Obesity & Weight loss Surgery

Obesity & Weight loss Surgery


What is obesity?

Obesity is a condition that is associated with having excess body fat, defined by genetic and environmental factors that are difficult to control when dieting. This can be classed using a body mass index measurement (BMI) which is dividing a person’s weight in by their height in metres squared. A BMI ≥ 30 is considered obese.


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BMI Guidelines

    • ​​BMI 18.5 to 24.9:​Healthy
    • ​​BMI 25 to 29.9:​Overweight
    • ​​BMI 30 to 34.9: ​Obese (class 1)
    • BMI 35 to 39.9:​Severely Obese (Class 2)
    • BMI 40 to 49.9: ​Morbidly Obese (Class 3)
    • BMI ≥ 50: ​​Super Obese (Class 3)

 

  • Waist circumference risk:
  • Asians: 90cm (male) or 80cm (female)
  • Caucasians: 102cm(male) or 88cm (female)

 


There are numerous medical disorders that are associated with obesity. In Australia we have one of the highest prevalences of overweight and obese populations in the developed world. A publication by in the Australian Family Physician magazine in 2013 predicts close to 80% of our population will be obese by the year 2025.

Is my obesity dangerous?

Obesity is associated with increased risks of certain cancers.

It is further associated with significant diseases such as diabetes, obstructive sleep apnoea, cardiovascular disease (coronary heart disease, stroke & hypertension) , musculoskeletal disorders (osteoarthiritis, spinal disc disorders and back pain), gastrooesophageal reflux disease and gallstones.

What can I do about my obesity?

There are many different behaviour modification changes that a person can employ to help with weight loss:

  • Engaging in a weight loss support group
  • Changing eating habits
  • Dietary education
  • Increasing excercise

What if I have tried all of this and it has not worked for my weight loss?

Most patients that undergo weight loss surgery have tried some form of behaviour modification diet with limited success. The most difficult thing is to have sustained weight loss over a prolong period of time. The most successful method of achieving this is with weight loss surgery.

What is weight loss surgery?

This can be a procedure to remove part of he stomach, reduce the size of the stomach with an adjustable band (gastric band surgery) or by removing part of the stomach (sleeve gastrectomy) and rerouting the small bowel to a small stomach pouch (gastric bypass surgery). These 3 surgeries would be the main surgical options for weight loss surgery.

Which weight loss surgery is for me?

This requires an in depth consultation with your specialist. He will discuss the risks of each procedure and the potential complications of each surgery. He will make a joint decision with you to see if you should consider weight loss surgery and which procedure between laparoscopic gastric band, laparoscopic sleeve gastrectomy and laparoscopic gastric bypass would be the way to go.

Do all obese or overweight people qualify for weight loss surgery?

Here is a summary of some of the current guidelines which have been established to guide which patients should be considered for weight loss surgery:

  • BMI >40 with or without coexisting medical co-morbidities
  • BMI >35 with one or more n associated obesity illness such as diabetes, obstructive sleep apnoea, osteoarthirits or hepertension)
  • Age 18-65 years
  • Obesity related health problems
  • No psychiatric or drug dependency problems and a capacity to understand the risks and
    commitment associated with surgery

It is important to meet and discuss your goals with your specialist to get a better understanding of the importance in taking this step of surgery for weight loss. As a specialist we aim to reduce central obesity and its associated modifiable risk factors resulting in an improvement in your cardiovascular disease , diabetes, sleep apnoea , osteoarthirits , etc. This will then align into most patients’ perception of weight loss surgery which is to have improvement or resolution of co-morbidities as well as better quality of life with fitness and body image.