Morbid Obesity: Weight Loss That Works
A major focus of our practice is the treatment of morbid obesity. Morbid obesity is defined as having a body mass index (BMI) of atleast 30kg/m2. BMI is calculated by weight in kilograms divided by height in meters squared.
Today, obesity has reached epidemic levels in the United States, and also in developing countries. The cause of obesity is multifactorial and includes a complex interplay of energy-rich diets, limited physical activity, and hormonal, psychological, and genetic factors. There are many associated illnesses of obesity. These associated illnesses affect essentially every organ system.
The cardiovascular system is affected by high blood pressure, diabetes, ischemic heart disease and peripheral vascular disease, high cholesterol, strokes, and venous insufficiency. The respiratory system is affected by asthma, and obstructive sleep apnea. Gastroesophageal reflux, fatty liver disease, gallstones, and colorectal cancer affect the gastrointestinal system. The musculoskeletal system is affected by osteoarthritis, back pain, and disc disease. The neurologic system is impacted by pseudotumor cerebri, carpal tunnel syndrome, and depression. The reproductive system is affected by polycystic ovarian syndrome, fetal abnormalities, prostate, ovarian and breast cancer. With such an exhaustive list of various illnesses, one can clearly appreciate the fact that obese patients are at an increased risk of early death compared to their aged-matched control cohorts with normal body mass index. The treatment of morbid obesity therefore requires a multidisciplinary approach as well as, close follow-up and a willingness to adapt and combine treatment modalities.
In our practice, we employ surgical and nonsurgical options. Patients must demonstrate that they have failed diets and other weight-loss programs before we offer surgical options. Our pharmacologic treatments include Phentermine, Phendimetrazine, Qsymia®, Belviq®, Contrave®, and Saxenda®. Our endoscopic treatments include the gastric balloon and endoscopic plication. Surgical options are generally employed when less invasive modalities have failed to achieve significant weight loss. We offer the laparoscopic or robotic vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and duodenal switch. Our patients are enrolled in a nationwide database, which provides valuable information that leads to best-practice standards. Our minimally invasive approach leads to a quicker recovery, less pain, less scarring, and improved cosmetic results when compared to the open approach.
We realize that such a recalcitrant disease requires vigilance and persistence at therapeutic interventions. Patients who initially lose at least 50% of their excess weight may regain a significant amount of weight loss. Without long-term monitoring, patients who initially were considered cured of their associated illnesses may redevelop their associated medical conditions. Revision surgery is an option for patients that are willing to accept the risks of reoperative surgery and pledge to adhere to a healthy lifestyle and behavior modification. Unfortunately, the perfect treatment option for all morbidly obese patients does not exist. Areas of research include hormones, bacterial flora of the colon, endoscopic devices to limit absorption of calories, medications that enhance energy expenditure and procedures to alter the digestive anatomy. At the Laparoscopic and Endoscopic Surgery Institute, we are dedicated to the treatment of morbid obesity using both surgical and nonsurgical options.
Our surgeons at Laparoscopic & Endoscopic Surgery Institute, P.C. have over 25 years of experience in management of a wide array of bariatric and general surgical issues. They have both undergone extensive specialty training that has enabled them to incorporate cutting-edge technology and advanced minimally invasive techniques into their care for patients. Services offered include medical and surgical weight-loss options. Our general surgical services also cover a range of conditions, including gallbladder disease, acid reflux, hernias, small intestinal and large intestinal conditions, any lumps or bumps (e.g., lipomas, cysts) and more.
Laparoscopic & Endoscopic Surgery Institute • www.bariatricsmd.com • (770) 500-3660