| Bariatric Surgery.info Surgical Treatment of Obesity |
Valid option to treat malignant, morbidly
obese patients |
Surgical Treatment of ObesityWeight loss surgery is now established as a valid and effective way of treating both morbid and malignant obesity, yet this surgical approach still carries a stigma. Obesity - Dramatic IncreaseObesity, usually defined as having a body mass index of 30+, is dramatically increasing throughout the world, especially the Western world. For example, 20 years ago 5 percent of the population in the United Kingdom was obese; now 17 percent is. Moreover, the obesity-related health care costs now total £2 billion in the United Kingdom and $68 billion in the United States. How Obesity is TreatedMost patients who are obese are treated with a combination of advice on diet and lifestyle, and in some cases with weight loss drugs, such as Xenical. However, for patients who have morbid obesity (body mass index >40), this conventional approach to weight reduction is doomed to failure. If left untreated, patients who are morbidly obese (1-2 percent of the population in the United Kingdom) have only a 1 in 7 chance of reaching their normal life expectancy. Surgical TreatmentIn comparison, a Cochrane review in 1997 noted that good results had been gained from surgery for obesity in these patients. Over the past decade both the National Institutes of Health in the United States and the Scottish Intercollegiate Guidelines Network have suggested that bariatric surgery is the most effective treatment for selected patients who are morbidly obese. Both organisations have advised that such weight loss surgery be carried out more frequently. Weight Loss Surgery CriteriaThe selection criteria for surgery have been established by the International Federation for the Surgery of Obesity. The criteria are having a body mass index >40 or body mass index of 35-40 in patients with serious co-morbid disease that is treatable by weight loss, being obese for a minimum of 5 years, having had conventional dietary treatment that failed, having no history of alcohol misuse or major psychiatric illness, and being aged between 18 and 55 with acceptable operative risk as determined by preoperative assessment. Women must avoid becoming pregnant within two years of the operation. Bariatric Patient Support and CounselingThe surgery must be delivered in a multidisciplinary environment. There should be a dietician or specialist nurse to counsel the patient before and after surgery, a physician to assess fitness for surgery and to exclude patients who have endocrine causes of obesity, a psychologist to help the patient adjust to new eating habits after surgery, an anaesthetist who is experienced in anaesthetising obese patients, and a radiologist who can interpret special radiological investigations and carry out band adjustments if a gastric band has been inserted. See also: ------------------------------------------------ Gastric Bypass Bariatric Information |