| What
Can Be Done About Severe Obesity?
Non-surgical
Intervention
Eating less, more sensibly, and exercising more are the first
recommended steps to take in order to reduce weight. But for people
who are severely overweight, this solution probably sounds like an
over-simplification. As most dieters will agree, adhering to a strict
regimen is a difficult and sometimes painful task. Many of those who
have succeeded in losing some excess weight have found themselves
quickly returning to their old weight when they discontinue dieting.
The result is another diet, a meal replacement drink or a perceived
“wonder pill.” This cycle of weight-loss-weight-gain,
weight-loss-weight-gain, or the yo-yo effect, may make it harder to
lose weight in the future, although even temporary weight loss may be
helpful.
Seeking professional help from a physician or dietitian for
nutritional counseling can help you change your lifestyle, and a
program of improved eating habits and exercise will be important in
your progress. These specialists may also prescribe certain drugs to
temporarily reduce your appetite. Some people find that keeping a
journal of their food intake, exercise, weight loss, and goals can aid
them. However, numerous studies have demonstrated that diets and
weight-loss aids rarely succeed in helping severely obese people
achieve the desired result of long-lasting weight reduction.
Drugs have been developed to assist in weight loss and weight-loss
maintenance. Unfortunately, no drug therapy has been shown to result
in substantial and sustained weight loss in people suffering from
severe obesity. Jaw-wiring, hypnosis, counseling and other
non-surgical methods have not been shown to be effective in the
long-term.
Surgery
If diets, exercise programs,
medications and other non-surgical methods have failed to help you
lose excess weight and keep it off, an operation to reduce the
capacity of the stomach may be an option. It is important to remember
that a positive attitude is fundamental to the success of the surgery.
Only if you are well motivated and committed to losing weight and
keeping it off can this operation help you achieve the desired result
of long-term weight loss.
You should consider the following.
If you are then comfortable with your decision to have WLS, you should
do some research and become familiar with all aspects of each
weight-loss procedure.
Can you comply with the therapy
and follow up that is so necessary after weight loss surgery?
You have to follow the directions of your surgeon, especially diet,
exercise, labs and office follow up. The surgery is a only a tool.
Results are only as good as your use of this tool. It would be
disastrous if one depended on the surgery alone to "take care of
the obesity". There will never be a break in following the
guidelines set forth by your surgeon regarding diet, exercise and
follow up. You are making a life long commitment.
Are you looking for the surgery
for the right reasons? Do you just want to look better?
Bariatric surgery is NOT done for cosmetic reasons. It is always done
to improve failing health. If you meet the medical criteria, you are
doing it for health reasons. Feeling better is the goal, looking
better is a nice "side effect".
Have you made many attempts at
weight loss?
Only you can decide if you have reached the point where you have
exhausted all other options to lose weight. You are making a serious
decision that only YOU can make, once you feel you are well informed
about the risks and benefits of weight loss surgery.
Are you comfortable with your
decision? Are you apprehensive?
Once you are feeling comfortable with your decision to make a
lifestyle change forever and you know you can do it, you are ready. If
you know exactly and feel comfortable with how the surgery rearranges
your digestive system and the short and long-term risks of bariatric
surgery, you are ready. If you have found a surgeon that you feel very
comfortable with, you are ready. If you are apprehensive about the
whole process, you are normal!!
Types of surgical
procedures
There are two basic
types of surgical procedures for obesity: Malabsorptive and
Restrictive.
1. Malabsorptive - Shortening the
digestive tract
a) Gastric
Bypass
In this procedure, the majority of
the stomach is excluded from the digestive process by suturing or
stapling, and a lower portion of the intestines is attached to the
small stomach pouch. Most of the stomach and part of the intestines
are bypassed. The result: Reduced absorption of nutrients and
calories.
2. Restrictive - Reducing the stomach
capacity
a) Stomach
Stapling (Vertical Banded Gastroplasty)
In this procedure the capacity of the
stomach is restricted by suturing or stapling. You achieve the feeling
of satiety (fullness) when the small stomach pouch is full. The
result: Food intake is limited. This procedure is done less often now,
since the arrival of the Lap Band because this band is not adjustable,
in cases where there are problems eating or not losing weight
appropriately.
b) The
LAP-BAND Adjustable Gastric Banding System
In this procedure the capacity of the
stomach is made smaller by placing an adjustable band around the upper
part of the stomach. No cutting or stapling is required to create
division between the upper stomach pouch and lower stomach. You
achieve the feeling of satiety (fullness) when the small stomach pouch
above the band is full. The result: Food intake is limited. The band,
unlike the Vertical Banded Gastroplasty, is designed to be adjusted as
your situation requires.
The advantage of
reducing the capacity of the stomach
Food provides energy. It arrives in
the body via the alimentary canal, which consists of the mouth, the
esophagus, the stomach, and the small and large intestines. The
digestive process begins in the mouth with chewing and the addition of
saliva. After the food passes through the esophagus, this process
continues in the stomach. Gastric juices which contain enzymes break
down the food so that the energy can be carried further into the body
by the circulation of the blood. The stomach then serves as temporary
storage for food.
Reducing the capacity of the stomach
makes the food storage area smaller so that the feeling of fullness is
achieved sooner. The stomach digests nutrients and calories normally.
The LAP-BAND System uses innovative
surgical technology to help you attain desirable weight-loss results
by reducing the capacity of the stomach and lengthening the feeling of
satiety. The ultimate success of the LAP-BAND System surgery, however,
also depends on your motivation and commitment to achieving
long-lasting weight loss.
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