Surgical Weight Loss
Weight loss surgery is major surgery. Its growing use to treat morbid obesity is the result of three factors:
* Our current knowledge of the significant health risks of morbid
Gastrointestinal surgery for the purpose of surgical weight loss has been performed on hundreds of thousands of patients since 1954. The most common surgical procedures for weight loss have been jejunoileal bypass (intestinal bypass), gastric bypass, and horizontal or vertical gastroplasty (stomach stapling). Other gastrointestinal surgical techniques have included biliopancreatic diversion, jejunocolic bypass, stomach wrap, and truncal vagotomy. Many procedural variations were developed by modifying surgical techniques without prior testing.
The most common justifications for performing gastrointestinal surgery are improved health, increased longevity, better psychosocial adjustment, and a decrease in the economic costs of obesity. Health is assumed to improve through a decrease in factors associated with obesity - such as hypertension, non-insulin dependent diabetes (NIDDM), and sleep apnea.
To qualify for insurance coverage of a weight loss surgery like gastric bypass surgery, many insurers require patients to have a history of medically supervised weight loss efforts. In most cases, the minimum qualification for consideration as a candidate for the procedure is 100 lbs. above ideal body weight or those with a Body Mass Index of 40 or greater. Occasionally, a weight loss procedure will be considered for someone with a BMI of 35 or higher if the patient's physician determines that obesity-related health conditions have resulted in a medical need for weight reduction and, in the doctor's opinion, surgery appears to be the only way to accomplish the targeted weight loss.
As well, it is very important for there to be commitment on the part of the patient to long-term follow-up care. Most bariatric surgeons require patients to demonstrate serious motivation and a clear understanding of the extensive dietary, exercise and medical guidelines that must be followed for the remainder of their lives after having weight loss surgery.
How Obesity Surgery Reduces Weight
Bariatric surgeons first began to recognize that there was potential for surgical weight loss, while they were performing operations that required the removal of large segments of a patient's stomach and intestine. After surgeries, doctors noticed that in many cases patients were unable to maintain their pre-surgical weight. With further study, bariatric surgeons were able to recommend similar modifications that could be safely used to produce weight loss in morbidly obese patients. Today's bariatric surgeons have access to a substantial body of clinical data to help them determine which weight loss surgeries should be used and why.
Today, the American Society for Bariatric Surgery describes two basic approaches that weight loss surgery takes to achieve change:
1. Restrictive procedures that decrease food intake.
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