Bariatric Surgery Vs. Standard Medical Therapy

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).

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).

Extensive literature is available to suggest that it is time to move on and include MGB as a mainstream bariatric procedure (8). Furthermore, LMGB appeared to be effective in weight loss and T2DM remission and non-inferior to other bariatric surgeries

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.

Type 2 Diabetes Mellitus (T2DM) is a chronic disease that is modifiable and preventable through diet and exercise. The incidence of T2DM is propagated by a sedentary lifestyle and excessive caloric intake. Maintenance of a desirable body weight, diet, and exercise are the mainstay therapy for T2DM (Buttaro, Trybulski, Bailey, & Sanberg-Cook, 2013).

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.

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)?

BPD is achieving the highest sustained weight loss of all procedures (approximately 75 %). Additionally, it is especially appropriate for diseases with uncontrollable food intake like binge eating disorders or in patients with Prader–Willi syndrome. Furthermore, BPD has also the highest potential for comorbidity (diabetes, hypertension, and obstructive sleep apnea) resolution (Scopinaro et al., 2005), (Prager

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

Most patients who have this done have a BMI of 30-40, 40 being the max due to being morbidly obese. In a study discussed in the Journal of the American Medical Association, “ The average patient started with a BMI of nearly 47-about 345 pounds for a 6 foot tall man or 280 pounds for a 5 foot 5 inch woman. By the end of the studies, most of which lasted less than two years, the average gastric-bypass patient had a BMI of 30; the average gastric-band patient, 36” (“Consumers Union”). The National Institutes of health states, “ Patients be either morbidly obese, which is defined as having a body mass index of 40 or more, or that they have significant health problem related to obesity, such as diabetes, heart disease or Hypertension of sleep apnea. In addition, these guidelines state that surgery should be a last resort, only after other methods of weight reduction have failed” (“Hall”).

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)