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December 2000 Issue

It's Still Politically Correct to say "FAT"

By Deborah Biskin Levine

Americans are bombarded with media images of thin actresses and models. The not so subtle message is that in order to be beautiful, we need to be waif-like. At any given time, approximately forty percent of the population is on a diet. Another eight percent, roughly fourteen million individuals, are severely or morbidly obese.

Although it would ideal if our culture would be tolerant of people of all shapes and sizes, those who are a hundred or more pounds overweight are unlikely to ever gain acceptance in our culture. In addition, even if morbidly obese people are happy with their own body images, and never feel discriminated against, the excess weight they carry is unhealthy. The term "morbid," used to describe this level of being overweight, is no accident.

People who suffer from the disease of obesity experience an array of health problems associated with being severely overweight, such as diabetes, high blood pressure, and arthritis. However, what may be even more painful, is that they also suffer discrimination at the hands of society.

The ramifications of their disease affect them in the work place, in academia, and in social situations. It's unclear why this prejudice continues to persist. Perhaps these negative attitudes toward the obese are born out fear--fear of becoming obese (and therefore >unattractive) ourselves.

Beyond the health issues, obese people have difficulties negotiating some aspects of a world made for thinner people. Daily life can be a trial for the morbidly obese.

"When I weighed 400 pounds," recalls Erica Greenberg of Manhattan, "I had trouble sitting on a seat on an airplane. I couldn't find stylish clothes that fit me, and I couldn't even fit behind the wheel of my car. I had a horrible time taking care of my own hygiene--I just couldn't reach crucial places. Tying my own shoes was a nightmare. I hated being dependent of everyone around me for help."

As is the case with so many others, Erica tried everything to lose weight--Weight Watchers, Jenny Craig, Slim Fast, and hypnosis. Each time she lost weight, but then regained it and then some. Finally, she decided to look into the concept of weight loss surgery, which the National Institute of Health says is the only effective weight loss treatment for the severely obese.

At Saint Lukes/Roosevelt Hospital in New York, the folks in the Bariatric Surgery Department, headed by Louis Flancbaum, MD (aka "Lou"), are attempting to make life easier for people like Erica. Dr. Flancbaum is not Mark Greene or Peter Benton of ER fame, but to his patients, this real-life surgeon is just as much of a hero.

"Dr. Flancbaum gave me my life back," says Doreen Stein of Rye, New York. "My teenage kids were humiliated to walk down they street with me. To them, I was an embarrassment. If I had any other kind of disability, they probably would have been less ashamed of it and me. But in the 21st century, kids can still make remarks about 'your fat mother' and that's acceptable. A year after my gastric bypass surgery, I've lost 110 pounds and now my kids actually invite their friends over to our house."

GenerationJ.com had a bird's eye view in the operating room as a 27-year-old female patient was wheeled into the operating room and put to sleep. Flancbaum gave her a last minute of reassurance--and then it was 'all systems go' for her gastric bypass.

As Lou began the surgery by cutting open her abdomen, it seemed almost as if he were beamed to another planet, concentrating totally on his work. Within forty-five minutes, he had transformed the stomach of this 440 pound woman from the size of a football to the size of an egg, and then re-routed her intestine.

From time to time he stopped what he was doing to point out different landmarks like the liver and the intestine. He showed the resident who was assisting him how to perform a plastic surgery stitch when he was closing the patient. Thanks to Lou's efforts, within the next year, this woman will probably lose over 100 pounds, her diabetes will be cured, and her heartburn improved.

Some in the media tend to refer to this operation as "radical" or "drastic." It is a major abdominal operation--carrying a one percent risk of death. However, the risk of doing nothing is oftentimes much greater.

Why does Flancbaum, who could perform any kind of general surgical procedures, choose to dedicate his life to helping the morbidly obese? As a child of Holocaust survivors, he has a keen sense of wanting to right wrongs, to fix injustices wherever he sees them.

"Discrimination against the obese is one of the last remaining acceptable forms of prejudice in our society. It's still politically correct to call someone 'Fat'. As a culture, we finally understand that alcoholism is a disease, but we still haven't recognized obesity as a disease influenced by genetic and environmental factors. Imagine refusing to pay for treatment of lung cancer or open heart surgery because a person smoked for years," explains Flancbaum.

"This surgery has been hailed by the National Institute of Health as the only effective long treatment for severe obesity, and yet in order for most insurance companies to pay for it, my patients have to jump through numerous hoops’ proving that they have previously tried every diet program on the market."

Naturally, Flancbaum's patients are grateful for improvements in their health, but what sometimes matters even more to them is the way their lives change and the way others treat them after they've lost weight.

"A year after my surgery," says Sandra Cohen of Merrick, Long Island who went from 350 pounds to 215 pounds, "I'm just happy that I no longer have to endure stares and nasty remarks every time I take a bite of food in public. I remember once being standing in line at a buffet. This guy walks up to me and says, 'May I cut in front of you?' 'Of course,' I answered. 'Good,' he said. 'I just wanted to make sure there would be something left for me.' He laughed out loud as if he was the funniest thing in the world. My self-esteem was so low, I laughed right along with him--to hide my own pain. I don't think he ever considered that obese people have feelings too."

Flancbaum took a break from his hectic day to tell GenerationJ.com what taking care of these patients means to him. "As a surgeon, you don't always have an opportunity to establish relationships with patients. You repair a hernia or remove a gallbladder and then you never see the person again", he says.

"I've committed myself to caring for the morbidly obese on a long-term basis. When they come in for their follow-up appointments, I witness the tremendous positive changes that occur in their lives. They tell me how people treat them with more dignity and respect. As a human being and a surgeon, this is tremendously satisfying for me."

Deborah Biskin Levine is a frequent contributor to GenerationJ.com and Lifestyles Magazine. Her first book, Acts of Loving-Kindness (JPS) will be out in April of 2002. Recently, she co-authored a book with Dr. Louis Flancbaum and Erica Manfred entitled, Weight Loss Surgery: The Complete Guide to Gastric Bypass and Other Procedures (www.weightlosssurgeryguide.com) Additionally, Ms. Levine has essays coming out in the next issue of Olam Magazine and Modern Bride Magazine.

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