Morbid Obesity is a DISEASE. It has been recognized as a disease since 1985(!!!!) by the National Institutes of Health (NIH).

This is going to be a long rant… I mean, post.

The longer I thought about doctors who make a patient lose weight before weightloss surgery as “proof” of their commitment to a healthier lifestyle, the angrier I got. I am FURIOUS. I am INCENSED. These surgeons are making their livings “treating” obesity, and THEY DON’T EVEN KNOW ENOUGH ABOUT OBESITY TO CALL IT A DISEASE. THEY DON’T KNOW ENOUGH ABOUT OBESITY TO REALIZE THAT IN 1991, THE NIH CONCLUDED IN ITS CONSENSUS CONFERENCE THAT DIETS, EXERCISE PROGRAMS, APPETITE SUPPRESSANTS AND BEHAVIOR MODIFCATIONS ARE NOT EFFECTIVE THERAPIES. YES, I am YELLING.

Because if they DID, they would NEVER tell a patient who desperately needed their help that they must lose weight FIRST – to PROVE they are serious about getting better!!!!

And to have this kind of attitude propagated on a weightloss SUPPORT board as acceptable under ANY kind of circumstances is absolutely reprehensible, and a symptom of just how well the prejudice against fat people is accepted. Not only is it tolerated, it is expected as our “just” punishment for being fat. Because after all, we are merely gluttons. The formula is so simple: too many calories in = too much fat. So diet and exercise. Too bad for you that you’re not one of the “normal” people who can regularly consume more calories than they need without getting fat – you are NOT a “normal” person, so you must just go hungry and exercise your butt off.

Guess what? The formula is NOT that simple. NO ONE really knows the complete explanation of why some people become MO and some people don’t. But not understanding “why” is NO excuse for discriminating against the MO, or continuing to blame the patient for their disease.

If a person could not swim, would it be acceptable for the lifeguard to say, “I could save you, but FIRST you must swim 20 feet to PROVE that you really want to be saved.”? Or better yet, “You can’t swim, so you should never have come into the Water in the first place. Why should I bother saving you? This is your fault.”

Except in the extreme cases of denying organ transplants to smokers and alcoholics, I have NEVER heard of denying treatment until the patient starts to get better on their own as an acceptable medical response. (I’m not saying I agree with the transplant thing, just that I have heard that a smoker who doesn’t quit wouldn’t be considered for a lung transplant, and an alcoholic that doesn’t quit wouldn’t be considered for a liver transplant. I don’t even know if that’s true – I’ve just heard it.)

Diabetics are not denied medication until they can prove they can get their blood sugar under control with a commitment to eliminating sugars from their diet and exercise.

Smokers are not denied the nicotine patch until they can prove that they can quit smoking for four weeks first.

A double-amputee is not denied their prosthetics to enable them to walk until they walk two blocks without the prosthetics, to PROVE that they really want to walk again FIRST. The prosthetics, after all, are just TOOLS – not “cures” for amputeeism.

People with high cholesterol are not denied medication until they are able to lower their cholesterol first, through diet and exercise.

If a depressed person goes to the doctor for treatment, and they meet the protocol, the doctor would NEVER say “Snap out of it first. Then I’ll give you the medication you need to maintain a non-depressed state.”

Anorexics are never told "JUST eat!!" Their condition is taken very seriously, and requires medical and psychological intervention.

I ask you all, then, WHY IS IT ACCEPTABLE TO REQUIRE A MO PERSON TO LOSE WEIGHT BEFORE TREATMENT?!?!?!? YES, we have to make lifestyle changes – but just like the amputee, we can’t do it without a TOOL. We have a DISEASE.

I feel that I have done the emotional work. I have completed a professional counseling program specifically for compulsive overeaters. I’ve been hypnotized. I’ve done every diet known to man, and some that I made up myself. How DARE ANYONE tell me that I am NOT serious about losing weight?!?!

I cried on the way into work this morning thinking about this. I am crying now. I will NOT accept punishment for this disease. I will NOT accept blame for this disease. I WILL accept the responsibility of doing something about it, however. But I cannot do it alone – because I am NOT “normal”, and I will ALWAYS need some sort of treatment to HELP me, until they find a cure. And I cannot stand by and let anyone forget that we are NOT here because of some moral failing, some character flaw, some personal weakness. We are here because we have a DISEASE. We need treatment, not judgment. If we were not serious about getting better, we would not be here.

NO ONE deserves to feel badly about themselves because they have a disease. NO ONE should be made to jump through hoops to prove they want to recover from their disease. MO is NOT A CHARACTER FLAW. This is NOT my opinion – this is medical FACT. It is up to US to know and understand this, and to eradicate the long-held beliefs that we have allowed to shame us for all of our lives. We must NEVER EVER allow anyone to get away with propagating beliefs that MO is anything but a disease that requires medical treatment.

***************

http://216.239.63.104/search?q=cache:OTJxKzuvN8QJ:www.shapeup.org/profcenter/diabesity/PoriesPres.ppt+is+morbid+obesity+a+disease%3F&hl=en

"The truth is that Morbid obesity is a disease, not a moral failing."

“Obesity is a chronic, lifelong, genetically-related, life-threatening disease with highly significant medical, psychological, social, physical, and economic co-morbidities.”

Statement on morbid obesity and its treatment. Obesity Surgery 1997 7:40-41

“In 1991, the National Institutes of Health concluded in its Consensus Conference that diets, exercise programs, appetite suppressants and behavior modifications are not effective therapies.”

Report of the Consensus Conference on Surgery of Morbid Obesity, National Institutes of Health, Washington, DC 1991

**************

http://www.rsapc1.com/morbid_obesity_surgery/

"Morbid obesity is the most common form of malnutrition in the United States and in the world today. It is considered after smoking to be the second leading preventable cause of death in the United States. It is a chronic disease which is very complex and has multiple etiologies."

"We lose over 300,000 patients a year to morbid obesity and morbid obesity related medical problems."

"There are social, psychosocial and economic consequences of morbid obesity that can be devastating. Unfortunately, the prejudice against the obese is very common in our society."

"Conservative management of morbid obesity that includes diet, behavioral modifications, exercise programs and the like have been found to be ineffective over the long term. A person who is morbidly obese who attempts conservative management, as mentioned above, either alone or in any combination, is not expected to be successful more than 5% of the time. Over 95% of patients who are morbidly obese and meet the criteria for morbid obesity will regain their weight and often overshoot their previous weight. Surgery for morbid obesity is the only method that has resulted in long-term maintenance of weight loss and the reduction of the comorbid diseases that are associated with morbid obesity. In particular, hypertension, dibetes mellitus, risks for coronary disease, osteoarthritis, gastroesophageal reflux disease and many others.

Morbid obesity is a chronic disease which is defined as a disruption of bodily function that develops slowly and persists for an extended period of time and often for life. It is multifactorial and includes genetic predisposition, environmental factors, social economic factors, cultural influences, hormonal influences and digestive abnormalities. In 1985 morbid obesity was recognized as a disease with associated comorbid diseases by the National Institute of Health. In 1991, surgical weight loss stated to be superior to nonsurgical weight loss methods and that only surgical intervention produced acceptable long-term results. In 1993 the National Institute of Health recognized the vertical banded gastroplasty and the gastric bypass procedure to be effective in significant reduction of excess body weight. The National Institute of Health recognizes morbid obesity as being an epidemic that can only be reduced significantly by surgical intervention for both morbid obesity and its associated comorbid problems."

****************

http://www.landauercosmeticsurgery.co.uk/obesity/

"OBESITY: A MEDICAL CONDITION

People who suffer from obesity are poorly misunderstood by those of the population who are not obese. There is a common attitude that overweight people are stupid and unable to control themselves. People who are obese are often the brunt of cruel jokes and thoughtless humour, even to the point of suffering abusive comments in public places.

We now know that the medical condition of morbid obesity is a complex disorder, and not simply due to over-eating. The vast majority of people living in the Western World eat more calories than they need but it is only a small proportion that relentlessly lay down every excess calorie in their fat stores. Most people have a mechanism, by which their body knows when their stores have been refilled, but there is an unfortunate group of people where this mechanism is defective, and when they eat it can be likened to filling up the bath with the overflow blocked off.

There are of course no fat people in starvation areas of the world, but this is because these are regions with chronic malnutrition and nobody there has access to even adequate calories.

People who are morbidly obese often find it difficult to believe that their problem is a medical disease and not simply due to overeating.

MORBID OBESITY IN FAMILIES

The disorder of morbid obesity often runs in families. The chance of having morbid obesity is clearly increased if other people in your family have the condition. Studies of identical twins who were separated at birth and brought up separately show that if one twin becomes obese, then the other one is likely to become obese as well."

Donali,

Oh so true!!! Great read and great info.

Amen! Amen! Amen! Thank you, Donali! Now if we could just get the rest of the world to "wise up"!

Donali - This is a wonderful post! How true everything in it is! Thank you so much for taking time to post this for us. I will be thinking about this for a long time.

Wow Donali, That is a great post thank you, it really made me think... its so ture! Thanks again for posting it

Rock on, D! I hope everyone who has been instructed to lose weight before banding has a chance to read your post. You speak eloquently for legions of angry fat people who have been made to feel weak, self-indulgent, inferior, and unworthy of respect. Thank you for kicking ass.

Absolutely girlfriend! I'll never forget turning in my food diaries and then being told... well... you eat too often and too large of quantities... DUH... so... we'll need 4 more weeks of diaries proving that you can follow a post-banding diet before we'll even make an appointment with the surgeon. Well... I jumped through all of the humiliating hoops... but I still yearn to change the process that most have to endure in order to prove themselves worthy of bariatric surgery.

Donali, this is profound and so very much appreciated. I <3 you, as always.

I'm so glad my doctors don't take the approach that we have to lose weight to "prove" we're worthy of bariatric surgery. It's indefensible, and I agree with everything you've said.

OUCH, what brought that on? (Ducking under table.) Maybe you should e-mail that to all of us so we can send it to five friends, and they can send it to five friends, and so on, and so on. Maybe one day everyone will get it.

You would think that I'd feel better after this long rant... But I am still very angry.

I find it unbelievable that treatment for the co-morbidities that are often caused by MO is provided without question: c-pap machines for sleep apnea, diabetes medication, cholesterol treatment, hyper-tension, infertility, cancer, gallbladder disease, osteoarthritis, gastro-esophageal reflux, urinary stress incontinence, lower extremity venous stasis disease, cardiovascular disease.... A doctor would NEVER withhold treatment for any of these things until a person lost a certain amount of weight - and yet, the underlying CAUSE for them all is often MO!

My Mom is not MO - she's maybe 40-50 pounds overweight. Her doc told her he wasn't going to lose any sleep over her health as long as she was fat.

I still have no way to process that statement without being angry at the end of it.

My thin PCP offered to send me to nutrition classes when I asked him about banding. He's slender - I asked him if he counted calories, or exercised regularly. He said no. I asked him if he thought he COULD count calories, go hungry, and exercise regularly. He was honest, and said no.

None of this rant is meant as an excuse to not try and live as healthy a lifestyle as possible, or to escape responsibility for the choices I make. I have a disease, and it is up to me to take care of myself the very best way that I can, to seek the treatment that I need, and to never give up. I don't expect it to be easy, or fun, or fair. But I do expect that people recognize that it ISN'T easy, fun, or fair - and that the challenges I face with the disease of MO cannot be compared to the challenges that 'normal' people face with food. Just as I cannot expect it to be easy for an alcoholic to NOT drink, just because I have no interest in alcohol. It's EASY for me to not drink - it simply doesn't interest me. It's NOT easy for an alcoholic to not drink.

If a person has no interest in food, or very little appetite, it is easy for them to not overeat. Anyone with a non-food addiction who has kicked their "habit" will tell you that quitting is 100 times easier than moderating. And we can't "quit" food.

People do learn to moderate... about 5% of them. I keep struggling to be in that 5%.

And to top it off...Why won't so many medical insurance's cover Gastric Banding? It's like preventive medicine, If loosing weight would relieve diabetes and all the other diseases you mentioned. It would save them money in the long run.

Rant on

"Anorexics are never told "JUST eat!!" Their condition is taken very seriously, and requires medical and psychological intervention." From Donali's post.

Amen. Isn't it odd, that if you don't eat, it's officially classified as an eating disorder. But if you overeat, that isn't an eating disorder, that's a lifestyle disorder. This is according to my insurance company.

Thin people don't consciously diet. Nor do they obsess about food. Ergo: If you want to be thin, you mustn't obsess over food, and you must not diet. Our food choices must flow naturally. If I gotta diet then I risked my life on the operating table for nothing, and my insurance company wasted their money.

I've got a band. It helps. I've got an addiction. I've got to battle the addiction demon. The enemy isn't food, and the answer isn't counting calories. The enemy is my own perverse spirit. The answer is to find my triggers and diffuse them, then I can eat what I want, when I want, and not over eat.

What I'm saying isn't the result of listening to thin experts telling me how not to be fat. I've been listening to my own soul. Some of the things it's telling me are hard to hear. But all of them are true, for me. Others must listen to what is true for them. I know that there is no easy way out. I know that addiction doesn't go away. I know that obsession doesn't moderate.

I don't buy that I must count calories, and diet for the rest of my life. That might get me thin, and keep me thin for a time, but until I face my own personal demons I won't stay thin. Not for life. Not with quality of life.

Once there was a man who's son was bugging him for attention. The man tore a page out of a magazine with a picture of the world on it. He then tore the world up into many pieces. He handed the pile of shreds to his son. "Here, put this puzzle together, and when you're done, we'll go outside and play"

Only five minutes had passed when the boy brought the picture of the world taped together perfectly. Every shred in place. "How'd you do that so fast, son?" He asked.

"Well, Daddy" the boy replied, "On the back of the world was the picture of a man. So I put the man together right, and the world just fell into place."

When my husband was told that he had to lose weight before the surgery, it wasn't to prove that he was serious, but so that there would be room to do the surgery. It was more about his safety and the fact that they had never opperated on someone so large.

Donali, were we thinking the same thing? It is almost like we read each other's long rants before we posted our own.

That wonderful post should be forwarded to every insurance company since they have a difficult time with the definition of obesity.

Thanks for this post Donali - it makes me feel recognised and respected, albeit, among my "own kind" - Like I have mentioned before, I have an anorexic/bullimic (sp?) sister, and I myself have been MO for about ten years yet my family railed around my sister, whispering about her, trying to get her help, advising her, worried and upset about her... whereas no one recognised MY eating disorder - I gained 100lbs in a year and people just said " Oh she can't say 'no' to herself". Until I gathered up my fragile ego and abused body and went to see my french surgeon ALL ON MY OWN, I felt guilty and greedy about being fat. When the surgeon looked at me and said softly "you are suffering", I began to realise that there was more to MO than gluttony. I came here to Lapband Talk and now, from all of you great people, feel empowered, respected and validated as a human being, recognising a problem and trying, imperfectly, to cope with it. I say the words Morbidly Obese like someone else says "Depression" or "Flu" - I'm not ashamed anymore....But like Donali, I am REALLY ANGRY at how little help and recognition there is for us....I just came back from having my first grown up fill (!!) yesterday, and found out from my doc in the UK that he has banded at least 10 other Irish women IN THE LAST YEAR - none of them want to be public with their disorder, and prefer to let the world know, they are losing weight by the time honoured, correct and dignified method of "diet and exercise".....Like I said on another post - where's our Rehab? Where can I go for 28 days to be detoxed of sugar???

We are the sufragettes for morbid obesity people, kids will be studying our posts in 2045 when they've figured it all out.....

Bright... I think that more and more people are fighting this fight... and one day they won't be able to catagorize us so easily. Somehow we all seem to believe that we deserve to be obese... and we are ashamed to tell people that we are seeking a tool to help... well I'm with ya Bright! I would sing from the rooftops about my band and about how the world looks upon people suffering from obesity!