Morbid Obesity and Treatment Options
What is morbid obesity?
Morbid obesity is a Body Mass Index (BMI) of 40 or more, which is roughly equal to 100 pounds or more over ideal body weight. The disease of morbid obesity interferes with basic physical functions such as breathing or walking. Long-term effects of the disease include shorter life expectancy, serious health consequences in the form of weight-related health problems (co-morbid conditions) such as type 2 diabetes and heart disease, and a lower quality of life with fewer economic and social opportunities.
What causes morbid obesity?
The causes of morbid obesity are multiple and complex. Despite conventional wisdom, it is not simply a result of overeating. Research has shown that, in many cases, significant, underlying causes of morbid obesity are genetic, environmental, and social. Studies have demonstrated that, once the problem is established, efforts such as dieting and exercise programs have a limited ability to provide effective long-term relief.
What is a co-morbid condition?
There are two definitions for a co-morbid condition: the presence of one or more disorder or disease in addition to a primary disorder or disease; or, the presence of a disorder or disease that is caused by or otherwise related to another condition in the same patient. The primary disease of morbid obesity can lead to several co-morbid conditions.
What is bariatric surgery?
Bariatric surgery is a procedure designed to make the stomach smaller so the patient feels satisfied with less food. It is intended for people who are 100 pounds or more overweight (with a Body Mass Index of 40 or greater) and who have not had success with other weight loss therapies such as diet, exercise, medications, etc. A person with a Body Mass Index (BMI) of 35 or greater and one or more co-morbid condition also may qualify for bariatric surgery.
What is Body Mass Index (BMI)?
BMI is a measure used to index a person's height and weight. BMI allows healthcare professionals and patients to better understand health issues associated with a specific weight classification (classifications such as obesity and morbid obesity).
How do I know if I qualify for bariatric surgery?
Patients should have:
- 100 pounds or more of excess weight; or a BMI of 40 or greater
- A BMI of 35 or greater with one or more co-morbid condition
Other common guidelines include:
- Understanding the risks of bariatric surgery
- Committing to dietary and other lifestyle changes as recommended by the surgeon
- Having a history of weight loss treatments having failed the patient
- Undergoing a complete examination including medical tests
Is bariatric surgery right for me?
Talk with your surgeon about the different surgical treatments, as well as the benefits and risks.
1. Bariatric surgery is not cosmetic surgery.
2. Bariatric surgery does not involve the removal of adipose tissue (fat) by suction or surgical removal.
3. The patient must commit to long-term lifestyle changes, including diet and exercise, which are key to the success of bariatric surgery.
4. Problems after surgery are rare, but corrective procedures may be required.
What are the complications and risks associated with bariatric surgery?
As with any surgery, there are immediate and long-term complications and risks. Possible risks can include, but are not limited to:
- Complications due to anesthesia and medications
- Deep vein thrombosis
- Dehiscence (separation of areas that are stitched or stapled together)
- Leaks from staple lines
- Marginal ulcers
- Pulmonary problems
- Spleen injury
- Stenosis (narrowing of a passage, such as a valve)
What are the possible side effects of bariatric surgery?
Side effects include:
- Dumping syndrome
- Nutritional deficiencies
- Need to avoid pregnancy temporarily
- Nausea, vomiting, bloating, diarrhea, excessive sweating, increased gas, and dizziness
What is a gastric banding procedure?
Gastric banding is a purely restrictive surgical procedure in which a silicone band is placed around the uppermost part of the stomach. The band is adjustable and can be periodically tightened or loosened depending on the patient's needs.
How successful is bariatric surgery?
Studies show that bariatric surgery can effectively improve and resolve many co-morbid conditions. A review of more that 22,000 bariatric surgery patients showed:
- Improvement in or complete resolution of conditions including type 2 diabetes, hypertension, and sleep apnea
- 61.2 percent reduction of excess weight
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