Surgical weight loss: Key points

• Morbid obesity is a serious medical condition with serious medical consequences.
• Roughly 65 percent of all Americans are overweight, 25 percent are obese, and 4 percent are morbidly obese. Morbid obesity means that you are severely overweight, usually by at least 100 pounds with excessive amounts of body fat. Know your body mass index (BMI). This is an estimate of how much you should weigh based on your height. You also need to know your waist size. This may be even more important in predicting health problems. Most men should have a waist less than 40 inches (ideally 35 inches), while most women should have a waist less than 35 -37 inches (ideally 32.5 inches).
• Being morbidly obese puts you at very high risk for a host of serious medical problems, including high blood pressure, diabetes, heart disease, cancer, and many others.
• Being obese increases your chance of dying this year. You have a greater risk of dying from heart disease, the most common killer in the U.S. You also have an increased risk of dying from cancer. In addition, obesity increases your risk of dying from all causes.
• The main goal when dieting is to learn new, healthy ways of eating and make them a part of your everyday routine. If you drop pounds slowly and steadily, you are more likely to keep them off. DO NOT use over-the-counter or herbal weight loss preparations without the knowledge and consent of your health care provider.
• Exercise is a key component to any healthy lifestyle. Exercise can help you lose weight more quickly.
• Despite their best efforts, some people aren't able to lose weight through diet, exercise, and lifestyle changes alone.
• If you are morbidly obese and other methods (like self-driven and commercial diet programs) have not worked, consult a structured weight loss program. These use a team of qualified professionals (physicians, nutritionists, exercise trainers, and counselors) to provide care.
• Medication or surgery may be considered if you are morbidly obese and other methods have not worked. There are very specific criteria to determine if you are a candidate for weight loss surgery.
• Weight loss surgery modifies the size of your stomach. This will decrease the amount of food you can eat, allow you to feel full much faster than usual, and possibly prevent the normal absorption of fat calories.
• There are risks and complications associated with the surgery.
• Talk to your physician, the health care professionals at a structured weight-loss program, and a weight-loss surgeon to determine if you are a candidate for surgery. Also discuss whether the benefits outweigh the risks for you, and which type of surgery would be best for you.
• After surgery, lifestyle changes are still ABSOLUTELY necessary to bring down your weight, keep it off, and help prevent complications related to the surgery.

References

Li Z, Bowerman S, Heber D. Health ramifications of the obesity epidemic. Surgical Clinics of North America. 2005 August;85(4):681-701.

Hubert HB, Feinleib M, McNamara PM, et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67(5):968–977.

Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med. 2003;348(17):1625–1638.

Sjostrom LV. Mortality of severely obese subjects. Am J Clin Nutr. 1992;55(Suppl 2):516–523.

Manson JE, Stampfer MJ, Hennekens CH, et al. Body weight and longevity. A reassessment. JAMA. 1987;257(3):353–358.

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