Options for Morbid Obesity

Morbid obesity is defined as having a body mass index (BMI) of 40 or more. For people of average height, this means they weigh about 100 lbs. or more above their top ideal weight. According to the American Obesity Association, 9 million Americans were afflicted with morbid obesity as of May 2005. Morbid obesity can lead to type 2 diabetes, osteoarthritis, gallbladder disease and other health problems. Morbidly obese individuals can have an average 20-year shorter lifespan. Treatment to help the morbidly obese lose weight and reduce health risks includes non-operative and operative methods.

Non-Operative Treatment

• The majority of morbidly obese patients who undergo non-operative treatment regain all of the weight they lose within five years of treatment, according to the American Society for Metabolic and Bariatric Surgery (ASMBS). Diet and exercise changes can cause temporary weight loss, but the amount of weight lost and the time the weight remains off is usually not enough to cause a reduction in the health risks associated with morbid obesity. Non-operative treatment includes restricted, very low-calorie or liquid diets, exercise programs and behavior modification through psychological therapy. Weight-loss drugs, such as Phentermine and Fenfluramine, have been used in combination with diet and exercise plans in morbidly obese individuals. These drugs have a high association with cardiovascular problems, and the average weight loss in a four-year study published in a 1992 issue of Clinical Pharmacology and Therapeutics regarding weight-loss drugs for morbid obesity was only 3 lbs.

Surgery

• According to the American Obesity Association, surgery is the most effective treatment for morbid obesity. The mortality rate for bariatric surgery is only about 1 percent, and surgery is the only treatment option that provides significant weight loss and reduces obesity-related health risks. Bariatric surgery involves binding or reducing the size of the stomach so that patients consume fewer calories at each meal. Serious complications are rare for bariatric surgery, but some patients experience a reaction to the anesthesia, wound infections, ulcers and pulmonary problems. Medical personnel carefully monitor morbidly obese patients during and after the procedure to keep surgical risks low. Patients who undergo bariatric surgery must commit to lifestyle and behavioral changes to ensure the surgery's success. Healthy eating habits and exercise are a vital part of post-operative treatment. According to the ASMBS, morbidly obese patients who undergo bariatric surgery usually reach their maximum weight loss between 18 and 24 months post-surgery.