Surgery: Last Resort for Obesity?

What the heck do people mean when they say “surgery can be effective as a last resort for obesity?” Whatever their point, they need to stop it.

That pernicious idiom cropped up this week in reporting on a new position paper regarding bariatric surgery in children and adolescents with severe obesity. The position paper was straightforward. The authors acknowledge the limitations of available data and outline the types of pediatric patients that surgery can benefit. Though they caution against “widespread and general use,” they say nothing about a “last resort.”

Health reporters and their biases provide that idea. The underlying thought seems to be that this shouldn’t be necessary — that surgery is an act of desperation. The problem with that kind of thinking is twofold. It discourages people with a genuine medical need for bariatric surgery from seeking it. In a recent study, we found that nearly 70% of people with severe obesity think that surgery would be inappropriate for them to even consider.

But more important, it tells people that surgery is the end of the line for them. If the outcome of surgery is less than perfect, “last resort” thinking dictates that they have no further options. Such a lie leads to despair when people hit bumps in their journey, as most people do. A good obesity specialist can help people through these bumps, but only if people know they still have options.

The problem is especially difficult for adolescents with severe obesity. Surgery, for a young person who needs it, can be tremendously helpful. But obesity is still a chronic disease, even with successful treatment. Young people who get the treatment they need should understand, with their whole life ahead of them, they may well need further help in the future. And the options will be there for them.

So don’t let the words “last resort” in connection with bariatric surgery go unchallenged. People always have options.

Click here to read the new position paper and here to read an example of the reporting on it. Click here to read a study of bias against people who undergo bariatric surgery.

Despair, oil painting by Edvard Munch / WikiArt

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