There is a growing awareness that obesity is a disease, one that affects about one-third of adults in the United States. What’s worse is it is often accompanied by other serious health conditions including diabetes and heart disease.

We also know that bariatric or weight-loss surgery has been shown to be effective in eliminating or improving these conditions, as well as helping individuals reach their target weight.

How does someone determine whether they are a candidate for this kind of surgery? Patients are typically about 100 pounds or more overweight. They are exhausted from trying, and failing, every diet out there.

But as I tell our patients, the operation is only the first step toward recovery to a stable and healthier life. Emotional suffering may be one of the most painful parts of obesity, and one of the most difficult to heal. American society emphasizes physical appearance and often equates attractiveness with slimness, especially for women. Such messages make overweight people feel unattractive. In addition, many people think that individuals with obesity are gluttonous, lazy or both. This is not true. As a result, people who are obese have often faced years of prejudice or discrimination in the job market, at school and in social situations. Feelings of rejection, shame or depression may occur.

The good news is that major weight loss has almost immediate advantages. Most obese patients are also living with one or more serious ailments such as diabetes, high cholesterol, gallbladder disease, coronary artery disease, osteoarthritis or other health conditions, collectively known as co-morbidities. Bariatric surgery is often effective in treating these conditions. In a study of 104 patients, 90.8 percent of patient conditions were improved or eliminated a year after the operation.

However, patients go through stages of adjustment not only physically but also psychologically. In fact, we find that there is almost a period of mourning for the old, unhealthy lifestyle and the false comfort that overeating brought. People learn weight-loss surgery will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have inflicted on their emotional well-being.

I know this firsthand, because, in addition to being director of the Bariatric Surgery Program at Pali Momi, I have been through the surgery myself.

That’s why the Bariatric Support Group is such a key component of Pali Momi’s program. According to Dr. Mark Grief, bariatric surgeon at Pali Momi Medical Center, continuing post-surgical support helps produce the greatest level of success for patients. The group provides patients with a safe, caring environment in which to discuss both personal and professional issues.

They also have fun learning together. The Pali Momi Support group is multifocal, addressing body, mind and spirit. Topics range from healthy cooking classes to discussions on willpower. Recent sessions gave instruction on core muscle strength, Zumba basics, how music affects mood, and plastic surgery after weight loss. Twice a month, the group meets outside the support session for a fun, easy walk. The wide-ranging activities help members find ways to help each other engage in the transition to lifestyle behaviors that are essential for a successful surgery outcome. Studies show that it’s easier to adopt a new habit when you have someone by your side.

The Pali Momi Bariatric Support Group meets at 6:30 p.m. the second Wednesday each month. The next session is tomorrow. It’s free and open to all. Call 485-4173 or visit www.palimomi.org/bariatrics/.

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Christie Keliipio, R.N., M.S.N. is the director of the Bariatric Surgery Program at Pali Momi Medical Center. The monthly Health Scene column features information and advice from Hawaii health care professionals.