Obesity is the medical term for excess body fat and is defined as having a body mass index (BMI) greater than 30 kg/m2. As we recognize World Obesity Day on March 4, it is important to remember obesity is associated with many health conditions, including diabetes, hyperlipidemia, hypertension, obstructive sleep apnea, and several cancers, including endometrial cancer and pancreatic cancer.
According to the Centers for Disease Control and Prevention (CDC), approximately 40.3% of adults in the United States are obese. Obesity is a chronic medical condition that is caused by a variety of factors. There are behavioral, hormonal, genetic and environmental characteristics that play a role in the obesity epidemic. While obesity is more than just calories in and calories out, sugary beverages and processed foods have contributed to the obesity epidemic.
Bariatric surgery is a powerful tool in the fight against obesity. The sleeve gastrectomy and gastric bypass are the most performed bariatric surgeries. The yearly estimate of bariatric surgeries in 2017 was 228,000, of which 59.39% were sleeves and 17.8% were laparoscopic Roux-en-Y gastric bypass.1
Vertical sleeve gastrectomy is a procedure in which 85%-90% of the stomach is removed. A sizer, called a bougie, is placed in the mouth and advanced into the stomach. A cutting stapler is then used to staple alongside the sizer so that a uniform amount of stomach or "sleeve" is left behind. The surgery is restrictive, which aids in weight loss. There is also a metabolic component, as ghrelin decreases following sleeve gastrectomy. Ghrelin, a hormone that stimulates appetite, is made by cells in the stomach. When a large portion of the stomach is removed, patients experience appetite suppression. Sleeve gastrectomy is very effective in the treatment of obesity. Patients can expect to lose 60% of their excess body weight, and most of the weight loss occurs within the first year.
Roux-en-Y gastric bypass is a procedure that is both restrictive and malabsorptive. A stapler is used to create a gastric pouch, which is separate from the remainder of the stomach. In this procedure, the intestines are also re-routed. After the intestines are re-routed, they are in the configuration of a “Y,” which is why the procedure is called a Roux-en-Y. Since food is bypassing the larger part of the stomach and being held in a small pouch, there is a component of restriction. Therefore, patients consume less food and fewer calories, which aids in weight loss. Due to the re-routing of the intestines, there is also decreased absorption, which further facilitates weight loss. Patients can expect to lose 70% of their excess body weight after gastric bypass surgery. The gastric bypass is a great option for obese patients with Gastroesophageal Reflux Disease (GERD) since it is an anti-reflux operation.
Bariatric surgery has been proven to improve and, in many instances, reverse obesity-related conditions such as diabetes and obstructive sleep apnea. Many patients have improved energy following weight loss surgery and a new lease on life. The Northside Hospital Surgery & Weight Management Program provides comprehensive care and services in the treatment of obesity. The program is nationally accredited through the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.
Learn more about bariatric surgery at Northside Hospital.
- Estimate of Bariatric Surgery Numbers, 2011-2017. American Society for Metabolic and Bariatric Surgery. In: American Society for Metabolic and Bariatric Surgery. Available online: http://asmbs.org/resources/estimate-of-bariatric-surgery-numbers.
