How Surgery is used for Treating Morbid Obesity

Obesity occurs when the energy generation exceeds the energy requirement of the body for physical activity and growth. As a result there is an accumulation of fat, which is stored as adipose tissue. The excessive adipose tissue may be distributed generally all over the body or it may be localized. In women the excessive adipose tissue is distributed predominantly in the lower part of the trunk and extremities, while in men it is frequently more pronounced in the upper part of the trunk, often sparing the extremities.

Obesity can be caused by various diseases of the hypothalamus, and other endocrine diseases of the thyroid, adrenals, pancreas, gonads etc. However the most common cause is due to overeating habits which are imbibed at an early age. Psychological factors also play an important role whereas a person uses food as a substitute for the satisfaction that ordinarily would be derived from other sources. Increased food intake could also be manifestation of depression, anxiety, and the resulting obesity may aggravate the tendency towards isolation or the ineffectiveness of performance.

Surgery is one of the methods used for the treatment of morbid obesity. In this article, you will know the basic information about how surgery is used in morbid obesity. Morbid obesity is a situation where a person is more than twice the normal weight for height. The death rate among these individuals is twelve times more than an obese person of the same age and the sex.

Severe obesity can predispose a person to variety of serious disorder ranging from coronary, artery disease, hypertension, diabetes, mellitus, to marked osteoarthritis of the same weight bearing joints, respiratory distress, gall bladder disease and psychological in capacity.

Frequently minor or standard operative procedures are major endeavors because of the anesthetics and preoperative problem directly related to obesity. Surgery for such morbid obesity has evolved over the years. Procedures short circuiting the gastrointestinal tract so that food can be short circuited to the large intestine before absorption can take place had so many disadvantages that it has been all but abandoned. Procedures which cause mechanical restriction like making the stomach smaller either by stapling or stitching it up or by introducing a balloon into it and via an endoscope have become popular. This do not cause any metabolic disturbance by interfering with food absorption or digestion. The patient will lose a considerable amount of weight after these procedures. About a year later the redundant skin and fat is removed. Surgery is usually resorted to if other methods to combat obesity have failed.

Some medical expert are against surgery and others have approved it as a suitable and best remedy for severe obesity requiring long term solutions. Most of the obesity treating doctors feels that the only way to manage severe obesity long-term is surgery.

Major Complications of Obesity and Their Causes

Obesity leads to various ailments and psychological problems. The muscles of obese persons are weak and flabby. Arthritis is also common in obese persons. The weight bearing joints are under constant stress and strain due to excess weight of the body. Blood vessels of obese persons get constricted due to excess cholesterol, which form plaques (atheromas). This leads to high blood pressure, stabbing pain in the chest (angina pectoris), heart attacks and strokes. The digestive system of obese persons is prone to diseases like diverticular pathologies. Gall stones may be formed due to excess cholesterol. Cancers, diabetes are all products of obesity. Obesity also creates problems during pregnancy.

The various diseases and complications due to obesity shorten the lifespan of individuals and can lead to premature death. Mortality and morbidity are both to associate closely with obesity. An obese person not only suffers physical pains but also suffers psychological trauma. He feels inferior, and there may be psychological problems as he is often ridiculed and teased.

Causes of Obesity

The various causes of obesity include overeating, lack of exercise, sedentary lifestyle, genetic factors, endocrine (hormonal imbalances) – all constitute important causative factors of obesity. Among endocrinal causes we need to discuss certain syndromes. In syndromes we have a set of pathologies grouped in a very characteristic manner.

1. Cushing’s syndrome
This is due to excessive glucocorticoid hormones (cortical). This can also occur due to excessive corticosteroid administration. That is, both endogenous and exogenous cortisols can cause cushings. The clinical features are:

• Wasting of tissue myopathy (weak muscles); thin skin, osteporosis, purple abdominal striations.
• Water retention oedema, high BP.
• Obesity of trunk, head, neck.

Apart from there they will be excessively prone to infection; poor wound healing, hirsuitism (hair growth in women).

2. Pickwickian syndrome

This syndrome is caused by many factors; obesity is one of the causes. Enlarged tonsils, acromegaly, myxoedema are all other causes. What happens in this syndrome? During sleep there is collapse of pharyngeal walls leading to respiratory obstruction, sometimes for well over a minute. O2 and CO2 disturb sleep and there is daytime somnolence. Personality changes, intellectual deterioration, headaches, enuresis are all presenting features. One of the important aspects of treatment is to lose weight.

3. Laurence moon biedl syndrome

There is polydaetyly (extra digits) retinitis pigmentos, cataract, microphthalmia, obesity, absent facial hair, hypogenitalism. This is a pituitary gland disorder. Also called Frohlichs syndrome or Adipose genital syndrome, some consider the fat boy of Pickwick Papers as an example of this syndrome. Others put him in the ‘pickwickian’ syndrome, i.e., obstructive sleep apnoea syndrome.

Thus we see in the above syndromes that either obesity is a cause or manifesting feature.

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Disclaimer: This article is not meant to provide health advice and is for general information only. Always seek the insights of a qualified health professional before embarking on any health program.