Wednesday, April 23, 2014

Gastric Surgery for Severe Obesity

Table of Contents

Definition

Obesity is a medical term meaning the storage of excess fat (adipose tissue) in the body. When a patient begins to have illnesses due to their weight, it is termed morbid obesity. Weight loss surgery (Bariatric Surgery) is sometimes an option to help patient lose weight and better control the associated illnesses.

Description

Often referred to as a "disease," obesity is actually a sign of what may well be a spectrum of different kinds of disorders - genetic or environmental. In fact, there is no single definition of obesity. It may be simply an extreme degree of overweight, but a person can be overweight without being obese: a 250-pound six-foot linebacker, for example, may be overweight according to ordinary standards, but may actually have a below-average amount of body fat. In contrast, a person in a normal weight range but with very sedentary habits could have a small muscle mass and be storing excess fat and thus be classifiable as obese. A patient’ s ideal body weight is estimated by tables that use height as a major determinant for ideal weight. However, this is not an exact science.

Estimates from national databases suggest that perhaps two-thirds of all Americans are above their ideal body weight as determined by standard tables. For the majority of these people, the excess weight is in the form of body fat, not muscle mass. One-third of all Americans are classified as obese because their Body Mass Index (BMI) is greater than 30. BMI is calculated by dividing the measured body weight in kilograms by the height in meters squared. The normal BMI is 19 to 25 kilograms per meters squared.

Morbid obesity is a condition in which people are at very high risk of suffering from medical problems or even death. Consensus recommendations are to limit surgical therapies to patients with a Body Mass Index (BMI) greater than 40 without any obesity-related illnesses or 35 with one or more-obesity related diseases, such as high blood pressure or diabetes.

BMI is calculated by dividing the measured body weight in kilograms by the height in meters squared. The normal BMI is 19 to 25 kilograms per meters squared.

Successful programs for weight loss reduction and maintenance should be started and continue under the care of a physician. The program may include:

  • A low-fat, high-complex carbohydrate, high fiber diet
  • Behavior modification to change eating behavior
  • Exercise
  • Social support
  • Medications, both over-the-counter and by prescription

Questions

Am I considered overweight, obese or morbidly obese?

What is my ideal body weight?

Is the obesity caused by other medical problems, or are any of my other medical problems worsened by my obesity?

What are they?

Do you recommend surgery to help reduce weight?

What type of surgical procedure do you recommend?

What are the risks and complications?

What is the long-term prognosis?