I have noticed a lot of talk in the Facebook groups about WLS (weight loss surgery). Some have had it, some regret it, some are considering it, and some are vehemently against it.
I have been asked to weigh in on my feelings about WLS, so rather than answer you all individually, I thought it was important to tell you about one of my closest friends in the world… Eloise.
Her real name is not Eloise, but in my head she could totally be an Ellie. She’s really charismatic and vibrant and alive and confident. She has the ebullience of an Ellie.
Anyway, Ellie and I have been friends for close to 20 years. We got married in the same year, we had our first kids within mere weeks of each other… We are super tight. And as long as we’ve been friends, we’ve had open and frank conversations about what we have dealt with in terms of food issues, disordered eating issues and body image issues. There are differences though. I of course went through deep deep recovery for my disordered eating and even became a therapist to help others deal with it. As much as I did have severe food and body image issues, the body image issues seemed to reside mostly in my own head. Sure, I saw myself as unacceptable and my ED told me that I truly was unacceptable, and I strongly believed that the world found me unacceptable. But in recovery I came to understand that it was a cognitive distortion. A trick of ED. Ellie has the same issues, except her body image issues are not her own, they are society’s problem. So despite the fact that Ellie is a brilliant, hilarious, beautiful and super talented woman with lots of confidence, she still has to contend with society and the medical community’s collective feelings about fat women.
Back in May Ellie told me that she was considering having Gastric Bypass Surgery and wanted to know what I thought. It’s a hard question because my instinct is to say “NO NOT EVER, DON’T EVEN CONSIDER IT!” Which is basically what I said. I told her that the long term studies on bariatric surgery weren’t well documented, that the surgery is risky during, but also complications years later can be deadly, and that it was a very difficult road. I told her to first try an eating disorder program that was specifically geared for people who were considering bariatric surgery but might look into working through the specific issues first. And she said to me, “do you realize that I’ve been in therapy with an Eating Disorder specialist for years? Do you realize that my therapist has read YOUR book in the process of researching her own? do you realize that you and I have been friends for close to 20 years and you’re on the other side of recovery and I’m not? Do you realize how frustrating that is?”
I hadn’t. I hadn’t thought about how frustrating it might be for her to continue working on recovery and feel like she couldn’t get any where.
“But what about acceptance?” I asked her, “What about accepting your body size and just working on your health, your own self-care, your own inner-peace, your own self-love…”
“I can’t,” she told me, “I can’t accept this body size. You know I used to think that people paid attention to me because I was pretty and now I realize that people pay attention to me because I’m fat…”
“Umm…” I said to her, “People pay attention to you because you’re fucking awesome. You have more charisma in your pinky than most people have in a lifetime… when I’m out with you, we’re always surrounded by people and meeting new friends. That doesn’t happen to me when I’m not with you.”
“It doesn’t?” she asked.
“No, ” I told her, “Not even a bit. You know how you meet new friends wherever you go? It’s because you’re cool and people want to be near YOU… I don’t have that when I’m not with you, when I’m with you, people are literally clawing their way toward us to get close to you. You’re just… really likeable. Inherently.”
“REALLY?” she asked me,
“Yup. Totally…” I told her. “Your spirit and your soul are much bigger than your body. And, you know, more significant of course.” But even if this wasn’t the truth, even if she was unpleasant (which she’s nowhere close to), she would still be valuable and worthy as a human being.
It’s amazing the stories we can tell ourselves about ourselves. We have these mythologies, these “roadmaps” about who we are and what other people think about who we are and what we look like that we then build our self-esteem around. Our super-ego can tell us anything to agree with the stories with have in our heads about ourselves. Ellie had at one point believed that people paid attention to her for the way she looked, she then believed that people paid attention to her for, well, the way she looked. People pay a lot of attention to her because she’s fun, funny, the life of the party, compassionate, kind, calming to be around and loving. When she took that in she realized that she might not be seeing the full picture. We left it off by her saying that she would consider the acceptance piece and the Health at Every Size ideology.
Last weekend we took the boys swimming together and she told me that she’d decided to go forward with the surgery. That she talked to a surgeon, an RD and several people who had gone through the surgery. I asked her what they said, she told me that they all said the same thing, that it didn’t change their brain around food, just their ability to eat it, and it was a battle, a struggle every day, even for those 10 years or more out from it. So her idea is to schedule it for April and spend the next 8 months working on health and self-acceptance and finding other things to use as coping mechanisms and that maybe she will opt not to when the time comes, but that she likes having that option open to her.
She told me that she was afraid to tell me because she thought I might not be supportive. Here’s the thing. I believe this: Your body Your choice. And I also believe that when there are big decisions to be made, you have to get all the information and be well informed. You have to be informed of the risks, the long term side-effects, the possible outcomes either negative or positive, and told all of this in a neutral way as to not sway your opinion.
Gastric Bypass surgery is not the easy way out. It’s a hard-core surgery with side-effect that border on discomfort to death. For some people it can be a positive experience. It varies greatly. My feeling is, if you are considering it, be as informed as possible, know all your options, all the possible side effects and make your choice based on real facts rather than promises of a better life or feeling pushed into it by friends or doctors. Being fat doesn’t make you inherently unhealthy (or unworthy) and fatness is not a sickness to be cured from. If you do make the decision to do it, find your support tribe, the friends and family who will be there for you without judgment or disdain. Your body, your choice. But make your choice from a very, very, very informed and well thought through space. Take months, if not years to make the decision. This is your life and your choice. I do encourage you though to work with a therapist who specializes in EDs to help you change your brain so that you’re not stuck after surgery without your coping mechanism and feeling alone and feeling as though you need to turn to another sort of coping mechanism (such as pain pills or alcohol) which does happen as well. Gastric Bypass surgery can only treat the weight, but it can’t treat the underlying behavioral issues or the drives that create these behaviors. So working on coping mechanisms and behaviors is paramount as the surgery can often undo itself due to the disordered eating that was never addressed.
I hope that this post can explain to you more about my feelings about weight loss surgery. It’s extremely complicated and there is not a black and white answer. No one should be shamed for their choices or their desires. No one should be shamed about anything related to their bodies. But of course everyone should be informed and educated.