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Obesity is a chronic (long-term) medical disease that affects over 11 million people in the United States.
"Severe obesity" means that a person is 100 lbs. or more above ideal weight, or has a Body Mass Index (a ratio of a person's height and weight) of 40 or higher. Because severe obesity so often causes deadly health problems, it is also referred to as "morbid obesity."
Risks of morbid obesity include high blood pressure, heart disease, type 2 diabetes, stroke, osteoporosis, respiratory problems, sleep apnea, and some cancers. Because of American society's emphasis on physical appearance, obesity also causes significant emotional stress.
Every year, over 300,000 people die of obesity-related diseases in the United States.
Weight loss surgery can be an effective therapy for obesity in patients who do not achieve sufficient weight loss through changes in diet and exercise. The most common weight loss surgeries in the U.S. are Roux-en-Y Gastric Bypass (RYGB) and Laparoscopic Adjustable Gastric Banding (LAGB). In RYGB, part of the stomach is closed off with staples and a portion of the small intestine is re-routed to the remaining pouch. The RYGB method has been proven to result in significant weight loss and reduction of patient mortality.
During Laparoscopic Adjustable Gastric Banding, the surgeon works through several small incisions in the abdomen, fitting an adjustable band around the upper stomach. This “pinches off” a small section of the stomach, and when the patient eats, he or she will feel full as soon as this small pouch becomes full. Only small amounts of food can be consumed at one time. LAGB is proven to result in short-term weight loss. Long-term effects are less certain, because the procedure is relatively new— it has only been used in the U.S. since 2001. It is less invasive than RYGB and results in fewer post-surgical complications.
Risks of weight loss surgery are significant. RYGB risks include obstruction of the stomach, bleeding, gastrointestinal leakage, and protein malnutrition. Complications that may occur with LAGB include slippage of the band, band erosion, and infection. All weight loss surgery patients should receive pre-surgical counseling and nutritional coaching, as well as substantial follow-up support.
Sources:
American Obesity Organization, "What is Obesity?" AOA Fact Sheet, 2002. Available online at http://www.obesity.org/subs/fastfacts/obesity_what2.shtml
Massachusetts Department of Public Health, "Weight Loss Surgery: A Primer for Patients," 2002. Available online at http://www.mass.gov/dph/betsylehman/patients_primer_04.htm
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