Obesity Surgery: Stories of Altered Lives

281 Pages·2008·12.74 MB·English

by  Marta Meana

health

meana
Using these interviews as a foundation, From Obesity Surgery
and
the authors summarize the typical path that ricciardi
most post-surgery patients follow. They also quincy: When I was heavy, if I was to say something to you that hurt your
present a step-by-step program that will help feelings, it wouldn’t bother me —— it really wouldn’t. Now it would bother
Obesity
individuals considering surgery or who have me because I want you to like me. Before it didn’t really matter because I
already had it anticipate and manage the figured 99 percent of the time you wouldn’t like me anyway because I was a
O
besity is a major national health
many changes that lie ahead of them. big person.
problem, and science has been
Obesity Surgery is for people deliberat-
surgery developing a number of ways to address it.
ing about whether or not to have weight-loss maggie: You go into the surgery thinking that once you lose the weight
O
The most revolutionary is surgical interven-
surgery and will prepare patients—— along things will get better. The bad will disappear. You’ll be able to handle life
tion to alter the gastrointestinal system so
with their health-care professionals, families, differently, and everyone will accept you, and things will be glorious. And b
and friends—— for the plethora of psychologi- what you don’t realize at the time is that it changes some of the people e that less food/nutrients can be consumed
s and/or absorbed. People who undergo this
cal changes and social challenges that follow around you, but it changes you more greatly than anyone else. i
t surgery usually experience drastic weight
the surgery. It also offers the general public
y
loss and dramatic health improvements.
an insider’s perspective on the emotional, helena: My boyfriend started going through an identity crisis of his own

s They also discover a new sense of self and
physical, and social problems that often ac- when I lost the weight. He had real difficulty with my gaining self-esteem
u stories face challenges often unimaginable when
company severe obesity. and becoming more outgoing. So he started seeing someone else, and
r
they were obese.
when I found out I broke off with him. He said, “To be honest with you, I g
of altered
Obesity Surgery is based on interviews
marta meana is an associate professor of liked you better when you had no self-esteem and were heavy because I e
psychology at the University of Nevada, Las could control you. Now I can’t.” r with thirty-three gastric-bypass patients
lives
y reflecting on life before and after surgery.
Vegas, with expertise in women’s health and
Their accounts vividly describe the frustra-
sexuality. She has published and lectured candace: When you’re morbidly obese, it doesn’t matter if you have a
tions of limited mobility and energy, as well
extensively on issues related to the health of master’s or a doctorate or whatever. I had a degree, and it didn’t matter at
as the sometimes heartbreaking isolation
women. work. They looked at what was on the outside. Now that I’m losing weight I
the seriously overweight endure in a society
think my coworkers are getting threatened. They are used to seeing me at
that views excess poundage as a character
lindsey ricciardi received her Ph.D. 500 pounds and lifeless. Now I have to catch myself at work and keep my
flaw. The changes these patients encoun-
in clinical psychology from the University cool because I’m much more confrontational. I think they feel threatened

tered as their weight dropped were some-
of Nevada, Las Vegas. She is director of be- because I have goals now; before I didn’t have goals. I didn’t compete with
times exhilarating, sometimes bewildering.
havioral health services at Creative Health any of them. They have been really nasty.
They had to deal with varied reactions of
Solutions, an interdisciplinary weight-
family members and associates, complica-
management program in Las Vegas.
tions of romance and dating, and a new self-

image, and they had to confront the factors
marta meana, ph.d. that made them obese in the first place,
university of nevada press

all the while following a severely restricted
and
diet. And they often had to learn that some
lindsey ricciardi, ph.d.
of the problems they had attributed to
their obesity were still there after they lost
nevada weight.
jacket illustration: © photodisc, 2007
Colors: 4 color process C M Y K
green 80 0 75 0
Trim Size: 6 x 9 inches
gold 0 11 70 6
Panel width: 6-1/8 inches
red 15 100 100 0
Spine width: 7/8 inch
light green 22 0 35 0
Panel depth: ` 9-1/4 inches
blue 100 5 0 7
Obesity Surgery
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University of Nevada Press
Reno & Las Vegas
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Marta Meana Ph.D. and Lindsey Ricciardi Ph.D.
Surgery
Stories of Altered Lives
Obesity
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University of Nevada Press, Reno, Nevada 89557 usa
Copyright © 2008 by University of Nevada Press
All rights reserved
Manufactured in the United States of America
Design by Louise OFarrell
Library of Congress Cataloging-in-Publication Data
Meana, Marta, 1957–
Obesity surgery : stories of altered lives / Marta Meana and
Lindsey Ricciardi.
p. ; cm.
Includes bibliographical references and index.
isbn 978-0-87417-739-8 (hardcover : alk. paper)
isbn 978-0-87417-740-4 (pbk. : alk. paper)
1. Obesity—Surgery—Patients—Interviews. I. Ricciardi,
Lindsey, 1976– II. Title.
[dnlm: 1. Bariatric Surgery—psychology—Interview.
2. Obesity, Morbid—psychology—Interview. 3. Obesity,
Morbid—surgery—Interview. 4. Weight Loss—Interview.
wd 210 m483o 2008]
rd540.m432 2008
617.4'3—dc22 2007048452
The paper used in this book is a recycled stock made from
30 percent post–consumer waste materials and meets the
requirements of American National Standard for Information
Sciences—Permanence of Paper for Printed Library Materials,
ansi/niso z39.48-1992 (r2002). Binding materials were
selected for strength and durability.
First Printing
17 16 15 14 13 12 11 10 09 08 5 4 3 2 1
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This book is dedicated to the gracious women
and men in these pages who gave so generously
of their life, time, and stories so that others
could benefit from their experience.
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Contents
Preface ix
Introduction 1
part i GettinG there FrOm here
chapter 1 taking the Leap: Deciding on Surgery  11
Resisting the Last Resort 15
The Turning Points 26
The Unexpected Revolution of Losing Weight 51
chapter 2 responding to the Kindness of Strangers:
now You Don’t See me, now You Do  54
Suddenly Waiters Are Smiling 57
Workplace Changes 63
Receding Weight—Romantic Advances 72
Attention Is a Good Thing . . . Right? 83
chapter 3 Changing the Dynamics in Your inner Circle:
Your Change Becomes everybody else’s  88
Loving the Loss or Losing the Love? 91
Is Looking Sexy Being Sexy? 104
From the Mouths of Babes 109
Rocking the Friendship Boat 114
Shaking Up the Family 125
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chapter 4 Deconstructing the Self:
Who Was i and Who Am i Becoming?  131
How Could I Have Let Myself Get to This? 134
Who Might I Have Become? 139
Is It Them or Is It Me? 144
Will My Brain Ever Catch Up? 148
chapter 5 Facing the music of Self:
When Weight is no Longer the reason  159
What Made Me Fat in the First Place? 160
Losing the Armor of Fat 166
Owning What’s Yours 176
Is There a User’s Manual to the New Me? 180
Losing the Pounds and Finding Your Self 184
part ii mAppinG the JOurneY
chapter 6 Greater than the Weight of Our parts:
making Sense of it All  193
Getting From Before to After 195
Born Again? 203
Tension in Change 204
What Is Success? 207
chapter 7 through thick and thin: planning for Success  212
Presurgical Module 215
Postsurgical Module 226
Concluding note: neither Weight nor Weight Loss  233
Selected Resources for Public and Health Professionals 235
Notes 241
Bibliography 255
Index 263
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preface
This book has no agenda other than to provide the reader with a collective
account of life before and after obesity surgery from the perspective of a
group of individuals who are likely to be representative of many people opt-
ing for this surgery. This is neither a pro- nor an anti–obesity surgery book. It
aims simply, or perhaps complicatedly, to explore how this procedure can af-
fect lives. As a matter of fact, every one of the individuals we interviewed, re-
gardless of all manner of postsurgical dilemmas, told us they would have the
surgery all over again in a heartbeat. But almost all of the people we inter-
viewed also said that they were completely unprepared and flabbergasted at
the psychological and social upheaval of losing that much weight so quickly.
This was true even when the changes were long wished for. That is the focus
of this book. We simply wanted to know what happens to the psychological
and social lives of people who step out of clinically severe obesity.
Part I consists of five chapters organized around the interviews we con-
ducted and the stories our interviewees told us about life before and after
the surgery. These chapters cover the motivations for surgery and then the
changes that the weight loss caused in relationships and in their self-concept.
Part II consists of two chapters: One summarizes our interviewees’ experi-
ences into a model of the postsurgical process and delineates the path that
most of their experiences appeared to follow. The last chapter presents a step-
by-step program to help individuals who are considering surgery, or who
have already had it, prepare for and cope with the changes they will experi-
ence. We hope that this account of pre- and postsurgical life and our recom-
mendations will accomplish the following:
ix
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