I’m gonna ramble here.  Be forewarned. 

I have been thinking about the stigma often associated with WLS, which has led me to think about the stigma associated with other health issues.

To begin with, I’ll say that I guess I was a little naïve in the beginning because when I decided to have WLS, it never occurred to me that there was a stigma associated with it.  It never occurred to me that some people would think I was being lazy or taking the easy way out.  And I was really lucky, not one person I told I was having surgery made any really critical comments.  The people close to me actually seemed happy and excited for me.

So why is there a stigma?  Is it related to the fact that weight in general is such an emotionally charged issue in our culture?  And is there as much of a stigma for men as for women?  Like, are men as likely as women to be told they are taking the easy way out?  And what makes people think it’s OK to be judgmental about someone having WLS when they would not act the same way about someone having their gall bladder removed?

There are a few other health care issues where I see a stigma, too.  Mental health issues is one.  People are ashamed to say they suffer from a mental illness and if you say that you do, people may treat you weird.  If you say you take antidepressants, someone might tell you they don’t believe you need those, and say you could fix your depression by exercising/eating right/thinking positive, etc.

But what makes these things different than other choices we make about health care issues?  Why should I be embarrassed to say I suffer from depression but not embarrassed to say I have asthma?  And why do so many people think it’s OK to express criticism about my choice to have WLS or take antidepressants when they would not criticize me for choosing to treat my gall stones by having my gall bladder removed?

And how do we deal with the stigma?  Do we keep quiet about our WLS or mental health issues or whatever in order to make life easier for ourselves?  I believe that is a valid choice.  There’s no reason we should invite criticism into our lives if we don’t want to – and who likes to be criticized on a regular basis?  But does talking about it and being open about it begin to reduce the stigma?  And does keeping silent not only save us from having to deal with criticism, but does it cause us to begin to internalize the shame?  Because that seems like a pretty bad thing.

OK, I’m going to stop babbling now.  Maybe in a moment I’ll post about how I’ve chosen to deal with the stigma.  But I’m interested in hearing other people’s thoughts.  Please understand, though, that I am not suggesting people should tell others about their WLS if they prefer to keep it private.  I think people have the right to keep it private if they want, but should also have the right to be open about it without facing criticism.

 Kelly I too don't understand why some health problems are ok to talk about and treat while others are not. I do think weight is such a touchy subject for people so they avoid it at all costs. Those that have a problem with wls are the ones that have no idea what really is involved in it. So they do the easy way out speach.

For me if and when I do run into someone that thinks that way I go into MY speech about what wls really is. How it isn't easy or fun. That they only see the weight come off people not what goes on behind the scences. Then I ask if they have any questions they want answered and answer them. 

I do find tho that in my experience it is over weight people that tend to try and put me and my choice down. 

I think it all boils down to people being misinformed. All you hear is the negative side to the surgery. All you hear is that people who kill people have mental health issues. That alone puts a negative light on these health issues. People think you can treat these two illnesses with diet and exercise when it is more that that. You wouldnt put a bandaid on a compound fracture. Why wouldnt you treat obesity or depression with the best possible solution. People are too judgemental on things they do not understand.

Wow, that's a really great topic, thanks for your thoughts. You are always so insightful, and give me something to think about. Sorry for the novel in advance (and all of this is JMO)!

I think a lot of the "stigma" comes from ignorance about the actual procedure, how it really works and what it really does. There is a good portion of American society that has been totally brainwashed by "diet" marketing, and IMO a big way that the diet culture (Big Calorie?) maintains itself is by fostering the belief that if you just work hard enough, show enough "discipline and self control", then you will be thin, and ergo "good." Everything food has moral judgements placed on it- "I was so good today, I only had 2 crackers and a banana for lunch", "I was so bad today, I had a cookie after lunch". Hogwash. A cookie doesn't make you a bad person. Being overweight does not make you a bad person. But there is a very, very real amount of people making heaps and heaps of money off of it, and people buy into it. Because at the end of the day, we're human, and it's easier to believe it's my fault, and all in my control.

Ah, but it's not! Our hormones play such a huge role, our metabolisms ebb and flow, and it's all one great algorithm we still don't understand. But we do know that it's not as simple as "calories in and calories out". And I think that terrifies a lot of people, for a lot of reasons. Our society's collective "fear" of being overweight, of social isolationism. A lot of people think, incorrectly, that RNY is "stomach stapling", that you simply cannot eat as much and therefore it's cheating. That we're somehow tricking the system, getting something for nothing. And that's simply not true. If it were, then there would be many fewer revisions from the Band. This segment of the population believes that if you "just go to the gym" and "stop eating" then the same effect would occur. And hey, maybe in some people, people without a history of obesity or without significant impact on their metabolic processes, that's true. But for the people who tend to reach the point where RNY becomes a viable option (possibly, arguably, a necessity), our bodies have been wrought with aftermath from countless diets, our insulin production can be totally wrecked to the point of Diabetes, and we will gain weight even when there is no logical reason for it, because our bodies are so confused.

Now that I think about it, maybe it does have something in common with the stigma against mental illness. In both of these cases, there are so many little processess that can't be seen by the naked eye, and I think a lot of our monkey brains have a hard time wrapping around that. Why can't you just "stop eating"? Why can you just "stop being sad"?

Anyone that holds this stigma is, IMO, misinformed about the realities of WLS and of obesity. They see it as a moral failing, rather than the incredibly complex system of processess it is. I can't blame them, really, like I said there is a gigantic amount of money to be made by continuing these fallacious assumptions, by making overweight and obese people feel like we failed and are bad people and that is why we are overweight or obese.

So, I guess the question you asked is something that everyone who decides to have the surgery will have to figure out for themselves- on the one hand, if we're open and forthcoming about our surgeries, then it's possible that we become the "posterchild" for RNY in our own little worlds, and people will judge it's efficacy by what we do. There is the opportunity to educate people, to maybe counter those people who are misinformed, but there is the very real chance that those same people will hold you in scorn or say you're "making excuses" or whatever. And after spending so long dealing with these issues, of being defined by our weight to so much of society, do we want to then be defined by our surgery?

Ugh, it's complicated. And hell if I know. There's not one answer for everyone, I guess any change will come after enough minds are opened to the realities and enough people know someone whose life has been changed by WLS.

I agree that a lot of the stigma comes from ignorance about things, both about obesity and WLS, and also ignorance about mental  health issues.  If that's the case, though, then isn't the only way to get rid of that stigma to educate people?  And how are we going to educate people if we don't talk about it and keep it all a secret?

But at the same time, I don't think it has to be our responsibility to educate the public.  Certainly not if it means subjecting ourselves to additional stress, to poor treatment, to judgment, to discrimination.

I'm guessing most of us do not want to be the RNY poster child.  I don't wanna be the PTSD poster child, either.  What I do want, though, is to be able to live my life out in the open, without shame, without fear of someone learning one of these things about me and worrying how I will explain it or what excuse I will make.

This is kind of off topic, but I think it's related.  A number of years ago, I had a relationship with another woman.  I decided early on that I was going to be "out" as a lesbian.  It was going to be too hard to hide our relationship and I was not ashamed of it and was not going to act ashamed.  One thing I found was that when I mentioned the fact that my partner was a woman to someone in a matter-of-fact way, like it was perfectly normal and acceptable, people usually accepted it that way.  If I acted like it was a big deal, they were more likely to act like it was a big deal too.

My partner was out to some people but not to others.  I saw how complicated her life was, keeping that secret.  Her family didn't know.  Well, that's not really true.  They at least suspected but she'd never come right out and told them and they'd never asked.  But they'd have had to be complete idiots not to know.  But anyway, I saw how much energy it took for her to keep the secret and how much easier it was for me just to be open about it.  I think she internalized a lot of shame, too.  She did eventually tell her family and they were like, yeah we kind of thought so.  Are you happy? Well, OK then.

I don't think she was wrong to keep it a secret for so long.  I do think she made her life harder in many ways, though.  And again, if a lot of the stigma has to do with ignorance, how will people every get less ignorant if no one talks?

The WLS stigma probably has to do with the stigmas associated with obesity.  People often think that people who are obese are lazy and that obesity is really just a sign of a personality defect.  

I don't understand the stigma.  I really don't.  When I was doing my pre-op research, I found that only 1% of the people that qualify for surgery have it done -- so, we're in a clear minority.  Why 99% of people dismiss surgical options is beyond me.  Obviously many many misinformed people out there.

Wow! I've never seen that stat before, that is astounding. I wonder if that's mostly financial, like people qualify for it but then just can't afford to get it if their insurance doesn't cover it. I hope so, because the alternatives make me sad :(

Finances are definitely an issue.  Another is the misconception that you have to be in the SMO category to qualify.  People with a bmi of the minimum 40 are often told that "they aren't that big".

I don't know if people that choose not to have surgery are misinformed or not.  I can think of many perfectly valid reasons someone might choose not to have surgery.