Obesity, when do you need surgery?
 
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Obesity, when do you need surgery?

Date: 23/01/2017
Last edited: 01/05/2017

Obesity is one of the most pervasive, chronic diseases in need of new strategies for medical treatment and prevention.It is increasing around the world. High body mass index now ranks with major global health problems such as childhood and maternal under-nutrition, high blood pressure, high cholesterol, unsafe sex, iron deficiency, smoking, alcohol and unsafe water in total global burden of disease.

Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both terms mean that a person’s weight is greater than what’s considered healthy for his or her height.

Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active.

The presence of obesity increases the risk of a number of medical conditions, including cancer. A co-morbid condition is a health condition related to a primary disease such as obesity.

There are many health conditions related to morbid obesity, but some of the most common are:

  • Type 2 diabetes, which can lead to heart disease, kidney failure, blindness, amputation of the feet or legs, and nerve damage
  • Heart disease, such as hardening of the arteries, heart attack, and angina
  • High blood pressure, which can lead to heart disease, stroke, kidney failure, and vision loss
  • High cholesterol, which can lead to heart disease, stroke, and kidney failure
  • Obstructive sleep apnea has been associated with high blood pressure
  • Acid reflux/GERD, which can lead to esophagitis, Barrett’s esophagus, and esophageal cancer (adenocarcinoma)
  • Cancer
  • Depression
  • Osteoarthritis and joint pain, which can lead to loss of mobility
  • Stress urinary incontinence
  • Female reproductive health disorder, which can lead to infertility and sexual dysfunction

Are you a candidate for surgery?

Obesity surgery is the last resort, when all other attempts at weight loss have failed and the person’s health is at risk. Even then, this type of surgery needs careful consideration by balancing the risks of obesity against the chances of success and possible side effects of such procedures. It is not a form of cosmetic surgery, nor an alternative to good eating habits and regular exercise.

Obesity surgery can offer rapid weight loss but, to be successful, it must be accompanied by healthy eating habits and regular exercise. If the surgery is reversed, weight will inevitably be regained (even with the best of willpower), as the genetic tendency resulting in obesity can never be cured and is only modified by surgery.

You may be a candidate for weight loss surgery if:

  • You’re an obese adult, especially if you have a weight-related condition, such as type 2 diabetes.
  • You know the risks and benefits.
  • You’re ready to adjust how you eat after the surgery.
  • You’re committed to making lifestyle changes to keep the weight off.

Types of surgery

There usually are 4 types of surgery to reduce obesity (bariatric surgery):

  • Gastric Bypass
  • Sleeve Gastrectomy
  • Adjustable Gastric Band
  • Biliopancreatic Diversion with Duodenal Switch (BPD/DS)

Each of these procedures have there advantages and disadvantages.

Gastric bypass:
The Roux-en-Y Gastric Bypass – often called gastric bypass – is considered the ‘gold standard’ of weight loss surgery. The surgeon leaves only a very small part of the stomach (called the pouch). That pouch can’t hold a lot of food, so you eat less. The food you eat bypasses the rest of the stomach, going straight from the pouch to your small intestine. This surgery can often be done through several small incisions using a camera to see inside (laparoscope). Doctors can also perform a mini-gastric bypass, which is a similar procedure also done through a laparoscope. In Geneva, this surgery is performed with the Da Vinci Robot.

Sleeve Gastrectomy
This surgery removes most of the stomach and leaves only a narrow section of the upper part of the stomach, called a gastric sleeve. The surgery may also curb the hunger hormone ghrelin, so you eat less.

Adjustable Gastric Band
The surgeon puts a small band around the top of your stomach. The band has a small balloon inside it that controls how tight or loose the band is. The band limits how much food can go into your stomach. This surgery is done using a laparoscope.

Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
This is complicated surgery that removes most of the stomach and uses a gastric sleeve to bypass most of your small intestine. It limits how much you can eat. It also means your body doesn’t get as much of a chance to absorb nutrients from your food, which could mean you don’t get enough of the vitamins and minerals you need.

With any type of weight loss surgery, you still must focus on eating a healthy diet and becoming more active as part of your lifestyle.

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