Obesity: a Disease You Can Live Without
This article, written by Dr. Matthew Brengman, first appeared on the website for Advanced Surgical Partners of Virginia.
Obesity is a complex, misunderstood, and mistreated disease, and with over 30% of the United States adult population suffering from it, it has become the number one public health concern, according to the Centers for Disease Control. The World Health Organization defines Obesity as a disease in which excess fat is accumulated to an extent that health may be adversely affected. Measured by a person’s BMI (Body Mass Index), a person is diagnosed as Morbidly Obese when their BMI is more than 40. This presents significant health risks as well as opens the door for co-morbid conditions such as Type 2 Diabetes, High Blood Pressure, Heart Disease, Asthma, and Obstructive Sleep Apnea, among others. Morbid Obesity is the second leading cause of preventable adult death in the United States, behind cigarette smoking.
There are two treatment methods for Morbid Obesity – medical and surgical. Medical management involves tactics such as a very low calorie diet, exercise, anti-obesity medications (appetite suppressants, fat absorption blockers, etc.), and behavior modification. These are all overseen by a physician or a medical professional, but do not have a very high long-term success rate. Surgical management of Morbid Obesity is intended to induce substantial, clinically significant weight loss that is sufficient to reduce obesity-related medical complications to acceptable levels. Options for bariatric (weight-loss) surgery include Adjustable Gastric Banding, Vertical Sleeve Gastrectomy, and Gastric Bypass procedures.
The benefits of bariatric surgery are many, and research continues to positively evolve on this topic. Bariatric surgery tames hunger, enabling patients to feel satisfied with small amounts of food. It helps to eliminate or prevent many medical problems, and improves mobility, energy, self-image, and the ability to lead an active life. When accompanied by sensible behavioral changes of prudent nutritional choices and regular exercise, bariatric surgery patients achieve and maintain greater than 50% of excess weight loss for ten years and longer.
Some impressive statistics regarding post-bariatric surgery outcomes include:
- Type 2 Diabetes remission in 76.8% and significantly improved in 86% of patients.
- Hypertension eliminated in 61.7% and significantly improved in 78.5% of patients.
- High Cholesterol is reduced in more than 70% of patients.
- Obstructive Sleep Apnea is eliminated in 85.7% of patients.
- Joint Disease, Asthma, and Infertility are dramatically improved or resolved in patients.
- Bariatric surgery patients, on average, lost between 62-75% of excess weight.
What makes someone a good candidate for bariatric surgery? Our patient selection criteria are based on National Institute for Health (NIH) and American Society for Metabolic and Bariatric Surgery (ASMBS) standards for consideration of weight loss surgery. Prospective patients will have tried and failed at non-surgical treatments for Severe and Morbid Obesity, have a BMI greater than 40 or greater than 35 with significant presenting co-morbidities. Patients must complete and comprehensive medical, psychological, and nutritional evaluation before surgery, and must be well-informed and show an understanding and acceptance of the operation’s benefits and risks. Most importantly, to ensure post-operative success, patients must be willing to commit to a long-term lifestyle focusing on physical, psychological, and nutritional healthy living. This is supported by long-term follow-up post-surgery.
When is bariatric surgery not the best option? Contraindications for bariatric surgery include cases where the procedure represents an unacceptable risk to the patient, the patient doesn’t understand or accept the risks and commitments that accompany such a life-changing procedure, there is active evidence of alcohol and/or drug abuse, the patient has untreated or unmanageable psychiatric disability, patients who have not tried non-surgical potentially effective treatments, and those with reversible endocrine disorders that can be the root cause of their Morbid Obesity or Metabolic Disease.
The MBSAQIP-accreditedbariatric surgery program at Advanced Surgical Partners of Virginia and Parham Doctors’ Hospital offers a comprehensive clinical approach to weight loss management for the morbidly obese. Our program has a full complement of resources for surgical weight loss to help provide every patient with personalized attention and compassionate care. Our continuum of care includes highly experienced weight loss surgeons who are trained in the latest minimally invasive surgical techniques, a caring and specially trained nursing and support staff, pre- and post-operative nutritional counseling, in-depth pre-operative dietary and behavioral modification education, an individualized plan of treatment and care to assure consistent and successful outcomes for patients, monthly support group meetings, and long-term follow-up with all of our patients.
You can contact Dr. Brengman with any questions here.