"THE TRUTH"

BY: FOREST LEWIS, PH.D.

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I decided to write on the subject of obesity in America, after witnesssing a full shot of ABC anchorman, Charles Gibson. Gibson has a beer belly that would have made Archie Bunker proud.

Observing Gibson from the neck up, one would never guess that the man's stomach is terribly distended. He reminds me of the alcoholics that I have worked with over the years. Although their stomachs are bloated beyond measure, the rest of their bodies are frail looking.

I am in no way saying that Mr. Gibson is an alcoholic. To make such an assertion, I would have to do a comprehensive substance abuse evaluation. I am simply saying that Gibson's physique is frightening to look at. He is opening his body up to a number of opportunistic diseases. Most notably a heart attack or a stroke.

Al Roker of the "Today Show" also prodded me in a sense to do this story. Roker lost a number of pounds after undergoing what many of us believed to be "Gastric Bypass Surgery", a few years back. I will discuss this procedure in greater detail later in this write-up.

A few years ago, Roker was a shell of his former self. He lost a lot of weight. However, today the weight appears to have returned. How is that possible you ask? The reader needs to understand that candidates who undergo gastric bypass surgery--are not immuned from ever gaining weight again. Americans are very inventive. I've had patients who figured out how to "Beat" the gastric bypass "System". For the sake of people lives, I will not explain what my patients have told me.

Adults in this country--and now children--are faced with being labeled morbidly obese. We are in the throes a major epidemic. This epidemic will come into sharper focus as the children of today, become the adults of tomorrow.

In addition to the opportunistic diseases of heart attacks and strokes, obese Americans also face cancer, and a surge in diabetes. James O. Hill, Ph.D., the director for the Center of Human Nutrition at the University of Colorado Health Sciences Center says, at the rate that we are going, "obesity-related diabetes alone, will break the bank of our healthcare system".

How did we reach this point in America? Some say, (a) Eating (GENETICS) too much, and (b) A lack of exercise. I would like to join this debate and propose a third component, "Depression". Persons facing depression can either noticed a spike in their eating, or a decrease. It has been my experience that most people who are suffering from a Major Drepressive Episode, use food as their antidepressant. As a result, clinically depressed people face significant weight gains during an episode of a clinical depression.

I have had patients tell me that they have fixed dinner for their families. After consuming what is on their plates, the depressed patient looked at at loved ones dish, and beseeched that person to leave a portion on their plates for them.

I have also had patients report that they have awakened at two or three in the morning, and "Make Another Dinner" for themselves.

Many of these patients are victims of hypertension and diabetes. They are also on welfare; and have a medicaid card. This is part of the drain on our healthcare system that Dr. Hill was alluding too.

Before a person undergoes gastric bypass surgery, there are a number of things that she/he must do. First, the patient's doctor must say that the person is a candidate for this procedure. After that, the person has to meet with a Clinical Psychologist, and is evaluated.

I will do a comprehensive evaluation. Sometimes, I will also include performing psychological testing. This includes I.Q. testing, Rorschach projective testing, MMPI, or PAI, etc.

If I conclude that the person's weight gain is a result of psychological issues, I will not hesistate to recommend therapy as a way to assuage that person's problem(s).

To perform gastric bypass surgery on someone whose issues are psychological in nature, would be contraindicated. In other words, the procedure should not be done.

Surgeons performing gastric bypass surgery create a tiny pouch in the person's stomach with staples or a plastic band. This procedure restricts the amount of food that the person can ingest. During the surgical procedure, doctors attach a small portion of the small intestines to the pouch to allow the the food to bypass the rest of the stomach, and the upper portion of the small intestines in order to reduce calories and nutrient absorption.

Gastric bypass surgery is not a magic bullet. I say this because if you have not dealt with your psychological baggage, you are simply setting yourself up for failure.

Yes, America, you are disgustingly fat. However, there is hope. Start by not blaming others for your obesity. "Own Your Own Stuff".

Next, sit down and discuss with your physician, the options that are available to you.

If you do not have an understanding doctor, fire him.

After all, it is your life that is at stake.