A gastric band – whether it’s real or imaginary – can stop you from eating; but can it stop you from craving?
In this current war on obesity; the latest weapon that the weight-loss industry is keen to promote is bariatric surgery, or “the gastric band”. Even our NHS seems more than happy to spend countless thousands of on these procedures; but not a single penny on behavioural change. This has now lead to a bizarre situation of patients who are under the weight threshold for surgery being told to put ON weight so that they can qualify for the operation. (London Metro 27th Jan 2011)
There have also been reports of some of the more unfortunate patients apparently now finding that they simply can’t eat anything more than a cupful of solids as post-op they now have a severely restricted capacity; yet still crave food as they used to*.
The message seems to be that bariatric surgery is a safe and effective method of bringing about drastic weight-loss, provided the patients learn to modify their food intake accordingly. But surely, if these desperately overweight people could be shown how to do that in the first place, might they then avoid the need for surgery?
John Morgan, a consultant psychiatrist at the Yorkshire Centre for Eating DisordersW states: “If you’re eating because of a need in your brain rather than a need for stomach satiety signals, then having your stomach reduced is not going to solve that.”
This is obviously exactly the same for “virtual” or “imaginary” gastric bands too. The restriction in the gut may not in these cases be physical, but if the cravings are not addressed and greatly reduced, then the client will still be in a situation of wanting to eat inappropriately – exactly as they did before!
The magic formula for any long-lasting weight loss solution for those whose eating habits have caused unhealthy weight gain has always been and always will be “less in and more out”; and clearly, this must involve behavioural change. Only a method that addresses this and enables it to occur can begin to yield results that have any chance of becoming acceptable and permanent.
*Daily Mail September 16th 2010 page 37
WProfessor John F Morgan MD(Cantab) MA FRCPsych MB BChir FHEA DipCBT Senior Lecturer & Consultant Psychiatrist