Morbid obesity is medically defined as over 100 pounds of excess weight or a Body Mass Index of more than 40.
Obesity is recognized as an epidemic and a major public health threat around the globe in countries. With developed market economies, like the United States and Canada. It is characterized by a build-up of excess body fat and with a BMI of over 30 kg/m2.
- 30-35 is mild obesity class I
- 35–40 moderate obesity class II
- Over 40 severe/extreme/morbid obesity class III
Body Mass Index (BMI) is used to assess the level of obesity and cardiometabolic risk.
Causes of the Obesity Epidemic
The obesity epidemic can be linked to genetic vulnerability and the modern environment:
- Inheritance the Tendency to be Obese
- Food Composition
- No Exercise or Vigorous Activity
- Psycho-social Issues
- Metabolic Disorders
- Stress Level
- Not Enough Sleep
- Weight-Gaining Drugs
Obesity is considered a health problem that may reduce quality of life, adverse health risks, and premature mortality.
Body Thermostat
The traditional view of maintaining a “healthy lifestyle” overlooks how the body regulates energy. The Set-Point Theory states that the body absorbs and adapts to a more progressive increased level of fat and weight. It recognizes it as a new setpoint. The body sets this new elevated weight as a new normal and resists any diet restriction by the following mechanism:
Body Fat Setpoint is influenced by:
- Genetic Susceptibility
- Environmental Exposure
- Developmental History
An obese body sees a calorie reduction diet (Calories In < Calories Out) as a starvation threat and tries to defend itself. Throughout most human history, calories were relatively scarce and hard to get, and physical activity was unavoidable. We have no defense against overeating.
Weight loss surgery changes the setpoint and shifts your neuro-hormonal axis to a lower weight. The patient’s body will be in an overfed state, and it will not be as hungry, and your metabolism goes higher. This will give you a second chance in life!
Weight Loss Surgery to Treat Obesity
Losing weight with diet and exercise alone is not an effective long-term solution. A dieter’s body may encourage fat to regain after initial rapid weight loss by complex mechanisms. Bariatrics is shown to be the most effective long-term treatment for obesity. Non-surgical dietary weight loss options are often not long-term.
Common Weight Loss Surgery Procedures
Bariatric treatment for obesity is performed to restrict food intake or reduce nutrient absorption (shorten part of the digestive tract). The surgery is normally performed laparoscopically using cameras and surgical instruments through small incisions (about five) in the abdomen.
- Laparoscopic Adjustable Gastric Banding (LAGB) – Gastric Band (Lap-band) was once a popular procedure. It reduces the amount of food intake by adding an inflatable band to the top of the stomach. It is an outdated procedure and is causing a lot of complications.
- Laparoscopic Sleeve Gastrectomy (LSG) – Gastric sleeve is when a surgeon removes part of the stomach creating a small pouch. The patients experience less hungry and feel full faster. The process is also minimally invasive.
- Vertical Sleeve Gastrectomy (VSG) – It is done with a single incision through the belly button. This is less invasive compared to the single incision laparoscopic, which cuts 4-5 small incisions.
- Laparoscopic Roux-en-Y Gastric Bypass (RYGBP) – Gastric bypass surgery combines the restrictive and malabsorptive components to achieve weight loss. Part of the small intestine will reroute to the smaller stomach. These rerouting processes include the amount of food, calories and nutrients, vitamins, and minerals one consumes to a smaller stomach.
- Laparoscopic Biliopancreatic Diversion with Duodenal Switch (BPD/DS) – Duodenal switch uses stomach resection. Most of the stomach is removed. Similar to the gastric sleeve and malabsorption to achieve weight loss.
- Intragastric Balloon (IGB) – Gastric Balloon or tummy balloon is a non-surgical procedure to jump-start weight loss. It is considered a restrictive procedure as the balloon occupies almost one-third of the stomach.
- Endoscopic Sleeve Gastroplasty (ESG) – This procedure is performed endoscopically on an outpatient basis. There is no need for full anesthesia and no surgery. This procedure is ideal for BMI of 30 to 40, resleeve, and revision of gastric bypass.
Many Canadian patients have opted to start their journey to a new life with Mexico Bariatric Center (MBC). Many didn’t want to wait 2 to 15 years or pay the high cost of surgery in America or Canada.
There is no wait and they pay a fraction of the price with reliable medical services and top-notch surgeons. Patients from the United States opt for surgical treatment of obesity and give themselves a second chance in life.
Bariatric Revision Surgeries
Revisional bariatric surgery refers to a surgery that follows a previous weight loss procedure. Sometimes a bariatric procedure may not be successful or may have complications and needs to be revised. Here is a list of possible revision surgeries:
- JIB -> Reversal or GBP
- VBG -> GBP
- AGB -> GBP, VSG, DS
- BPD -> Reversal, shortening of BP limb, GBP
- VSG -> GERD, GBP, Weight/DM, DS
- GBP -> GBP
Abbreviations:
- JIB – Jejunoileal Bypass
- VBG – Vertical Banded Gastroplasty
- BPD – Biliary Pancreatic Diversion
- AGB – Adjustable Gastric Band
- VSG – Vertical Sleeve Gastrectomy
- GBP – Gastric Bypass
- DS – Duodenal Switch
Mexico Bariatric Center surgical teams are equipped and experienced to rescue failed surgeries, such as gastric band revision.
