Why Weight Loss Surgery?
Obesity is a lifelong disease that has serious implications for the health of an individual. Obesity reduces life expectancy, decreases quality of life and is associated with complications from multiple medical conditions including hypertension, Type 2 diabetes, cardiovascular and respiratory diseases. It also increases the risk of developing several forms of cancer.
Morbidly obese adults face intense prejudice and stigmatization. A survey of severely obese individuals found that nearly 80% reported being treated disrespectfully by members of the medical profession. These patients are perceived as ignorant, weak-willed, lazy and self-indulgent. The assumption is that they are solely responsible for their size and state of health.
In reality, individuals suffering from morbid obesity generally are genetically predisposed to the condition. Environmental, social and psychological factors play a role and can add to the likelihood of developing this disease. Losing weight, for the severely obese individual is not a simple matter of willpower, diet and exercise.
If you suffer from severe obesity, you know the cycle all too well: the countless diets, the struggle to lose a few pounds only to regain that weight later. Published reports document this fact:
  • People on medically supervised weight loss programs incorporating diet, exercise and long-term weight loss medications are able to lose up to 10% of body weight, but almost all of the weight is regained within 5 years [1]
  • Less than 5% of people in weight loss programs are able to maintain their weight loss after 5 years [2]
  • Long-term drug therapy for obesity is problematic due to high attrition rates (typically 30 – 40% of patients drop out of these programs). Mean weight loss after long-term (minimum 1 year) treatment with Orlistat (Xenical®) was only 2.9kg [3]. NB. Leading anti-obesity drug Sibutramine (Reductil®) was recently withdrawn from use in the UK, European Union, Singapore and other countries amid fears that it increases risks of heart disease and stroke.
The medical literature confirms the fact that for the severely obese, achieving significant and sustained weight loss is a monumental task and non-operative treatment methods rarely succeed [4].
For the severely obese, surgical treatment is the only proven method of achieving long-term weight control
Bariatric surgery is not a cosmetic procedure; it is medically necessary for the severely obese. Surgery for severe obesity does not involve removal or suctioning of excess fat. Bariatric surgery involves surgical manipulation of the stomach and digestive tract in such a way that food intake is restricted. Some bariatric procedures are also designed to alter the ability of the intestines to absorb nutrients.
Published data show that surgical treatment of obesity:
  • Has a good safety profile [5]
  • Achieves significant and long-term weight loss [6]
  • Improves or cures medical conditions associated with obesity [6]
  • Reduces the risk of an early death [4]
References
  1. AACE/ACE Position Statement on the Prevention, Diagnosis and Treatment of Obesity. Endocr Pract. 1998; 4:297-330
  2. State-Level Estimates of Annual Medical Expenditures Attributable to Obesity. Obes Res 2004; 12:18-24
  3. Long term pharmacotherapy for obesity and overweight; updated meta-analysis. BMJ 2007; 335:1194-9
  4. Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects. NEJM 2007; 357: 741-52
  5. Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery. The Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. NEJM 2009; 361: 445-54
  6. Bariatric Surgery: A Systematic Review and Meta-Analysis. JAMA 2004; 292:1724-37