HealthCommentary

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Going Under the Knife to Lose Weight

Posted on | August 22, 2007 | Comments Off on Going Under the Knife to Lose Weight

What you don’t know about bariatric surgery can hurt you

“Obesity is an epidemic!” That’s what we’ve all heard. And the facts are convincing. Our collective Body Mass Index (BMI – which factors in weight and height, and is normally 20 to 25) is growing too fast.

The percentage of Americans with a BMI over 30 (the definition of “obese, versus “overweight” at 25 to 30) was 15% in 1995. A decade later it was 24% and rising, with 5% “morbidly obese” with a BMI over 40.

The causes? Experts say that two thirds of the cause is genetic predisposition, while one third is behavioral – such as too-little exercise and increased ingestion of large amounts of energy-dense food.

Being obese can kill you. BMI’s over 30, and especially over 35, are associated with increased rates of high blood pressure, diabetes, high cholesterol, sleep disturbances, heart attack, and stroke. So it’s not too surprising that people with high numbers, symptoms of disease, and a history of failed diets turn to the knife.

When people hear the words “bariatric surgery,” they don’t dig very deep. But what you don’t know can hurt you. Here are some facts:

1. There’s disagreement over who should have the surgery. There’s no consensus that it’s a good idea for the very young (under 18) or the older (over 60). Most agree that a BMI over 40 warrants consideration. Many (but not all) feel that a BMI of 35 with associated medical conditions is serious enough to warrant evaluation. Few believe that BMI’s in the 30 to 35 range deserve consideration for surgery.

2. There are many different types of procedures, not just one. Some restrict the flow of food; some decrease food absorption; and some do both. They all involve stitches, bands or staples in varying degrees. Here’s what four of the moist popular varieties look like from the inside out.

3. People come in for these surgeries thinking they’ll sail right through, loose tons of weight, and not require much in the way of discipline or effort to do so. Not true!

4. One study of over 1000 patients who had one of the popular procedures (the rous-en-Y gastric bypass) showed that they spent an average four hours on the operating table. About eight percent spent some of their four-day stay in the Intensive Care Unit.

5. The chance of dying from one of these procedures is 1 in 100. If you’re older, or have a BMI greater than 50, or have serious medical problems, you run higher risk.

6. What can you do to even the odds? Shop around for the right doctor and hospital. Doctors who do more than 100 of these cases a year, and hospitals that do more than 150, have much better results. That means there is a good chance that you may want to look outside of your own community.

BOTTOM LINE: Bariatric surgery is a big deal! Go into it with your eyes wide open!

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