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Obesity

 

Obesity: A Disease

Obesity is emerging as a health epidemic around the world. According to the Centres for Disease Control and Prevention, obesity is rapidly spreading across all regions and demographic groups.

Obesity is an excess of total body fat, which results from caloric intake that exceeds energy usage. A measurement used to assess health risks of obesity is Body Mass Index (BMI).

Click here to find out more about Body Mass Index (BMI).

Causes

Obesity could be a combination of the following:

  • The genes you inherited from your parents
  • How well your body turns food into energy
  • Your eating and exercising habits
  • Your surroundings
  • Psychological factors

Am I a Candidate

Selection Criteria

There are a number of widely accepted criteria which make a patient suitable for Bariatric or weight loss surgery:

  • BMI > 35 by itself or > 30 if there is already an associated obesity illness , such as diabetes or sleep apnoea
  • Obesity-related health problems
  • A capacity to understand the risks and commitment associated with the surgery.
  • Pregnancy preferably not anticipated in the first year following surgery

There is considerable flexibility in these guidelines. Patients as young as 12 have been offered surgery. Sometimes a lower BMI between 30-35 is accepted if comorbidities exist.

Consequences

If you are obese, severely obese, or morbidly obese, you may have:

  • Major health risks
  • Shorter Life Expectancy-10-12 years less
  • Compared to people of normal weight, obese people have a 50% to 100% increased risk of dying prematurely
  • Obese people have more risk for:
    • Diabetes (type 2)
    • Joint problems (e.g., arthritis)
    • High blood pressure
    • Heart disease
    • Gallbladder problems
    • Certain types of cancer (breast, uterine, colon)
    • Digestive disorders (e.g., gastro-oesophageal reflux disease, or GORD)
    • Breathing difficulties (e.g., sleep apnoea, asthma)
    • Psychological problems such as depression
    • Problems with fertility and pregnancy
    • Urinary Incontinence

Risks to psychological and social well-being

  • Negative self-image
  • Social isolation
  • Discrimination

Difficulties with day-to-day living

  • Normal tasks become harder when you are obese, as movement is more difficult
  • You tend to tire more quickly and you find yourself short of breath
  • Public transport seats, telephone booths, and cars may be too small for you
  • You may find it difficult to maintain personal hygiene

Treatments

Non-Surgical Treatment

Dieting, exercise, and medication have long been regarded as the conventional methods to achieve weight loss. Sometimes, these efforts are successful in the short term. However, for people who are morbidly obese, the results rarely last. For many, this can translate into what's called the "yo-yo syndrome," where patients continually gain and lose weight with the possibility of serious psychological and health consequences.

Recent research reveals that conventional methods of weight loss generally fail to produce permanent weight loss. Several studies have shown that patients on diet, exercise programs or medication are able to lose approximately 10% of their body weight, but tend to regain two-thirds of it within one year, and almost all of it within five years**. Another study found that less than 5% of patients in weight loss programs were able to maintain their reduced weight after five years*.

There are many new drugs being researched but an ideal is far from being developed.Many have numerous side effects.Duromine is the one which can help for minor obesity not qualifying for surgery.

Surgical Treatment

Over the years, weight-loss surgery has proven to be a successful method for the treatment of morbid obesity#. Surgical options have continued to evolve and is pleased to be able to offer patients. This procedure is the least traumatic and the only adjustable and reversible obesity surgery available in the United States. The Gastric Band  and Gastric Sleeve or Bypass provide unique ways that can help you achieve and maintain significant weight loss, improve your health, and enhance your quality of life.

** American Association of Clinical Endocrinologists (AACE) / American College of Endocrinology. (ACE) Statement on the Prevention, Diagnosis, and Treatment of Obesity (1998 Revision). AACE/ACE Obesity Task Force. Endocr Pract. 1998; Vol. 4 No. 5: 297-330.

* Kramer FM et al. Long-term follow-up of behavioral treatment for obesity: patterns of weight regain among men and women. Int J Obes 1989; 13:123-136.

# SAGES/ASBS Guidelines for Laparoscopic and Conventional Surgical Treatment of Morbid Obesity. American Society for Bariatric Surgery. www.asbs.org/html/guidelines.html

  • Australian Medical Association
  • The European Association for Endoscopic Surgery
  • Obesity Surgery Society of Australia & New Zealand
  • Gastroenterological Society of Australia
  • Sydney Upper Gastrointestinal Surgery
  • Central Coast Medical Association
  • International Society for Digestive Surgery
  • Royal Australasian College of Surgeons