Tag Archives: weight loss surgery

Killer Fat: A Review

Lynne Murray says:

I love the cover of Killer Fat: Media, Medicine and Morals in the American “Obesity Epidemic” because it graphically illustrates the current perception of fatness and fat people as Monsters That Threaten Life As We Know It.

book cover: people running scared down a city street

More in a moment on the cover, how it happened and how it reflects some of the issues in the book. Meanwhile, I just love how it reflects the widespread belief that Evil Fat Cells are going to sneak down in the night and strangle their victims, no doubt with a hideous laugh.

Boero begins with a distressing quote from a weight bigot wearing the cloak of scientific authority without actually bothering to take real science into account, U.S. Surgeon General Richard H. Carmona, who states: “Obesity is the terror within… [It] is eroding our society.”

Media and diet industry scaremongers trumpet the idea of fat as unhealthy in itself. Indeed, as Ragen Chastain at Dances with Fat reports:

[In 2012], the American Medical Association charged its Council on Science and Public Health with studying whether or not obesity should be considered a disease. Today they ignored that council’s recommendation … [and] the AMA declared body size … to be a disease. No actual health measurements necessary, just a quick ratio of your weight and your height and they’ve got you diagnosed.

Most of the people Boero interviewed about diets, and even gastric bypass surgery, simply wanted to be allowed to rejoin the human race and stop being seen as hopeless failures. As one woman said, she wanted “to blend in, to be one of the crowd, you know?”

Boero attended Weight Watchers and Overeaters Anonymous and interviewed participants in each group. She also attended informational seminars on bariatric surgery, One woman admitted that she had no health problems at all when she had the surgery, though she confidently expected them based on no evidence but the commonly accepted prejudice. “[A]t the rate I was going it was just a matter of time before I had high blood pressure, diabetes, and all that good stuff.”

As Boero says:

Although it may seem odd to do major intestinal surgery on healthy fat people, it is the risk assumed to be inherent in obesity that becomes the justification for such surgeries. It is taken for granted by surgeons and patients alike that though obese persons may not have any obesity-related health problems at the time of surgery, it is a virtual certainty that without the surgery they would develop them.

Doctors pushing weight-loss surgery on healthy patients now invent “future” health categories such as “pre-arthritic” and “pre-hypertensive” in order to help them qualify for surgery.

For most of the people I talked to … a more elusive desire to be normal matched or outmatched all other reasons for having weight loss surgery.” Boero says. She notes that marketers of weight surgery openly play on the discrimination faced by fat people. One brochure captions diagrams of the surgical procedures with the words: “Patients no longer face the social stigma or the many indignities attached to obesity.”

In a chapter on post-surgery experiences, Boero touches on how the culture’s exclusion of fat women from being perceived as objects of sexual desire (while simultaneously situating us as sexually insatiable, easily seduced and manipulated) makes it easier to market gastric bypass surgery .

Unsurprisingly, when weight loss surgery goes wrong, the patient is inevitably blamed (when it “succeeds,” the medical team gets the credit). As one woman put it, “No one seems to want to talk to you when you are a WLS failure. They only want to hear the good things.”

The most heartbreaking moment in the book for me was what Boero calls, “the single most telling statement I heard throughout my research.” A weight-loss surgery survivor told a convention audience, “my surgery didn’t fail me. I failed my surgery.”

In suggesting that she could “fail” a surgical procedure, this woman gets to the heart of the individualizing and normative nature of disciplinary power. …

Though surgeons and weight-loss surgery advocates cite well-known statistics on the high failure rate of traditional diets as a justification for weight-loss surgery, when patients are two or more years post-op and their bodies have adjusted to the caloric restriction inherent in most weight-loss surgeries, it is exactly such traditional dieting that is required to maintain weight lost through surgery.

Many post-op WLS patients re join Weight Watchers or resort to prescription diet pills, anorexia and bulimia in an effort to maintain weight loss. Where oh where is the tidal wave of malpractice suits?

Boero’s publication experience with Rutgers University Press was a refreshing contrast. She said that she refused to accept any of the suggested conventional images.

I went back to my editor and told him I was out of ideas but I knew that I DID NOT want food, headless fat people, tape measures, scales, utensils, etc. on the cover in any way. He went to the Rutgers art department and they found the stock image the current cover is based on and with a little editing (I believe there was a spaceship in the original image) they arrived at what you see.

Applause for Boero and her editor at Rutgers University Press for digging deeper into central cultural metaphor the book explores–how deeply certain myths have turned fat and fat people into monsters onto which every evil can be projected.

Another Black Mark for Weight-Loss Surgery

Debbie says:

Earlier this week, the San Francisco Chronicle ran a story about how people who’ve had weight-loss surgery (or “bariatric” surgery) are much more likely to show up in the hospital with acute liver failure due to acetaminophin poisoning. Acetaminophin, more commonly known as Tylenol in the U.S. and as paracetamol in Europe, is an extremely common drug–it’s also found in “more than 200 prescription and over-the-counter medications, including narcotics Vicodin and Percocet along with NyQuil and Sudafed,” in the U.S. at least.

Although the study was very small, the number of liver-compromised people was 17 times what you would expect–one percent of the U.S. population (not a small number) has had weight-loss surgery, and seventeen percent of the people in this tiny study were in that group.

A different report of the same study, with different numbers but the same conclusions, is here. This write-up suggests twice as many patients (still a tiny sample) and also (in direct contradiction to the Chronicle article) says that several kinds of weight-loss surgery are tentatively implicated, including not only stomach stapling but also Roux-en-Y and duodenal switch. The difference in how the study is reported just tells you how useful mainstream news is when reporting science.

If you have had weight-loss surgery, be careful !

The most common link to “bariatric” and “acetaminophen” is about how wonderful acetaminophen is for post-weight-loss-surgery patients, so if you’re planning WLS, please warn your doctor. Because this is a small study, and because no one can follow all the studies out there, you could be hugely overexposed to danger if you don’t advocate for yourself.

Third, notice the “faith sentence” in the Chronicle article. “Obesity is such an important public health problem, and bariatric surgery is highly effective.” In fact, this may not be so true.

If there are significant hidden cases of WLS-related deaths by acetaminophen-fueled liver failure, the numbers may be worse than we know.