Weight, BMI and Bariatric Surgery - Essay Example

Weight, BMI and Bariatric Surgery In the past few decades, there has been an increase in the number of people being diagnosed with obesity. Besides the obvious increase in weight, there are also other factors as to why a person is diagnosed to be an obese. However, what is obesity? Are there any other risks that this disease may bring to a person? What is bariatric surgery? Is it advisable for people who are suspected to be suffering from obesity or already diagnosed as an obese? Majority of the human population are fond of cooking and eating. People eat for various reasons. The major purpose why a person eats is for survival. In order to perform numerous tasks in a day, the human body needs the nourishment, vitamins and minerals that comes from the food that a person eats. In the modern world, people have lesser time to prepare their own meals due to the workload one needs to fulfill in a day. There can be several conditions on how a person’s eating habit can be subdivided. One condition is that due to lack of time, a person tends to eat unhealthier yet readily available meals like fast-food meals or junk foods. Another condition is that due to the work that is very time consuming and demanding, often a person skip meals or not properly chew the food that has been taken in. When a person feels extreme emotions, it has a tendency to take in more food than the usual. The latter statement is another condition as to how a person eats. The last condition previously stated actually is not restricted at the event of extreme emotion. A person does have a tendency to exceed the food intake than the required amount that the body need. The human stomach can store an approximate of 3 pints of food at a given time. However, there are instances when a person exceeds the 3 pints of food capacity of the stomach. The unnecessary food that contains fats, proteins and carbohydrates are not properly digested therefore build up in the stomach area and eventually circulated to the other parts of the body. Due to uncontrollable or unhealthy eating habit, a person’s body mass index (BMI) increases (Weight-control Information Network, 1). What is body mass index (BMI)? How is it calculated? A person’s BMI is just one of the many gauges towards the possible health hazards linked to obesity or overweight. According to Ferrera, “BMI is commonly used in clinical practice because it is straightforward and relatively cheap to obtain, but its clinical interpretation remains controversial (85).” This is also the tool that classifies a person on whether one is obese or not. As stated by the Surgical Associates at the Virginia Health Center, if a person’s BMI falls at the range of 25-29.9, that person is considered to be overweight. Once the BMI falls at range 30-39, the person is already considered to be obese. Morbid obesity is considered when a person’s BMI is calculated to be falling in the range of 40 or higher (7). People who are considered to be obese or morbidly obese often or not has eating disorders or cannot control their food intake. If one cannot control the increase food intake or its weight gain, surgery is considered as an alternative step to reduce the probability of obesity being the root cause of other diseases like high-blood pressure, high cholesterol, Type 2-diabetes, coronary heart disease, cancer and many other ailments. This surgery is being pertained to in the medical field as Gastric Bypass surgery or Bariatric Surgery. Others may consider this as their last resort to lose weight and their first step to a healthier life. Originally, the bariatric surgery is being pertained to as gastric by-pass surgery. As noted by Farraye and Armour Forse (47-54), Mason and Ito first introduced the term gastric bypass in the latter part of the 1960s. The original purpose of the surgery is to lesser the amount of malabsorption through a combination of restrictive and malabsorptive procedures. Gastric bypass is the forefather of the bariatric surgery. This process gave a noticeable decrease with the amount of severe malabsorption and the associated complication that comes with it. The website MedicineNet.Com defined Bariatric Surgery as: Surgery on the stomach and/or intestines to help a person with extreme obesity loses weight. Bariatric surgery is an option for people who have a body mass index (BMI) above 40. Surgery is also an option for people with a BMI between 35 and 40 who have health problems like Type 2-diabetes or heart disease. However, surgery is not advisable for all the patients diagnosed as obese or morbidly obese. There are other factors that need to be considered before a patient is advised to undergo operation. Further exploring the procedure, there are 2 kinds of surgery that can be performed. The 4 types of Bariatric Surgery being performed in the United States, namely: adjustable gastric band (AGB), Roux-en-Y gastric bypass (RYGB), biliopancreatic diversion with a duodenal switch (BPD-DS), and vertical sleeve gastrectomy (VSG) (Weight-control Information Network, 2). These procedures stimulate weight boss by limiting the intake of food. There are instances that there are occurrences of nutrition interference or malabsorption. Instead of the normal digestion process, the surgery introduces a mechanism to restrict excessive food intake to the body. Though there might be instances when patients have the tendency to consume more than what is prescribed, the surgery introduced a way that the digestive system will reject the unnecessary nourishments that has been taken in (Weight-control Information Network, 1; Farraye &Armour Forse, 47-54). Undergoing any type of bariatric surgery is just an option for those patients who are suspected or diagnosed to be either obese or morbidly obese. It is just a procedure being introduced or an option to be considered for those patients who finds it difficult to go through a diet or even perform exercises. Though surgery is the last option for the obese or morbidly obese patients, there has been an increase in number of patients agreeing to undergo the knife. There have also been studies that support the surgery has been creating a big impact in the mortality rate of obese and severely obese patients. Surgery is not enough to achieve a healthier life. A patient should start having a healthier lifestyle after undergoing the surgery (Weight-control Information Network, 1). Adjustable Gastric Banding (AGB) or Laparoscopic Adjustable Gastric Banding (LAGB) is just one type of the Bariatric Surgery. Between the 2 types of surgery, this is the most common being performed to patients. LAGB has started to gain popularity in England and the United States. As Farraye and Armour Forse described this procedure: The procedure involves the placement of an adjustable silicone band around the upper stomach that constricts the stomach and restricts the amount of food presented or absorption. The band is tightened by saline injection into a subcutaneous port that is attached to the band through connecting tubing. (207) This type of surgery aims mainly to control the food intake. Just like the name implies, a band is introduced to the digestive system to induce control. A more complex form of bariatric surgery is the Roux-en-Y Gastric Bypass (RYGB). Unlike AGB that only restricts the food intake; RYGB not just restricts the intake of food but also decreases its absorption. Besides the gastric band which is introduced to the digestive system, there is like a rerouting of the food to avoid most of the usual digestive track procedure. After surgery, the food now travels from the pouch and straight into the small intestine which will eventually be excreted from the body. It has also been observed that most patients with hypertension undergo this type of surgery more often than the other types of surgery (Weight-control Information Network, 2). Biliopancreatic Diversion with a Duodenal Switch (BPD-DS) is the third type of bariatric surgery. It is commonly known as duodenal switch. From the AGB that is considered as the simplest form of the bariatric surgery, then came RYGB that serves 2 functions, duodenal switch is considered as the more complex procedure. According to the Weight-control Information Network, there are 3 procedures involved in a Duodenal Switch surgery and these are: 1) removing a large portion of the stomach to promote smaller meal sizes, 2) re-routing of food away from much of the small intestine to partially prevent absorption of food, and 3) re-routing of bile and other digestive juices which impair digestion. (2) Instead of a pouch being introduced in the system for the first 2 types of surgery, a gastric sleeve or vertical sleeve gastrectomy, (VSG) is produced or introduced into the digestive system. In this process, the food travels a shorter distance from the stomach to the colon. This procedure inclines more towards food malabsorption instead of focusing on the control in food intake. Since the procedure deals more towards malabsorption, there is the risk that a patient who undergoes the Duodenal Switch surgery will have long-term complications since the body is lesser capable of absorbing food and nourishments (Weight-control Information Network, 2). The term vertical sleeve gastrectomy (VSG) first came into the scene of the bariatric surgery as the first step in the BPD-DS procedure. Coincidentally, this is the fourth type of bariatric surgery. With BPD-DS having a higher risk towards long-term complications, instead of going through the other steps of the surgery, a patient will just undergo the first step which is the creation of a gastric sleeve. For some patients, undergoing VSG or just the first step of the BPD-DS surgery seems to give them sufficient results and eliminate the needs of undergoing further surgical procedures (Weight-control Information Network, 2). Just like BPD-DS, VSG also promotes restriction in food intake. What makes them different is that VSG does not stimulate malabsorption. In this type of surgery, a large portion of the stomach is removed. This decreases the production of a hormone that introduces the feeling of hunger. The hormone was identified as ghrelin. Since there is a decrease in the hormone, the patients have a lesser tendency to feel hunger and therefore reduce the need for any other food restrictions such as the gastric band. A downside of this procedure is that there are not enough studies or numbers that support how many VSG-only patients still need a secondary procedure (Weight-control Information Network, 2-3). Just like any medical procedures, there is no such thing as a perfect procedure. There is still room for errors. Bariatric surgery is not an exemption. Since the surgery involves the digestive system, the patient’s health and nutrition status is always at risk. Besides the usual complications like infection, bleeding or maybe leaks since intestines and organs will be sewn together, there can also be blood clots or complications that can affect the lungs and the heart. Every surgery has complication risks. Though there are precautions that surgeons can do, it is not a guarantee that no complications will occur after the patient has been discharged from the medical facility. The most common complications that occur to patients who have undergone gastric bypass or bariatric surgery are vomiting and unrelenting nausea. These 2 complications occur to 23% to 38% of the patients who have proceeded with the operation. Most of the time, complication occurs due to noncompliance of the patients to the instructions of their physicians towards their eating habit and lifestyle. The list of complications is numerous and yet the number of people undergoing the bariatric surgery is increasing. A person who has undergone any of the 4 types of surgery has a possibility to acquire hernia (Farraye &Armour Forse, 209; Weight-control Information Network, 3). One of the reasons why a person take the risk of undergoing surgery is to lose weight since weight is perceived to be the main health problem or threat. Since operations do not guarantee anything even weight-loss itself. Studies have shown that there are at least 10% of patients who have undergone the surgery have not achieved the amount of weight-loss aimed prior to surgery. It would be either the latter statement of the amount of weight lost after the surgery will eventually be gained a few months after the procedure. Not all complications are shown physically, there are also emotional complications that a patient may experience. The Weight-control Information Network reminded people who consider surgery as a way to lose weight: There are no guarantees for any method, including surgery, to produce and maintain weight loss. Success is possible only with maximum cooperation and commitment to behavioral change and medical follow-up—and this cooperation and commitment must be carried out for the rest of your life. (3-5) When a person wants to be healthy, physical health is the first thing that is being considered and thought of. Emotional and mental health is also important for a person. The body may be physically able to perform certain task yet emotionally; the person is not yet ready to fulfill it. A person’s health is not composed of the physical body. For a person to be considered healthy, the body, the mind and the heart should also be healthy. It is truly a courageous act for a person to undergo and survive a surgery. A more courageous act is to accept the fact that though there are shortcuts in achieving the weight-loss and gain the ideal health condition, the best way to be healthy is to live a healthy life. Temptations are everywhere. It will take great will power and mental health for a person to avoid these temptations and continue living towards the healthier self. Works Cited “Definition of Bariatric Surgery.” MedicineNet.Com. MedicineNet, Inc. 19 May 2006. Farraye, Francis A. and R. Armour Forse. Bariatric Surgery: A Primer for Your Medical Practice. Thorofare, NJ: SLACK Incorporated. 2006. Ferrera, Linda A. Focus on Body Mass Index and Health Research. New York: Nova Science Publishers, Inc. 2006. Surgical Associates at Virginia Hospital Center. Weight Loss Surgery. Arlington, VA. 2009. Weight-control Information Network. “Bariatric Surgery for Severe Obesity.” NIH Publication. No. 8. Bethesda, MD. March 2009. Read More