Surgery for Obesity
The inability to lose weight permanently, or weight regaining despite appropriate, supervised, combined efforts with diet, exercise and professional psychologic support, have led to the development of operations, which decrease the storage capacity of the stomach and/or decrease the absorption of the food consumed. Such operations have been around since the 1960’s, but it has been only for the last 20 years that they are performed in large numbers. There is a variety of operations for obesity that have been historically performed and are currently in use and now, all the advantages and potential disadvantages of all kinds of these operations are fully studied and very well known. The indications of each of those operations available, depend on each patient’s Body Mass Index (BMI), as well as his/her existing diet habits. This means that, although general rules and principles should always be followed, the choice of an operation should be individualized according to the unique characteristics of each patient. It is not prudent for a surgeon to suggest the same operation to every single patient “across the board”.
Usual fears and misconceptions
The reality is that the vast majority of patients with morbid obesity do not have a full understanding of the extent of their problem. Their understanding usually is limited to “feeling uncomfortable” physically, psychologically, and socially because of being overweight, and sometimes they may have a vague idea of a “health problem”, not further defined and understood. Generally, patients are not aware of the fact that their life expectancy is statistically 20 years shorter just because of their condition, or that their risk of developing gynecologic, or colon cancer, a heart attack, or a stroke is far greater compared to any individual with normal weight. The result of this, is that they are afraid to undergo an operation that would solve their problem definitively. They subconsciously try to save themselves an operation and they do not realize that, by doing that, they are exposed to a huge risk of undergoing a mean of six operations in the future, only to take care of complications of their obesity (i.e.: hip and knee replacement, spine surgery, vascular operations, heart surgery, etc.). In other words, they do not understand that the real choice they are making is not between one operation or no operation, but unfortunately between one operation and six operations.
It is our job, as health professionals to offer this education to patients and their families, so they become aware of the full magnitude and scope of their morbid obesity. This is the only way informed decisions and correct choices can be made, so patients can be relieved from the potentially lethal risks that morbid obesity is associated with. Surgery for obesity (bariatric surgery) is safe and efficient. The choice of the operation should be individualized, based on patients’ characteristics. These operations are now performed laparoscopically and are associated with very short hospital stay and fast recuperation.
