When surgery may be the best weight loss option

Uploaded by PennStateHershey on 19.07.2012

So the reason people think that weight loss surgery is really the only durable and effective
treatment for weight is that obviously doctors have been recommending diet and exercise forever
and they’re very important for people. Diet and exercise are obviously good things but
the problem is, only about 5 percent of people can lose a significant amount of weight through
diet and exercise and keep it off long term. That’s what the problems is, It’s the
keeping it off and the surgery helps with that.
So there are different weight categories and one of the ways we do that is through body
mass index which is not a perfect way to define someone’s weight and health but it’s the
best thing we have. Its based on essentially a calculation of height and weight. So, if
a body mass index between 20 and 25 is considered normal. Something above 25, up to 30, is considered
over weight. So if you get into a body mass index of above 30 then you’re considered
obese. And then, there are different classifications of obesity. So, classically, if you have a
body mass index of 40 or greater, you qualify as having clinically sever obesity. It’s
also true at a BMI of 35 as long as you have some sever associated medical problem like
diabetes or sleep apnea. We occasionally have patients who qualify
for weight loss surgery with a body mass index of 40 who happen not to have any other associated
medical problems. I would say that’s rare. Most of our patients have a big long list
of medical problems and that would be things like high-cholesterol, high-blood pressure,
joint problems. Diabetes is very common among obese patients. Sleep apnea, there are many,
many things and depression I would say goes along with weight in a lot of our patients.
So, generally speaking it’s unusual to be clinically severely obese and not have the
associated medical problems but even for those patients the weight predisposes them to having
medical problems later so even without current medical problems there is still a good reason
to have weight loss surgery There are a couple different ways to think
about costs of this surgery and the people who have studied it look at it on a sort of
population base and what we know is, that it costs a lot of money to take care of the
medical problems that go along with weight. And so the people that have studied this have
found that a patient who has weight loss surgery within two to four years, the cost to taking
care of them health wise will be less than they would have been. Filling prescriptions,
going to the doctor, having other operations, so basically this is something that pays for
itself in a couple years which is really important for insures to know and for employers to know
because this is an operation that is making people healthier.
I think a lot of people have a misconception that weight loss surgery is a risky surgery
and what our national database has shown recently is that weight loss surgery is now as safe
as gallbladder surgery, which is amazing because most people would not think twice if their
doctor said they needed to have their gallbladder out, they wouldn’t concern themselves too
much about the risk because they knew it was something they needed for their health. This
is absolutely true about weight loss surgery as well. It’s now gotten to be a very safe
set of procedures and so honestly, the risk to patients caring the weight and having those
medical problems is greater than the risk of having the surgery itself.
In order to be successful after weight loss surgery, you do need to make significant life
style changes and most programs that offer weight loss surgery have you go through a
three to six month program of education so you know how to take care of yourself both
before and after surgery. So our patients learn a lot. They learn about how to shop,
how to cook, how to read a label, what are good choices. They learn about calories and
different kinds of calories. They learn a lot about exercise and also about family dynamics
so there is a lot that patients have to do to get ready for this surgery so that they
can do the right things afterwards.