What Fullness Is

On getting weight reduction surgery

The first weight-loss surgery was performed during the 10th century, on D. Sancho, the king of León, Spain. He was so fat that he lost his throne, so he was taken to Córdoba, where a doctor sewed his lips shut. Only able to drink through a straw, the former king lost enough weight after a time to return home and reclaim his kingdom.

The notion that thinness — and the attempt to force the fat body toward a state of culturally mandated discipline — begets great rewards is centuries old.

Modern weight-loss surgery began in the 1950s, when surgeons employing various techniques caused their patients fairly distressing problems, like severe diarrhea, dehydration, kidney stones, gallstones, and even death — but, generally, the patients lost weight. Surgeons have since refined their techniques, using a range of restriction or malabsorption methods to force the human body to lose weight. They have tried wiring patients’ jaws shut to force weight loss through liquid diets. They have stapled stomachs into smaller pouches to restrict caloric intake. They have developed gastric bands and balloons to restrict the amount of food that can enter the stomach. But it was the first laparoscopic gastric bypass—in which the gastrointestinal tract is routed around a person’s stomach—performed in 1994, that enabled bariatric surgery to go more mainstream by way of minimal invasion.

Some of these interventions have succeeded for people, and some have failed, because not even surgical intervention can overcome the reasons why many people gain and then struggle to lose weight. Some bodies and minds simply cannot be brought to heel.

I capitulated to a procedure after more than 15 years of resistance and had a sleeve gastrectomy at the UCLA Ronald Reagan Hospital in January 2018. I told only a few people; I did not tell my family. I felt — in equal parts — hope, defeat, frustration, and disgust.