An estimated 66 percent of adults in the United States are overweight or obese, according to the Centers for Disease Control and Prevention. Although doctors recommend that those who wish to lose weight first try to do so through dieting, exercise, behavior therapy and anti-obesity drugs, an increasing number of people are turning to surgery when these steps fail.
In 2006, for example, about 150,000 patients in the United States underwent what is known as bariatric surgery, says Michael Schweitzer, director of minimally invasive bariatric surgery at Johns Hopkins Bayview Medical Center. That number is up from about 14,000 patients in 2003.
What is bariatric surgery?
Bariatric surgery is surgery for the morbidly obese and is aimed at addressing medical problems, [which can include diabetes, heart disease and severe sleep apnea], related to obesity and decreasing the patient's weight to a safe weight.
Who should consider bariatric surgery?
A patient who qualifies for this kind of surgery must have a BMI [body mass index, which is calculated using a person's height and weight] of 40 or more. That is about 100 pounds overweight for a man and about 80 pounds overweight for a woman. Or the patient must have a BMI of 35 and have an obesity-related disease such as diabetes, heart disease or sleep apnea.
The surgery is for patients who have tried and failed at diets in the past, who have a good support network of family or friends and who are psychologically prepared.
If a patient, for example, is going through enormous life upheavals, acute depression or a divorce, this is not a good time to get this surgery.
Could you describe the surgery?
The three bariatric surgeries most commonly done in the United States are known as the Roux-en-Y gastric bypass [or gastric bypass], the adjustable gastric band, and the duodenal switch with biliopancreatic bypass.
The first - Roux-en-Y gastric bypass - we usually do laparoscopically. It entails dividing the stomach into a very small upper pouch that is less than the size of an egg. We then divide the intestine so that we can bring an isolated segment of the intestine up to that small pouch.
Therefore, the food will bypass the rest of the stomach and the first part of the intestine. This makes the patient feel full after eating a small amount of food.
