There is an article in the New York Times today about the quest to increase the number of people who qualify for Lap-Band surgery by lowering the BMI requirement. The hero of our quest? Why the manufacturer of the Lap-Band, of course: Allergan. The change being sought would more than double the number of potential consumers.
Under the current rules, in order to qualify for the surgery, one must have BMI (Body Mass Index) of 40 or greater if no “obesity related health problems” exist. If you are lucky enough to suffer from an “obesity related health problem” then you can get this surgery if your BMI is greater than 35.
The proposed change would lower these numbers to 30 for those with health problems and 35 for those without.
I would have qualified for Lap Band at my starting weight of 287 pounds. At my height of 5’8″ I had a BMI of 43. I can’t say I’ve ever had an “obesity related health problem” except perhaps some mild depression, which probably doesn’t count.
When my BMI got to 35, I weighed 230 pounds. Simple diet and exercise for 9 months got me there. I most certainly had no health problems then. In fact, I think I was just starting the Couch to 5K Running Program.
Here’s what I don’t understand about Lap-Band or Gastric Bypass: the reason you lose weight is because you are forced to eat less. So why not simply choose to eat less and save the money, pain, and whole bloody cutting your body open and sewing it back together thing?
I understand that some people have a compulsion to eat. Some people have a compulsion not to eat. Some people have a compulsion to inject heroin into their systems every day. All of these will most likely kill you eventually, but that isn’t part of the picture when you’re in the grips of that kind of obsession. I really do understand that and I don’t doubt there are people for whom these surgeries are life-saving when there is no other option.
But is being 50 pounds overweight really life-threatening in the first place? How about 20? 10? At more than 100 pounds overweight, I never even considered any of these surgeries. I knew how to lose the weight. Eat less. Exercise. Doesn’t everyone know that? I only had to choose to do it.
And how is the BMI chart a good criteria for whether or not you qualify for these types of things? The BMI chart is just plain inaccurate for anyone with more muscle mass than Mary Kate Olsen, anyone short, or anyone tall. Oh, and it over-predicts obesity (as measured by body fat percentage) in African Americans.
Have I mentioned recently that my BMI is currently 26? But my body fat percentage (as measured by calipers) is 22. I’m just saying.
Obesity is not a disease and we need to stop approaching it as such if we’re ever going to do anything about it (although honestly you have to wonder if maybe there are interests that would like us to remain obese… the food and diet industries, or companies like Allergan, to name a few)
Diabetes, heart disease… these killers aren’t “Obesity related health problems.” They are “Lifestyle related health problems.” They are caused by our over-sugared, over-fried, nutrition-less Western diet. They are caused by our complete and utter lack of physical activity.
You don’t need surgery for this. We need education, patience, and determination. You can get so much more from the journey than you get from the weight loss. Trust me. If you allow yourself to change, the weight loss is your lifestyle-related reward. Along with many other things, like cardiovascular health, better sleep, mood improvement, and a whole host of positive benefits.
Is surgery really more appealing than exercise? I guess for many, the answer is yes. And if the FDA approves the change, a lot more people can avoid the gym.