timeimmortal

Gastric bypasses. Stomach stapling, as I gather the procedure is also known — a last-ditch treatment for obesity, to stave off a heart attack or stroke.

Being married to a nurse, I occasionally get to hear about this kind of procedure, and I gather that it really is intended to be last-ditch. The long-term survival prospects aren’t exactly stellar, nor are the odds of the surgery really doing all that much to help a person*. It does, I gather, occasionally work as intended, but not often.

Still, as more and more people in society are becoming obese, such procedures are expected to be commonplace. Britain has seen a 41% rise in the number of bypasses done in the last year, at an average cost of 7,000 pounds per operation.

It’s on the rise here in Canada too, although I don’t know by what percentage.

The problem is: surgeries like this are, more often than not, like rearranging deck chairs on…well, you know which ship, O Reader. Treatment is one thing, but a problem like obesity has more and deeper causes that are, frankly, not always addressed, nor always rectified:

I worry that not enough is being done to make sure people don’t gain the weight back. See, a lot of people think the surgery is a miracle cure. It’s not. I have talked to dozens of people who have had it done, only to go back to their old habits and gain all the weight back. This is not a good use of public money. I realize that obesity is a serious issue (my fat ass reminds me of that every day!), but I would rather see the price of green peppers go down before I would want to see so much being spent on a cosmetic surgery that may not solve the long-term problem. Progressives are always on about “root causes”, and this is one area where I agree with them. You cannot change a lifetime of habit in a 3 hour surgery. A person has to be in the right headspace in order to lose weight. Sometimes it takes a health scare. Sometimes it’s a nasty comment from a trusted loved-one. Sometimes it is a positive, like wanting to be more fertile and start a family.

But like going into detox for that last time, you need to have hit your bottom (no fat pun intended) before you can lose the weight. The NHS is spending a lot of money on the symptom, not the disease.

This is something Grace and I talk about every once in a while. The plain fact is, a lot of people who go in for this and other forms of surgery related to complications from obesity do not change their own lifestyles, which are the real cause of the problem in the wake of the surgery. If a person’s liver fails because the last time they didn’t eat at McDonald’s was sometime in the 90s, they expect a new one. And when they get a new one, they finish the post-surgical healing time and go right back to the Big Macs.

(Basically, it’s the culture entitlement at work again, with the usual lack of understanding that rights are tempered and accompanied by responsibilities. People have the inalienable right to eat at McDonald’s, and when something fails in their own body they demand, as though they are owed, corrective treatment. God forbid it cross their minds to amend their own destructive habits to prevent a re-occurrence of the failure!)

To be fair, some people do transform their lifestyles, and they deserve to be commended for that; this is especially true from within a Christian understanding of the world, since we should rejoice every time someone turns his or her life around, in same way that God rejoices over every sinner who repents.

But I agree with my wife when she observes that responsive treatments like this are, ultimately, a losing battle. As long as people in places like Canada and England know that the government will foot the bill when their body craps out, there’s no real incentive for them to change…especially when that same government mandates and enforces a human rights regime that basically encourages people to feel entitled to…well, everything.

What ultimately needs to happen, and this is hinted at in the excerpt above (i.e. “green peppers”), is that health care services need to focus more on preventative medicine, instead of just on responsive medicine. Surgery is all well and good, but we could do more and better to fight obesity if we focused on responding to people at risk of becoming obese, and getting them to change their lifestyles accordingly. Yes, programmes of this nature would still have quite a cost associated with them, but in the long term they would probably save quite a lot of dollars if they were, in fact, succecssful to any meaningful degree.

A person really “cannot change a lifetime of habit in a 3 hour surgery,” and our health care systems need to be able to address this reality. At present, as I understand it, patients in for bypass surgery do receive counselling, and (correct me if I’m wrong, O Reader) have to have demonstrated the ability to lose a certain quantity of weight on their own prior to undergoing the surgery itself. That said, somewhere along the line that person did begin down a path that led them to become obese, and one gets the sense that more could have been done for them earlier on to perhaps prevent them ever becoming so morbidly overweight as to require drastic surgery in the first place.

The elephant in the room is a pair of questions: what could be done, and how do we get people to take it seriously. And this brings us back to our culture of entitlement, because while such a thing persists it may well be nigh-impossible to put in place programmes that work to prevent morbid obesity by way of counselling, teaching, and exercise.

In a way, the prevalence of gastric bypass surgery, and obesity as well, is just one more testament to the way in which our rights-obsessed, responsibility-free, post-Christian society is ultimately destroying itself.

It might be entirely predictable of me to point out that modern atheism bears a goodly deal of the blame for this self-destructive trend in society, as surely as it bears the blame for other such trends (e.g. demographics). But I observe that I’m not the only one who thinks so…and the sane Hitchens brother has quite the thing to say about another trend with the same root causes.

I did mention Atheism at the beginning. For that is at the root of all this. Once people don’t acknowledge any moral authority outside themselves, they can choose which rules to take seriously and which not to entirely according to their own feelings at any time. They will generally do this on the basis of what suits them. It begins with little things, and moves on to the great. We are now at the stage where it is moving on quite fast.

One of the key features of atheism is that atheists themselves are unable to grasp this point. We’re just as good as religious people, they respond, if not better. Maybe so. Religious people who understand their creeds know perfectly well that they’re no better than anyone else. That’s not the issue. What is?.

It is this. What do you really mean by ‘good’? Why (for example) is fidelity better than adultery, patience better than impatience? Watch people who are nice to you in the office, as they drive, in a hurry, in frantic traffic, and you may see another side of them. ‘Road rage’, where we are unrestrained by fears about how we will look to those we live and work with, is an interesting measure of what we are really like. Cars are a powerful moral lie-detector.

The connection might not seem immediately intuitive, but it is there, and it has a great deal to do with both individual liberty and the distinctions drawn between what are considered private matters, and what are considered public matters.

What we eat, most people would agree, is a private matter. What, where, and how fast we drive can be similarly classified, but in the case of a car it is easier to observe that what can at first be viewed as a private matter can very rapidly become a public matter, if in fact we drive too fast or too recklessly. What we eat can similarly become a public matter, if we are reckless about it as well. This is perhaps not as true in places like America, given that one pays for one’s health care there, but it certainly is true in places like Canada and England, where the government generally foots the bill. Obesity — which, psychological considerations aside, arises out of too much consumption — and the expensive surgical treatments for it are an example of how the private issue of what we eat becomes a public issue; basically: we have eaten too much, and are now a burden on the public purse.

Drugs? Take them. Sex? Have it now and to hell with the consequences. Abortion’s easy now. Manners? Who cares. Patience? What’s that? Parents? Ignore them as soon as you can, and especially once you’ve got to university thanks to their money and effort. Teachers? What do they know? Rules? They’re for other people. Religion? It’s a wicked fraud designed to keep us down. This belief is itself a moral code, but one which is entirely based on the desires of the person involved — and which is destined to cause growing problems as more and more unfettered egos bump into each other.

The same attitude could probably be observed, I suspect, in response to the above suggestion that medicine become more preventative in nature — this is the illustration of the elephant, so to speak. For as surely as our society believes that rosaries should be kept far away from ovaries, we believe every bit as much that nobody is allowed to tell us to put the cheeseburger down in favour of a green vegetable…even if that is exactly what we need to do.

It might seem strange for a “freespeecher” to be thinking in this manner, but let us come back to what was said above, O Reader. Let us look again at the issue of where the private exercise of rights becomes a public issue. With freedom of speech, that line ostensibly exists at the exact point where the articulation of an idea or viewpoint becomes incitement to violence. We have laws against that sort of thing (and rightly so).

Where does that line exist regarding the issue of what we eat? Does it exist at all? Should it exist, if it currently does not? How might we effect such a thing in real life? One possible answer is that receiving treatment is contingent upon meeting a set of criteria both pre- and post-surgery, although what the penalty would be for breaking such an agreement post-surgery would be, I do now know (a gastric bypass can’t really be undone, after all). The idea of a user-pay system for obesity treatments is a tempting thought, but given that even in the U.S. obesity is on the rise, the effectiveness of that idea is called into question. Denial of treatment to those who did not seek counselling earlier on in their obesity is a possibility, although that raises other issues.

Social upheaval would probably achieve the best results, but it would be rather unrealistic to expect such a thing to occur.

Update: Welcome, Steynians!

~ by Kenneth on May 28, 2008.