Obesity affects over one in two Australians and is a very real medical condition with a metabolic component. Therefore, obesity is linked to a range of metabolic diseases such as Diabetes, Insulin Resistance, Dyslipidaemias and Thyroid conditions.
The main factor in obesity is metabolic, where there is a genetically programmed tendency to efficiently store excess calories as fat. Obesity also comes under the influence of environmental, cultural and lifestyle factors.
Body mass index is the widely accepted measurement used for classification of obesity. It is defined as weight in kilograms, divided by height squared. The world health organisation (WHO) has defined obesity as:
|Underweight||BMI < 18.5|
|Normal weight||BMI 18.5 to 24.9|
|Overweight||BMI 25 to 29.9|
|Obese – One||BMI 30 to 34.9|
|Obese – Two||BMI 35 to 39.9|
|Super obese||BMI > 40|
The social stigma associated with obesity often means that obese individuals can be isolated from society, suffer from depression and have lower health and quality of life.
Medically, obese patients have longer waiting periods on public hospital lists and they are often overlooked for elective surgery. The social impact on these individuals can extend to being disregarded for job promotions and difficulty in finding long term relationships.
Even a small weight loss provides health benefits
There is a tendency to believe that obesity results largely from laziness and over-consumption, and therefore, there is a need for correction of these common misconceptions by re-education of both the general population and health professionals.
All weight loss strategies involve lifestyle modifications, including prepared meals, meal replacement, prescription medication, surgery, over the counter products, alternative treatments, diet based commercial programs, self directed diets and exercise.
A relatively small weight loss (5-10%) can result in significant metabolic and cardiovascular health benefits. These include blood pressure reduction, improvement in dyslipidaemia and hypertriglyceridemia, reduction in blood sugar levels for Type II Diabetics with insulin resistance and improvement or resolution of sleep apnoea. Weight loss of greater than 10% of the initial body weight provides further health benefits.
Energy balance is the key to all successful weight loss programs. All effective treatments essentially involve a change in the balance of the amount of calories or kilojoules consumed in relation to the energy expended.
The energy input is determined by the amount of food and drink consumed, and depends on the energy density, portion size and frequency of consumption. Energy expenditure is determined by metabolism, thermogenesis and activity. This is influenced by the frequency, intensity and duration of exercise.
Varying any one of these factors can have a significant impact on the total volume of energy consumed and metabolised, and can therefore have a significant impact on body weight.
However, for individuals with a body mass index (BMI) of greater than 35, diets alone rarely work and the National Institute of Health (NIH) has reported that most diets do not produce a sustainable weight loss. Therefore, the most effective treatments are likely to involve a combination of strategies, unique to each patient.
Most effective means of long-term weight loss control
Bariatric surgery is currently the most effective strategy available for long-term weight loss control. It is designed principally to enable easier modification of food intake, resulting in weight reduction to a safer and more comfortable range. Most of the associated conditions are then reduced in severity and many, completely reversed.
There is an improvement in mobility, body image, self-esteem and enjoyment of life.
Choosing Gastric Sleeve or Band Surgery
Like all other treatment, surgery is only effective when combined with lifestyles changes. International studies have proven that a multidisciplinary team approach to weight loss is required for optimal results, both prior to and following surgery. This means that the patient has access to the necessary expertise to obtain advice, treatment and support, allowing more effective care and results.
As healthcare providers, we will only proceed with surgery if we believe that you have made an informed decision. You should have an understanding of your obesity and the procedure involved. Also, you should also have realistic expectations of what the procedure can accomplish and are be aware of the risks involved.
We are committed to doing everything necessary to get the best possible results for you. Also, a large commitment is required from you to achieve your goals, which means that you will have a responsibility to modifying your lifestyle, eating and exercise habits.
Your decision to proceed should only be made after careful consideration and discussion with your family. This decision could ultimately change your life in a very powerful and positive way. However, you must be committed to work for this change.