Obesity - when surgery becomes the only real option

Weight loss surgery is the treatment of choice for the morbidly obese. The definition of "morbid obesity" is having a Body Mass Index (BMI) of 40 or higher or weighing 100 pounds over ideal weight. Another group for whom surgery may be the treatment are the "seriously obese," those with BMIs of 35-39. Both types of obesity have added weight-related complications such as diabetes, heart disease, hypertension, sleep apnea and osteoarthritis.

With regard to the morbidly obese, research shows conventional diets - including weight loss medications - result in only a 10 percent reduction in body weight with less than a 1 percent chance of keeping the weight off long-term. For someone weighing 300 pounds, this means losing 30 pounds, but only one out of 100 people are able to maintain that weight loss. For the morbidly obese, even the best diet and exercise programs usually are not effective. Weight loss surgery (or bariatric surgery) is usually the most effective treatment for these individuals. Recent scientific research suggests this may be equally true for seriously obese individuals.

The argument in favor of weight loss surgery has been strengthened by the recent scientific study in the Journal of the American Medical Association. It demonstrates that weight loss surgery is far better at managing type 2 diabetes than conventional approaches through medication and diet. One type of weight loss surgery, known as Laparoscopic Adjustable Gastric Banding (or Lap Band), resulted in 73 percent complete remission of diabetes compared to 13 percent for conventional treatments. This is very good news for those who are overweight and diabetic.

Diabetes is considered a treatable, but not curable disease. It can lead to progressive, serious and potentially disabling medical disorders. Another surgical procedure, gastric bypass, has even better results, with more than 90 percent remission rates for type 2 diabetes.

However, weight loss surgery is not to be taken lightly. This is major surgery with all the typical risks. It is not a "magic bullet" but considered a tool. Flagstaff Medical Center's Bariatric Surgery and Weight Loss Center helps patients prepare well in advance of their surgery. The team at the center helps guide patients as they make lifetime commitments to the dramatic and life-changing behaviors needed after surgery, such as changing their relationship with food. Surgery also is not a guarantee. The success of each patient's surgery always depends on the commitment of the patient to a lifetime change in eating and exercise behaviors.

To be eligible for surgery, patients typically must have made reasonable and sustained efforts in the past to lose weight and be fully informed about the surgery and the lifestyle changes required. The FMC Bariatric Surgery and Weight Loss Center provides support groups, which play an important role in helping patients sustain these changes. This type of surgery is not the easy way to weight loss, but most bariatric patients say the benefits far outweigh the challenges.

Those interested in learning more about weight loss surgery can attend one of FMC's Bariatric and Weight Loss Center's information sessions held every second Tuesday of the month from 7 - 8 p.m. For more information, call 214-3737 or visit FMCBariatrics.com.

Richard Langsdorf, Ph.D, is a psychologist at Flagstaff Medical Center and is a member of the Bariatric Surgery and Weight Loss Center team. Is there a health topic you'd like to know more about? Please write to Mountain Medicine, c/o Flagstaff Medical Center, Public Relations, 1200 North Beaver Street, Flagstaff, AZ 86001. For more information, please see your physician.