Recently I was privileged to be a guest of Dr. Veronica Anderson on her program “Wellness for the Real World” on BlogTalkRadio. The subject was Weight Loss Surgery, something I am very familiar with, having performed these operations for the last nine years. Dr. V. had several other guests on the show, and each was an expert in various aspects of this extremely complex issue. As the one-hour conversation proceeded, it reaffirmed for me the conclusion I actually came to many years ago; successful weight loss following surgery requires a team of dedicated individuals. But most of all it requires a dedicated patient.

The reason I was asked to be on this panel was the fact that several years ago I co-authored a book on weight loss surgery with one of my patients, Linda Rohrbaugh, who was also a guest on the program. Our book is titled “Weight Loss Surgery with the Adjustable Gastric Band – Everything You Need To Know Before and After Surgery To Lose Weight Successfully.” While this is the title we agreed on after discussions with the publisher, it is not the one Linda and I used to submit the manuscript. Our preference was “Stepping Out of the Shadow of Obesity – A Comprehensive Guide to the Adjustable Gastric Band.” At least for me this said it all, and the word “surgery” was not in the title anywhere.

 Anyone who has struggled with their weight for years understands the concept of living beneath their own shadow. For these patients, their size and weight impacts virtually every aspect of their day to day lives, physically, socially, economically, emotionally and even spiritually. I have had countless patients try in vain to explain their frustration with their inability to conquer this problem despite repeated diets and countless trips to the gym. What they, and many of my medical colleagues, often fail to recognize is that obesity is a disease. But unlike virtually every other disease, this one carries a stigma of personal failure.

Whether they say it or not, many physicians blame their patients and expect them to fix the problem themselves with diet and exercise. This is despite a National Institutes of Health White Paper published 20 years ago on the growing obesity epidemic in America. The NIH conclusion was that morbidly obese patients have only a one in twenty likelihood of losing weight and keeping it off with diet and exercise alone. I don’t know of any medical or surgical treatment that would be offered to anyone if the chances of success were measured in single digit percentages, yet Americans spend more than one-hundred billion dollars annually on diets and exercise programs, and we keep getting fatter as a nation.

While weight loss surgery is not right for everyone, and there is no single procedure that is clearly superior in all cases, the fact is that when combined with a comprehensive weight management program it can be life changing for many patients. The key is getting everyone, including the entire medical team as well as immediate family members, committed to the patient’s success. This starts with making sure the patient is completely informed about everything from the preoperative diet to possible surgical complications. Surgery merely provides them with a tool that they must learn to use to change their lifestyle habits.

But from my perspective the element that is most often overlooked involves getting the patient actively involved in developing their own realistic goals and expectations, including acknowledging what they must do to achieve them. When patients are required to accept personal responsibility for this part of their program, a process of personal empowerment begins.

I tell every patient the same thing. Obesity is not your fault, BUT, it is your responsibility. In the end, only those patients who are willing to accept the responsibility to do whatever it takes to regain control of their lives and their health are likely to succeed long term. So, back to the original question, is weight loss surgery right for you? The answer depends on your willingness to actively step out of the shadow of your obesity.

Robert Sewell, M.D., F.A.C.S.