Bariatric Surgery: Info I Learned While Preparing My Shad Valley Presentation

From my Healthy Living column in Moncton’s Times & Transcript.

As our thoughts turn to weight gain and weight loss during this season of eating, drinking, and celebration, here’s a question to ponder.

Should people undergo surgery to lose weight? With a growing percentage of the population becoming severely obese, bariatric surgery is becoming more common since it is the only effective weight loss treatment for those who are severely obese and need to lose weight to avoid death due to obesity-related complications.

Some people find the idea of weight-loss surgery scandalous and think that people should be able to lose weight through more natural methods rather than resorting to surgery. But there are in fact many arguments in favor of bariatric surgery for those who qualify for it.

A bariatric surgery is a surgery performed on the digestive system destined to induce weight loss. As I learned during the question and answer period following my presentation about obesity to fellow students this summer, many people confuse bariatric surgeries with cosmetic surgeries like liposuction.

Liposuction removes fat from various areas of the body for body contouring purposes and should be used only by healthy people who already exercise and eat well who want to remove persistent pockets of fat from a few areas of their body. Again, liposuction is a cosmetic procedure and will generally not result in significant weight loss–no more than a few pounds.

Bariatric surgery on the other hand doesn’t remove fat at all, but, depending on the procedure, reduces stomach capacity and production of gastrointestinal hormones (thus reducing appetite) and reduces the absorption of energy-providing macronutrients like lipids. Weight is not instantaneously lost after a bariatric surgery. It is lost more slowly, as the body’s amount of energy intaken through food is reduced and the body must burn existing fat stores to survive. Bariatric surgery is the most effective method of weight-loss. It can actually ”reverse” type 2 diabetes.  A successful surgery allows a patient to lose a minimum of 20 to 30% of his body weight. In comparison, a loss of 5 to 10% of body weight when lifestyle changes and medications are paired is considered successful.

Of course, there are explanations for why bariatric surgeries are not rampant today despite the climb in obesity rates. Bariatric surgery is expensive–typically around $20 000. Although it can now be done through endoscopy (meaning no incision in the stomach area is necessary, equipment is inserted through the mouth instead), it is still associated with surgery-related risks and problems caused by rapid weight loss. Bariatric surgery is only an option that can be considered by obese patients with a BMI (body mass index, a ratio of height and weight) of over 35 (the healthy range for BMI is 20 to 25; to qualify as obese, patients should have a BMI of over 30) and complications or a BMI of over 40 without complications.

If bariatric surgeries are effective, but only suitable for a select few and other methods of weight loss treatment like lifestyle changes and medication likely to improve overall health, but not cause as much weight loss as desired, what is there to do? The answer, again, is preventing obesity, not waiting until problems occur.

For more information, visit www.obesitynetwork.ca/, the source for this article.

 

Originally published in the Times & Transcript on December 3rd, 2011.

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