Surgery for Obesity does in fact exist in various methods, and for some it may seem like the only option.
The ultimate biological basis of severe obesity is still unknown and therefore specific therapy for the severe obese is not yet available. Severe obesity is accompanied by a reduction in life expectancy.
In 1978, the National Institutes of Health (NIH) formed a consensus on surgery for severe obesity and considered primarily intestinal (jejunoileal) bypass, which exerts its weight loss effects through poor absorption, decreased food intake, and possible other mechanisms. This surgery seemed effective, but came with serious complications! During the next 2 decades, other surgical procedures developed.
Bariatric surgery provides substantial weight loss and ameliorates co-morbid conditions, including sleep apnea, hypoventilation, glucose intolerance, diabetes, hypertension, and serum lipid abnormalities. It possibly prevents end-organ damage as seen in renal disease, stroke, heart attack and heart failure; and may improve mood and other aspects of psychosocial functioning.
Major types of surgery for the severe obese include vertical-band gastroplasty, Roux-en-Y gastric bypass and biliopancreatic bypass. However, it’s not the intention of this book to expand on the surgical interventions for the severe obese.
What I do like to point out is the many risks involved with these type of surgeries. Why? Well, many people who are obese (but not severly enough to have surgery), will opt for surgery because they ASSUME it’s the easy way out!
The immediate mortality rate is very low; however the morbidity in the early postoperative period is as high as 10%. WOW, 1 out of 10 people die? Almost unbelievable! This high morbidity rate is due to wound infections, dehiscence (a previously closed wound that reopens), leaks from staple line breakdown, stomal stenosis (narrowing of stomach), marginal ulcers, various pulmonary problems, and DVT (deep venous thrombosis, or simply a blood clot).
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In the later post-operative period other problems may arise such as pouch and distal esophageal dilation, persistent vomiting, cholecystitis (infection of the gallbladder), and failure to lose weight or keep the weight off!
Long-term complications such as micronutrient deficiencies are common (B12, folate, iron).
“Gastric dumping syndrome” is another possible complication. This happens when the lower end of the small intestine expands too quickly due to the presence of hyper-osmolar food from the stomach. Symptoms include nausea, vomiting, bloating, cramping, diarrhea, dizziness, fatigue, weakness, sweating, and dizziness.
Mortality and morbidity rates are higher with re-operation. In other words, it’s key to keep the weight off after the first surgery (if you survive).
And then there are some quality of life considerations. Not only will there be reorientation and adjustment to the side-effects of the surgery, but one has to also consider the effects of changing body image. Euphoria can be seen in the early postoperative period; and some patients experience significant late postoperative depression.
Surgery is ONLY recommended if the body weight is in excess of over 100 pounds (BMI: 35-40+), if co-morbidities threaten the patient’s life, AND ONLY if ALL OTHER conservative measures failed!
Yours in Optimal Health,
Dr. Mike
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Tags: healthy lifestyle, morbidly obese, obesity, Sensible Weight Loss, surgery for obesity
Interesting article
Comment by Christina — January 4, 2010 @ 11:22 pm
These procedures seem pretty extreme! They’re the easy way out, but I’d only consider them if I was on the verge of death. Walking alone would be a great start to healthy living.
Comment by Dylan — January 5, 2010 @ 10:27 am