Morbid Obesity

What is Morbid Obesity?

Obesity Morbid Obesity is typically defined as being 100Ibs or more overweight. The most common and reliable way to measure obesity is by the use of the body mass index or BMI. Body Mass Index is the weight in kilograms divided by the height in meters, squared.

A person is considered overweight if their BMI is between 25 and 29.9, a person is considered obese if their BMI is over 30, and a person is considered morbidly obese if their BMI is over 40. To calculate your BMI, use BMI calculator.

Who is candidate for surgery?

Patients meeting the criteria of a BMI greater than 40 are candidates for weight loss surgery. Also those patients with a BMI of 35 or greater can be a candidate for surgery if they have a co-morbid condition. The most common co-morbid conditions include diabetes, high blood pressure, high cholesterol, and obstructive sleep apnea.

Patients with a BMI greater than 30 with a co-morbidity may qualify for a lap-band.

The Surgeries Offered:

Laparoscopic Gastric Bypass

Gastric bypass has been performed in the United States for many years. It is the procedure that most other bariatric surgeries are compared to when discussing safety and effectiveness. The introduction of the laparoscopic approach has made this procedure the gold standard, and provided lower complication rates, shorter hospital stays, and faster recovery.

We perform the Roux-en Y gastric bypass. In this procedure a small stomach pouch is created and disconnected from the rest of the stomach. At the same time, a new outlet is made for the small stomach pouch by attaching it further down the small intestine.

The unused part of the stomach and intestines continue to produce digestive juices which empty into the part of the intestine the food is traveling through. This provides sufficient length for food and enzymes to mix together and essential nutrients to be absorbed but does not allow the same amount of nutrient absorption as a normal digestive tract. This is why the gastric bypass is called a restrictive and malabsorptive procedure.

Therefore gastric bypass restricts the amount of food that can be ingested and decreases the amount of high sugar, empty calories that can be absorbed. The overall result is an excellent weight loss procedure. Typically the gastric bypass will result in approximately an 80% loss of excess weight.

Lap Band

In our program we offer the adjustable lap band system for morbid obesity.  The lap band procedure typically is technically easier to perform and has less frequent serious complications than other weight loss procedures. Unfortunately it is also less effective overall in total weight loss and speed of weight loss. There is no malabsorption of sugars so while it avoids the dumping syndrome since sugar is well tolerated overall weight loss is reduced. In our program we have found that young people with a BMI of under 45 do very well with the lap band system. Since we perform all the available procedures we can tailor the procedure that is best suited for individual patients and thus optimize results and minimize risks.

Sleeve gastrectomy

The sleeve gastrectomy has gained popularity as a safe procedure with good long term weight loss and low long term complication rates. It is a purely restrictive procedure with weight loss somewhat better than the lap band but less than gastric bypass. Many insurance companies are now covering it in addition to the gastric bypass and lap band. In our program we offer it to selected patients with BMI under 45 and have been pleased with its results.

Gastric plication

This is the newest weight loss procedures with less than 2 years of popularity.  It is still considered experimental and long term results are pending. We offer the gastric placation to highly selected patients as long as they are aware of its experimental nature and lack of long term results. It appears to be poised to become a very popular procedure due to its low risk of future complications. It has results similar to the sleeve gastrectomy.

In order to minimize risk and maximize results, weight loss procedures should be individualized depending on the patient. We offer a comprehensive weight loss surgery program which includes all the available procedures and will work with you to choose the one that’s best for you! Beware of programs that can only offer one procedure for all patients.

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