This month’s column is personal. I have a family member who I hope will consider bariatric surgery. I also work with a woman who had bariatric surgery three years ago. She is my nurse. She looks incredible, lost 90 pounds and considers it the best money she ever spent. She also is my patient and all of her medical conditions were “cured” by her procedure, and when she brings in “before” pictures, I have trouble recognizing her.
There are an estimated 61.3 million (30.5 percent) obese adults in the United States, and 9.6 million morbidly obese adults. Obesity, a leading cause of death worldwide, is a condition where excess body fat accumulates to the extent that it adversely affects health. In a doctor’s office, a number called the body mass index (BMI) is calculated to determine obesity levels. Healthy values range from 18.5 to 24.9. Anything above 30 is obese, while anything above 40 is morbidly obese.
Many common diseases are strongly associated with obesity. Life expectancy decreases by 20 years for a morbidly obese man and five years for a morbidly obese woman.
The primary treatment for obesity is dieting and physical exercise, and anti-obesity drugs may be tried. When these treatments fail, the last resort is surgical intervention or bariatric surgery.
To qualify for bariatric surgery an individual must meet specific criteria.
How does bariatric surgery work? Simple. The bariatric surgeon alters your digestive tract – the stomach and small intestine – making it impossible to eat much food in one sitting. There are two main types of surgery:
1. Restrictive Surgery (Lap band, stomach stapling or vertical banded gastroplasty). These procedures alter the size of the stomach to restrict calories. The size is reduced to the size of an egg using special staples or a silicone band. These are reversible and don’t fundamentally alter the anatomy of the digestive system
2. Malabsorptive Surgery (Roux-en Y). This is a two-part procedure. First, the surgeon reduces the size of the stomach, and second, the surgeon bypasses the first portion of the small intestine. This causes food to pass more rapidly through the digestive tract. So, even if the patient over-eats, fewer calories will be absorbed
The Success rate for bariatric surgery is very high. Also, high blood pressure is cured in 50 percent of patients, Type 2 Diabetes is cured in 80 percent, sleep apnea is cured in 75 percent, and shortness of breath is relieved in 80 percent.
The cost of the procedure can be substantial, and not all health insurance plans cover it.
There are risks to both procedures, but with experienced surgeons in an appropriate hospital, the risks are minimized. Memorial Regional Hospital in Hollywood has been designated as a “Center for Excellence” for bariatric surgery. There are free informational seminars offered on a regular basis for those considering the surgery. One group of surgeons I highly recommend has a very informative Web site at www.hollywoodbariatrics.com.
Obesity is an extremely common problem and a very serious health concern. It goes far beyond cosmetics. It is an excellent reason to visit your doctor and begin a discussion.
Richard J. Wilbur, M.D. is Board Certified in Internal Medicine. Dr. Wilbur practices at
Safecare Medical Center’s Hollywood office, located at 4050 D Sheridan St., Hollywood, FL 33021. For an appointment with Dr. Wilbur, contact his office at 954-989-7441 or online at www.safecare.com.
