MORBID OBESITY
Morbid obesity is a chronic, lifelong, multifactorial, genetically-related disease of excessive fat storage with highly significant medical, psychological, social, physical and economic co-morbidities. As such, it also involves hereditary, biochemical, hormonal, environmental, behavioral, public health and cultural elements.
Morbid obesity is, therefore, an extreme health hazard which is rarely the result of an aberrant moral problem or addictive behavior. There is an extremely high incidence of failure to sustain even a 10 per cent long-term weight loss in morbidly obese patients with any form of non-operative treatment. Bariatric surgery, on the other hand, has been shown to be the most effective means to aid in management and prophylaxis of the life-threatening complications and severe degenerative problems of morbid obesity. It is indicated due to the ineffectiveness of non-operative treatment methods for morbid obesity, the high risk of untreated morbid obesity, and the safety and effectiveness of operative treatment. Safe, effective bariatric operative procedures increase the longevity and quality of life in morbidly obese patients. Such surgery is performed as treatment for the co-morbidities of morbid obesity. Weight loss, while an essential component of this process, is only incidental to these goals, as is any possible cosmetic outcome.
Patients with sleep apnea, obesity hypoventilation, cardiac failure, or other life-threatening complications may require emergency admission and care. An operation can then be planned at a time when the patient`s condition is stable with adequate cardiorespiratory reserve.
Size discrimination condemns morbidly obese people to be excluded from access to medically necessary, quality care. Such discrimination and consequent exclusion is unacceptalbe. There is, therefore, no justification in requiring morbidly obese individuals to participate in long-term weight loss programs or requiring them to surmount comparable barriers as a prerequisite for approval of bariatric surgery, unless the surgeon`s judgement precludes same.
------Courtesy of American Society for Bariatric Surgery
What is Morbid Obesity?
Medically, the word "morbid" means causing disease or injury. Morbid Obesity is a serious disease process, in which the accumulation of fatty tissue on the body becomes excessive, and interferes with, or injures the other bodily organs, causing serious and life-threatening health problems, which are called co-morbidities.
Morbid Obesity is also called Clinically Severe Obesity, and is recognized by the consensus of medical opinion as a serious problem, a disease process. In most cases, the underlying cause is genetic -- you inherit the tendency to gain weight, and once the problem is established, there is very little that will power can do about it -- any more than a diabetic can control his blood sugar by will power.
How do we know it's genetic?
Numerous scientific studies have established that there is a very powerful genetic predisposition to Morbid Obesity:
· Children adopted at birth show no correlation of their body weight with that of their adoptive parents, who feed them, and teach them how to eat. They show an 80% correlation of their body weight with their genetic parents, whom they have never even met.
· Identical twins, with the same genes, show a much higher similarity of body weights, than do fraternal twins, who have different genes.
· Certain genetic populations, such as the American Indians of the Southwest, have a very high incidence of severe obesity. They also have a markedly increased incidence of diabetes and heart disease.
How do you know if you are Morbidly Obese?
We use three criteria:
· Are you more than 100 lb over your "ideal body weight"? This is a weight established actuarially, at which you are likely to live the longest, not what you wish you could weigh - which is usually less. (Another alternative criterion is called the Body Mass Index (BMI). If this is greater than 40, surgery should be considered. If it is greater than 35, and is accompanied by serious co-morbidity, surgery may be indicated. To find out your BMI, and visit a very informative site, visit Dr. C.Everett Koop's Shape-Up America site).
· Do you have co-morbidities of your serious overweight? We look for health effects that are known to be caused by, or aggravated by serious obesity. (See Health Effects of Serious Obesity).
· Have you tried dieting, especially medically-supervised dieting, and been unable to achieve a sustained healthy body weight. Everyone knows diets don't work in the morbidly obese, and there has actually never been a scientific study reported which shows that they do, but you should at least have tried it.
What can you do to regain your health?
· You could go on another diet. Unfortunately, although diets work for a little while, the effects seldom last, and the answer to Morbid Obesity needs to last a lifetime. No diet program, even the drug programs such as the Phen-Fen, or Redux, programs, are sufficiently powerful, or adequately long-lasting, to produce the necessary sustained weight loss in the severely obese. There has never been a scientific study which has shown that dietary management is beneficial or effective, in the severely obese.
· You could look at how much your health is at risk, and consider taking some risk to achieve a more lasting solution: surgery to change your body's physiology, and to help you to gain control of your weight. In our opinion, surgery is the only effective way to achieve lasting weight control, and a healthy body weight.
---Taken from Alvaredo Center for Surgical Weight Control