Ask the Pros: Dr. Jacqueline Jacques

I know it’s been a bit since I posted one of these… I have other folks I’m hitting up and will continue to pop these up as I get them back.

Dr. JacquesA quick recap – I had this idea to present some questions about men and obesity/bariatric surgery to some “pros”, not just patients. This go around, I have some feedback from Dr.Jacqueline Jacques, ND. Dr. Jacques works for Bariatric Advantage as their Chief of Scientific Affairs. She does a lot of speaking world-wide and I heard her a couple years back when she was here in the Minneapolis area. Since then she’s been kind enough to actually chat with me once in awhile via twitter and email.

Ok, so on to the Q?&A!

What do you see as the trend when it comes to men seeking weight loss surgery?

More men are definitely having surgery – I actually just saw some number on this at ASMBS, but I apologize that I don’t recall exactly what they were.

What do you see as the barrier or barriers, internal and/or external, to men seeking out weight loss surgery?

Men don’t seek out any option for weight loss as often as women do – really until recently, the weight loss market in general is very much female-dominated. I think the collective reasons are complex – social acceptability, psychology that leads men to think they have to do it themselves, perhaps even a greater range of size acceptance for men than women in our culture.

We all know the percentage of men who have weight loss surgery is rather low, somewhere around 15-20%, but it seems that when it comes to participation in “after-care” (ie. support groups, online forums, and other groups that make up the “WLS community”) it seems the numbers are even lower. Do you agree with this, and if so, why do you think this is?

While it’s not my area of expertise, I think this is likely to be rooted in male psychology – men more often see themselves as supporters, not those in need of support. The need to seek support is still too often seen as a weakness and a sign of failure. This plays together with societal “blame and shame” around weight (it is the fault of the individual being weak and not controlling what they eat, etc…) – so I think this really gets exaggerated for men. Although I will say this – I have attended many hundreds of support groups all around the US in the past decade and there are many more men present than ever before. I used to see them rarely – now I hardly go to a group that has no men. So something has shifted. In part, this is likely to be more men having surgery, but maybe as obesity becomes more accepted as a chronic disease this starts to change how people view themselves and their care.

What do you think you can do, in regards to your particular profession, to help “get the word out”, to help the men out there realize that WLS is a valid treatment for their obesity? And what suggestions do you have for other individuals out there in how they might help as well.

Rob, frankly, we are not doing a great job of getting most of the people – male or female – into any treatment for obesity at all. I think the U.S. Preventive Services Task Force (USPSTF) recommendation to screen all patients for obesity and refer them for treatment is a decent step in the right direction.

Once we start treating obesity like the chronic disease it is, we will get more people to the best treatment options – surgical or otherwise. I think much of the total problem starts there. As it is, less than 1% of the people in the US who would qualify for surgery actually get it.

But the root of this is that we have treated weight historically more as an issue of personal responsibility than as a serious medical condition. If we can shift that, if we can treat obesity as we treat all other chronic disease, I think the question will be different. We might be asking “how do we train more bariatric physicians and surgeons?” rather than “how do we educate more men about surgery?” Does that make sense?

The emphasis in that last quote is mine… and I think it’s one of the key take aways from what Dr. Jacques had to say.

Thank you again to Dr. Jacques, if you want to connect more with her you can find her as twitter or on her personal blog, Not Born to Run.

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About Rob

I had RNY Gastric Bypass on April 8, 2009. I went from my heaviest of over 380 down to a low of 188 (for about a day!) before working on rebuilding muscle and such. Now I maintain at about 225. WLS has changed my life in so many ways, including my career as I now tackle nutritional coaching and other obesity education issues and is also a co-host on The Wake Up Call, a health and wellness radio show.