Dr. Sheetal Nijhawan, assistant professor of surgery at the University of South Alabama College of Medicine, said obesity is widely prevalent in the United States, with less than one-third of the country’s population at a healthy weight.
“Obesity is a progressive and life-threatening disease that can lead to life-long health problems,” said Dr. Nijhawan, who is a laparoscopic and bariatric surgeon with special qualifications in robotic surgery. “It is important to achieve a healthy weight to increase life expectancy and improve quality of life.”
“Treating obesity is a medical necessity,” Dr. Nijhawan added. “Consequences of obesity include a large number of cardiovascular diseases, which in turn can predispose you to other health problems.”
Obesity, a disease of excess fat storage, can be caused by genetics, hormonal imbalances, or environmental factors such as how much you eat and exercise.
A patient’s body mass index (BMI) is used to diagnose obesity by measuring body fat as it relates to a person’s height and weight. A normal BMI is 18.5-24.9. If a person’s BMI is greater than 30, they are considered obese.
According to Dr. Nijhawan, the three most common surgical options for obesity are gastric bypass, the gastric band, and the sleeve gastrectomy.
“Gastric bypass is the gold standard,” she said. “It has been done for several years and is a very powerful tool for weight loss with a low rate of complications in experienced hands.”
During this procedure, a small stomach pouch is formed and connected directly to a portion of the small intestine. As a result, food bypasses part of the small intestine, making you feel full faster. “With gastric bypass, a patient can lose up to 70 percent of excess body weight,” Dr. Nijhawan said. “Bypass has been shown to resolve diabetes in 71-74 percent of patients and has been shown to significantly decrease cardiovascular risk factors.”
Dr. Nijhawan said the second most common procedure after gastric bypass involves the gastric band, which is placed around the top portion of the stomach. “Performed laparoscopically, the gastric band procedure is minimally invasive and has the lowest rate of complications,” she said. “Patients can lose up to 40 percent of excess body weight.”
Another procedure is the sleeve gastrectomy, a relatively newer procedure that greatly reduces the size of the stomach. During the procedure the lateral aspect of the stomach is stapled off and removed. Patients can lose 60-70 percent of excess body weight. “This procedure falls midway between the gastric bypass and the band,” Dr. Nijhawan said. “Mid-term data regarding efficacy is very encouraging.”
Dr. Nijhawan stressed that with any of these procedures, you must undergo lifestyle modifications to achieve and maintain weight loss. These modifications include exercising, achieving portion control and mindful eating, avoiding fast food and cutting back on high calorie beverages like sodas and juices.
“Obesity prevention is a journey,” Dr. Nijhawan said. “Not a destination.”
Dr. Nijhawan presented the October Med School Café Lecture on weight loss surgery. To view video from the lecture, click here.
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