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Understanding Overweight and Obesity

Causes

Taking in more calories than you burn can lead to overweight and obesity because the body stores unused calories as fat. Overweight and obesity can be caused by eating more food than your body can use, drinking too much alcohol and not getting enough exercise. Sometimes, medical problems or treatments can cause weight gain, including an underactive thyroid gland (hypothyroidism) and medicines such as birth control pills, antidepressants and antipsychotics. Other factors that can lead to weight gain include: quitting smoking; stress, anxiety, depression and insomnia; menopause; and pregnancy.

How is obesity defined?

Most bariatricians (doctors who specialize in treating overweight and obesity) use a patient’s BMI (Body Mass Index) measurement as an initial screening tool to identify people who may be at increased health risk due to being overweight or obese. (Calculate your BMI.) The following BMI ranges are recommended by the National Heart Lung and Blood Institute when classifying overweight and obesity:

                Underweight: lower than 18.5

                Normal weight: 18.5 to 24.9

                Overweight: 25 to 29.9

                Obesity (Class 1): 30 to 34.9

                Obesity (Class 2): 35 to 39.9

                Extreme Obesity (Class 3): greater than 40

Health risks

Obesity is a life-threatening health condition that should not be ignored. In addition to limiting a person’s quality of life, obesity can lead to Type 2 diabetes, cancer (endometrial, breast and colon), heart disease, heart attack, stroke, high blood pressure, liver and gallbladder disease, gynecological problems (abnormal menses and infertility), sleep apnea and arthritis. Even lower levels of excess weight can constitute a health risk, particularly when other disorders such as diabetes, hypertension and heart disease are also present.

Are you a candidate for weight loss surgery?

  • BMI 35-50 with co-morbidities (ex., diabetes, hypertension) or 40-50 without
  • Healthy enough to undergo a major operation
  • Failed attempts at medical weight loss
  • Absence of drug and alcohol problems
  • No uncontrolled psychological conditions
  • Consensus by multi-disciplinary team
  • Understands surgery and risks
  • Must be dedicated to a lifestyle change and lifetime follow-ups.

Non-surgical and surgical options

Unlike many weight loss centers, which focus primarily on surgery, we offer both non-surgical and surgical treatment options. Our bariatric navigator works with you and your primary care physician to determine a course of treatment (which may or may not include surgery). In some cases, patients have already been under the care of a physician and have fulfilled the steps necessary to undergo bariatric surgery. In those cases, patients will be referred to one of our surgeons for further evaluation.

Choosing the procedure that's right for you

Considerations: Age, health risk (depending on co-morbidities), amount of weight to lose, lifestyle and eating behaviors

A mutual decision between patient and surgeon is important

  • Discuss with surgeon during initial consultation
  • Discuss with family and friends

Surgery procedures

Adjustable Gastric Banding: With this type of weight loss surgery, a silicone band is placed around the upper portion of one's stomach. The stomach becomes a small "pouch" that can hold about an ounce of food. A plastic tube that connects to the silicone band runs from the band to just under the skin where a device is located and saline can be added or removed as weight loss progresses. The saline tightens and relaxes the band as needed.

  • Laparoscopic
  • Second most frequently performed bariatric procedure
  • Mean excess weight loss at one year of 42 percent
  • Requires implanted medical device
  • Lowest rate of complications

What to expect after gastric banding:

  • Recovery takes time and patience.
  • The diet is strict.
  • The capacity of the food you can eat has changed.
  • You may experience discomfort and pain as your body heals.
  • Length of time to return to normal activities can vary from patient to patient.
  • Your health care team will advise you when to return to work and resume prior activities.
  • Lifestyle changes are necessary to ensure success.

Gastric Sleeve: With this weight loss procedure, about 75 percent of one's stomach is removed and a "sleeve" shape remains. By reducing the size of the stomach, one will feel full from food more quickly and will remain feeling full for several hours. This procedure may also decrease one's appetite which can also assist with weight loss.

  • Laparoscopic
  • May be an option for carefully selected patients, including high-risk or super-obese patients
  • Mean excess weight loss at one year of 59 percent
  • No implanted medical device

What to expect after a gastric sleeve:

  • Recovery will take time and patience.
  • The diet is strict.
  • You may experience discomfort and pain as your body heals.
  • Length of time to return to normal activities can vary from patient to patient.
  • The capacity of the stomach has changed.
  • Your health care team will advise you when to return to work, resume prior activities and schedule your follow-up appointments.

Roux-en-Y Gastric Bypass: This is a weight loss procedure where one's stomach is condensed to a small "pouch." This reduces the amount of food that can be consumed. The surgeon will then connect the pouch to the small intestine. By doing so, the amount of fat and calories absorbed from foods are reduced. This allows for further weight loss

  • Laparoscopic
  • Most frequently performed bariatric procedure
  • Mean excess weight loss at one year of 67 percent
  • No implanted medical device
  • Low rate of complications

What to expect after a Roux-en-Y Gastric Bypass:

  • Recovery takes time and patience.
  • The diet is strict.
  • You may experience discomfort and pain as your body heals.
  • Length of time to return to normal activities can vary from patient to patient.
  • Some patients are able to return to work within a few weeks and see weight loss fairly soon after surgery. For others, a couple of months go by before they experience noticeable weight loss.
  • One study found that laparoscopic gastric bypass patients (median time):
    • Started on oral diet in one to two days
    • Left the hospital on the second day
    • Returned to work at 21 days

Surgery can help to change your life

  • Improves or resolves obesity-related illnesses
  • Decreases mortality risk
  • Reduces health care utilization and direct health care costs

 Remember…surgery is a tool that requires strong commitment to a lifestyle change and a lifetime of follow-up appointments.

Meet your surgeons

Questions?

Contact us at:

Cass Regional General Surgery Clinic
2820 East Rock Haven Road, Suite 220 (located in Rock Haven Medical Mall)
Harrisonville, Missouri  64701
Phone: (816) 380-2446