It is nearly impossible, no matter where you live or what you read, to ignore the words “obesity epidemic.” Once regarded as an issue that primarily affected Americans, the honor associated with this problem is now shared internationally and getting worse.
Obesity is a very public and very dangerous condition that most of us know we need to be aware of and prevent, to the best of our abilities. And yet, we are often left wondering how we got to the point where being overweight has become a global, medical affair. Contributing factors to this condition lay in the hazards and risks inherent in sedentary lifestyles, poor food choices, time restrictions, increased stress levels and for some, late nights that include far too much alcohol.
While many overweight individuals try to lose weight by eating healthy foods and exercising, not all are successful. In addition, there exist obese people who have underlying medical conditions that make necessary weight loss near impossible. When weight reduction becomes a life-saving issue, drastic measures are sometimes needed. Enter: bariatric surgery.
Bariatric surgery was introduced in the 1960’s and its popularity and safety as an effective weight loss tool grew in the 1990’s and beyond. Though there are multiple types of bariatric procedures that have developed and evolved to meet patient-specific needs, there are many shared principles surrounding them all.
Types of bariatric surgery
The American Society for Metabolic and Bariatric Surgery lists four main procedures:
In this procedure, the top and bottom parts of the stomach are divided, as is the small intestine. Part of the small intestine is then connected to a newly formed, smaller stomach, while the remaining part of the intestine is attached to itself to aid in overall digestion. The newer stomach pouch is designed to be far smaller than the previously existing organ, that presumably held more food than was physically necessary. With the stomach’s smaller capacity, patients feel full with much less food and therefore eat less than they used to.
The Sleeve, as this procedure is commonly called, reduces stomach size by removing nearly 80 percent of its previous capacity. The procedure itself greatly affects digestive hormones that increase levels of satiety and control blood sugar.
Adjustable Gastric Band
This surgery is often referred to simply as “the band” and involves stretchable, inflatable tubing that is secured around the stomach; the band cuts off one portion of the stomach from another. The tubing helps to create a stomach pouch that is far smaller than its original size and can be tightened with a saline injection that fills the band and makes it tighter. As the band is tightened, the stomach can tolerate only small portions of food.
Biliopancreatic Diversion with Duodenal Switch (BPD/DS)
In this last procedure, a new stomach is created after part of the organ is removed and a significant part of the small intestine is completely bypassed. Because the surgical interventions in this procedure are more drastic than in the others, patients are at a higher risk of losing valuable nutrients and may need to take supplements and vitamins for the rest of their post- surgical lives.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, any of the four general types of procedures can be performed through open or laparoscopic surgery. While the latter allows physicians to access the site they are operating on with minimal, exposed tissue thereby decreasing the risk of infection, there are individuals for whom an open abdominal procedure is needed. Either way, bariatric surgeries can be effective.
Pros, Cons, and Misconceptions
There are pervasive beliefs that surround bariatric surgery. Some individuals, including those that have themselves struggled with weight, believe that a surgical weight loss intervention constitutes taking the easy way out. If, they pontificate, they can exercise and eat right and lose weight, then why can’t everyone else? The simple answer to that is that frankly, everybody is different and none of us follow the same or monolithic way of monitoring our weight.
Others believe that patients who have had the procedure only go on to gain it all back. While, in general, everyone who loses a significant amount of weight regains some of it as their body adjusts to their new, metabolic normal, there is no definitive guarantee that bariatric surgery won’t work for the long haul.
Certainly, there are risks associated with these procedures, much the same way there are risks with all surgical procedures. Each individual with their physician, dietitian, and medical team have to determine their level of candidacy, dedication to health, and the procedure’s sustainability. There are people who have died as a result of these procedures and there are others who have substituted one addictive behavior for another. Every person’s case has to be evaluated, a benefit- risk analysis must be considered, and recognition of individuals as just that is a prerequisite for understanding the value of these procedures altogether.
Surgical Success and Second Chances
Bariatric surgery often improves one’s quality of life by introducing a return to health that morbid obesity had stolen. After patients have fully recovered from surgery, the health benefits and effects they desired are often immediate. For many, the weight seemingly melts off their bodies as they adjust to an entirely different level of homeostasis. As they reap the benefits, the toll obesity took on their hearts, knees, and lungs often abates.
Long term results vary from patient to patient, but longitudinal data on post-operative bariatric patients indicates that long lasting weight loss is both feasible and realistic. When one considers the life shortening effects of obesity, one must also entertain the possibility of surgery as tool in the battle of the bulge.
Determining if Bariatric Weight Loss Surgery is Right for You
Weight loss surgery is not for everyone. Individuals must discuss their weight loss options with their medical provider in order to determine if it is right for them. With your healthcare team, practical health goals need to be established prior to surgery. Ultimately, it is up to the individual to determine the path that is right for them – be it surgery, increased diet and exercise, particular diets such as the Atkins or the HCG, or perhaps treatment for an underlying condition. The end goal – of course – is for each patient to live their best, most manageable life to its fullest.
Achieving and Maintaining a Healthy Weight
Dr. Shahen Kurestian, DC and his team at Body Systems Wellness in Glendale, California just outside of Los Angeles, help individuals manage their weight through personalized diet, meal and exercise planning. By taking into account the client’s medical profile, Dr. Kurestian, DC is able to design and conduct treatment plans that target overall patient health and welfare. Obesity can diminish quality as well as quantity of life and that is why Body Systems Wellness’ dedication and conviction to client health is so strong.