Reeger Cortell has been puzzling over the reasons that many people do not seek out surgical treatment for severe obesity, even though they could benefit. Roughly 70% of people with severe obesity say they would not even consider surgery. As a Nurse Practitioner, Cortell cares for people seeking bariatric surgery and produces the outstanding Weight Loss Surgery Podcast in her spare time. So she reached out to the people who follow her to do a survey of the obstacles.

She came up with ten. We share them with you as she so generously shared them with us.

1. Financial. Health plans put a financial wall around bariatric surgery with exclusions, limitations, and out-of-pocket costs. On top of that, there’s the cost of missing work during recovery. Contrary to the bigoted stereotypes out there, people with obesity tend to be a hard working tribe.
   
2. Fear. Despite a good safety record, the prospect of surgery evokes an outsized fear of complications, including death. Equally daunting is the fear of failure and weight regain, both of which would be humiliating. Other fears, not to be dismissed, are the fear of change and the loss of food as a source of comfort and coping.
   
3. Independence & Self Reliance. People have it drummed into them that worthy people can lose weight on their own. They shouldn’t need surgery. It’s a powerful lie.
   
4. Negative Press. Popular media is full of stories like the People magazine annual edition of “100-pound Losers Without Surgery or Gimmicks!” The suggestion is that outliers are the norm.
   
5. General Negativity. Surgery is consistently portrayed as cheating or the “easy way out” for character flaws and lacking willpower. A recent study found significant job discrimination against people who had success with weight loss surgery. It demonstrates how pervasive the negativity is.
   
6. Families and Friends. Surprisingly, being shamed by family and friends for seeking surgery is all too common. The impact is devastating.
   
7. Internal Locus of Shame. “I was too ashamed to ask for help.”
   
8. Lacking Knowledge about Surgery. Let’s be frank. The process can be overwhelming to prepare for surgery. “I had no idea where to start so I never did. Way too many hoops to jump through.”
   
9. Lacking Knowledge of One’s Own Obesity. People don’t seek solutions for a problem they don’t fully recognize.
   
10. Resistance from PCPs. “I asked my doctor and he refused to refer me.”

Cortell summarizes by saying, “Bariatric surgery has a terrible brand image.”

Deserved or not, such an image problem is no small task to fix. It requires a thoughtful, long-term strategy. It requires innovation in the delivery of care. It requires commitment.

If you haven’t yet discovered Cortell’s Weight Loss Surgery Podcast, click here to check it out.

This is a repost from an awesome blog I read on a daily basis. See more at: http://conscienhealth.org/2015/01/10-obstacles-for-people-who-need-bariatric-surgery/#sthash.SAHIDMsU.dpuf

I think number three is a biggie and number 5 strongly correlates. Just show some willpower, just move more, just cut out the sugar or cheese or alcohol or whatever. Ugh.

That said, I see a difference from when I was banded in 2008 to my revision this month. Whether its due to the AMA classification of obesity as a disease or the recognition by the medical community that for many people the only route to long term success is surgery or the numbers of people undergoing surgery and seeing success or insurance realizing lower expenses from healthier people following WLS, I think there's been a perceptual change.

It was 2,3,5 & 6 for me Lol. I have overcome, Feb. 17th is "the" Day.

I think numbers 2, 3, and 5 are really prominent~~ in my experience. First off, back in 2007 when I started this journey, I was ignorant of the importance of surgery in saving my life. I didn't quite accept, at that time, that I couldn't do it on my own. Then years passed by and I failed time and time again.

Secondly, the fear of surgery was very big and real in me. I was afraid I'd die, have horrid complications, live with perpetual nausea, lose my hair, etcetera. I was more afraid, however, in my sick thinking, to lose my hair than to lose my LIFE. Craziness!! In reality, either none of my fears materialized or they were really so insignificant and made no real impact on my life.

Now that I was sleeved in late 2014, and am on this trip at last, I find a lot of negativity and skepticism and CRITICISM. Don't get me wrong, there are many people I have found who are supportive to the max, including my family and friends. But generally, in society at large, there is so much negativity about surgery. I think it is born of ignorance and stigma/prejudice. "Fatism" is possibly the last widely accepted social prejudice. I also get rude comments from acquaintances I see on a regular basis.

So I believe as time passes, all this stuff surrounding surgery will dissipate to a lesser degree~~ at least I hope so. All I can do about it personally is live my life openly and honestly and help educate others on a one-on-one basis.

Thanks for the article, Alex!

Once 1 was taken care of, number 2 became my strongest obstacle. I have to put everything down on my faith to get through it. My parents were very supportive. My husband was scared because of lack of knowledge but got on board eventually and my journey started.