The prevalence of fatness is the highest has ever been nowadays. There is no doubt that excessive overweight is a major cause of a number of serious and potentially life-threatening diseases. According to WHO, overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Using BMI provides the most useful measure of overweight and obesity as it is the same for both sexes and for all ages of adults. So, for instance the body mass index (BMI) of 25 or more is defined as overweight and a BMI greater than or equal to 30 is termed as obesity.
Overweight and obesity are associated with insulin resistance, type 2 diabetes, dyslipidemia, hypertension, cholelithiasis, certain forms of cancer, obstructive sleep apnea, degenerative joint disease, gout, lower back pain and polycystic ovary syndrome.
For that possible complication, nowadays people look for various weight loss interventions in order to combat their obesity and also reduce such complications related to obesity. Such intervention is common to us as weight loss surgery or bariatric surgery. In fact, there are three main bariatric surgery procedures that are widely used. These are gastric bypass, gastric banding and sleeve gastrectomy.
Studies have shown that long-term weight reduction — achieved by bariatric surgery — substantially improves the cardiovascular risk profile ultimately resulting in a decrease in overall mortality.
Sarcastically, even an intensive programme of lifestyle modification only leads to a modest weight loss, however some individual tried using pharmacologic treatment of obesity, but unfortunately longer-term data regarding weight, cardiovascular incidence and prevalence of diabetes as well as side effects of these drugs are lacking.
Moreover, serious complications can occur and therefore a careful selection of patients is of utmost importance to ensure that those with the greatest predicted benefit undergo these procedures. I feel that bariatric surgery should at least be considered for all patients with a BMI of more than 40 kg/m2 and for those with a BMI of more than 35 kg/m2 with concomitant obesity-related conditions. Not forgetting that certain criteria would be considered when such patient going for weight loss surgery, such as the commitment of the patient to prolonged lifestyle changes, documented failure at nonsurgical approaches to long-term weight loss, BMI more than 40 or 30 with related illness, in addition to other criteria known by the patient’s physician.
I would say here that people who are seeking such type of weight loss procedure often think if they just get this surgery, their life will change and they won’t have diabetes anymore. I say to them you are still the same person you are still in the same life.
I should conclude that any weight loss is going to improve patient health, especially, by reducing the amount of fat, however patient normally gains some weight back after the procedure, but if he or she gains all of it back after surgery, then this mean that the patient has again engaged in old eating habits.
Dr Yousuf Ali Almulla, MD, Ministry of Health. He is a medical innovator and educator. For any queries regarding the content of the column, he can be contacted at: firstname.lastname@example.org