Saturday, May 15, 2010


Bariatrics is a speciality in medicine that treats obesity.  Bariatric surgery is the term used for operations to help promote weight loss.  There is an epidemic of obesity in the United States and around the world.  Physical Education is rarely taught in school, and the abundance of fast food has contributed to an unhealthy lifestyle & poor eating habits.
Obesity has resulted in multiple medical problems such as heart disease, diabetes and hypertension.  Any surgical procedure has higher complication rates in patients that are obese.  When a person's weight increases to an extreme level, it is termed morbid obesity.

Bariatric surgery is beneficial in patients with morbid obesity (over 100 pounds overweight or a body mass index of greater than 40). It is always better to try to loose the weight with diet, exercise and lifestyle changes, but when these things are unsuccessful, surgery is an option.  The body mass index (BMI) is a standard way to classify obesity.  The BMI is calcuated based on a person's weight in kilograms (2.2 pounds equals one kilogram) divided by the square of the height in meters (39.37 inches equals one meter).
For instance, if you weigh 180 pounds and are 6 feet tall, your BMI would be calculated as follows:
Weight (180 pounds equals 81.8 kg)
divided by Height (72 inches equals 1.83 meters) squared

81.8 kg
divided by 3.35 meters        
equals a BMI of 24.4.

Overweight:      BMI of 25 or more
Obesity:            BMI of 30 or more
Morbid Obesity: BMI of 40 or more

Bariatric surgery is major surgery and has risks and long-term consequences.  With newer laparoscopic techniques (surgery performed through lighted scopes with smaller incisions), the surgery has become less invasive, although not every patient may be a candidate for laproscopic bariatric surgery. There are various types of Bariatric Surgery.  In Gastric Bypass (Roux-en-Y Gastric Bypass), the stomach size is permanently reduced to an "egg-sized" pouch. The pouch is reattached to a segment of intestine that bypasses the stomach.  In the Gastric Sleeve Resection, a portion of the stomach is removed, turning the stomach into a narrow tube. In the Adjustable Gastric Banding Procedure, the size of the opening from the esophagus leading into the stomach is reduced by an adjustable band that can be controlled via a port placed under the skin.  By inflating or deflating the band through this port, the band can be adjusted to make the opening larger or smaller.  The band can be removed at any time making this a reversal procedure.

Before considering this surgery, do your research and select a board certified surgeon with special training in this procedure.  Make sure he has had significant experience with all techniques. The hospital should be one that is committed to this type of surgery on a regular basis.

After the weight has stabilized (usually about a year), attention can then be turned to the excess skin in various areas of the body.  I will hold that discussion for another day!