For years, I’d avoided answering this question because I initially resented it.
In the beginning of starting this blog, it wasn’t common to see people losing triple digit figures in pounds without surgery, which meant many of the conversations that were sparked by people who shared my blog included the phrase, “I bet she had surgery and is just lying about it.”
I had people who saw my c-section scar and accused me of hiding a tummy tuck—a c-section scar isn’t anywhere near as large as a tummy tuck scar, which extends the entire front of the body as opposed to the c-section scar which usually is only wide enough for what is necessary to pull out the newborn—and people who were asking my old friends, sorority sisters, and family if I’d really did it on my own with no surgical intervention. It was rough—despite writing regularly about what I’d learned and was learning about how to lose the weight and keep it off, I couldn’t shake that stupid question.
But that resentment was more about me feeling hurt because it was a challenge to my integrity—I wouldn’t lie about something like that. If anything, there’s a space for someone who absolutely has had a form of weight loss surgery and is honest about it and the struggles that come with trying to maintain the weight loss permanently, because it isn’t easy. But that person was not me—short of the two c-sections I’d had, I’ve never been cut open for anything, ever.
However, when someone asked me about this in the comments on my Instagram today, I decided to finally answer. My experiences are different now, my expertise is different now, and I’ve had clients who’ve undergone some form of weight loss surgery. It’s less about me now, and I can see that.
Whether or not a person should get weight loss surgery is a personal decision, best made between that person and their doctor. Not me. Full stop.
Bariatric surgery itself prevents people from being able to comfortably overindulge. Some forms of the procedure remove a portion of the stomach entirely; some place a device inside the stomach to reduce the amount of space available for food, meaning you fill up faster than you otherwise would because something is already permanently inside the stomach, taking up space. Because of this, it can result in weight loss—it physically impairs your ability to overeat, makes it uncomfortable and, in some instances, painful, and therefore serves as an internal deterrent.
Post-surgery, patients may find themselves trying to eat their former favorite foods and, because of the surgery, find it uncomfortable to eat the way they used to. They can’t eat as much, and can’t eat it as quickly. When you can’t eat a high-carb food quickly, it feeds into your blood stream differently and therefore doesn’t result into the same ‘euphoric’ feeling of “ahhh” that comes from overindulgence, which also serves as a deterrent. If it doesn’t feel the same, and in fact hurts now when you try to do it, you will do it less and less.
That is the benefit to the surgery—the internal deterrent to the behavior itself.
Weight loss surgery has saved lives—there are people who for any number of reasons cannot stop the series of behaviors that cause them to keep gaining weight, and very well could potentially eat themselves into an early grave if they aren’t able to stop. Weight loss surgery, which ultimately creates barriers within your body to prevent you from being able to eat as much as you usually do in a single sitting, has prevented people from that same compulsive overeating.
And, much of the research around the post-surgery benefits of these procedures can tell you a lot about food and the effects our current food system are having on the public. Weight loss surgery patients are experiencing reduced rates of breast cancer, reduced rates of heart related diseases and events (like stroke and heart attack), successful remission of type 2 diabetes, and reduction of cancer risk.
It’s not the weight loss itself that’s doing this—it’s eating fewer calories.
And there are people who will ask, “Well, can’t I just do that on my own, by myself, without surgery?” Of course you can. But if your doctor is scared for your health, and believes you are at severe risk, what decisions will you make, then?
It’s certainly not for me to judge. However, there is cause for concern, here.
I’ve had conversations with women who, in a quest for that “euphoric” feeling of “ahh,” were running their old favorites through a blender so that they could get the food into their system quick enough to make it happen. I’ve had conversations with women who were still eating the same unhealthy meals and snacks they were eating before, just in smaller portions, wondering why they were still hungry and still eager to eat sooner than expected. And I’ve frankly spoken with primary care physicians and bariatric surgeons who’ve seen people cause damage to their stomachs because they were still overeating, so much so that their stomachs expanded or altered the surgical implementation altogether. But, because they still manage to successfully lose weight to some degree, it continues to incentivize the bad behavior—if the weight loss is still happening, even with all the cheating, there’s little incentive to change or leave the bad behaviors behind altogether.
There is a lot about weight loss surgery that tells us what the processed food industry doesn’t want us to know:
1) the food is purposely designed to encourage compulsive overeating;
2) it is engineered to give the highest rush of feel-good chemicals in our brains as quickly as possible;
3) there is little regard for amounts of fat, salt, or sugar; and
4) the most reliable way to ensure and preserve one’s health and weight is to disengage from the industry altogether.
Because of this, here’s the real truth about bariatric surgery: regardless of whether or not you have the surgery, you will want some kind of behavioral therapy. Why the attachment to compulsive eating behavior? Why the need to overindulge? What can you do instead of compulsive eating when you need to feel “better?”
Regardless of whether or not you have the surgery, you will still need to learn how to eat healthier, and—most importantly—how to leave the attachment to the unhealthy foods behind. You’ll need to ask yourself why this food, why do I want this food right now, what do I feel when I eat this food, and am I relying on this food to give me something I struggle with getting in a healthier fashion?
To me, there is a reason to not get the surgery, and that’s this: an inability to eat also means an inability to fuel oneself sufficiently for exercise. One of the most frustrating things for me, as a trainer, is having to strategize for a client who wants to lift but can’t eat in a way that ensures recovery. If you need protein, and protein is one of the most filling things you can eat, it’s going to be hard for someone who has undergone surgery to eat enough of it, even if you resorted to protein powders.
I know that’s a “so what!?” to some people who don’t really want to work out at all, but that’s another thing—you’re going to want to work out, because the very thing that is protective against weight gain isn’t the surgery itself—it’s muscle. Never mind the potential for hair loss. (Pardon my vanity.)
With bariatric surgery, your metabolism drops substantially because of the rapid weight loss, and the only healthy way to rebuild and increase it is muscle development. That is extremely difficult post-surgery.
It’s not my place to say whether or not I think it’s “worth it,” because that’s a value judgment that a person has to make on their own with the information they get from their own doctor. I’m not putting my finger on the scale either way. Nor do I think people should allow the blogosphere and social media sway them in either direction—I’m watching people who I believe have had bariatric surgery lie through their teeth claiming they’ve lost triple digit amounts through a trendy diet instead of going under the knife; I’m looking at people selling waist trainers who’ve very obviously undergone liposuction; and I’m seeing people who are claiming that their bariatric surgery was life-saving, but are ‘selling’ it through the lens of “look at all the unhealthy shit I can eat and still lose!”
Before I go, I have one last point: we’ve gotta stop snarking about weight loss surgery as some kind of “cheat code” or as the “easy way out.” We have to ask ourselves, “easy way out… of what?” A food system that profits off of our overconsumption, with no care for how much damage it causes? A country that makes health care inaccessible in virtually every meaningful way it can? A society where the overwhelming majority of its citizens are overweight yet still can’t be bothered to stop shaming people for being overweight? We need to focus our anger in the right direction: it’s not the people who are using whatever means necessary to stay alive, it’s the people in power who make it so hard for us to do so.
As I said, I’m not putting my finger on the scale either way. I don’t have the authority or the right to make a judgment, but here’s what I do know: whatever you decide, you will have to do the work, and we here in the #bgg2wlarmy will be here to support you through it.