing enough to realize the full benefits of the surgery at this time. Why? It is HARD to be ready for gastric bypass because, as I see it, morbid obesity is not as much a physical condition as it is a mental condition.

I'm not alone in that opinion. According to Dr. Sean C. Amore, PhD in Nothing from the University of Make Believe, there is absolute and undeniable clinical proof that any person who can get to a weight and a BMI significant enough to qualify physically for GB has no doubt been through enough mental stress in their life to lead to their weight and mass.

It could be any number of things to explain the mental impact on the physical condition on the day OF evaluation. According to the WebMD article the main mental reasons barring people from surgery are . . .

- Overeating to cope with stress or emotional distress (62 percent)
- Eating disorder (27 percent)
- Uncontrolled mental disorder (20 percent)
- Current significant life stressors (11 percent)
- Lack of effort at following a formal diet program (8 percent)
- Lack of social support to cope with the transition after surgery (4 percent) - Unrealistic expectation of change (2 percent)

I would argue that the list of things that lead, mentally, to the day of the evaluation and the weight of the patient might include abuse (physical, sexual, mental, verbal, etc.) as a child, adult or both, a poor self image through negative reinforcements and peer pressures, a significant life event that lead to depression without enough other coping mechanisms beyond food and, in my case, a sense that you are not your weight and people should know better.

I, myself, had two significant mental problems that lead to my life of severe obesity. One, I was never really sure of myself as a child/adult/person and two, I was pretty sure that as long as I didn't know myself, I might as well keep on eating. I was crazy enough to think that I would find myself at the bottom of a bag of chips or at the crust of the last slice of pizza or in the bottom of a large soda or whatever.

I won't blame any one person or any one thing for my life or my weight. Well - I blame MYSELF for it, I suppose.

In the meantime - I'm less emotional than I once was. I'm very much at peace with my role as a husband and a father and with profession and with my family and with my friends. I found myself some where along the way and realized, about two years ago, that I had to have this surgery and I started trying to clean up the mental challenges at that time to be more ready when my surgery date actually arrived.

To those people that maybe did not get through the mental screening of the pre-surgery procedure or for people who are prepping for surgery and are afraid they won't be able to say good-bye to food or that they are not ready for the changes they will have to undertake - I say GOOD FOR YOU. Take pause. Think it over. Be ready. Get ready. Look at why you are eating and try to figure it out and deal with it and put it to peace before the surgery. Another month or year of delay as you work on the mental - or never having the surgery period but KNOWING what is driving you to overeat and gain weight, etc. - is worth the delay because you will be better off on the other side of that delay.

As any one who has gone through the procedure only to find themselves not ready on the other side could tell you - that number, 20%, sounds fair but - if it was 21% or more . . . it might not be a terrible thing.

In the meantime, I wish continued health and success - physically and mentally to you!

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