Obesity is a growing problem in the United States. According to a recent National Health and Nutrition Examination survey, the prevalence of obesity is approximately 33 percent among adult men and 35 percent among adult women. In 1997 only three states, Kentucky, Indiana and Mississippi, reported obesity rates equal to or greater than 20 percent.
By 2009, only Colorado and the District of Columbia had an obesity rate lower than 20 percent. Fortunately, there are surgical options for people who struggle with their weight and want to improve their health.
People are considered obese if they have a Body Mass Index of 30 or higher. This excess weight it not just a cosmetic problem. Obesity or having a waist circumference over 35 inches for women and 40 inches for men can increase the risk of many diseases and health conditions, including heart disease, diabetes, certain cancers, high blood pressure, gastroesophageal reflux, fatty liver disease, stroke, sleep apnea, osteoarthritis, and reproductive problems in women.
Weight loss surgery may be recommended for people who are very obese and have tried unsuccessfully to lose weight through other programs. This type of surgery is not a quick fix to treat obesity. Weight loss surgery is designed for those with a body mass index equal to or greater than 40, or equal to or greater than 35 with serious co-morbidities. The procedure can provide long-term results only if the patient makes a serious commitment to exercise regularly and eat properly.
One surgical option for weight loss surgery is LAP-BAND® adjustable gastric banding (LAGB). This procedure involves placing an adjustable band around the top part of the stomach to create a small pouch for food. The band restricts the amount of food that can be eaten and increases the amount of time it takes for food to digest. The band can be adjusted to change how quickly food leaves the pouch, or surgically removed if necessary. LAGB can be performed laparoscopically.
LAGB® is a simpler procedure compared to traditional gastric bypass surgery. However, it may result in less weight loss at a slower rate compared to traditional surgery. Gastric bypass involves closing off a large portion of the stomach while leaving only a small portion to hold food and dividing the small intestine to allow less food to be absorbed by the body. LAGB® is not recommended for people with certain medical conditions, including Crohn’s disease, large hiatal hernias, or a history of gastric ulcers.
Due to the reduced size of the stomach after surgery, patients may be advised to eat about six small meals per day rather than three large ones. Also, because large amounts of fat, alcohol or sugar are typically not tolerated as well, eating fast-food and high-sugar, high-fat or deep-fried foods should be reduced. Incorporating exercise into a regular routine is very important to improve metabolism and support long-term, sustainable weight loss.
Before undergoing weight loss surgery, patients typically have a psychological evaluation to determine if they are ready to adopt a healthy lifestyle. Nutritional counseling usually is provided both before and after surgery.