I’m not sure which is grabbier news: That New Jersey Governor Chris Christie underwent weight-loss surgery in February or that he felt compelled to keep the operation secret until The New York Post was about to publish a story about it.
I asked Dr. Daniel B. Jones, director of the Weight Loss Surgery Center at Beth Israel Deaconess Medical Center and a Harvard professor of Surgery, for his perspective. He began by emphasizing that all patients are entitled to privacy about their health care, including a governor. He went on:
That said, it is not uncommon for patients, when they have weight loss surgery, to say, ‘I don’t want anyone to know about this.’ We try to get patients over that hump as part of the pre-operative evaluation.
As physicians, we really want patients to identify: Who’s your support group? Who’s your champion? If your spouse doesn’t know what you’re doing, they’ll bring junk food into the house; if family members don’t know, they may think you’re not eating enough. So we really want some core people to know what’s going on. That said, most people do have a core group but don’t want other people to know.
We don’t know the reason but we think there’s still sort of a stigma to having weight-loss surgery. So even though we’re doing 150,000 weight-loss operations a year [in the United States], there’s the idea that if you have a weight-loss operation you’re somehow ‘taking the easy way out.’ You’re kind of ‘cheating.’ You’re just not tough enough to do the diet and exercise required for weight loss. You’re somehow ‘weak,’ right?
We even see this with gastric bypass patients who, six months after surgery, when they’ve lost 100 pounds and they’re healthier and more mobile, they still ask themselves, ‘Should I have done this without an operation?’
So this is sort of normal. In fact, I had a nurse — this was a real clandestine operation. She came in with a separate name, only a bare-minimum number of people got to know who it was. It was done in complete secrecy, but three to four months later, after her lap band was working, the whole hospital knew she’d had it. So what happens is, you reach a point of ‘Everyone can know.’
The other part of it is a concern that you might fail. And the pressure’s kind of high. So once you’re winning, everyone likes to share success. Not everyone knows whether they’re going to achieve it. You have to remember, everyone who’s had a weight loss operation has, by definition, already been on multiple diets — that’s a requirement for any operation in an accredited bariatric program. It’s very common for people to have lost 15 or 50 or 100 pounds, and for one reason or another they’ve gained back even more. It has to do with our physiology. It’s not about willpower.
The body has a set point and whether you like it nor not, your body hovers there. So if you diet in the traditional sense and knock the weight down, your body thinks you’re somehow starving it. And the first chance it gets, it fires off chemicals that not only push you back to where you started, it sets your new set point higher. We call this yo-yo-ing.
Whether it’s the band or the sleeve or the bypass, [weight-loss operations] do things that make it possible for people to get the weight off and keep it off. Continue reading