Morbid Obesity

What is morbid obesity

Morbid obesity is today the second most important cause of death, after smoking.

It is estimated that in the United States alone, there are more than 300,000 deaths a year due to morbid obesity and its complications. 

Reports by the US National Institutes of Health (NIH) show that obesity is as wide as it can be considered an epidemic.

The definition of morbid obesity (obesity) depends, from a medical point of view, on the "Index Mass Body" (BMI) scale. 

This ratio is calculated according to the following mathematical formula: a person's weight (in kilograms), divided by the square of his height (in meters). 

If the BMI is higher than 25 then this is considered obese. 

If the BMI is 35 and above, then this is considered morbid obesity, while if the BMI is 50 and above, then this is considered extreme morbid obesity, due to the presence of accompanying diseases, such as diseases of the heart, joints and lungs.

Treatment of morbid obesity

Obesity treatment best suited to morbid obesity is surgery. 

But before that, he must undergo a comprehensive investigation that includes an accurate assessment

 and examination of the endocrine system, a deep analysis of lifestyle and eating habits, as well as clarification and documentation of previous attempts to reduce weight. 

At the end of this clarification process, and if the patient is suitable for surgery, they are directed to a psychological counseling.

There are two methods of treating morbid obesity with surgery for a person whose clarification examinations have shown that they can be performed for him:

1. An adjustable gastric banding is fitted. 

This surgery is intended for people whose obesity lies in the BMI range of between 35 and 50. 

This surgery is generally performed by laparoscopic surgery, during which a ring made of soft silicone is placed 2 cm below the point of connection of the esophagus to the stomach. 

The ring is connected, by means of a small flexible tube, to a PORT implanted in the abdominal wall

 under the subcutaneous fat tissue, by which the ring can be inflated and thus control the narrowing of the part of the stomach being narrowed. 

The method of treating obesity depends on a simple principle, which is to determine the effective size

 of the stomach, which necessarily leads to a feeling of satiety after a small meal compared to the size of the usual meals that the obese person used to eat before surgery. 

The success of this surgery depends on the cooperation of the obese patient, the readiness and commitment to changing his lifestyle and eating habits. 

It is preferable to reduce the weight slowly and in a controlled manner (this may take one to two years). 

It is also worth noting that the higher the BMI (50 and above), the less excess weight that can be eliminated in this way (up to 50% of excess weight loss).

The success rate is high, provided that the appropriate and correct choice of morbid obesity patients who are subjected to this operation, and that the ring is properly installed.

Complications may occur during the treatment of morbid obesity, or in its aftermath, including

contamination of one or more components of the ring, slipping of the ring or even its entry into the stomach. 

These complications usually require a repeat operation.

2. Gastric bypass. 

This surgery is recommended for people with morbid obesity (extreme morbidity - BMI over 50) or for people whose ring surgery did not achieve the desired goal. 

This surgery is more complex than the previous one and requires a high degree of experience and skill.

 The surgery is performed as a laparoscopic surgery or as an open surgery and, in most cases, it requires a longer period of recovery to recover. 

In this surgery, the stomach is divided so that the upper part of it, and the substantially smaller part of the stomach, becomes the new stomach. 

Small intestine diverters (connections) are connected to this section, which forms a bypass route to the absorbed portion of the digestive system (Proximal intestine).

There are possible complications after this surgery: leakage (leakage) from the contact areas, bleeding or infection. 

Also, there are complications that may stem from disturbances in the absorption process and a deficiency of essential food compounds. 

These complications generally diminish and the body returns to its proper position during the months

after surgery, and therefore, there is great importance for continued supervision and follow-up on those who undergo this operation, especially by a doctor and a nutritionist.