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Archive for May, 2012

WEIGHT LOSS SURGERY

Tuesday, May 22nd, 2012

Weight loss or bariatric surgery consists of a group of  surgical procedures which alter your digestive system in a way that enables you to lose a significant amount of weight by reducing nutrient absorption or limiting the amount of food you can eat. When efforts at diet and exercise have failed to produce the desired weight reduction results, a person who meets the accepted screening criteria may be a candidate for bariatric surgery.

A person with a body mass index (BMI), discussed in our previous blog, of 35-39.9 is considered obese and, in conjunction with a weight-related health problem, is considered a candidate for weight loss surgery.  A BMI of 40 or higher is considered extremely obese and would also be a potential beneficiary of these procedures.  However, additional medical guidelines and lifestyle changes must be met to be accepted for these procedures.WEIGHT LOSS SURGERY

Weight loss surgery requires a lifetime commitment to maintaining a healthy lifestyle. Weight related health problems that can benefit from these procedures include: heart disease, high blood pressure, type 2 diabetes, gastroesophageal reflux, and sleep apnea.

The three most widely practiced types of weight loss surgery include Gastric Bypass, LAP-BAND®, and the Gastric Sleeve.

Gastric Bypass

The smaller, upper part of the stomach is stapled, separating it from the rest of the stomach. The net result is that the amount of food you can eat is reduced. The small intestine is rerouted and connected to the smaller stomach pouch.

LAP-BAND®

A silicone rubber band is placed around the top of your stomach, creating a very small stomach pouch. When you eat, you feel full very quickly. Food slowly filters down from the smaller pouch into the lower part of the stomach and then into the rest of the digestive tract. The band can be adjusted afterwards and is reversible.

Gastric Sleeve

About 85 percent of the stomach is surgically removed in this procedure. The remaining stomach takes the shape of a tube or sleeve.

Weight loss surgery is performed under general anesthesia and can take one to four hours for gastric bypass surgery, 30 minutes to one hour for Lap-Band Surgery and up to four hours for gastric sleeve resection. Most are done using laparoscopic technique through small incisions. A hospital stay may be required.

It is best to consult a surgeon who specializes in these types of surgeries to determine your options for treatment. A good place to start is the American Society for Metabolic & Bariatric Surgery website.  The procedures that can be performed to treat the consequences of large volume weight loss on the appearance of the body will be discussed in our next blog.

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THE OBESITY EPIDEMIC

Wednesday, May 16th, 2012

Obesity occurs when a person consumes more calories than he or she burns, resulting in an excess proportion of total body fat. For many people this amounts to eating too much and exercising too little. The American diet is high in sugar, fat, and salt. It is no surprise that obesity has become an epidemic in the United States when an unhealthy diet is combined with a sedentary lifestyle. However, several other factors play a role in obesity. These may include: age, gender, genetics, environmental factors, psychological factors, medications, and illness.

A person is considered obese when his or her weight is 20% or more above normal weight. The most common measure of obesity is the body mass index or BMI. A person is considered overweight if his or her BMI is between 25 and 29.9; a person is considered obese if his or her BMI is over 30.

To measure your BMI:

BMI = Weight (lb) / (Height (in) x Height (in)) x 703 For example: if your weight is 170 and your height is 5’6” (66”), then the calculation is: (170/662) x 703 = 27.4

THE OBESITY EPIDEMIC

© 2012 Copyright – The Endocrine Society

Statistics published in January 2012 by the Centers for Disease Control show that 35.7% of U.S. adults and 16.9% of children are obese. In 2000, no state had an obesity prevalence of 30% or more. In 2009, nine states had an obesity rate of 30% or more and in 2010 this obesity rate has increased to 12 states.

Adult obesity is associated with a number of serious health conditions including heart disease, diabetes, and some cancers. Obese children are more likely to become obese adults. If children are overweight, obesity in adulthood is likely to be more severe.

Obese children are more likely to have:

  • High blood pressure and high cholesterol, which are risk factors for cardiovascular disease (CVD).
  • Increased risk of impaired glucose tolerance, insulin resistance and type 2-diabetes.
  • Breathing problems, such as sleep apnea, and asthma.
  • Joint problems and musculoskeletal discomfort.
  • Fatty liver disease, gallstones, and gastro-esophageal reflux (i.e., heartburn).
  • Obese children and adolescents have a greater risk of social and psychological problems, such as discrimination and poor self-esteem, which can continue into adulthood.

It is important for your doctor to evaluate your calorie intake, exercise activities, medical history, and family history in determining how best to manage a weight problem. A comprehensive program of diet and exercise is the first remedy that should be considered to treat obesity. In recent years, a variety of surgical choices for treating obesity have been popularized.

Next, we will discuss the different types of weight loss surgery options and the guidelines used to determine if someone should consider undergoing these procedures.

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