There's a new option for people who have considered stomach-shrinking bariatric surgery as a solution to their weight problem but are put off by the serious risks of the operation. It's a "virtual" surgery that uses the power of hypnosis to convince people that their stomach size has been surgically reduced. Even though no actual surgery is done, hunger abates dramatically...and the pounds start dropping off.
It's risk-free, effective and relatively economical. And unlike real bariatric surgery, which is only for people who are severely obese, this virtual surgery is an option for people who are merely overweight as well as for those who are obese. Here's how it works...
New way to "Think Thin"
Real bariatric surgery involves stapling off or removing part of the stomach... or cinching a plastic gastric band around the stomach. Either way, the amount of food that can be consumed is drastically reduced and rapid weight loss typically occurs. However, surgery carries significant risks, including the possibility of cardiac problems, pneumonia, bowel obstructions, bleeding, infection and even death. Also, certain foods must be permanently avoided after surgery because they would cause serious cramping, diarrhea or other upsets.
Safer alternative: The "virtual surgery" called gastric band hypnosis (GBH) carries none of those risks, according to Jennie J. Kramer, MSW, LCSW, founder and executive director of Metro Behavioral Associates Eating Disorder Treatment Centers in New York City and Scarsdale, New York, whose center provides GBH in conjunction with psychotherapy and nutritional counseling. With GBH, surgery takes place only within the "theater of the mind," not in an actual operating room, Kramer said. In essence, during hypnosis, the person's brain is retrained to believe that the stomach has undergone surgery to make it smaller-so that afterward, he feels satisfied with much smaller amounts of food and thus loses weight. ''And since there is no cutting, there is no anesthesia, no pain, no scarring, no recovery time and no risk,'' Kramer said.
The GBH experience: After an initial consultation, the GBH protocol typically consists of four weekly hypnosis sessions, each lasting 60 to 75 minutes. The virtual "surgery" is done during the first session. The patient reclines comfortably and is hypnotized so that he is in a fully conscious yet deeply relaxed state.
Then the practitioner mentally guides the patient by describing each phase of the procedure... donning a hospital gown, signing a consent form, being wheeled into the surgical prep area, receiving anesthesia, having the gastric band applied around the stomach, closing the incision and being wheeled into the recovery room. To make the experience seem more real, the patient listens to hospital sounds (doctors and nurses talking, monitors beeping, etc.) through headphones. Some practitioners also may arrange for the patient to smell an appropriate aroma (such as an antiseptic) and/or feel a scratch on the back of the hand when "anesthesia" is administered. When the virtual procedure is finished, the patient is brought back out of the hypnotic state.
Why might this work? "The subconscious mind, which is where hypnosis takes effect, is very susceptible to positive suggestions and does not really differentiate between fantasy and reality," Kramer said. "So if your subconscious mind believes that you have had actual gastric banding surgery, your body-including your appetite and satiety cues-responds as if you'd really had the surgery."
Effective, but not magic
The patient's work doesn't end when the hypnosis component of the therapy is finished-because he still has to make permanent changes in his diet. "Let me be clear that GBH is no more a miracle than bariatric surgery. GBH can fail in exactly the same way that surgery can fail if the proper supports are not in place and the underlying causes of food addiction are not addressed," Kramer said. "You have to look at the patterns in your life to find out how your relationship to food got so distorted, then develop a healthier and sustainable relationship with food. That way, GBH can be a kick-start that sets you on the road to losing weight and keeping it off."
To that end, Kramer said, a complete GBH program includes not only the virtual surgery element, but also additional hypnotherapy and counseling during which patients explore the issues that underlie their weight problems and that trigger their overeating.
During the second, third and fourth hypnosis sessions, which take place a week apart, the hypnotherapist addresses the emotional aspects of overeating. For example, Kramer said, the patient might be asked to recall past incidents related to eating... or to summon up an image of himself as a child, then have a kind and gentle conversation about food with that child. Another exercise might involve imagining a beautiful, safe, comfortable place-one to which he can return, in his own mind, whenever he needs help coping with cravings, anxiety or stress. The patient also works on these emotional issues at home every day, guided by CDs and workbooks provided by the hypnotherapist.
Following that, patients participate in six monthly sessions of individual and/or group therapy that reinforce positive lifestyle changes as the excess weight is being lost. Kramer also recommends participating in a relevant 12-step group such as Overeaters Anonymous and receiving nutritional counseling as further insurance against going back to old unhealthy eating patterns after GBH.
Practical Matters
How effective is GBH? Numerous studies have shown that hypnosis is an effective means of bringing about weight loss, and that when used in combination with psychotherapy, hypnotherapy is more effective than psychotherapy alone. But the question about GBH specifically is still under investigation because no randomized clinical trials have yet been published on the technique. "Currently, a trial is being conducted under the auspices of the National Health Service of Great Britain, and the results thus far are quite compelling,'' Kramer said.
Who is a candidate for GBH? Due to its risks, actual bariatric surgery generally is limited to people who are morbidly obese, with a body mass index (BMI) of 40 or higher... or to obese people with a BMI of 35 to 40 who also have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea. But because gastric band hypnosis is virtual and completely safe, it is an option not only for obese people, but also for those who are merely overweight.
Finding a practitioner: Many hypnotists work with patients who want to lose weight, but you may have to hunt some to find one who's trained in GBH. One option is to visit the website of the program's British originator, Sheila Granger (www.sheilagranger.com), which lists practitioners who have trained directly with Granger. Or check with established professional organizations such as the National Guild of Hypnotists and the International Association of Counselors and Therapists to find hypnotherapists near you, then contact them to ask whether they practice GBH. Note that techniques similar to GBH are known by other names, including virtual gastric band (VGB) and various trademarked terms.
The cost: Actual weight-loss surgery typically costs $20,000 to $35,000. Though GBH is far less expensive than surgery, it's not cheap, typically running $1,000 to $1,500 for the first four sessions, plus about $200 for each of the six subsequent monthly sessions, for a total of about $2,200 to $2,700. Unfortunately, health insurance generally does not cover these costs. However, hypnosis for medical reasons is an allowable expense for health-care flexible spending accounts and health savings accounts-and if it allows you to get your weight down for good, it could be an excellent investment in your health and well-being.
