Bariatric surgery is a popular form of weight management that gets a lot of media attention because the weight loss is hailed as fast and permanent, particularly with Roux-en-Y gastric bypass but also with the less invasive Lap Band Surgery.  Its popularity is driven by three other factors, two of which are not so obvious: It can work when other weight loss attempts fail, it’s legitimized by celebrities who’ve had the procedure and it’s a financial boon for hospitals.  Let’s examine the latter first.

From an administrative point of view, if weight loss surgery wasn’t profitable, hospitals wouldn’t spend their marketing budgets aggressively advertising their programs.  Not long before I first started working in a surgical weight loss clinic, that hospital was the first in town to perform bariatric surgery.  Having almost no local competition, it was the most lucrative department in the hospital.  Now, ten years later, a Google search on “bariatric surgery, Boston,” turns up 286,000 results with seven hospitals in and around Boston on the first page of the search, all competing for a chance to help you change your life.  It’s estimated that in 2020, 1/3 of the US population will be overweight.  Even if only one quarter of 1% of that population wants surgery, the number of people seeking surgical weight loss will be ample reason for hospitals to invest a lot more money competing for patients.

Another reason weight loss surgery is popular is because very public people have gone very public about their surgery, lending their names and thus their endorsements.  Star power makes “ordinary” people take notice.  When celebrities like Carnie Wilson, Sharon Osbourne, Al Roker, Rosanne Barr, Big Boy, Randy Jackson, Tyra Banks and Star Jones publicize their before and after pictures, the striking difference seems easy; like overnight success.  The problem is that these pictures don’t show the time or struggle it took to get from before to after.  The pictures bypass the recovery period, making the whole process look easy.  It’s not easy.  It is serious.  Little is mentioned in the popular media about the possible risks and potential complications; gall stones, infection, and even malnutrition if meticulous attention is not paid to a follow up diet.

I am not cynical enough to think that hospitals provide bariatric surgery only because it’s a money maker.  I couldn’t have worked in a surgical weight loss clinic assessing people’s readiness for such a life altering procedure if I didn’t believe that it’s right for the right people.  Those who perform bariatric surgery and support the process through nutritional and psychological counseling are dedicated professionals who believe that they are saving lives.  For many people weight loss surgery is a life saver because obesity kills.

Nor do I believe that celebrities go public just to boost their careers because it’s not a news bulletin that most people want to broadcast.  It takes courage to come out as an obese person who needs help even when you’re famous.  To some extent we owe a big thank you to those who are willing to tell their stories.  At the same time, the celebs are the best marketing tool a hospital could ask for.

Bariatric surgery is an inviting last resort in a quick fix society but it’s not a quick fix.  The answer to weight loss that lasts is not in the surgery despite the number of hospitals that offer the procedure or the numbers of celebrities who tell their success stories and make it look like a trendy option.  The procedure can be successful — and you can still fail to maintain your weight loss.  I’ve seen this happen too many times in my clinical practice; you don’t want this to happen to you.  Eating healthy, planning meals and exercise all remain an important part of self care, even more so after bariatric surgery.  So before deciding to join the chorus of people singing the praises of surgical weight loss, it’s important to do your research on a life-altering procedure.  Get the facts.  Then ask yourself if you’ve honestly tried everything and if you’re truly willing to change your life.