Obesity is recognized as an epidemic and a significant public health threat around the globe; in countries with developed market economies, like the United States and Canada. Overweight and obesity are characterized by a build-up of excess body fat, with a Body Mass Index (BMI) of over 30 kg/m2.
Morbid obesity is medically defined as having more than 100 pounds of excess weight or a BMI of more than 40.
The only quick and sustainable cure for obesity and its comorbidities is surgical interventions, such as VSG (gastric sleeve), RNY gastric bypass, and hypoabsorptive operations.
Body Mass Index (BMI)
Body Mass Index (BMI) is used to assess the level of obesity and cardiometabolic risk. Here are different classes,
- 30-35 is mild obesity class I
- 35–40 moderate obesity class II
- Over 40 severe/extreme/morbid obesity class III
Causes of the Obesity Epidemic
Obesity is considered a health problem that may reduce quality of life, increase adverse health risks, and premature mortality. The obesity epidemic can be linked to genetic vulnerability and the modern environment:
- Inheritance of 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
Metabolic System
The traditional view of maintaining a “healthy lifestyle” overlooks the body’s natural regulation of energy. The Set-Point Theory states that the body absorbs and adapts to a progressively increasing 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 a state of overfeeding, and they will not feel as hungry, resulting in a higher metabolism. 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 effective in the 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 typically performed laparoscopically using cameras and surgical instruments through small incisions (about five) in the abdomen.
- Laparoscopic Adjustable Gastric Banding (LAGB) – Gastric Band, also known as Lap-band, was once a popular procedure. It reduces food intake by adding an inflatable band to the top of the stomach. It is an outdated procedure that is causing numerous complications.
- Laparoscopic Sleeve Gastrectomy (VSG) – Gastric sleeve is when a surgeon removes part of the stomach, creating a small pouch. The patients experience less hunger and feel full faster. The process is also minimally invasive. It can be done with a single incision (SILS) through the belly button. SILS is less invasive compared to the traditional laparoscopic approach, which makes 3-5 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, nutrients, vitamins, and minerals one consumes to a smaller stomach.
- Laparoscopic Ileal Metabolic Surgeries – Hypoabsorptive procedures, such as biliopancreatic diversion with duodenal switch (BPD/DS), SADi-S, SASi-S, and MagDi. The duodenal switch procedure involves stomach resection (most of the stomach is removed), similar to the gastric sleeve, and utilizes an ileal bypass to achieve malabsorption, promoting weight loss.
- Intragastric Balloon (IGB) – A gastric balloon, also known as a tummy balloon, is a non-surgical procedure designed 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 a BMI of 30 to 40.
Many Canadian patients have chosen to begin 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 for reliable medical services and top-notch surgeons. Patients from the United States opt for surgical treatment of obesity and give themselves a second chance at 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 develop complications, necessitating revision. 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
Mexico Bariatric Center’s surgical teams are equipped and experienced in rescuing failed surgeries, such as gastric band revisions.
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