Bariatric Surgery Vs. Standard Medical Therapy

Weight loss surgery, also known as bariatric surgery is recommended by many physicians to people who are unable to benefit from traditional weight loss methods. However, choosing to undergo weight loss surgery isn’t an easy decision. It is an important decision that will drastically and permanently impact a person’s life. Therefore, before making such a significant decision, an individual should be aware of both the risks and benefits associated with weight loss surgery (McGowan & Chopra ix).

Benefit of bariatric surgery is that overweight patients lose excess Body fat. Another benefit is that obesity related health conditions often improve or are eliminated because of this loss weight. The common conditions are diabetes, severe arthritis, high blood pressure and sleep apnea which often improve after a patient undergoes bariatric surgery. For some, weight loss surgery can even be a lifesaving process. Noticeably, weight reduction surgery also conveys dangers. They are quite negligible. Truth be told, weight reduction surgery carries a risk that is proportional to having your hip supplanted. That

“I think I may go out on the town today and see what kind of fun things I can do.” Mommy look at that fat girl, fat people shouldn’t be allowed out, quack quack waddle fat girl, hey shamu go back to the water. These are some of the things that I have endured and heard on a day-to-day when going out in public as an obese individual. Like myself, a lot of other obese individuals have embarked on many failed weight loss attempts only to gain instead of lose weight. Bariatric Surgery is a great lifelong tool to help aid in weight loss and manage the success;, however, many individuals shy away from the surgery because many health professionals only state the risks over the benefits. Bariatric surgery has become very popular in the United States, but there are many factors to consider such as the risks and benefits, success rates, and procedure options offered. Bariatric surgery has afforded many obese individuals a new lease on life. Medical doctors and insurance companies seem to be down playing the benefits as a way to keep patients with many obesity related ailments to keep them in business. The benefits that bariatric surgery has greatly outweigh the risks and allows for new beginnings.

In regards to proper nutrition, a diet that has a low glycemic index has been found to improve blood sugar control. Unfortunately, diet and exercise aren’t enough to achieve glycemic control for some individuals. At this time, medication is usually introduced to the treatment regimen. Oral medications such as Metformin, sulfonylureas, nonsulonylurea secretagogues, alpha glucosidase inhibitors and thiazolidinediones are available. However, Metformin is usually the first line of treatment. In some patients, insulin can be added to their medication regimen. Consequently, in cases where the individual is morbidly obese and lifestyle modifications with medication therapy prove to be ineffective in maintaining glycemic control, weight loss surgery can be considered (Polonsky, 2014).

In Bijal P. Trivedi’s report, “The Bypass Cure” she details the history of gastric bypass surgery, its effect on type 2 diabetes, and the how one doctor is using his understanding of modern gastric bypass applications to save the life’s of his patients. The patient, Nancy Rubio was nearly twice the normal weight of a person her height. Her weight had slowly increased throughout her life, due to her unhealthy diet and having two kids. She eventually developed type two diabetes, which then led to other health issues, such as arthritic knee pain, high blood pressure, cholesterol and blood sugar. Fearing for her life, Rubio opted to receive a modern version of the Roux-en-Y. The Roux-en-Y involves reducing the lining of the stomach to a small pouch, which reduces the patient’s appetite and eating. The pouch is then connected to the lower section of the intestine. Do the nature of the surgery Rubio will lose weight very fast, but miraculously have her type 2 diabetes become remitted or possibly abolished.

Diabetes type II is a devastating disease. It has been established that the higher a person’s body mass index (BMI) the more likely they are to develop diabetes type II. 96.4% of type II diabetes can be directly attributed to obesity. This disease often results in daily medication usage and hospitalization. It can even result in loss of organs or limbs. Often diabetic patients suffer from failed kidney function and must rely on daily dialysis. The direct cost of obesity related type II diabetes in 1995 was $32.2 billion and the indirect cost was $30.74 billion.

Interventions used in treatment of type 2 diabetes should be those that improve the probability that the patient will have better long term control of diabetes. It is therefore imperative that early diagnosis is given fast priority especially when metabolic abnormalities of diabetes are less severe. Lifestyle interventions are key in containing type 2 diabetes. It is common knowledge that sedentary lifestyle and over nutrition which lead to obesity and overweight increase the risk of type 2 diabetes (Peters & Davidson, 1996). Interventions that reverse or improve these factors have beneficial effects on control of glycemia in established type 2 diabetes.

In Bijal P. Trivedi’s report “The Bypass Cure,” she details the history of gastric bypass surgery, its effect on type two diabetes, and the how one doctor is using his understanding of modern gastric bypass applications to save the lives of his patients. Diabetes is a serious disease that affects over 25 million people in America, and 439 million people worldwide. Over 200,000 gastric bypasses are performed in America each year. Due to the cost many patients are unable to receive the life changing procedure. One of the patients who will be receiving this procedure is Nancy Rubio who was nearly twice the normal weight of a person her height. Her weight had slowly increased throughout her life, due to her unhealthy diet and having two children. She eventually developed type two diabetes which then led to arthritic knee pain, high blood pressure, increased cholesterol and elevated blood sugar. Fearing for her life, Rubio opted to receive a modern version of the Roux-en-Y. The Roux-en-Y involves surgically decreasing the lining of the stomach to a small pouch, which reduces the patient’s appetite and eating. The pouch is then connected to the lower section of the intestine. Due to the nature of the surgery Rubio will lose weight very fast, but also miraculously have her type two diabetes go into remission or possibly eliminated.

The number of gastric bypass surgeries has been increased in the last few years and it is considered the ‘‘gold standard’’ of bariatric operations. Bariatric operation or weight reduction surgery is recommended mainly for people whose BMI exceeds 40 kg/m2 as reported by the National Institutes of Health Consensus Development Program, or for those whose BMI is between 35 – 40 40 kg/m2 and who are have life-threatening complications such as cardiac problems (Franco et al., 2011). On the one hand, traditional treatments for weight loss such as lifestyle change do not work for some people. On the other hand, bariatric surgeries have emerged as an effective and safe treatment for obesity; most patients lose 60% of their weight within the first year (Lemmens et al., 2014). Three procedures are commonly performed: laparoscopic Roux-en-Y gastric bypass (LRYGB), the novel laparoscopic sleeve gastrectomy (LSG), and laparoscopic adjustable gastric banding (LAGB). Of these, the Roux-en-Y gastric bypass is the most common (Franco et al., 2011).

Some of them are still under development, but others have already been approved by the FDA in the USA, or are currently used in Europe and South America. Its main assets are its higher safety profile, its greater effectiveness as compared with hypo-caloric diets and modification of habits, and its lower price and greater availability than bariatric surgery. Endoscopic bariatric therapy is gaining acceptance as more effective and less invasive than bariatric surgery. In addition, it can be used as an adjunctive therapy for patients with obesity who are unable to manage the disease with lifestyle interventions alone, or used prior to bariatric surgery.3-5 The goal of primary EBT is to induce weight loss and improvement in medical co-morbidities, with a safety and efficacy profile similar to operative bariatric therapy. Endoscopic bariatric therapy can consist of any of the following procedures: intragastric balloon (IGB) placement, endoscopic sleeve gastroplasty, gastric-bypass revision, and aspiration therapy.3,5. Multiple devices and procedures are currently being evaluated for clinical use or are currently in clinical

Long-term weight loss is the desired end-result following gastric bypass surgery. However, this long-term goal is contingent upon lifestyle changes, including nutrition and exercise. More importantly, postoperative gastric bypass patients often have limited knowledge with regard to how to maximize weight loss. In order to measure changes and progress, two critical concepts to achieve optimal weight loss results are body mass index (BMI) and calculation of daily caloric intake. It is imperative to find out the status of respondents in post gastric bypass surgery (P), if ongoing nutrition and lifestyle training (I) compared to standard postoperative guidance (C) result in greater weight loss and decreased BMI (O) over a period of time (T)?

Bariatric surgery is the last resort for morbidly obese patients who have tried other options, such as diet and exercise, but have fallen short from obtaining their desired health goals. The surgery is safe and effective, but as with any surgery, there are risks involved. Furthermore, the National Institutes of Health (NIH) has put forth very specific criteria that must be met before bariatric surgery can be performed on a patient. The Obesity Action Coalition

A Canadian study published in September 2004, have shown that surgery improves or even cures conditions stated above. It was common for most patients who were on insulin before the surgery to go off it the day of or after surgery for good. 90 percent of these patients that have high blood pressure or high cholesterol, shown great improvement or their problem went away all together. I found that improvement or possible cure was only found in patients who had a BMI of 40 or lower compared to patients who had a BMI of 40 and greater in a study done on 796 patients in 11 different studies all

In the cases of most morbidly obese patients, the only way for them to successfully treat their condition and obtain a healthy weight is through surgical procedures. There are a large variety of weight-loss procedures that are performed by skilled professionals. The majority of these procedures involve manipulation of the stomach in order to restrict calorie intake. While these procedures may seem like a “quick fix,” they are not. The patients that undergo these operations must be dedicated to becoming a healthier individual and must stick to a prescribed diet following the procedure. In addition to this, it is often beneficial for the patients to go to therapy in order to discover and work through the issues that may have triggered their extreme weight gain so that they are less inclined to return to old habits

The risk factors of T2DM are mainly attributed to the lifestyles and behavioral factors. Although the etiology cannot be pinpointed on a single cause it is proved that obesity, socioeconomic conditions and genetic factors increase the risk of T2DM. (Cite)