Laparoscopic Surgery

Bariatric Surgery: Essential, Underutilized, or Both?

Somehow we find ourselves now in a puzzling situation with bariatric surgery. On one hand, we have Jane Brody, an icon of healthy nutrition for a healthy weight, telling us that bariatric surgery is underutilized. On the other, we’re hearing that demand for bariatric surgery is robust – despite or perhaps because of COVID-19. So is bariatric surgery today underutilized or essential? Or are we at an odd tipping point where both descriptions are true?

Brody Speaks

Brody has lived through many definitions of healthy nutrition. She began writing on medicine and biology in 1965 for the New York Times. Her Personal Health column had its debut in 1976. For many people, she codified the definition of a healthy low-fat diet. But her core focus was always moderation and health. Her husband helped with typing (before computers) her iconic 1981 best seller. He changed his dietary habits as a result and lost 26 pounds.

Jane Body’s Nutrition Book carried a telling subtitle – A Lifetime Guide to Good Eating for Better Health and Weight Control. Now, 40 years later, she is finally telling us more:

“Growing rates of obesity among Americans are clear evidence that even the best intentions and strongest motivations are often not enough to help seriously overweight people lose a significant amount of weight and, more important, keep it off.

“But for those who can overcome fears of surgery and perhaps do battle with recalcitrant insurers, there remains another very successful option that experts say is currently vastly underused. That option is bariatric surgery, an approach that is now simpler, safer and more effective than in its early days in the 1990s.”

The reality of pandemic obesity has finally overtaken the conviction that all we need is healthy eating.

The Odd Dynamics of a Pandemic

Meanwhile, people seem to be figuring out that they need to seek help for obesity during the COVID-19 pandemic. The idea that bariatric surgery might be an especially important option now seems to be taking hold. Ali Aminian is Director of the Cleveland Clinic’s Metabolic and Bariatric Institute. He tells the Wall Street Journal:

“We’ve had patients who wanted to come and take care of their obesity, to be healthier, and when we ask them, why did you come now? It’s because they’ve heard this message that it’s a risk factor for Covid infection.”

John Morton is Medical Director for Bariatric Surgery in the Yale New Haven Health System. He tells the WSJ that bariatric surgery seems to be “COVID-proof.” Yale and other centers are seeing a surge in demand.

We’ve known for years now that bariatric surgery can be both life changing and life saving. But obesity is a slow-burning threat to health. Perhaps the immediate threat of COVID-19 will finally prompt people to take it seriously now.

Click here for Brody’s reporting and here for more from the WSJ.

Laparoscopic Surgery, U.S. Navy photograph by Jesse Ehrenfeld / Wikimedia Commons

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September 30, 2020

One Response to “Bariatric Surgery: Essential, Underutilized, or Both?”

  1. September 30, 2020 at 12:03 pm, Carol Clarke said:

    Did you see this study published Sept 23? Risk Factors for Hospitalization, Mechanical Ventilation, or Death Among 10 131 US Veterans With SARS-CoV-2 Infection.JAMA Netw Open. 2020;3(9):e2022310. Findings: In this national cohort study of 88 747 veterans tested for SARS-CoV-2, hospitalization, mechanical ventilation, and mortality were significantly higher in patients with positive SARS-CoV-2 test results than among those with negative test results. Significant risk factors for mortality included older age, high regional coronavirus disease 2019 burden, higher Charlson Comorbidity Index score, fever, dyspnea, and abnormal results in many routine laboratory tests; however, obesity, Black race, Hispanic ethnicity, chronic obstructive pulmonary disease, hypertension, and smoking were not associated with mortality.