Get Rid of the Stigma that Lower BMI Patients do Not Need or Deserve Bariatric Surgery

There is a common misconception when it comes to lower BMI bariatric surgery that you are too small to get weight loss surgery. Weight loss surgery is the last hope for those who are severely overweight. The stigma is such that if you are a lower BMI patient, you are almost afraid to ask if it is even an option for you. The thing about lower BMI weight loss surgery is that it is used as a preventative and has very very high success rates. Over the years, it has become more and more apparent with the research that obesity, even lower BMI obesity, is a health risk, and not one to be taken lightly. Bariatric surgery, because of this research, has come a long way as well. It is a very safe, effective long term treatment for obesity. Some people, for whatever reason it may be, whether its genetics or emotional, do not respond well to diets. Some don't respond at all. This is where bariatric surgery is a great tool. You will still have to do the heavy lifting, but this surgery makes it feasible as a long term option and has been proven to take away most if not all obesity-related health issues.

For those thinking that it is only for the morbidly obese, wouldn't you have wanted to attack the monster before it took over? Why not get preventative care if you know the weight gain is only going to get worse. Don't let it get to that point; attack the issue before it gets too dangerous. Melanie from Pompeii Surgical addresses this point.  

"There is really a difference in mentality because in the States you primarily work with insurances, and in Mexico, we don't deal with insurance. I feel like because we have that freedom, we have a lot more ability to simply look at the person and see why they want that surgery in the first place. I feel like they do have a strong belief in that preventative care for the patients."

There are all sorts of stories and instances in which preventative care is so critical.

 "In my case, I was 5'4, and my highest weight was 237 pounds. I feel like there is this stigma where people watch my 600-pound life, and they just assume that surgery really should be reserved for these people who are 3,4,5,600 pounds, and that's kind of the mentality that people have when they think of weight loss surgery. When I talked to Dr. Quiannones's office, I expressed my concerns because I was concerned that they would take one look at my chart and say I'm sorry, you don't need surgery, you're too little. But that's not what I encountered at all, and actually, when I talked to them, I explained my history with weight loss. I never had problems losing the weight; my issue was always long term maintenance of that weight that I lost. So I explained that to them, and I explained my family history and the patterns that I had seen generationally with our weight issues within our family. I was following down those same footsteps that I had seen my mother go. She had been a size zero her entire life up until she had children, and after that, she rapidly gained weight, I had my son, and I experienced the same thing. I was at my highest weight ever, and it was challenging for me to lose it, so I upfront expressed to them that I was interested in preventative care. I had watched generations go through this, and for me, it was not a matter of if I was going to become morbidly obese, it was just a matter of time, and they were very understanding of that notion and very willing to help me."

Patients feel like if they are not a high enough BMI that they won't be able to have the surgery, or they might be afraid to come forward and ask for help for fear of ridicule.

"There is a certain stigma. There is an assumption of who is more deserving of surgery. That is difficult for me because, again, I believe in the preventative care. If you really think about it, I personally feel that these people that have gotten to a certain weight, if you were to go to them and say if you had the opportunity to have surgery before you got to this point, would you have done it, and I think the vast majority of them would say yes. So for me, I definitely heard opinions and comments. Still, I was very well researched, so when I encountered those things, I would explain it very clearly to people like, one, you can't look at a person and say I know what it's like to live in your body. Two, I've always been a rather muscular person; I was very athletic when I was little. Then as I did gain weight, I gained it very evenly. Hence, I never looked as big as I actually weighed, so a lot of people would look at me and say oh you're crazy for having weight loss surgery, but the thing is I could tell because I have to live in my body the impact it was having at such a young age. I was 26 when I had surgery and being that much overweight I could feel it, you know my joints would ache, my back would hurt I would be out of breath so even though I wasn't in that super morbidly obese category it was still starting to take effect at a very young age for me. So to me, people can have their opinions, but that's why we leave it up to the doctors opinion to determine who is a candidate for weight loss surgery because they have the expertise and knowledge and be able to weigh that properly and be able to understand what is going on with the patient as a whole."

"The success after surgery, you know, is not something that just comes easily. It was something I did have to work for, and in the beginning, I had a huge learning curve I was a very stubborn patient, but one thing that I'm so thankful for is that I did lose my excess weight. I did have to learn things the hard way I was very, very hard-headed when it comes down to it. But now, in retrospect, I'm seven years out, and for the first time in such a long time, I've actually maintained control of my weight. So for me, in my case, it was just an amazing experience. I don't feel like I would have lost and maintained that weight had I continued that cycle of yo-yo dieting or taking the diet pills or things like that, and I feel like had I not had the surgery today my health would be in a very different place than it is."

"I think education is everything, and I think if you're trying to wrap your head around why people with the lower BMI classifications want to have surgery, you should ask them, and you should really be open to listening. You know there's this stigma that people just assume these lower BMI patients, it's all vanity you know they are not happy at, let's say 220 pounds they want that ideal 125 or whatever it is, and you would be surprised at how often that's not really the case. I've actually known quite a few people who have come through Pompeii Surgical, and they don't have an issue with their weight as far as how they view themselves, you know they are not unhappy with it. They want the weight loss surgery for very valid reasons. And if they could achieve these things without having to undergo surgery, they absolutely would. Still, sometimes surgery is the only option for them, so for example, you've got a person, and they have a previous knee injury, and their excess weight is preventing them from being as active as they want to be. So they undergo it for that or say they need a knee replacement surgery, but they won't perform that without them losing weight. We have worked with countless people who want to become mothers, and they don't, again, mentally hate on themselves they don't dislike their bodies, they simply suffer from a medical condition in which the excess weight is preventing them from being a parent, and that goal is fundamental to them, so this is an opportunity that can really help them with that. I think one of the most inspiring stories I've ever heard is a person that simply wanted to be on a donor registry. And they couldn't qualify because of their weight. It was a really inspiring story. This person was out one day, and they saw a grandfather that said they were looking for a kidney donor for their grandchild. That inspired them to want to help somebody else, so when they came and wanted surgery it wasn't a matter of oh I want surgery so I can lose weight for myself, it was I want to do this so I can turn around and give back to somebody. So when you sit there and talk to somebody who is a lower BMI patient, really listen to them. Listen to the stories, listen to why they want it, and, as I said before, this is why we leave it in the hands of medical professionals because you cannot look at a persons size and automatically assume their health condition. So that's a stigma that I really wish the world would be a little bit more educated on."

Pompeii Surgical has many lower BMI patients, and they all have a story. Sissy Barber-Spain was not under the impression from Pompeii Surgical that she was a lower BMI patient. She was treated just like anyone else because that is how Pompeii Surgical treats their patients.  

"I didn't realize it was on the low side. I just knew I weighed 252 lbs and was having issues with my back and cholesterol. I had tried diet and exercise for several years, always gaining the weight back. I knew I needed a tool to help me."

Sissy was not afraid of the surgery itself but was worried she would lose too much weight. She did lose more than she wanted, but life has a way of throwing curveballs.

"Five months into my weight loss journey, I lost my 19-year-old son, so I'm not sure if it's the stress that caused me to lose so much or if I would have anyway — hoping to gain at least 15 lbs. My highest weight was 252. Surgery weight was 238. Current weight was 148 this morning. My goal weight was 170, so I'm a little under, but I love shopping for clothes now. I'm smaller than my husband for the first time in 23 years. I'm getting boudoir pictures made soon. I would never have had the confidence to do that before."

Due to stigma, Sissy was told she could just lose the weight on her own if she just tried hard enough, which is a common misconception that needs to be stomped out and fast. People who have a hard time losing weight are not lazy; there is often a perfectly reasonable explanation for why they can't lose weight, and why surgery is the best option for them.

"My experience with Pompeii was awesome. Everyone was really nice. I didn't need an interpreter because everyone spoke English. Dr G. was great and visited me several times. It was as clean as any place I've been to in the states. They managed my pain great and treated my mom like she was a patient too. Can't say enough good things about Pompeii. I've already referred one person, who had surgery last week. My advice to someone with a lower BMI wanting surgery would be to just go for it. It's a tool, not a magic wand. This has been the hardest year of my life, and it's not an easy fix. Research, learn as much as possible. And take lots of pics of your progress after surgery. That's something I didn't do and regret it very much."

Laura Castillo is another patient who, when talking to Pompeii Surgical, was not even aware that she was at a low BMI based on what they said.

"They didn't really point out my low BMI; they just approved me and were very informative over the process and the requirements for the surgery date."

Laura had some very common fears about worrying that the surgery wouldn't work for her and that she wouldn't lose any weight.

"I also thought about just getting liposuction and a tummy tuck but ended up deciding on the sleeve." Laura decided on weight loss surgery not because she was having vanity issues, but because she knew the situation was unhealthy.

"I've done diets before, and I always end up gaining the weight back. I chose the sleeve because, in my mind, if I did plastic surgery like lipo, I would probably gain the weight back in a few months. I feel like the sleeve is more long term versus a quick patch to the problem. Also, the health benefits that come with it. I was recently diagnosed with diabetes, and when I told my doctor I was getting sleeved, she said my diabetes would go away and that I was making a great decision, which made me feel more confident in my choice."

Laura, unfortunately, was another person who heard a lot of negative comments about her desire for weight loss surgery.

"I feel like there's a lot of envy from bigger people because they "wish" they were at that weight, so they try to persuade you away from it. I noticed that people that haven't had the surgery tend to say, "just exercise and eat better," but realistically, we're all different. Some people have fast metabolisms and don't gain weight, so it's not as easy as they make it seem. Bigger people say "I wish I were at that weight, if I were I wouldn't even waste money on the surgery, I would just exercise.." but I feel like they just feel envious because they wish they hadn't let themselves get that big and wish they were smaller (don't we all). And people that have already had the sleeve done were much more positive. They would say, "do it; you won't regret it." Or "you will lose weight much faster since you're not that big, just go for it. I'm here to help ask me anything, and I'll guide you."

Laura was very impressed by her level of care and is so thankful for Pompeii Surgical's way of making their patients feel cared for and validating their reasonings for getting surgery. She is impressed at how much Pompeii has done for her, and she hasn't even had surgery yet.

"So far, everything has been amazing. I was always scared to ask questions for fear of being annoying or asking "stupid questions," but they are so nice and reassuring when answering all questions. If I remember correctly, I told one of the staff I'm sorry for all the questions but, and proceeded to ask my question. Their answer was something along the lines of, "Don't be afraid to ask, we are here to ensure you're comfortable and informed, ask away that's what we're here for."

For someone currently in the process of her lower BMI surgery, she has words of wisdom to those who buy into the stigma or don't completely understand the issues surrounding this type of preventative surgery.

"Be more conscious of your comments. Just because we weigh less doesn't mean we hurt less. At one point, you too were at that weight, if it was that easy to lose 50 lbs as they say, then why didn't they do that when they too were at that weight? I don't want to end up like that, so that's why I'm doing it now before I reach that point. The same feeling they have when they look at us and wish they were our weight, is the same feeling we have when we look at small girls that weigh 100lbs. We might have different weights, but we have the exact same feelings of depression and unhappiness. Be someone's inspiration.! We all just want to succeed."

If you get anything out of this article, I hope that it is just to be a little more open and a little less judgmental about issues that are better left to the professionals and the patients themselves. Every situation is different, and it is unfair to judge a situation you know nothing about. Stomp the stigma.