Every year, in France, 22,000 patients with severe or massive obesity are operated on. One in two is no longer followed by the medical profession two years later. Midi Libre listened to five patients who tried this last resort option, while the disease continues to progress: 17% of French people are obese, and more than a billion people are affected worldwide.
Jean-Jacques Fabre loved large dishes of green salad and tomatoes ripened in the summer sun. He “can’t stand raw vegetables anymore” and now ignores meat whereas it was “a great amateur. “Fall” at 82 kg after having weighed 157, the official also “voluntarily gained back around ten kilos”, “it was no longer me”.
Like Jean-Jacques Fabre, each year, 22,000 “people who will remain sick for life” have sometimes held the first objective, to lose a lot of weight. But the impact of obesity surgery, a last resort option against the disease of extreme overweight highlighted on World Day on Monday, March 4, does not stop at lost pounds and often improved health. On the other side of the scale, there are divorces, depression, nutritional deficiencies, burn-out, extreme fatigue, hair loss… The High Health Authority has just reframed the conditions for care.
“Surgery is not a wave of a magic wand, it’s a kick in the ass…, a new birth”summarizes Jean-Jacques Fabre, long surprised by the reflection of his new silhouette in the street windows. “It is not an end in itself and it is not El Dorado”adds his wife Catherine, also operated on for her obesity, tired of another ready-made message, which would like that“we have surgery because we are lazy and we choose the easy way”: “When you have surgery, you cannot tell yourself that you are going to be thin, beautiful, and get better. Yes, it will be different. But the problems will always be there. I don’t wish surgery on anyone.”
“Some patients still imagine that it will solve everything, it turns their lives upside down”testifies Hafida Ahansal, the ear of thousands of patients on the helpline of the National League Against Obesity, born in Montpellier ten years ago just on the initiative of Agnès Maurin, director of an association, and David Nocca, surgeon. It spread throughout France.
Questions relating to surgery represent “one in three calls”.
On the front line, the association’s patient experts actively participated in the new HAS recommendations, which Catherine Fabre, general secretary of the League, is delighted to see hardened. Claudine Canale, another expert patient, also: “I think there have been a lot of deviations in bariatric surgery, it’s good to reframe, to redefine the pathways”.
“This work is for life”
“Obesity is not just a question of weight”recalls, as the diet season approaches which “revolt” the “big ones”, this resident of Bouches-du-Rhône who came to have an operation in the expert center of the Montpellier University Hospital in 2010, to have another operation in 2023 for complications and incessant vomiting, six years after her husband, a year after his son.
“In 2010, a sleeve allowed me to lose 35 kilos. I was at 130 kilos, the doctors told me that if I did nothing, I would not live beyond the age of 50,” testifies Catherine Fabre, 58 years old, “still obese” weighing 88 kg for her 58 meter height, arriving in Montpellier after a life of medical examinations, diets, humiliation, and guilt.
Since then, another existence has begun, “without sleep apnea”, “without joint problems”but under constant supervision, “because if you are not supported behind, if you do not follow up, if you do not work on your illness, you return to the starting point. This work is for your whole life”.
“My husband’s big fear was that I would change mentally”
Surgery but also “dietician, psychiatrist, psychologist, endocrinologist…” Claudine Canale, 62 years old, operated on twelve years ago “for my health, because I couldn’t breathe anymore”, understands that“we get tired” in the course. “Since childhood, obesity has been a daily struggle, a suffering. And still today,” testifies the sixty-year-old, who went from 140 kg to 90 kg, after having dropped to 80 kg.
“For me, it’s something that works really well, but you have to be followed”she insists. “I meet a lot of people who are not aware that it is not enough to cut or divert a piece of the stomach.” This Italian woman who “love food” had to wait two years to eat pasta again, “al dente cooking was not ok”. She now has to divide her days into four snacks of “150 g of food, no more”to digest well.
“For four years, I have been eating from a dessert plate. Dishes with sauce are difficult, my stomach no longer digests them. Neither does lasagna, and anything made with tomatoes,” testifies Johanna Nay, 36 years old, fully satisfied with the intervention, a “by-pass”, carried out in 2020 in the private sector, half at her expense. “I did it for my children because I couldn’t keep up. I had my third afterwards. I respect the protocol, and I have no inconvenience”, welcomes the Hérault resident, who “lost 50 kg in six months”.
“My husband’s great fear was that I would change not only physically, but also mentally”she remembers, happy to get away with it like that. “Six of us were operated on at the same time. One person is depressed, two others are in very difficulty and are gaining weight again”…
“I don’t want to scare people but you have to be aware of what can happen”
Beyond her own experience, Aurélie Quillet, both psychologist and patient expert at the League, recounts the difficulties that she experienced: “Tooth problems, sexuality, food allergies, irritable bowel syndrome, inequality” support in expert centers, but also according to the regions… “I don’t want to scare people, but you have to be aware of what can happen.”
For her part, with forty kilos less, she “felt better” but also has “felt the positive looks on me, including that of men. One of my problems was a sexual assault when I was 17. Totally insecure, I gained 10 kg in a short time”.
And today a little more, “I can’t tell you how much, I weigh maybe 115 or 120 kilos… I no longer have diabetes, no more cholesterol, no more sleep apnea. But in terms of weight, we can call it a failure .”