If you are overweight or obese, you are not alone. More than two-thirds of adults in the United States are overweight, and over one-third are obese, according to a recent article in the Journal of the American Medical Association (JAMA).1 In school-age children and adolescents, obesity has tripled since 1980, and it remains high at approximately 17%.2
The term overweight refers to having an excess of body weight compared to set standards, and obese means having an abnormally high accumulation of body fat. To determine whether a person is overweight or obese – and how overweight or obese an individual is – health care professionals frequently use the body mass index (BMI), an index of weight in relation to the height of the individual.
Although obesity is defined as having a BMI of at least 30 kg/m2, weight loss surgery is considered only in patients who meet certain criteria. Adult patients (between the ages of 17 and 70) must have a BMI of 40 or greater or a BMI of 35 or more with other diseases such as diabetes, heart disease, high blood pressure or sleep apnea. All patients must also have attempted a structured dietary weight loss program for at least six months without success. They must be evaluated and approved by a behavioral therapist, dietitian and physical therapist.
Problems Associated With Obesity
People who are severely obese (more than 100 pounds overweight) may be restricted in activities (such as riding an ATV or hiking), face awkward social situations (such as taking up two seats in an airplane) or even develop psychological disorders such as depression. Being overweight or obese also is a known risk factor for:
- coronary heart disease
- high blood cholesterol
- gallbladder disease
- osteoarthritis (degeneration of cartilage and bone of joints)
- sleep apnea and other breathing problems
- some forms of cancer (breast, colorectal, endometrial, and kidney)
Bariatric (Weight Loss) Surgery
Bariatric surgery may be an option for people who are severely obese and have been unable to lose weight through diet or other traditional means. Those who have serious obesity-related health problems may also be candidates. Generally, the various forms of surgery – gastric bypass surgery, gastric banding and laparoscopic sleeve gastrectomy – promote weight loss and reduce the risk of type 2 diabetes by limiting food intake. Some operations also interrupt the digestive process to prevent the absorption of some calories and nutrients.
For the surgery to be a success, patients must be committed to lifelong healthy eating and exercise habits, medical follow-up, and supplementation of vitamins and minerals.
Complications that can occur soon after surgery include bleeding, infection, intestinal leaks and blood clots that could travel to the heart and lungs. Some possible later complications are malnutrition (particularly in patients who don’t take prescribed vitamins and minerals), narrowing of sites where the intestines are joined, and hernias. About 10 percent of patients may have unsatisfactory weight loss or regain much of their previous weight. (Frequent snacking or lack of exercise may contribute to inadequate weight loss.)
Surgeons who perform bariatric surgery:
J. Christopher Eagon, MD
Shaina Eckhouse, MD
Arghavan Salles, MD, PhD
For more information, call 314.454.7224.
1. Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and Trends in Obesity Among US Adults, 1999-2008. JAMA. 2010;303(3):235-241.
2. Ogden CL, Carroll MD, Curtin LR, Lamb MM, Flegal KM. Prevalence of High Body Mass Index in US Children and Adolescents, 2007-2008. JAMA. 2010;303(3):242-249.
The Weight Control Informational Network (WIN) (informational service of the National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK] is the source of information on risk factors and surgical complications.