Bariatric surgery – Obesity treatment

What is obesity?

Obesity is a condition defined by the excessive storing of body fat, a fact which leads to a significant gain in weight. Common medical practice uses the body mass index (BMI) to establish the severity of each case of obesity. The BMI is a measure of body fat based on height and weight. The most extensively used means for establishing the stage of one’s obesity is the calculation of the BMI. A BMI value exceeding the 30 marker denotes that the subject in cause is in fact obese, and a BMI value above 40 signals the presence of morbid obesity.

Obesity has become a persisting health issue in several developed countries and regions still in development. The ratio of the population suffering from this condition puts Romania in a leading European position. An alarming 73% of the country’s adult population suffers from some type of obesity, making the phenomenon a true epidemic.

The causes of morbid obesity

Obesity’s aetiology identifies the following factors, which predispose an individual to this particular health condition:

A heightened calorie intake – The ratio of consumed foods is higher than the burning capability of the organism.
Eating disorders – These include, but are not limited to nocturnal sleep-related eating disorders (NS-RED) and bulimia nervosa. The first syndrome enumerated consists of morning anorexia, insomnia and evening hyperphagia (EH). The second ailment consists of recurring episodes of food consumption followed by an excessive compensating behaviour such as the use of diuretics or self-induced heaving.

Genetic factors – Research conducted in this area as well as a multitude of studies have identified that several genes are involved in the onset of obesity. Hereditary factors play a significant part in the onset of obesity. More exactly they have an important role in the susceptibility shown toward the disease.
Environmental and behavioral factors – These are best summated by the contemporary fast-paced lifestyle, characterized by unbalanced eating habits, which in turn may lead to weight gain. Leading a sedentary way of life denotes the existence of behavioral factors which favor the onset of obesity, and of a diminished rate of calorie-burning. This undoubtedly leads to the formation or worsening of a state of energy imbalance.
Psychological factors – persons who show signs of mental disorders, such as anxiety, depression, stress, or low self-esteem are acutely prone to developing morbid obesity.
Medical disorders – hormonal disorders, thyroid ailments, syndromes of hypothalamic dysfunction may all lead to the onset of morbid obesity.
Drug use – drugs which may predispose patients to obesity include but are not limited to oral contraceptives, antidepressants, anti-epileptics, steroids, phenothiazines, high blood pressure medicine. These pharmaceutical substances effect the appetite of the user, so they may favor excessive calorie intake, which in turn leads to the onset of obesity.

Complications of morbid obesity

Diabetes – persons who suffer from morbid obesity develop a resistance to insulin, a hormone administered to regulate blood sugar levels. In time the glicemic imbalance may lead to the appearance of certain severe complications.
Cardiac affections – Excess fat in the body may alter the proper functioning capacity of the heart and may lower peripheral resistance. As a direct result of this patients may develop hypertension, acute strokes, acute myocardial infarction, atrial fibrillation, venous insufficiency, thrombosis and the like.
Respiratory diseases – Gaining excess body fat around the area of the head and especially the throat may lead to partially obstructing the airways. Such respiratory issues appear mainly at night during sleep.
Heartburns – Due to abdominal fat, stomach acids reach the esophagus, giving it a burning sensation.
Depression – People with weight issues may be discriminated at their workplace, may be disapproved by their families and friends, or may encounter remarks which lower self-esteem. These in turn lead to states of anxiety and depression.
Osteoarthritis – This ailment consists of the destruction of cartilage, which protects the surface of the joints. This leads to bones coming into direct contact with each other, which in time will lead to their deterioration. People who suffer from morbid obesity show signs of intense pain especially in the area of the knees, the spinal chord and hips.
Infertility – Obesity may cause hormonal changes, that may lead to infertility both in the case of men and especially in that of women.
Urinary incontinence – involuntary loss of urine is due to the growing size of the abdomen and the relaxation of the pelvic muscles.
Sexual dysfunctions – There are several cases in which impotence and erectile dysfunction appears as a result of obesity, and may lead to considerable negative effects on male sexual performance. In the case of women obesity causes several gynecological issues such as irregular menstrual cycle and hormonal imbalance.
Incremental rise of cancer occurrence – Obesity is associated with a high risk of developing breast cancer, endometrial cancer, cancer of the esophagus, gastric cancer and renal cancer.
Brain maladies – Metabolic alterations associated with obesity may affect brain function and may lead to the onset of dementia. These modifications consist for example of high blood sugar and cholesterol.

What is bariatric surgery?

Weight loss surgery is better known as bariatric surgery and is the modern treatment recommended for patients who suffer from morbid obesity. The best results can be obtained through implementing surgical interventions aimed at treating obesity. These include gastric banding, gastric by-pass, gastrectomy, gastric plication, and abdominoplasty (aesthetic intervention after the weight loss).

The advantages of surgical interventions involving minimal invasive procedures

Surgical interventions involving minimal invasive procedures for the treatment of obesity assign surgeries which offer patients many benefits as opposed to the use of traditional techniques. Minimal invasive procedures are aided by next-gen technologies, which are an outstanding part of the progress, that has been made in the field of contemporary medicine.

Laparoscopic surgeries consist of inserting a minuscule state-of-the-art camera in the abdominal cavity through the means of which one may follow the entire surgical intervention on a projection screen. This is one of the most widely used abdominal surgical procedures.

The advantages of minimal invasive procedures include a short duration of the surgical process, which leads to a considerable reduction of the stress experienced by the patients. Furthermore laparoscopic surgeries produce far less discomfort and pain than traditional surgical methods. The surgical procedures involve very small incisions, and this produces barely any post-op scarring. Even the scar tissue that forms is hard to notice due to the fact that the tissue is not exposed to extensive damage. The final effect is a shortened period of compulsory hospitalization and a shorter span of recovery.

The majority of minimal invasive procedures present a much higher rate of accuracy than the traditional procedures. This is due to the fact that the surgeon has a clear and detailed view of the internal organs’ structure through the use of the state-of-the-art video equipment, and this provides him with maximum precision throughout the surgical procedure. The surgeon has a vast palette of instruments and techniques at his disposal meant to transform laparoscopic surgeries into procedures which provide beneficiaries with outstanding results.

The necessity of surgical interventions in the case of treating obesity, and the advantages of bariatric surgery

When prospective patients suffering of obesity have eliminated all other treatment methods and options, such as medication, dieting, practicing sports, undergoing endocrinological treatments, and behavioral therapies, they are advised to consider bariatric surgery, the only safe and definitive treatment method of obesity.

The global obesity pandemic prompts us to take firm action in implementing an appropriate medical education for the wide population, as well as applying aggressive therapeutical methods, which have been proven to be the only effective means of engaging this issue.

Gastric bypass surgery has proven itself to be the most efficient way of losing extra weight, but all other modern surgical treatment methods for obese patients provide excellent results. A number of studies and relevant research has shown that gastric banding provided the loss of 40-50% of excess body fat in the case of obese patients, whereas gastric bypass surgery has managed to provide a 65-80% weight loss in a one year period following the operation. Weight loss will usually continue for a period of 18 to 24 months following the bariatric surgical intervention.

Eliminating the excess weight will result in the improvement of comorbidities as well as an enhancement of the psychosocial aspects of the patient’s life. Therapeutic success is provided by the minimal invasive nature of the procedures. Bariatric surgery provides several major benefits regardless of the pathological history of the patients who undergo this type of surgical intervention.

It has been proven, that 90% of patients who underwent bariatric surgery have managed to maintain a 50% weight loss for a very long period of time.

There are a number of 600.000 bariatric procedures being done yearly on patients who present serious forms of obesity. Considering that there is a total number of about 100 million people who suffer from obesity worldwide, this number is not at all a high one.

Bariatric surgical procedures are essential means for providing a way out of the excess weight’s vicious circle, and they absolutely better the quality of life of the patients who resort to these treatment solutions to cure their obesity.