Bariatric Surgery Overview
Obesity is defined as a "life-long progressive, life-threatening, costly, genetically related, multi-factorial disease of excess fat storage." Severe obesity is a chronic condition that is difficult to treat through diet and exercise alone. Overweight and obese individuals are at increased risk for type 2 diabetes, heart disease, hypertension, stroke, obstructive sleep apnea, respiratory problems, gallbladder disease, osteoarthritis, endometrial, breast, prostate, & colon cancers, poor female reproductive health, & depression. Obesity is estimated to lead to 400,000 deaths annually. Diet and exercise only works for 1 in 20 people. Gastrointestinal surgery is the best option for people who are severely obese and cannot lose weight by traditional means or who suffer from serious obesity-related health problems. The surgery promotes weight loss by restricting food intake and, in some operations, interrupting the digestive process. As in other treatments for obesity, the best results are achieved with healthy eating behaviors and regular physical activity.
People who may consider gastrointestinal surgery include those with a body mass index (BMI) above 40 - about 100 pounds overweight for men and 80 pounds for women (see table 1 for a BMI conversion chart). People with a BMI between 35 and 40 who suffer from type 2 diabetes or life-threatening cardiopulmonary problems such as severe sleep apnea or obesity-related heart disease may also be candidates for surgery.*
|Table 1: Body Mass Index
Find your weight on the bottom of the graph. Go straight up from that point until you come to the line that matches your height. Then look to find your weight group.
|Body Mass Index (BMI)
|U.S. Obesity Prevalence
The concept of gastrointestinal surgery to control obesity grew out of results of operations for cancer or severe ulcers that removed large portions of the stomach or small intestine. Because patients undergoing these procedures tended to lose weight after surgery, some physicians began to use such operations to treat severe obesity. The first operation that was widely used for severe obesity was the intestinal bypass. This operation, first used 40 years ago, produced weight loss by causing malabsorption. The idea was that patients could eat large amounts of food, which would be poorly digested or passed along too fast for the body to absorb many calories. The problem with this surgery was that it caused a loss of essential nutrients and its side effects were unpredictable and sometimes fatal. The original form of the intestinal bypass operation is no longer used.
The Normal Digestive Process
Normally, as food moves along the digestive tract, digestive juices and enzymes digest and absorb calories and nutrients (see figure 1). After we chew and swallow our food, it moves down the esophagus to the stomach, where a strong acid continues the digestive process. The stomach can hold about 3 pints of food at one time. When the stomach contents move to the duodenum, the first segment of the small intestine, bile and pancreatic juice speed up digestion. Most of the iron and calcium in the foods we eat is absorbed in the duodenum. The jejunum and ileum, the remaining two segments of the nearly 20 feet of small intestine, complete the absorption of almost all calories and nutrients. The food particles that cannot be digested in the small intestine are stored in the large intestine until eliminated.
How Does Surgery Promote 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. Operations that only reduce stomach size are known as "restrictive operations" because they restrict the amount of food the stomach can hold.
Some 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.*
* Disclaimer: The testimonials, statements, and opinions presented on our website are only applicable to the individuals depicted, and may not be representative of the experience of others. The testimonials are provided voluntarily and are not paid, nor were they provided with free services, or any benefits in exchange for said statements. The testimonials are not indicative of future results or success of any other individuals. Association of South Bay Surgeons a Medical Group, Inc cannot and does not guarantee the medical outcome or the results of individuals utilizing the services provided by us.*
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