It started as a graduate student’s thesis project.
UNLV psychology professor Marta Meana was serving as faculty mentor to master’s student Lindsey Ricciardi, who was conducting her thesis research on the psychosocial impact of dramatic weight loss through gastric bypass surgery.
“A colleague of ours had told us that there was a gastric bypass surgeon in town who was very interested in the psychological impact of the surgery as well as the ways in which psychological factors impeded or facilitated progress after surgery,” Meana says.
When contacted by the psychologists, the surgeon, Dr. Barry Fisher, immediately agreed to cooperate, so Meana and Ricciardi decided to attend a workshop he offers to prospective patients.
“We were fascinated by the topic and by the people we heard speak at that workshop,” Meana recalls. “We wanted to know how the lives of people who had been morbidly obese changed when they lost vast amounts of weight. We approached Dr. Fisher about the idea of interviewing his patients, and he was extremely cooperative.”
Six years later, their resulting book, Obesity Surgery: Stories of Altered Lives, provides valuable insight into the psychological complexities that accompany profound weight loss.
“We went looking for a story about losing weight and found a story about finding self – a story about what happens when you get rid of the one thing you are convinced is standing between you and your dreams,” the two authors wrote in the introduction.
The psychologists suspected that the weight loss “would involve a cascade of other effects that would seriously alter the system that had been their interpersonal lives.”
Indeed, they found extensive changes and complicated stories in the interviews they conducted with 33 patients. Ricciardi’s master’s thesis, which was based on the interviews, resulted in two scholarly publications reporting the findings.
“However,” Meana says, “we felt that the richness of the patients’ narratives were lost in these articles, which were by necessity rather short.” The authors also realized that the general public probably would not access articles in scholarly journals.
“We wanted the stories we had heard to have a broader audience of individuals going through the surgery or the decision process, as well as individuals who counsel these patients,” Meana says, noting that writing a book was a natural choice.
Most of the interview subjects were women, Meana says, adding that the preoperative weight averaged 372 pounds; three individuals weighed more than 500 pounds before the surgery. The majority of the interviews were conducted within three years of the surgery.
The interviews tended to focus on the patients’ changes in self-image and in interpersonal relationships, especially with family and friends. The interviewees described their lives before the surgery and explained why they decided to have the procedure.
The excessive weight they had previously carried often prevented the individuals from participating in activities that many people take for granted. One woman told the researchers that after the weight loss she could finally show her 10-year-old daughter how to properly shampoo her hair. “I’ve had to backtrack a lot and teach them,” she told the researchers.
Health changes made by parents also influenced their children’s health habits. Prior to the weight loss, many obese parents felt they set a poor example for their children.
“I’m teaching my children a different way of eating,” one said. “My children got involved in caring for me after the surgery,” said another, “and it has also made them more health conscious.”
Several patients told the researchers that after years of being invisible to salesclerks and others, they wondered why they had been ignored. One woman said, “People looked past me before. I don’t know why. I don’t even know if I’d call it discrimination. I don’t know how at 290 [pounds] I could have been invisible. But I was.”
Women patients who had been tolerating unsupportive, sometimes alcoholic husbands gained a new and stronger sense of self that gave them the confidence to be more independent – so independent, in fact, that they sometimes filed for divorce.
Yet, a few said they still felt like the fat person they had been, despite the new image in the mirror.
After completing her master’s degree, Ricciardi went on to complete her Ph.D. in 2005 under Meana’s mentorship; today, she provides clinical services to individuals struggling with eating disorders. Meana’s current research focuses on female sexuality and sexual dysfunction. Both say they hope that their book will be helpful to those considering gastric bypass surgery in the future.