Saturday 18 January 2014

Surgery or Therapy? The West’s problem with obesity isn’t just a medical issue; it’s an emotional one too.



Yesterday, researchers from Imperial College London published a report that stated that up to 2 million people in the UK could be eligible for bariatric or weight loss surgery. Bariatric surgery involves placing a cuff around the top of the stomach, effectively restricting how much the patient can eat. For a one off cost of anywhere between £3,000 and £11,505 per person, the NHS could begin to make huge savings through the resulting reduced levels of type 2 diabetes and heart problems. And this all comes with an 80% success rate. But I have to say that as tempting a solution as this sounds; this report worries me. There are many reasons for the current obesity epidemic; both social and psychological. Psychologically speaking, people over eat because they're bored, sad, angry, have low self-esteem or just simply have never known anything different so offering bariatric surgery feels like an over-simplistic solution to a very complicated issue.

So much has been written about our emotional relationship with food and people will have their own very personal reasons for misusing or abusing it; whether through over eating or through food restriction. Many people are unaware of what they are doing or why they are doing it. The way they use food has become normalised; it's just what they do to feel safe or to feel like they are in control. In her book Eating Your Heart Out, Julia Buckroyd states that the misuse of food is 'instead of something; it is instead of feeling, or knowing, or understanding something that feels too difficult or frightening or unacceptable' (Buckroyd, 1994: 13).   In other words, it is an avoidance tactic.

At times, comfort eating has been a real problem for me. Interesting term that; comfort eating. Eating for comfort. This implies a sense of discomfort that food can somehow magically take away. It also sounds quite harmless yet I doubt that many people would be happy to admit to comfort eating on a regular basis. Personally speaking, there was something shameful about it so I would keep it hidden. For many years I did this without considering why I did it. It was not until I began training as a counsellor that I began to take a long hard look at how I cope with difficult emotions and accepted that I used food to avoid them. Now I notice my cravings and I use them rather than act on them. Don't get me wrong; none of this happened over night. First of all I needed to understand the difference between craving food for comfort and when I was genuinely hungry (I can highly recommend 'On Eating' by Susie Orbach as a good place to start with this process). Once I'd grasped that, I was more able to reflect on and work through the difficult emotions I was avoiding through therapy. It's still difficult sometimes, but now I know that eating will not take my pain or discomfort away. That happens through sharing my experience and asking others for their support.

I understand why bariatric surgery is part of the solution to the West's problems with obesity but it needs to be just that; a part. Advocating this very medical response to obesity as some kind of a magic bullet feels like a further denial of our emotional selves; like our out of control bodies need to be tamed, cuffed and subdued by the rational mind. It saddens me that no case was made in the media for counselling or psychotherapy to be offered alongside or even instead of bariatric surgery. But then I would say that, wouldn't I.

References

  • Buckroyd, J. (1989) Eating Your Heart Out.  The Emotional Meaning of Eating Disorders, London: Macdonald Optima
  • Orbach, S. (2002) On Eating, London: Penguin
  • (2014): Weight loss surgery: Up to two million could benefit on the BBC News website http://www.bbc.co.uk/news/health-25766253 - accessed 17/01/2014