What about obesity surgery?
Obesity surgery is recommended as a treatment option for persons with obesity that have: 1) a BMI > 40 or 2) a BMI of 35 to 39.9 with serious medical conditions. Obesity surgery is used to modify the stomach and or intestines to reduce the amount of food that can be eaten. Surgery is a well-established method for long-term weight control for persons with severe obesity.
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Much progress has been made to develop safer and more effective procedures used in obesity surgery today.
Before surgery, patients should be informed about the risks and benefits. Patients should be motivated and committed to making a lifestyle change after surgery. Obesity surgery helps you lose weight by changing the way your body digests and absorbs food. Your body digests food to break down what you eat into small pieces of nutrients (carbohydrates, proteins, fats, vitamins and minerals). When the pieces are small enough, the cells of your body absorbthe nutrients to give you energy to live. Digestion and absorption begin in the stomach, continue through the small intestine and end in the large intestine, which digests and absorbs what it can and eliminates the rest as waste. Obesity surgery involves making changes to the stomach and/or small intestine.
Two forms of surgery have been recommended by government consensus panels that can be performed to treat severe obesity. Both are for people with severe cases of obesity, over 100 lbs above ideal body weight (e.g., BMI >40 kg/m2*) who have not had effective weight loss with diet, exercise and drugs.
Gastroplasty involves surgically reducing the size of the stomach. About 40% of patients lose half of their extra weight the first year. Gastric bypass surgery creates a small stomach pouch and connects this pouch to the second portion of the intestines. This surgery is more extensive and difficult to perform than gastroplasty, but it is also more effective. From initial evaluation to post-operative follow up, requires careful monitoring for the first two-year period by a multidisciplinary teams of surgeons, physicians, psychologist and allied health professionals to counsel on special diets, exercise and monitoring for a lifetime. Liposuction is not a treatment for obese patients. It is a way to remove fat cells at certain points of the body for cosmetic reasons, but this operation alone does nothing to solve problems like overeating.
Improvements in surgical techniques have resulted in considerable progress in safety, effectiveness and long-term integrity for promoting weight loss. Within 30 days of surgery, 93.4% of patients from a national registry reported no complications from surgery. Weight loss usually occurs soon after obesity surgery and continues for 18 months to two years. Most patients regain some weight after this time, however few regain it all. After five years, patients have reported maintaining a weight loss of 60% of excess weight. Patients will often see improvements in obesity-related medical conditions that they had before surgery such as diabetes mellitus, glucose intolerance, high cholesterol/triglycerides, hypertension, and sleep apnea. In general, 60% of patients with obesity-related medical conditions are no longer on medication for these conditions three years after surgery. Patients have reported an enhanced quality of life, improved mobility and stamina, better mood, self-esteem and interpersonal effectiveness, and lessened self-consciousness. |