Bariatric Surgery and Obesity in America

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Obesity is a nationwide epidemic in the United States, with more than one in three adults (sixty million people) falling into the “obese” weight range, according to the Center for Disease Control. The instance of obesity has doubled in children and tripled in adults since 1980. People are not getting enough exercise and are failing to eat foods from the recommended food groups (Facts, 2000).

America, as the land of great wealth and opportunity, is also a land of vast amounts of food, both healthy and unhealthy. Due to an overabundance of “junk” food, such as potato chips, hamburgers, and sugary sodas, Many Americans struggle to keep their weight within a healthy range; when it comes time to drop the extra weight, a lot of people struggle to get results on the scale. Two articles on weight loss, Nathan Seppa’s “If You Can Stomach It” (2007) and Amanda MacMillan’s “What You Don’t Know About Weight Loss Surgery” (2007) offer two opinions on the growingly popular choice of surgery for weight loss.

The piece by Seppa theorizes that people who have “bariatric” surgery often end up living longer than people who do not. He cites evidence from a wide scope of sources, from research dating back to 1987 to more modern studies from the New England Journal of Medicine. He quotes surgeons, researchers, and previous studies in his report. The findings in the study offer powerful support for the use of bariatric surgery for the obese.

While the evidence in the article is rather favorable for bariatric surgery, the data referenced seems a bit old. Seppa discusses research that was originally published in the New England Journal of Medicine, in which the subjects studied had undergone obesity surgery dating back to the mid-1980s. One study refers to a group studied in Sweden in 1987 (more than 4,000 participants), in which half of those studied underwent surgery while the other half received counseling, behavior modification, and no other treatment. “The surgical group lost much more weight… people getting the surgery were 29 percent less likely than the others to die over the next 11 years” (Seppa, 2007).

He also quoted a study (year not mentioned) in which 15,950 subjects took part, with bypass surgeries dating back to 1984. “People who had the surgery had a 40 percent lower death rate during 7 years of comparison than did non-surgical patients… the better survival rate stemmed from lower rates of heart disease, cancer, and other serious illnesses in people who had surgery” (Seppa, 2007).

Seppa’s research offers several fallacies that need recognition. The first would be that, early in the piece, he notes that “…research may put to rest lingering doubts about survival after these operations” (Seppa, 2007). While this claim is a bit much and overreaching, the fallacy exists in that he later flatly contradicts his statement, stating that, “On the other hand, people in that group were more prone to die from accidents, suicide, or poisoning than were nonsurgical patients” (Seppa 2007).

Unfortunately, he fails to explore the possible causes of suicide in these surgical patients. The researcher also notes, “Bariatric surgery patients also face an increased risk of death from complications for a short time after their procedures” (Seppa, 2007). Again, the risk may be temporary, but it should keep alive the concerns that he says the research is supposed to end.

One underlying assumption in Seppa’s piece would seemingly be that, as time goes on and technology increases, bariatric surgery only gets safer and more effective; therefore, those who are morbidly obese should consider bariatric surgery. Another assumption is that the surgery will work for the vast majority of people who undergo it. There is no mention of failure rates, thus suggesting that more people lose a lot of weight than do not in the long run. If this is not the case, then it should have been stated by the researcher; such data would also uncover another fallacy in the researcher’s study.

Seppa’s strength would have to be his use of statistics and the overwhelming evidence that the surgery is effective and relatively safe. It would be hard to argue against his statistics, except for their dated nature. He could have made the article even more effective with more up-to-date information. As a whole, though, the article is thoroughly persuasive and does justice to the progress of bariatric surgery over the past few decades.

While Seppa’s research is eye-opening and shows the possibilities available through bariatric surgery, as stated previously, his data is off and lacks modernity. For an article that was published in 2007, his sources are dated and do not take into account the changes that have occurred over the years in bariatric surgery; in other words, there was no mention of the variations between people who had been stapled, had gastric bypass, or the lap band. A lack of clarity of the research does little to suggest which of the methods is most effective.

The second piece studied was one by Amanda Macmillian that was less intentionally persuasive than Seppa’s, but it served as a good counterpart for that article. Early on, the writer notes that “rates of bariatric surgery have increased more than sevenfold in the past 10 years” (Macmillan, 2007). Such a claim would have a double meaning for most readers; the first would be that the surgeries are becoming safer, and the second could be fewer people are reliant on exercise and a healthy diet for their wellness than they were in previous decades.

The rest of the article breaks down the risks and benefits of bariatric surgery. The research cites several studies, including one from the University of South Florida, another from the Mayo Clinic, and one from the University of Arkansas. Her data is presented straightforwardly, set up by body parts/ systems that would be affected, both negatively and positively, by bariatric surgery. In her presentation of the risks, she does not sensationalize the facts and simply presents them for the reader to interpret; the same can be said in her handling of the possible benefits of bariatric surgery.

Even though MacMillan does not appear to be attempting to mislead the reader, some possible fallacies exist in her article. She says that “University of Arkansas researchers recently showed that bariatric surgery can lead to confusion, hallucinations, and other neurological symptoms” (MacMillan, 2007). There is no statistical backup for this claim, and she uses the soft verb “can;” in the way that she words it, ambiguity as to the likelihood of such an event is glaringly evident. Also, in the “Benefits” section of the article, she notes that, “Overeating or eating too fast after bariatric surgery can cause vomiting and pain in the chest” (Macmillan, 2007). This hardly seems like a benefit, although the implied benefit is that patients will be discouraged to overeat.

The underlying assumptions in the article are many. It should be assumed that anyone reading the article must seriously be considering the surgery, as the risks include “hair loss” and lowered alcohol intolerance. One should assume that the possible injury to the ego in hair loss is a risk that a candidate must be willing to take. Another assumption that the researcher seems to make is that the reader already knows of the possible internal complications of such a surgery, as they are not mentioned anywhere in the article. This would also serve as the only true weakness of the article, the failure to mention internal risks and the risk of using anesthetics on a patient during the surgery.

The main strength of the article is its fairness to both the benefits and risks of such a surgery. There does not seem to be an agenda, but its truthful, manner of fact presentation does not hold back on the bad things that could occur to those who have the surgery (something often left out in the discussion of bariatric surgery).

Both articles present relevant and interesting information on the topic. There is no mention in either article of undergoing the surgery for purely vanity reasons, so it is to be assumed that people who will read the articles are researching a desire to increase their health rather than simple appearance’s sake.

In conclusion of the findings, most sources available to patients suggest that diet and weight loss be attempted by anyone who is considering bariatric surgery. Bariatric surgery should only be considered by people who are more than 100 pounds overweight, which is around 12 million people in America, according to the Cleveland Clinic (Cleveland, 2009). Thanks to the advancements in technology, the minimally invasive techniques used by many doctors today make bariatric surgery a definite option, as do the falling costs of the surgery.

References

Cleveland Clinic Bariatric and Metabolic Institute (2009). Web.

Facts About Obesity in the United States (2000). Web.

MacMillan, Amanda (2007). What You Don’t Know About Weight Loss Surgery. Prevention. 59, 42.

Seppa, Nathan (2007). If You Can Stomach It. Science News. 172, 115.

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Bariatric Surgery and Obesity in America

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