The Mitzvah of Weight Loss Surgery

Sermon delivered March 18, 2011, by Rabbi Barry H. D. Block

Like many people, I have struggled with my weight all of my life.  I was a chubby kid, and I suffered for it.  I became very heavy in high school.  During the summer after my first year in college, I was a counselor at Greene Family Camp.  Somehow, I managed to survive on massive amounts of coffee, little more than lettuce, too many cigarettes, and four hours of sleep each night for about eight weeks.  By the end of the summer, I had lost something on the order of 40 pounds.  No doctor would have approved of my methods, but I was thrilled.

Though I have never again been as overweight as I was in June of 1982, I have continued to struggle with my weight as an adult.  Our congregant, Michael Levine, used to sell me clothes.  Every time I walked into the store, Michael would say, “Oh, you’ve lost weight.”  I could have gained 20 pounds and needed a bigger size, but Michael complemented me on my supposed weight loss every time. Steve, do you use that one?   It works on me.

Admittedly, my own struggles with weight pale in comparison to the trials that some people endure.  For so many men and women, and increasing numbers of children, fat is the defining, even terrorizing, issue of their lives.  Diets don’t work, or they do work, but only for so long.  A combination of physical and emotional issues makes losing weight very difficult for tens of millions of Americans.  The medical community has yet to come to a full understanding of the growing problem of obesity, its causes and cures.

Making matters worse, a shameful stigma is often attached to being significantly overweight.  Many assume that people who are obese are gluttonous and slothful.  People who are very overweight face job discrimination, not to mention countless humiliations, from stepping on the scale in the doctor’s hallway to squeezing into an airline seat.  Depression and poor self-image are too often the results.  Refuge may then be most easily found in food, complicating and worsening the problem in an unending cycle.

Blessedly, many people are able to overcome even tremendous, debilitating weight problems through diet and exercise, and even through unhealthy rigors like my own youthful scheme.  The payoff is tremendous:  Losing a significant amount of weight improves a person’s health in countless ways:  lower blood pressure, less dependence on insulin for type-2 diabetics, lower cholesterol, and improvement in orthopedic problems are just a few.  And that’s even before we address enhanced self-esteem, improved job opportunities and even enhanced romantic prospects, not to mention fitting into those favorite old jeans.

Our Jewish tradition enjoins all of us to take measures to improve our own health.  Maimonides, the great philosopher and rabbi who codified Jewish law in medievalEgypt, was also a physician.  He taught that we must address our physical well-being in order to achieve a healthy soul.  I think, too, of Moses’ words to the Children of Israel, as they prepare to enter the Promised Land.  He exhorts them, “Choose life, that you and your children may live.”  People who have undertaken the hard work of losing a great deal of excess weight understand Moses’ words in ways most of us cannot.  They have overcome tremendous obstacles, choosing life for themselves, for their own children, and generations to come.

Often, in the 21st Century, that hard work is approached with the assistance of weight-loss surgery.  Whether by gastric bypass or lap band or some other new procedure, bariatric surgery offers hope to women and men who have lost hope in their struggles to achieve a healthy weight.  Life can be made better, and longer, with this new and developing technology.

Sadly, I also have found that some people who have undergone this surgery are ashamed.  That shame is as understandable as it is destructive.  From the advertisements we see on television to the photographs of models in magazines, our society sends a clear message:  Fat represents failure.  People who do not understand the rigors of weight-loss surgery imagine these procedures to represent a cop-out.  Bariatric surgery, in this mindset, is for people too lazy to restrict their diets or stick to an exercise regime.

My experience with Temple members who have undergone weight-loss surgery teaches me that nothing could be farther from the truth.  In many cases, patients are in fact required to restrict their diet and to exercise regularly for a year or more in order to qualify for the surgery.

The surgery itself is no picnic, nor is the recovery.  The risk of complications is considerable.  Most importantly, the patient absolutely must adopt a tightly controlled, extremely limited diet for the rest of his or her life.  Most can only eat or drink small amounts at any given time.  They continue to undertake the hard work of controlling their weight for the rest of their lives.

Why do they do it?  The men and women with whom I have spoken have chosen life, just as Moses commands.  In the months after their surgery, they lose massive amounts of weight.  They look great and feel terrific.  Still more importantly, their blood pressure comes under control, often without medication for the first time in many years.  They may no longer be dependent on insulin to manage their diabetes.  Their risk of heart disease and of debilitating stroke drops precipitously.

For most, though, the payoff is even greater.  More than one woman has told me that she can get down on the floor and play with her grandchildren in ways that she had never dreamed.  And they find that Maimonides was right:  Improved physical health and the loss of all that weight lead to greater self esteem, to improved mental health, to greater spiritual fulfillment.

The time has come to remove the stigma from those who undergo weight-loss surgery.  Instead of seeing themselves as failures, those who lose large amounts of weight with surgical assistance may understand themselves to have taken very difficult steps to overcome a problem of a lifetime.  Instead of hiding the fact that they have undergone surgery, let us help patients proudly proclaim that they have gone to great lengths to preserve and enhance their lives.  Instead of tolerating health insurance policies that do not cover this life-saving surgery, let us demand that this important avenue to health be made broadly available.

Weight-loss surgery is not a cop-out.  Instead, those who choose bariatric surgery are performing a mitzvah:  Men and women who have struggled with weight all their lives have found a way to fulfill the religious obligation to care for the bodies God gave them.  Instead of viewing weight-loss surgery with derision, let us respond to this medical advance with gratitude.  We give thanks for God’s healing power, implanted in the minds and hands of surgeons and researchers who have developed this new and unique healing gift.

Last week, we began reading the Book of Leviticus.  Tonight’s Torah portion, like much of this book, is filled with details of the ancient sacrifices.  This week, Rabbi Naama Kelman reminded us of an important rabbinic teaching.  When the messianic age comes, all sacrifices will become obsolete except for the offering of thanksgiving.  Even when all our cares are gone, when the world is at perfect peace, we will still owe an obligation to God.  Even when we no longer need to pray for peace, we must give thanks for peace.

Similarly, the obligation of a person who has undergone weight-loss surgery never ends.  Yes, they have requirements strictly regulating their diet.  Even more, let all who have undergone this life-saving surgery offer a lifetime of thanks for their renewal, in the loving embrace of family and community who rejoice with them.