Obesity isn’t just a concern about how people look from the outside. Obesity is a complex disorder of the body resulting from an excessive amount of body fat. Once considered as a problem of developed countries, obesity rates are on the rise in middle and low-income countries, as well. In the last 30 years, the prevalence of obesity is more than doubled.
But when is a person considered as obese? Normally, people with a BMI over 30 are considered obese. However, there are three different classes of obesity. People with a BMI from 30 - 34.9 are considered as Class I, people with a BMI from 35 – 39.9 are considered as Class II, while people with a BMI over 40 are considered as Class III or extremely obese.
What is BMI and how is it calculated? BMI, also known as Body Mass Index, is calculated by dividing the weight in kilograms by the height in meters squared.
Being obese increases the risks for many serious health conditions and diseases, like diabetes, high blood pressure, heart diseases, etc., a situation that we all should be aware off and try to maintain normal body weight before the situation gets out of control.
The most important thing in controlling and dealing with obesity is changing the diet. Behavioral changes, as well as physical activity, also help lose weight. However, in some cases medications as well as weight – loss surgeries are necessary to get rid of that extra fat.
Especially in really extreme cases, with Class III obesity the only solution that makes a change is bariatric surgery. But, what is bariatric surgery and when is it recommended?
Bariatric surgery is a safe and very effective treatment option, as mentioned especially for those dealing with extreme obesity. However, not every obese patient is a perfect fit for this type of surgery. Several criteria need to be fulfilled before an obese person is considered as the right fit for the surgery, like:
1. BMI over 40
2. BMI 35 to 39.9, accompanied by high blood pressure, type 2 diabetes or even sleep apnea.
3. No drug problems
4. No alcohol problems
5. No uncontrolled psychological conditions
6. No endocrine causes of obesity
7. Failed attempts for weight loss, etc.
Like any other surgical procedure, even bariatric surgery has its own risks and possible complications. Before making up your mind for this treatment option, it is well advised to consider and discuss all the risks and benefits with the health care provider.
What are the benefits of bariatric surgery? It results in weight loss of 10 – 35% of the total body weight. However, these changes occur during a period of one to three years after the surgery.
What are the risks and possible complications of bariatric surgery? This kind of surgery does not make miracles happen and people suffering from obesity will not always gain their desired body weight. So, this means that having realistic expectations is very important, as some patients are not satisfied with their weight after bariatric surgery. There is also always the possibility of gaining back all the weight, especially if this surgical treatment is not followed by a complete change of diet, physical activity, and everyday life.
Technical problems like separated stitches and complications with the surgical procedure itself are also possible. Other possible risks associated with bariatric surgery include adverse reactions to anesthesia, excessive bleeding, infections, lung problems, breathing problems, blood clots, leaks in the gastrointestinal system and in very rare cases even death. Long term risks and complications of bariatric surgery also include dumping syndrome, hernias, malnutrition, ulcers, stomach perforation, bowel obstruction, etc.
Choosing the right type of bariatric surgery is not an easy task. There are different types of bariatric surgery available today, like:
Roux-en-Y gastric bypass
Roux-en-Y gastric bypass is a non – reversible surgical method which consists in reducing the size of the stomach, by creating a small pouch and attaching the small intestines directly to the new stomach pouch created. This way a person can eat very small portions of food. However, the food also bypasses most of the stomach and the first section of small intestines, entering directly to the middle part of the small intestines.
Laparoscopic adjustable gastric banding
Laparoscopic adjustable gastric banding is another surgical method for treating diabetes which consists of placement of a belt around the upper part of the stomach. The belt itself once placed into its position, it separates the stomach in two parts the upper pouch which is smaller, and a lower pouch of the stomach which is larger. The band is connected with some tubes to a port that is placed below the skin of the abdominal wall. Fluid can be poured through the port, which fills the balloon, slowing this way the passage of food from the upper stomach pouch to the lower stomach pouch.
Vertical banded gastroplasty
Vertical banded gastroplasty consists in dividing the stomach into two parts, restricting this way the amount of food a person can eat. However, this type of bariatric surgery is not that popular, when compared to other bariatric surgery types due to the fact that the results are not so impressing.
Biliopancreatic diversion with duodenal switch
Biliopancreatic diversion with duodenal switch is a surgical procedure that results in removing about 80% of the stomach. The pyloric valve remains as well as a small part of the small intestine that normally connects to the stomach. This way, this type of surgery not only limits the amount of food a person can eat, but it also reduces the absorption of nutrients.
Sleeve gastrectomy is a new type of bariatric surgery. During this procedure, the stomach structure is changed to be shaped like a tube, which will normally restrict the amount of food a person can eat and the amount of food that is absorbed.
Remember that treating obesity is very difficult. However, the most important thing is to have a healthy life, especially a healthy diet with a lot of fruits and vegetables, regular daily activity and a total change of the way you are living. Only with hard work and determination, you can achieve your goals. Regardless of your methods or type of bariatric surgery that you have chosen, you should always look and try all your options in treating obesity. Keep in mind that with obesity, many other health problems come, affecting your overall health.