Surgery: Treating the Severely Obese

Surgery: Treating the Severely Obese

Lead in: According to the World Health Organization, globally there are now more than 1 billion overweight adults, and at least 300 million of them are obese. During the last 40 years, obesity has reached epidemic proportions. There are more obese people each year, and the severity is increasing. In the United States alone, 300,000 deaths are associated with obesity. Thesis: Many obese people fail diet after diet. For them, bariatric surgery is an option even though risks are involved (Flancbaum, et al. 7; Goodman par 3; “The Weight” par 2).

Overview

Obesity is climbing the charts as being a major killer of our population. This paper informs the reader on how bariatric surgery treats the severely obese. Focus is given on who should have bariatric surgery, how the surgery works, risks of bariatric surgery, and what the patient can expect. Bariatric surgery is reserved for people who have been unable to lose weight on professionally managed weight-loss programs and those with obesity-related conditions such as diabetes, or the risk of them.

When surgery is an option for weight loss

The best candidates for bariatric surgery are patients who have a body mass index (BMI) of 40 or greater, or 35 or greater and associated obesity-related conditions such as diabetes, heart disease, and sleep apnea (see figure 1.1, pg 8 & table 1, pg 6). In terms of pounds, qualifying for surgery estimates to being 100 pounds above ideal body weight. A patient must have also gone through some sort of organized weight loss program in the past, and failed to maintain weight loss (Flancbaum, et al.15).

How surgery promotes weight loss

Gastrointestinal surgery for obesity, also called bariatric surgery, alters the digestive process. The operations promote weight loss by closing off parts of the stomach to make it smaller. These procedures are referred to as restrictive procedures because they cut down on the amount of food the stomach can hold. These types of procedures are less common due to the complications involved (Flancbaum, et al. 27, 52).

The most popular operations combine stomach restriction with a partial bypass of the small intestine. These procedures create a direct connection from the stomach to the lower segment of the small intestine, literally bypassing portions of the digestive tract that absorb calories and nutrients. These are known as malabsorptive operations. Malabsorptive operations produce effective weight loss, and often reverse