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Weight Loss Surgery

Why Weight Loss Surgery?

Diets and exercise alone don't work:

If you're on this page, you already know that. No matter what you've heard. My patients can all relate to short term dieting success. They know more about diets and tried more of them than most of the rest of us know exist. They have succeeded at short term weight loss many times, but only to regain the loss and usually a few more pounds with each attempt. Your body is incredibly efficient at holding on to calories. When you limit your calories, your body wants to protect you from starvation. (make sense if you lived in peril of food shortages, but not very helpful to you now) It does this by slowing down your metabolism and sending signals to your brain that make you hungry. The more you lose, the stronger the hunger signals get. The signals aren't called Willpower, they're called Ghrelin -a very real hormone at work. Same with exercise, though I'm a huge proponent of its use as a tool to use in conjunction with surgery, its singular affect on weight loss, isn't enough to help our patients. You'd have to exercise long enough to get from L.A. to Orange County to burn off the calories consumed in a day. (that's at a rate of 10 calories per minute with vigorous exercise). Not very practical or sustainable.

How does weight loss compare?

Studies show the average weight loss 5 years:

After Gastric Bypass is 70% of excess body weight
After Gastric Banding 50%_ of excess body weight
After Gastric Sleeve 70% of excess body weigh

COSTS Of Obesity:

Being overweight can be expensive too.

  • Obesity accounts for nearly 21% of U.S. health care costs, with the 5% of morbidly obese Americans generating highest costs
  • Study by Society of Actuaries showed obesity cost the U.S. economy $198 billion in 2009
  • Included economic costs caused by increased need for medical care, and loss of economic productivity resulting from excess mortality and disability
  • CDC estimates medical care costs of obesity alone in 2008 were $147 billion
  • Costs related to obese people were $1,850 higher per year than costs related to normal weight and $5,500 higher per year for morbidly obese people
  • If obesity prevalence remained at 2010 percentages, the U.S. would save $549.5 billion over the next 20 years


Let's talk about another thing. Society still discriminates against people who are overweight; it's harder to find a job, get promoted. It's harder to get help if your car breaks down on the side of the road. Patients have sometimes been victims of bullying.

This is even more astounding when you consider the statistics in America:
  • According to the Centers for Disease Control and Prevention (CDC), more than one-third (35.7%) of U.S. adults are obese,1 up from 30.5% in 2000
  • Approximately 17% of children and adolescents are obese.
  • CDC study projects 42% of the U.S. population will be obese by 2030, a 33% increase in prevalence over the 2 decades

So, when people ask me "Why weight loss surgery"? – I tell them I think it's the best value in healthcare today.

Here are some other supporters of Weight Loss Surgery:

MEDICAL AND GOVERNMENT GROUPS SUPPORT BARIATRIC SURGERY

  • Scientific Statement from American Heart Association (AHA) March 2011: "Bariatric surgery can result in long-term weight loss and significant reductions in cardiac and other risk factors for some severely obese adults." First statement by the American Heart Association focused solely on bariatric surgery and cardiac risk factors.
     
  • American Association of Clinical Endocrinologists (AACE) July 2011: AACE Task Force on Obesity "Declared that there is significant clinical evidence to declare obesity as a disease state…Surgical therapy for obesity, or 'bariatric surgery,' is indicated for certain high-risk patients,"having clinically severe obesity." The comorbidities of severe obesity affect all the major organ systems of the body. Surgically induced weight loss will substantially improve or reverse the vast majority of these adverse effects from severe obesity."
     
  • American Diabetes Association (ADA) 2011: Position Statement: Standards of Medical Care in Diabetes 2011 recommends that "Bariatric surgery may be considered for adults with BMI > 35 kg/m2 and type 2 diabetes, especially if the diabetes or associated comorbidities are difficult to control with lifestyle and pharmacologic therapy."
     
  • International Diabetes Federation (IDF) 2011: Position Statement recommends "Bariatric surgery is an appropriate treatment for people with type 2 diabetes and obesity… Surgery should be an accepted option in people who have type 2 diabetes and a BMI of 35 or more. Surgery should be considered as an alternative treatment option in patients with a BMI between 30 and 35 when diabetes cannot be adequately controlled by optimal medical regimen, especially in the presence of other major cardiovascular disease risk factors."
     
  • U.S. Internal Revenue Service (IRS) 2002: Bulletin on Rulings and Decisions on medical expenses states "Uncompensated amounts paid by individuals for participation in a weight-loss program as treatment for a specific disease or diseases (including obesity) diagnosed by a physician are expenses for medical care under section 213 of the Code… Amounts paid for the primary purpose of treating a disease are deductible as medical care. Obesity is medically accepted to be a disease in its own right."
     
  • Centers for Medicare & Medicaid Services (CMS) 2006: Medicare National Coverage Determinations Manual outlines "Effective for services performed on and after February 21, 2006, Open and laparoscopic Roux-en-Y gastric bypass, open and laparoscopic Biliopancreatic Diversion with Duodenal Switch, and laparoscopic adjustable gastric banding are covered for Medicare beneficiaries who have a body-mass index > 35, have at least one co-morbidity related to obesity, and have been previously unsuccessful with medical treatment for obesity. These procedures are only covered when performed at facilities that are: (1) certified by the American College of Surgeons as a Level 1 Bariatric Surgery Center; or (2) certified by the American Society for Bariatric Surgery as a Bariatric Surgery Center of Excellence."
     
  • National Institutes of Health (NIH) 1991: Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults states, "Gastrointestinal surgery (gastric restriction vertical gastric banding or gastric bypass Roux-en Y) can result in substantial weight loss, and therefore is an available weight loss option for well-informed and motivated patients with a BMI 40 or 35, who have comorbid conditions and acceptable operative risks…Compared to other interventions available, surgery has produced the longest period of sustained weight loss.