Until I met Gemma* I too, thought that life would be far superior following such surgery and associated weight loss. Gemma was larger than life in all senses of the phrase. She was vivacious, had voluminous hair, was attractively made up, and could talk for Britain. That day I was pleased I had plenty of time to listen.
It was a routine pre-operative visit for an unrelated procedure and I went through my usual questions. Any medical conditions? Any previous anaesthetics or operations?
‘I’ve had a gastric band fitted’, she said.
An empty stomach is vitally important before anaesthesia, to prevent passive regurgitation and aspiration of its contents. I was considering the relevance having a stomach the size of a walnut when she continued
“It’s the worst thing I ever did you know” she paused for the first time during our consultation.
I looked up.
“What is, losing all that weight?”
“No,” she said, “Getting the gastric band put in.”
She had weighed over 20 stones a year ago and was now a mere 13 stones, thanks to her ‘band’ as she called it.
I was surprised by her statement. Many people are much happier having lost such a significant amount of weight. I assumed that everyone would be. Why ever not? My surprise must have shown.
“Oh, it was great at first” she said, “There was a definite high as weight started to come off. The numbers went down, my clothes became too big and the compliments were rolling in. I even persuaded my mum and my sister to go and have a band fitted too. But then it changed”.
“In what way?” I asked, genuinely bewildered and interested to hear.
“Well, I started to become normal.” This was clearly not a positive development for her.
“No-one stares at me in the swimming pool any more, I can now shop in high street rather than from out-sized catalogues, I can talk about diets like everyone else, yet I’m miserable”
“Oh, in what way?”
“Every way!” she exclaimed and launched into the difficulties she now had.
“I LOVE food and I can’t eat it; the band has left me with no choices. I can’t decide to have a day off the diet or decide to allow myself one chocolate bar; I physically cannot accommodate the food anymore. Socialising and even just going out is difficult. I can’t eat from a buffet, I can’t enjoy a canapé, and I can’t grab a quick sandwich if I’m out shopping at lunch time. I’m restricted to smooth, sloppy, baby like food that will fit through the band. It’s almost impossible to go out for dinner. If I see another bowl of carrot and coriander soup I will be tempted to drown myself in it! I used to be the centre of attention for all sorts of reasons but now I just blend in. I look the same as everyone else; a bit overweight and usually wearing the same party top as at least two other people in the room. I have become completely unremarkable.”
I was stunned by her revelations. I believed a gastric band to be an easy solution to a difficult problem. I believed losing weight would solve more problems than it would create. It seems in life as well as in medicine, things are never that straight forward.
It is easy to forget there are individuals behind the population guidelines. A Body Mass Index of 25 may not be the Holy Grail for the entire overweight population. Morbid obesity undoubtedly carries many great health risks, but so does chronic, deep unhappiness.
There are very few obese people whom I believe to be truly happy with their size, but I think Gemma is one of them.
*name has been changed to protect identity