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Surgical Management of Obesity

Obesity is a prevalent condition worldwide, affecting more than 30% of adults. In developed countries it is the primary factor in the most common chronic diseases such as hypertension, diabetes, heart disease and elevated lipids. Traditional weight loss interventions such as dieting, exercise and behaviour modification are not always effective, especially in individuals with morbid obesity (body mass index >40 kg/m2). In such cases surgery is an option.
The appropriate term for obesity surgery is Bariatric surgery. It is the most effective form of weight loss available and is recommended for individuals with morbid obesity and/or individuals with BMI >35 who suffer from other chronic medical conditions such as diabetes. Outcomes show a 20-30% weight loss after 1-2 years and partial or full resolution of Type 2 Diabetes, Hypertension, hypercholesterolemia and Obstructive Sleep Apnea.
Bariatric procedures work by either restricting the amount of food consumed or contributing to malabsorption of the food consumed. Some procedures have both effects. The first procedure was performed in the 1950s and was a malabsorptive type procedure, which led to significant nutritional problems such as vitamin deficiencies, diarrhea, protein-calorie malnutrition and others. This specific type of procedure is no longer performed but it served as the springboard for more effective procedures.
Current technology and surgical advancements have given birth to a number of simple, effective and minimally invasive bariatric procedures. Most surgeries can be performed either via the traditional open route or by laparoscopy. In 2003 20% of cases were by laparoscopy and this increased to 90% by 2008, which has resulted in less complications and a faster recovery. It is now one of the fastest growing surgical subspecialties with over 340,000 procedures performed annually worldwide with approximately 200,000 performed yearly in the U.S.
Individuals who meet the criteria for weight loss surgery should seek treatment through a recognized bariatric program. The key to a successful and satisfactory outcome is extensive education and counselling providing by a bariatric team. This should cover all aspects of the surgery; expectations of outcomes, nutrition, and lifestyle changes required to facilitate long-term success and include psychological assessment and counselling. The other major component of the team is a skilled and experienced surgeon. The American Society for Metabolic and Bariatric Surgery is one source for finding qualified providers.
If you suffer from Obesity and related chronic diseases there are options. Talk with your doctor to see if Bariatric surgery is an option for you. If your doctor is not knowledgeable, then search for a Bariatric and Weight Management program in your area. You can have a consultation visit where information is provided. In speaking with individuals who have gone through this procedure, it has been a life-changing experience. It may also be a life-saving.
I hope this article has provided you with information that will help you make wise choices, so you may:

Live healthy, live well and live long!
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Content copyright © 2015 by Dr. Denise Howard. All rights reserved.
This content was written by Dr. Denise Howard. If you wish to use this content in any manner, you need written permission. Contact Dr. Denise Howard for details.


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