Say you’re a bariatric surgeon. You’d think Americans would be beating a path to your door. After all, this is the land of Instant Gratification! Who wants to just eat less for the better part of a year to lose 50 lbs when one can be cut open and have one’s gastrointestinal anatomy rearranged — resulting in the necessity of eating less, but why quibble — to lose that same 50 lbs (or more)? Changing lifestyles is boring; surgery is exciting!
Funny how it turns out that in order for the surgery to succeed long-term, patients have to commit to lifestyle changes anyway. In fact, before any reputable bariatric surgeon will operate, patients have to demonstrate their dietary commitment by actually losing some weight on their own, prior to surgery. What I don’t understand is why people then go ahead with the damn surgery anyway? Logically, it’s almost like you have to prove you don’t need it before you can have it. Hey, I’ve never said I understand people.
Perhaps overcoming this paradox is the explanation for the behavior of a certain bariatric surgeon, brought to my attention by a mutual patient.
Before scheduling the procedure, the patient must undergo an exhaustive medical workup: sleep study, cardiac stress testing, gall bladder ultrasound, upper (and sometimes lower) endoscopy, and blood testing, not to mention Pulmonary, GI, Cardiac, and psychological consultations. Once you get through with them, you can be pretty sure that you’re in damn good shape. All you need to do is lose some weight.
My patient’s workup was complete. She was all set to schedule the surgery. Unfortunately, she’d gained a few pounds between appointments. The doctor came into the room and began to speak.
“You’ve got to quit eating those potato chips by the bag! What do you do, make a whole pot of mashed potatoes and eat them with a wooden spoon? Hey, I’m a big guy; I can get away with it. But you’ve got to cut down.”
Epic WTF, thought my patient.
Usually a fairly calm, collected personage, she was so shocked, she could hardly believe her ears. Her psyche heard it loud and clear, though. She was so upset and discouraged, she told me, that although she never eats while she cooks, she went home and proceeded to consume half the food she was preparing for a large family dinner. She eventually calmed down (I like to think telling me about the encounter was helpful) and consulted me on the advisability of going through with the surgery.
“Excuse me,” I said to her. “Why on earth would you allow someone who talks to you like that to cut you open?”
No procedure was scheduled. Interestingly, she has continued to come to me monthly, demonstrating a steady 4-5 lb weight loss each visit.
Still, I was struck by the man’s brilliance: humiliate your patients into morbid obesity. A unique marketing strategy, to say the least.
*This blog post was originally published at Musings of a Dinosaur*