In a new series, we’re debunking persistent myths of weight loss surgery. Read the first three posts in our series, Weight-Loss Surgery Myths Debunked – You’ll Have Terrible Scars, Weight-Loss Surgery Myths – You’ll Probably Gain Back the Weight, and Weight-Loss Surgery Myths Debunked – You’ll Miss Out on Key Nutrients.
The idea that weight-loss surgery is some form of cheating is, frankly, strange, and no more true than having an appendectomy is cheating for appendicitis, or levodopa is cheating for Parkinson’s disease. These are just the safest, most effective, most helpful treatments for illnesses that people get. It’s that simple.
The Idea of Cheating in Weight Loss
There are a few key questions one should ask when thinking about someone’s choice of pursuing metabolic surgery, and what would constitute “cheating.”
- What is the condition being treated? In the vast majority of the cases with metabolic surgery, the condition is obesity or type 2 diabetes, both of which shorten life expectancy and increase risks from everything including car accidents to cancer to covid.
- What is the best and safest treatment of the condition? Surgery is hands-down the best treatment, according to a mountain of randomized controlled trials and huge population studies. Guidelines from skeptical medical societies, like the American Heart Association and American Diabetes Association, say so too.
- Is there an alternative treatment, perhaps one that would not be considered cheating? Sadly, the answer here is a resounding nope. This is the most confounding because people would believe there is. Something honorable like a doctor-prescribed diet, exercise, and counseling program. But if one takes a fair reading of the published evidence since the obesity epidemic began, the well-funded, well-intentioned programs are failures.
Regrettably, we have been led to believe that weight gain and obesity, unprecedented in the last 5,000 years, is our fault because we make bad food choices and are lazier than other humans. This is 100% nonsense. The obesity epidemic is caused by chemical and biological changes in our environment and food supply that hijack our genetic machinery and make us fat. Blaming fat people is not just horribly wrong, it’s also a massive disservice and wastes time in the effort to combat the disease. I have met far too many wonderful people who have exercised like demons and kept meticulous food journals for years with no success, believing that surgery was only for those who did not have the commitment and diligence to “do it the natural way.” The underlying myth is that it is our fault and therefore in our control to reverse it. It is not. Obesity, metabolism, and the body weight set point are almost completely biochemically pre-determined, and you cannot change it despite what Jenny Craig tells you. (Or else, why do none of the commercial weight-loss centers publish any credible data on the outcomes?)
Once a person has gained 50 to 100 extra pounds, the only way to change the body weight set point and metabolism—and to create long term weight loss—is to change the hormonal profile, change our biochemistry. For now, that means changing the tissues themselves with surgery.
Finally, consider one more question. If your cherished son or daughter, brother or sister, partner or best friend suffers with obesity or type 2 diabetes, do you not want the safest, best treatment for them? Of course you do! Treatments that worked 75 years ago, before the widespread presence of genetically modified everything, widespread agricultural antibiotic use, ubiquitous obesogenic pharmaceuticals, and designer carbohydrate-laden foods, do not work today. Giant well-funded, well-intentioned programs like the LOOK AHEAD Clinical trial and even The Biggest Loser do not work. Everyone remains obese within two years and gains back all the weight even sooner. Meanwhile, metabolic surgery, a 45-minute procedure that is safer than an appendectomy, keeps saving lives and putting up astounding 25-year outcomes data that it improves health and extends longevity, producing long term weight loss and remission of diabetes.
Choosing the best, safest path for my loved one is not cheating. It’s being informed.