Conditions:

Obesity

We are constantly reminded of the dangers of obesity through media and health professionals. We are all aware of the growing "epidemic" of obesity in the United States and its emergence in Australia. Are we over-exaggerating or is it is bad as everyone says??

How much weight is too much?

Doctors use a formula to easily categorise weight known as Body Mass Index (BMI). BMI is your weight divided by your height squared

BMI = weight/height2 kg/m2

The ranges for BMIs are listed below

20-25 Normal
25-30 Overweight
30-35 Obese
35-40 Morbidly obese

How does obesity affect my health?

Obesity is much more than a cosmetic concern. In addition to many psychological consequences and mobility problems, obesity is directly linked to many medical conditions.

1. Diabetes
2. Heart Disease
3. High Blood Pressure
4. Stroke
5. Cancers
6. Sleep apnoea
7. Arthritis
8. Skin conditions

Obesity is a major contributor to the above conditions, but adversely influences many other diseases as well. Obese people are 50% more likely to die prematurely.

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Why are some people affected more than others?

As we all know, some people are more prone to becoming overweight than others. The main risk factors for obesity are

1. Diet - high caloric intake
2. Inactivity
3. Genetic - if one or more of your parents are obese, you have a increased risk of obesity by 25-30%
4. Sex - women are more likely to be obese compared to men as men generally have a higher muscle mass which consumes more calories on a daily basis.
5. Medical disorder - rarely, hormonal imbalances such as an under active thyroid gland can cause obesity

What weight reduction treatments are available?

The good news is that even modest amounts of weight loss can greatly reduce the risk of developing the above medical conditions. Diabetes is a good example where in some cases, the loss of as little as 5 kg can lead to dramatic improvement in blood sugars. It is not uncommon for medications to be no longer necessary in some diabetics who lose weight.

Weight loss is best achieved through healthy diet and regular exercise. If you are among those people who are unable to lose and maintain weight loss, weight reduction surgery may be an option.

Who is considered for weight loss surgery?

Dr Fenton-Lee considers gastric banding in people with a BMI greater than 40 (morbidly obese). Additionally, people with a BMI of greater than 35 who also have a complicating illness such as diabetes are considered.

What is weight reduction surgery?

Surgery for weight reduction has existed since the 1950s and multiple techniques have existed. Most techniques involve either food bypassing much of the intestinal tract to reduce absorption of nutrients or to reduce the size of the stomach compartment to reduce the amount of food able to be ingested.

Gastric banding is the most common procedure used in Australia and Europe and has major advantages over other obesity surgical techniques.

In gastric banding, an inflatable silicone band is placed around the upper part of the stomach. This partitions the stomach into two smaller compartments joined by a narrow opening. Weight reduction is achieved by reducing the amount of food that is able to be eaten and decreasing the time that the stomach can empty. The result is of feeling comfortable full with eating less and due to decreased emptying, a longer feeling of fullness.

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What advantages are there with gastric banding over other surgical options?

The main advantages of gastric banding are

1. Procedure is done through keyhole surgery
2. High success rate in weight reduction
3. Adjustable - the band around the stomach can be inflated and deflated quickly or gradually via a reservoir located below the surface of the skin. This is all done without re-operation.
4. Short hospital stay, rapid recovery period- one major drawback to previous obesity surgery was that open surgery was required. This meant long hospitalisation leading to higher complication rates such as deep vein thrombosis, chest and wound infections. Laparoscopic (keyhole) surgery has revolutionised obesity surgery with regards to recovery period.
5. No stapling or cutting of the stomach is required.
6. Reversible - The band can be completely deflated without further operation. As no stomach or bowel was stapled or cut, the procedure is completely reversible.

Does gastric banding work?

Results from multiple large studies show that gastric banding is very effective in reducing and maintaining weight loss. This is conservatively defined as losing greater than 50% of excess weight and maintaining that loss for greater than 5 years. Most people lose more than 50% of their excess weight.

Weight loss is gradual and consistent. It is usually lost at a rate of 30-50% of excess weight in the first 6 months, 50-75% in the following 6 months and continued weight loss for the first 2 years.

To learn more about gastric banding, follow this link.

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