Weight Management|Surgery and Obesity

iet and Weight Management

urgery and Obesity

The National Institute of Health consensus has suggested the

following guidelines for surgery in obese patients: Patients with

a BMI of greater than 40.

Patients with a BMI of greater than 35 who have serious

medical problems such as sleep apnea, that would improve

with weight loss. A study done in Sweden compared the rates

of diabetes and hypertension in two groups of obese patients -

those who underwent surgery and those who didn't. Each group

had similar body weight at baseline (the start of the study). At 2

years, diabetes and high blood pressure were lower in the

surgery treated patients.

Surgical procedures of the upper gastrointestinal tract are

collectively called bariatric surgery. The initial surgeries

performed were the jejunocolic bypass and the jejunoileal

bypass (where the small bowel is diverted to the large bowel,

bypassing a lot of the surface area where food would have

been absorbed). These procedures were fraught with problems

and are no longer performed. Currently, procedures used include

making the stomach area smaller or bypassing the stomach

completely.

In the cases of making the stomach smaller, vertically banded

gastroplasty is the most common procedure, where the esophagus

is banded early in the stomach. The other procedure is gastric

banding, where an inflatable pouch causes gastric constriction.

Changing the volume in the ring that encircles the stomach can

change the amount of constriction. Gastric bypass essentially

causes weight loss by bypassing the stomach.

The risks of surgery include the usual complications of infection,

blood clots in the lower extremities and in the lungs, and anesthesia

risk. Specific long-term risks related to obesity surgery include lack

of iron absorption and iron deficiency anemia. Vitamin B 12

deficiency can also develop and could lead to nerve damage

(neuropathies). Rapid weight loss may also be associated

with gallstones.

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