Few people can be unaware that being overweight is a bad thing. It contributes to a range of conditions most of us would wish to avoid, including heart disease, stroke, hypertension, diabetes, cancer, arthritis, and asthma, to name but a few. Diet and exercise are the obvious ways forward, with anti-obesity drugs helping in some cases.
Morbid obesity has a definition, a BMI (Body Mass Index) of 40 or more, or 35 or more in the presence of significant co-morbidities. A BMI of 40 for someone 1.8 meters (almost six feet) tall would mean a weight of about 130 kg (almost 300 lbs) or more. Here more extreme measures are suggested, including obesity surgical therapy.
Surgery for morbid obesity is considered when all other treatments have failed. Research has shown that surgery resulted in greater weight loss than conventional treatment, and led to improvements in quality of life and obesity related diseases such as hypertension and diabetes. But, complications (for example wound infection), side-effects (for example heartburn) and some deaths may occur. A number of different surgical procedures are available, but the evidence was limited and of poor quality, making it difficult to draw any conclusions about comparative safety and effectiveness. Weight loss following open and laparoscopic surgery was similar, but recovery was often quicker following laparoscopic surgery.
A new systematic review and meta-analysis of surgical therapy in people massively overweight indicates the results to be impressive, in terms of weight loss and other conditions. This type of surgery is known as bariatric surgery.
Bariatric surgery, also known as "weight-loss" surgery, is designed to help severely overweight individuals lose weight, achieve better health, and enhance their quality of life. Morbid Obesity has reached almost epidemic proportions, with millions of people suffering from its debilitating effects.
Obesity surgical procedures were grouped into gastric banding, gastric bypass, gastroplasty, biliopancreatic diversion or duodenal switch, and other procedures. Some of them are explained below.
Gastric banding or 'lap banding' limits the capacity of the stomach so you feel full after eating a small amount of food. Keyhole surgery is used to tie an inflatable band around the top part of the stomach, creating a small pouch at the top. This limits the amount of food your stomach can hold. Food then slowly passes from the pouch into the lower part of your stomach and on into your digestive system.
Gastric bypass is permanent surgery on the stomach to reduce the length of the digestive tract and stop food being absorbed. A small pouch is created at the top of the stomach. Part of the in testine is then grafted to the top of this pouch so food bypasses the stomach and much of the in testine, meaning it can't be digested.
Gastric balloon insertion is a less permanent type of surgery. A balloon is placed on the end of a thin, flexible tube called an endoscope. It is inserted into your stomach via your mouth. Liquid or air is then pumped into the balloon so it partially fills the stomach. This creates a feeling of fullness. The balloon is usually removed after six months.
Complications of weight-loss surgery include the usual risks of surgery and long-term digestive problems such as nausea, heartburn, vomiting and diarrhea.
After surgery your body absorbs less food, but it will also absorb less vitamins and nutrients. This means you are at greater risk of diseases caused by vitamin and mineral deficiency such as anemia and osteoporosis.
Recovery from morbid obesity surgery takes time and patience. The diet is strict; you may experience discomfort and pain as your body heals, and the length of time to return to normal activities can vary from patient to patient. Some patients are able to return to work within a few weeks and see weight loss fairly soon after surgery. For others, a couple of months go by before they experience noticeable weight loss.
The limited evidence suggests that surgery is more effective than conventional management for weight loss in morbid obesity. The comparative safety and effectiveness of different surgical procedures is unclear. Regular exercise, next to following your bariatric program’s dietary guidelines, is an important factor when it comes to optimizing your health outcomes and quality of life after morbid obesity surgery.