Table Of Contenth e a l t h
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
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 fgured 99 percent of the time you wouldn’t like me anyway because I was a
many changes that lie ahead of them. big person. besity is a major national health
Obesity Surgery is for people deliberat- Obesity O problem, and science has been
ing about whether or not to have weight-loss maggie : You go into the surgery thinking that once you lose the weight developing a number of ways to address it.
surgery and will prepare patients—— along things will get better. The bad will disappear. You’ll be able to handle life The most revolutionary is surgical interven-
with their health-care professionals, families, diferently, and everyone will accept you, and things will be glorious. And tion to alter the gastrointestinal system so
and friends—— for the plethora of psychologi- what you don’t realize at the time is that it changes some of the people surgery that less food/nutrients can be consumed
cal changes and social challenges that follow around you, but it changes you more greatly than anyone else. and/or absorbed. People who undergo this
the surgery. It also ofers the general public surgery usually experience drastic weight
an insider’s perspective on the emotional, helena: My boyfriend started going through an identity crisis of his own loss and dramatic health improvements.
physical, and social problems that often ac- when I lost the weight. He had real difculty with my gaining self-esteem They also discover a new sense of self and
company severe obesity. and becoming more outgoing. So he started seeing someone else, and sto r i e s face challenges often unimaginable when
when I found out I broke of with him. He said, “To be honest with you, I they were obese.
marta meana is an associate professor of liked you better when you had no self-esteem and were heavy because I o f a lt e r e d Obesity Surgery is based on interviews
psychology at the University of Nevada, Las could control you. Now I can’t.” with thirty-three gastric-bypass patients
Vegas, with expertise in women’s health and l i v e s refecting on life before and after surgery.
sexuality. She has published and lectured candace: When you’re morbidly obese, it doesn’t matter if you have a Their accounts vividly describe the frustra-
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 tions of limited mobility and energy, as well
women. work. They looked at what was on the outside. Now that I’m losing weight I as the sometimes heartbreaking isolation
think my coworkers are getting threatened. They are used to seeing me at the seriously overweight endure in a society
l indsey ricciardi received her Ph.D. 500 pounds and lifeless. Now I have to catch myself at work and keep my that views excess poundage as a character
in clinical psychology from the University cool because I’m much more confrontational. I think they feel threatened faw. The changes these patients encoun-
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 tered as their weight dropped were some-
havioral health services at Creative Health any of them. They have been really nasty. times exhilarating, sometimes bewildering.
Solutions, an interdisciplinary weight- They had to deal with varied reactions of
management program in Las Vegas. family members and associates, complica-
tions of romance and dating, and a new self-
image, and they had to confront the factors
university of nevada press m a r ta m e a n a , p h. d. that made them obese in the frst place,
all the while following a severely restricted
and diet. And they often had to learn that some
l i n d s e y r i cc i a r d i , p h. d. of the problems they had attributed to
their obesity were still there after they lost
jacket illustration: © photodisc , 2007 nevada weight.
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
Obesity Surgery
meana fm i-x.indd 1 1/9/08 10:39:35 AM
University of Nevada Press
Reno & Las Vegas
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Marta Meana Ph.D. and Lindsey Ricciardi Ph.D.
Obesity
Surgery
Stories of Altered Lives
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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
Te 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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Tis 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 beneft from their experience.
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Contents
Preface ix
Introduction 1
part i G e t t i n G t h e r e F r O m h e r e
chapter 1 taking the Leap: Deciding on Surgery 11
Resisting the Last Resort 15
Te Turning Points 26
Te 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 Ting . . . 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 Tis? 134
Who Might I Have Become? 139
Is It Tem 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 Tere a User’s Manual to the New Me? 180
Losing the Pounds and Finding Your Self 184
part ii m A p p i n G t h e J O u r n e Y
chapter 6 Greater than the Weight of Our parts:
making Sense of it All 193
Getting From Before to Afer 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
Tis book has no agenda other than to provide the reader with a collective
account of life before and afer obesity surgery from the perspective of a
group of individuals who are likely to be representative of many people opt-
ing for this surgery. Tis 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 fabbergasted at
the psychological and social upheaval of losing that much weight so quickly.
Tis was true even when the changes were long wished for. Tat 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 fve chapters organized around the interviews we con-
ducted and the stories our interviewees told us about life before and afer
the surgery. Tese 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. Te 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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