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Obesity Awareness Week (11-17 March)

This news item was added on 11th March 2007

There has been a marked increase in the incidence of obesity among the Western population over the last two decades. In the UK, some 1:5 women and 1:6 men are obese. Childhood obesity is now a rising problem with 1:8 children currently affected.

What is the impact of obesity on our health?

There is no doubt that morbid obesity has a detrimental impact on our physical and psychological wellbeing. The link between morbid obesity and type-2 diabetes, hypertension, angina, stroke, osteoarthritis of the spine, hips, knees and ankles, sleep apnoea and breathlessness, gallstones, acid reflux, stress urine incontinence, and cancers of the colon and ovary is well recognised. Severe obesity may be associated with loss of self-esteem and depression. The life expectancy of morbidly obese people is considerably shortened.

Am I morbidly obese?

Obesity is commonly defined in terms of where we are along the body mass index (BMI) scale as shown in this table

BMI (kg/m2) Description

< 20 Underweight
20-25 Desirable
25-30 Overweight
30-40 Obese
40-50 Morbidly obese
> 50 Super obese

Although morbid obesity is defined as a BMI of 40 or more, people with a BMI of 35 who have a related health condition such as diabetes are also considered morbidly obese

How can I calculate my BMI?

BMI= weight (kg) divided by height2 (m2)

To work out your body mass index, follow these steps:

Find out your weight in kilograms (multiply your weight in stones X 14, and divide the result by 2.2)
Find out your height in metres (one foot = 30 cm, one inch = 2.45 cm)
Divide your weight (in kilograms) by your height (in metres)
Then divide your answer by your height in metres again

Are there any new medicines to treat obesity?

Yes, medication is available through prescription, for individuals who have a BMI of over 30, in association with a significant weight-related disease, and should lose 5½ lb in weight with dieting prior to treatment. One also needs to lose 5% of the weight after 3 months of therapy to qualify for repeat prescription.

One-third or more of patients discontinue the treatment course, and many tend to regain weight after 1-2 years. The use of these drugs must be combined with modifications in behaviour and eating habits if patients are to reap the full benefits of such treatment.

Treatment of obesity through surgery

Surgery is the treatment of choice for most patients who suffer with ‘morbid obesity’ as defined above. Although dieting and exercise are effective in achieving weight loss, research has shown that the large majority of patients who reach this stage of obesity are unable to maintain a long-term sizeable weight loss with these measures alone.

What are the reliable operations for morbid obesity?

The two types of operations most commonly performed include;

Laparoscopic gastric banding (LapBand):

Designed to limit how much can be eaten at one time by reducing the size of the stomach. Usually performed laparoscopically (keyhole surgery).

Laparoscopic gastric bypass:

In addition to offering gastric restriction, this operation also reduces the amount of food that can be digested. The weight loss that can be achieved is superior to that obtained with gastric banding, and is more durable. Usually performed laparoscopically.

What are the risks of the operations?

These operations are well established. However, surgery carries a small risk of major complications (6-7%) and of mortality (<0.5% with banding, <1.0% with bypass) Several measures are taken before, during and after surgery to minimise these risks.

Which operation should I chose?

The laparoscopic gastric bypass operation is suitable for all patients and achieves excellent results. However, the gastric banding operation is suitable for the lighter patients (BMI <45-50). Heavier patients, those who crave for sweets (sweet-eaters), and those who desire to achieve a target weight that is as close to normal as possible are best treated with a gastric bypass operation. The decision on choice of surgery should always be undertaken in consultation with the Consultant.

Will surgery cure my health problems?

Losing the excess weight is known to cure the majority of patients from type-2 diabetes. In addition, weight loss achieved is also associated with improvement and often resolution of a number of other obesity-related diseases, including sleep apnoea, obesity hypoventilation, cardiopulmonary failure, gastro-oesophageal reflux disease, stress urinary incontinence, arthritis, and infertility, polycystic ovary syndrome, and complications of pregnancy and delivery.

Please note that patients cannot usually be seen or treated by specialists, either in the NHS or private practice, without an appropriate referral, usually from their general practitioner. References made within this article have been taken from varying sources, details can be obtained by contacting our free phone help line given below.

Notes

Article kindly supplied by:

Mr. Basil J Ammori, MB ChB, FRCS, MD Consultant Surgeon
The Alexandra Hospital, Mill Lane, Cheadle, Cheshire SK8 2PX

For further information on this subject you may access the author’s website: www.laparoscopic-specialist.co.uk or contact The Alexandra Hospital on 0800 3282 975 for further information.