Weight loss with bariatric surgery

Tired of dieting? Have you wondered about bariatric surgery? Surgical treatment is medically necessary for morbid obesity because it is the only proven method of achieving long-term weight control for these people. Morbid obesity correlates with a Body Mass Index (BMI) of 40 kg/m2 or with being 100 pounds overweight. Being overweight is associated with real physical problems, which are now well recognized. The most obvious is an increased mortality rate directly related to weight increase. In a 12-year follow-up of 336,442 men and 419,060 women, it was found that the mortality rates for men 50 percent above average weight were increased approximately twofold. In the same weight group the mortality was increased fivefold for diabetics and fourfold for those with digestive tract disease. In women, the mortality was also increased twofold, while in female diabetics the mortality risk increased eightfold and threefold in those with digestive tract disease. It is clear that overweight people of both sexes, especially young overweight people, tend to die sooner than their lean contemporaries. While obesity itself is a risk factor, most mortality and morbidity is associated with the co-morbid conditions. This applies to non-operated as well as peri-operative mortality and morbidity. These conditions have been outlined in the 1985 National Institutes of Health Consensus Conference and include hypertension, hypertrophic cardiomyopathy, hyperlipidemia, diabetes, cholelithiasis, obstructive sleep apnea, hypoventilation, degenerative arthritis and psychosocial impairments.

Surgical treatment is not just a cosmetic procedure for the obese. Bariatric surgery involves reducing the size of the gastric reservoir. This reduces caloric intake and ensures that the patient practices behavior modification. Success of any surgical treatment must begin with realistic goals and progress through the best possible use of well designed and tested operations. The option of surgical treatment is now offered to patients who are morbidly obese, well informed, motivated and acceptable operative risks.

Almost 60 percent of bariatric surgeries will be done by a laparoscopic technique. There continues to be a learning curve for surgeons performing this type of specialized surgery; less experience or inadequate training means more complications, including potentially lethal leaks. Unfortunately, it is becoming increasingly clear that a significant percentage of bypass patients will regain most if not all of their weight. The weight gain occurs in most cases when the patient finds eating strategies that allow the intake of high calorie foods in multiple, small portions. It is important to keep in mind that morbid obesity is a complex problem that is not simply fixed by technically successful surgery. Although the impact of bariatric surgery on type 2 diabetes in obese patients is impressive, it would be premature to recommend bariatric surgery on a large scale purely as a treatment for diabetes.

Remember to always check with your physician before incorporating any changes in lifestyle choices. E-mail me with your suggestions, questions, and comments on healthy living at [email protected].