No doubt you’ve heard of Americans flocking to Canada (virtually or really) for inexpensive pharmaceuticals? There’s nothing necessarily back-alley about it, it’s just that the name-brand legitimate pharmaceuticals are less expensive in other countries. But it seems that Canada may also be a destination for surgical procedures that are not exactly F.D.A. approved. People with life threatening diseases (with resources) have often flocked to other countries in pursuit of treatment not available/legal in this country. However, the recent surge in maple leaf medical tourism is for weight-loss surgery.
Since 2006 Canadians can have a balloon inserted into their stomachs. (Think of it as angioplasty for your tummy.) The balloon makes you feel full. I’m guessing nobody in the lab screamed “Eureka!” when they developed this device. To my (very) non-medical self, there is nothing necessarily all that different between this and any other inflatable device one would have inserted somewhere. Unless there’s some sort of high stakes patent wrangling in play, no doubt this procedure will be available in the lower fifty states soon enough.
But should it? All weight-loss surgeries involve reducing the amount of food the patient can comfortably ingest. In essence they are the modern-day equivalent of wiring one’s jaw shut. The theory behind these “solutions” is that people need to be physically blocked from responding to their desires. Rarely is putting a lock on the refrigerator door a sustainable weight-loss plan.
What would be most helpful to people, either in concert with surgery or not, is learning to cope with the sensation of hunger. Hunger is not necessarily a cue to eat. Needing nutrition is a cue to eat. Someone who is constantly thirsty shouldn’t just be watered, they should be checked for diabetes. A person who feels constant hunger needs help determining why and learning to manage the sensation. Beyond the standard analysis of; are you bored, thirsty, sad, lonely? is addressing the feeling of emptiness that might be present. The world is not a friendly place for the obese. Clothes, furniture, seats, etc. are all geared towards average sized people. Prejudice, mockery and serious health consequences lurk at every turn. In other words, nobody wakes up and decides that what they really want to be is obese. It tends to just happen. Over time.
Since the F.D.A. seems to be dragging its feet in approving the balloon method, I’d like to think it’s because they are giving serious thought to reforming the protocols of weight-loss surgery in general. While it is a slippery slope to mandate counseling before medical procedures, we do have precedent. Since its invention, a person can not undergo gender reassignment surgery without structured preoperative psychological counseling and clearance. (No doubt this protocol was created by male doctors who had their own issues about loss.)
If we agree that obesity is a problem, and that people are entitled to pursue good health, than we need to stop offering quick fixes in a vacuum. There is no such thing as any surgery without risk. But by ignoring the psychological side of the patient we are adding the risk of failure to the mix.