10 Obstacles for People Who Need Bariatric Surgery

Reeger Cortell has been puzzling over the reasons that many people do not seek out surgical treatment for severe obesity, even though they could benefit. Roughly 70% of people with severe obesity say they would not even consider surgery. As a Nurse Practitioner, Cortell cares for people seeking bariatric surgery and produces the outstanding Weight Loss Surgery Podcast in her spare time. So she reached out to the people who follow her to do a survey of the obstacles.

She came up with ten. We share them with you as she so generously shared them with us.

  1. Financial. Health plans put a financial wall around bariatric surgery with exclusions, limitations, and out-of-pocket costs. On top of that, there’s the cost of missing work during recovery. Contrary to the bigoted stereotypes out there, people with obesity tend to be a hard working tribe.
  2. Fear. Despite a good safety record, the prospect of surgery evokes an outsized fear of complications, including death. Equally daunting is the fear of failure and weight regain, both of which would be humiliating. Other fears, not to be dismissed, are the fear of change and the loss of food as a source of comfort and coping.
  3. Independence & Self Reliance. People have it drummed into them that worthy people can lose weight on their own. They shouldn’t need surgery. It’s a powerful lie.
  4. Negative Press. Popular media is full of stories like the People magazine annual edition of “100-pound Losers Without Surgery or Gimmicks!” The suggestion is that outliers are the norm.
  5. General Negativity. Surgery is consistently portrayed as cheating or the “easy way out” for character flaws and lacking willpower. A recent study found significant job discrimination against people who had success with weight loss surgery. It demonstrates how pervasive the negativity is.
  6. Families and Friends. Surprisingly, being shamed by family and friends for seeking surgery is all too common. The impact is devastating.
  7. Internal Locus of Shame. “I was too ashamed to ask for help.”
  8. Lacking Knowledge about Surgery. Let’s be frank. The process can be overwhelming to prepare for surgery. “I had no idea where to start so I never did. Way too many hoops to jump through.”
  9. Lacking Knowledge of One’s Own Obesity. People don’t seek solutions for a problem they don’t fully recognize.
  10. Resistance from PCPs. “I asked my doctor and he refused to refer me.”

Cortell summarizes by saying, “Bariatric surgery has a terrible brand image.”

Deserved or not, such an image problem is no small task to fix. It requires a thoughtful, long-term strategy. It requires innovation in the delivery of care. It requires commitment.

If you haven’t yet discovered Cortell’s Weight Loss Surgery Podcast, click here to check it out.

Obstacle, photograph © FredericRivollier / flickr

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7 Responses to “10 Obstacles for People Who Need Bariatric Surgery”

  1. January 29, 2015 at 6:57 pm, Desiree said:

    There are obstacles after the surgery. The year before is very intense with classes and meetings. But afterwards you are dumped. I have had to figure out things on my own. I had to learn what worked and what didn’t. It took about two months to figure out to how deal with constipation. I am 4 months out and have been going it alone, not losing weight as fast as I think I should. Thankful to be where I am but I want so much more. I am discouraged and wonder if this is really going to work. Have I stretched my pouch? Is there permanent damage from the vomiting? When I stuff protein I don’t lose, but when I add in more calories I do. Feeling pretty alone on the journey.

    • January 30, 2015 at 4:28 am, Ted said:

      Desiree, thanks for taking time to share your experiences. I have heard from others who have the same feeling of being alone. No doubt, you’re probably aware of some of the social networks and support groups online that might help with some of what you’re experiencing. Shelly Vicari (http://theworldaccordingtoeggface.blogspot.com/) has an excellent blog and is an amazing friend on Facebook. But there are others. Hang in there.

  2. January 30, 2015 at 9:44 am, Allen Browne said:

    Bariatric surgery is a great tool, but for the reasons noted (and others) it will always have limited application. It does need to be part of a lifeong program of support and education. And it’s successes should teach and inspire us to find more effective tools to help the people affflicted by this chronic disease. Charge on!

    • January 30, 2015 at 12:01 pm, Ted said:

      Well said, Allen.

  3. January 30, 2015 at 12:55 pm, Michelle "Shelly" Vicari said:

    Desiree, It is true. Most bariatric programs after the first year send you on your merry way only seeing you for lab work once a year. We need comprehensive bariatric programs with education before and support that continues for life. Obesity is a chronic disease and so chronic treatment is required. I may not be technically in the obese category but I will ALWAYS be a person affected by obesity. Post ops have found each other on sites like Obesityhelp.com (check out the WLS grads forum) and I invite you to attend the Your Weight Matters National Convention http://www.ywmconvention.com brought to you by the Obesity Action Coalition http://www.obesityaction.org (Ted and I are both proud members, encourage you to join that) the Convention is a great place to meet others on this lifelong journey and the education and speakers are top notch. Ted gave you my website address so please feel free to chat me up and I’ll happily link you up with the resources I am aware of. Best to you!

  4. February 03, 2015 at 6:32 pm, Reeger Cortell said:


    I am sorry you feel left alone. This hurts my heart to read and is much of the reason why I started my podcast- to extend a hand to people not only before surgery, but after surgery as well. Please reach out to get the support you need and deserve. There are people, thousands and thousands of people, who are there for you. As Shelly and Ted pointed out, there is the OAC, and Shelly’s blog and Facebook presence. There is my podcast. There is also Connie Stapleton, PhD and Cari De La Cruz of “A Post-Op and A Doc.” You can find them on Facebook too.

    Kindly, Reeger

    • February 04, 2015 at 5:47 am, Ted said:

      Reeger, thanks for joining the conversation. I recommend your podcast with my highest respect for what you offer.