Eating Disorders vs. Obesity Surgery: A Book Comparison

Introduction: Two Books on a Common Theme

Upon first examination, there would appear to be several areas of similarity between Carlos Grilo's Eating and Weight Disorders and Obesity Surgery: Stories of Altered Lives, co-authored by Marta Meana and Lindsey Ricciardi. Both works detail the finer points of cautionary measures regarding complications of eating, as well as the many hazards that may accompany this seemingly innocuous yet vital act. However, thorough analysis of each book reveals a departure in methodology and purpose. Eating and Weight Disorders takes a decidedly academic approach, presenting a comprehensive overview of the various types of disorders associated with eating — including specific symptoms, potential treatments, and overall prevalence. Obesity Surgery: Stories of Altered Lives, on the other hand, concerns itself with the nuances influencing the causes and procedures of surgery to correct obesity, adopting a more sociological focus in examining the psychological processes involved in this medical intervention.

The point of commonality between the books lies in their treatment of the all-too-frequent occurrence of obesity and its influence on self-image and overall health in contemporary Western society. While Meana and Ricciardi's manuscript deals solely with this particular condition, obesity is one of many disorders detailed in Grilo's work, which is primarily focused on eating disorders of all varieties. Interestingly, Grilo contrasts the nature of obesity with that of typical eating disorders, stratifying the former from the latter by classifying obesity primarily as a physical medical condition, while denoting that the root causes of eating disorders are primarily psychological in nature (Grilo, 2006, p. 14). The contrast continues with the author's assertion that obesity is an extremely common occurrence in Western society, while eating disorders are significantly rarer. Furthermore, Grilo cites obesity as one of the leading causes of morbidity and mortality, and notes that its prevalence is steadily increasing (Grilo, 2006, p. 4).

Divergent Approaches to Obesity

The premise of Meana and Ricciardi's book certainly seems to agree with many of Grilo's assertions regarding obesity, for the simple fact that the authors have devoted the vast majority of their pages to factors involved in what is commonly perceived as a correction to such an issue: a surgical procedure that inherently reduces the human body's capacity to become corpulent. Yet the authors' approach to deconstructing the nature of obesity greatly varies from Grilo's removed, academic analysis of qualitative statistics and citations of previous sources. Meana and Ricciardi instead focus on the social, psychological, and decidedly more human aspects of a condition that would drive people to consider — and actually undergo — gastrointestinal surgery.

The following quotation, in which the authors attend a prospective-patient seminar for the surgical procedure, elucidates the fact that this humanistic approach is one of the principal themes of Obesity Surgery: Stories of Altered Lives:

"Sitting among the audiences of severely obese individuals and a smattering of significant others, we found ourselves humbled by the challenges these individuals had faced in the past and were about to confront in their near future… We didn't discuss whether this surgery was really necessary or whether these folks would be better served by a good lifestyle-modification program. We wondered what their lives were like and the ways in which these lives would be changed by weight loss" (Meana and Ricciardi, 2008, p. 1).

This passage underscores a degree of compassion and highlights the authors' concerns for the specific, individual social and psychological ramifications of people's attempts to cope with obesity — concerns that Grilo's work does not address. What makes this comparison all the more noteworthy is that Eating and Weight Disorders addresses similar issues, albeit from a distanced, academic standpoint that rarely — if ever — considers the human dimension of the subjects whose statistical data it presents. The following quotation, in which Grilo presents information about individuals attempting to lose weight, illustrates his characteristically detached, academic approach:

"The prevalence of attempting to lose weight in the U.S. has been studied in several large and ongoing national studies. Serdula, Mokdad, Williamson, Galuska, Mendlein, and Heath (1999), based on data for 107,804 adults obtained by a random telephone survey as part of the Behavioral Risk Factor Surveillance System, estimated the prevalence of attempting to lose weight was 28.8% in men and 43.6% in women. Interestingly, among those who reported that they were attempting to lose weight, a common strategy (34.9% of men and 40% of women) was to eat less fat but not fewer calories" (Grilo, 2006, p. 32).

Thorough examination of this passage is necessary to understand a fundamental difference between Grilo's writing and that of the authors of Obesity Surgery: Stories of Altered Lives. Grilo is obviously engaged with his subject, as his interest in the particular weight-loss strategies of the men and women mentioned in the passage readily indicates. Yet the tone he employs in this quotation — as well as throughout the book — is authoritative and well removed from whatever crises, circumstances, and personal difficulties the subjects of his statistics may have endured. It may be inferred that Grilo undertook a book on eating disorders and obesity because he cares about the discomfort associated with these conditions, but this concern is never made manifest in his writing, which is altogether formal, impersonal, and analytical.

The Human Element in Obesity Surgery: Stories of Altered Lives

By contrast, as the passage from Meana and Ricciardi's work illustrates, it is precisely the interest in the human aspects of psychological and social despair, pain, and humiliation that drives their entire book. The entire first half of Obesity Surgery: Stories of Altered Lives details the mundane, minute occurrences that profoundly affect obese people and propel several of them — at least the ones mentioned in the book — to seriously consider gastrointestinal surgery. As the title of the work suggests, individual anecdotes and personal emotions are presented to give the general public a greater understanding of the reasons behind corrective surgery for obesity. This emotional appeal for understanding is extremely apparent in the following quotation, in which an obese subject recounts her feelings of despair regarding her weight:

"Daphne: I remembered I had stepped on the scale, and I saw how heavy I was [350 pounds]. I was taking a shower with my kids who were toddlers at the time. Now this is a small square shower, and I pretty much took up the whole space. I remember crying hard and looking up and crunching my fists and saying, 'Why? God, why are you letting me die? I'm a good person'" (Meana and Ricciardi, 2008, p. 14).

The emotional appeal of this passage is clear from the subject's tone and actions. Her cries regarding her dissatisfaction with her weight, and the imagery of her girth filling an entire shower while her toddlers stand beside her, are used by the authors to convey feelings about this particular subject — Daphne — as well as about the broader subject of obesity, both to engage the reader and to elicit understanding for why individuals pursue gastrointestinal surgery. Furthermore, this passage illustrates the authors' concern with the human reality behind the raw figures and statistical data that Grilo's work relies upon. It presents a more complete story behind the phenomenon of obesity in a way that Grilo's writing, even at its most illustrative, does not.

Conclusion: Complementary Commentaries

The personalized touch in the writing and depiction of obesity prevalent in Meana and Ricciardi's work, largely absent from Grilo's Eating and Weight Disorders, should not be taken as an indication that Grilo is indifferent to the plight of his subjects, many of whom struggle with eating disorders beyond obesity. Grilo's heavy reliance on statistical data and impersonal accounts of the various eating afflictions presented in his text serves a clear purpose: it helps him codify a number of useful methods to combat such afflictions. His book also helps illuminate the complications of obesity as manifested in other food-related disorders such as binge eating and bulimia.

Both works, then, are vital commentaries on the state of eating habits and their complications for residents of contemporary Western society. Each offers cautionary perspectives — in decidedly different forms — to help prevent and support those undergoing such problems in their lives. Read together, they provide a fuller picture than either could offer alone: Grilo supplies the clinical framework and evidence base, while Meana and Ricciardi supply the human stories that give that framework meaning.

References

Grilo, C. M. (2006). Eating and Weight Disorders. New York: Psychology Press.

Meana, M., & Ricciardi, L. (2008). Obesity Surgery: Stories of Altered Lives. Reno: University of Nevada Press.