Not a Crutch

Why Bariatric Surgery is NOT a Crutch!

December 11, 2019

Imagine a carpenter building a bookshelf. The carpenter gathers all the wood, nails, and tools, but instead of a hammer, the carpenter is given a shoe to hammer in the nails. The carpenter is able to hammer the nails in with the shoe, but it takes much longer than anticipated and the shoe breaks halfway through the project.

Now imagine if the carpenter was given a proper hammer instead of a shoe. Building the bookshelf would still take work and patience, but the carpenter would be able to finish the project properly and in a timely manner. Weight loss surgery is like the hammer; it is the proper tool to treat obesity.

The Prevalence of Obesity

According to the Centers for Disease Control (CDC), the prevalence of obesity was 39.8% and affected about 93.3 million of US adults in 2015~2016. Obesity-related conditions that include heart disease, stroke, type 2 diabetes and certain types of cancer are some of the leading causes of preventable, premature death in the United States.

The estimated annual medical cost of obesity in the United States was $147 billion in 2008; the medical cost for people who have obesity was $1,429 higher than those of normal weight individuals (1). Weight loss surgery provides life-changing, and in some cases lifesaving treatment to obese individuals suffering from obesity-related co-morbidities, such as Type 2 Diabetes Mellitus, heart disease, and obstructive sleep apnea for whom traditional weight loss approaches have failed. Most obese individuals have tried numerous diet and exercise programs prior to looking into having surgery. In fact, approximately 45 million American adults start a diet each year, yet an estimated 70 percent of Americans are overweight or obese (2). Typically diets do not provide lasting weight loss (3).

One of the reasons that traditional diet, exercise, and behavioral modification models do not work well in the obese population is that obesity leads to changes in metabolism.

Scientists are beginning to show that adipose tissue, once thought of as simply a “storage facility” for fat, is a major endocrine organ that produces hormones that regulate metabolism (4). Therefore, a significant increase in adipose tissue leads to an imbalance in the hormones that regulate metabolism, making traditional weight loss efforts in the obese population essentially futile.

Not only does obesity affect metabolism, making weight loss difficult, if not impossible, but it impacts joint health to the point that exercise-a key component in weight loss-becomes very difficult and painful. Some studies suggest that obesity increases the likelihood of joint pain by 60%. Not to mention, obesity-related co-morbidities such as diabetes and diabetes-related neuropathy further complicate one’s ability to exercise enough to create a calorie deficit sufficient enough to aid in weight loss.

Bariatric Surgery is NOT a Crutch!

Weight loss surgery is not the easy or lazy way out, it is not a crutch.  All surgeries carry inherent risks, and weight loss surgery is not different. 

The weight loss that follows surgery comes as a result, not just of the surgery, but from drastic lifestyle changes that follow the surgery. Weight loss surgery is the proper tool to lose weight, but using the tool effectively is the responsibility of the patient. Persons who have undergone weight loss surgery will tell you that after surgery the real work begins.

Following weight loss surgery, particular attention must be paid to making healthy food choices; not just to ensure weight loss occurs, but to make sure that both macro and micronutrient needs are being met. Special attention must be paid to consuming enough protein and key vitamins because the amount of food consumed will be extremely limited.

Patients Must Face Behavioral Issues

Patients must face behavioral issues that may have led to the obesity in the first place. Food can no longer be used to celebrate the joy in life or console the sorrows. Not being able to use food emotionally can lead to a feeling of loss. Having a strong support system-friends, family, or support group are key components to successful weight loss.

Exercise, often less painful thanks to a decrease in weight, still requires commitment and effort. Patients will be encouraged to exercise on most days of the week, working up to 30 to 60 minutes per session. Including different types of exercise results in maximal effectiveness and minimize boredom. Including strength and resistance training, flexibility training, as well as cardiovascular training, keeps exercise effective and fun!

Choose a holistic weight loss surgery program that will help you through each stage of this journey!

References


  1. Adult Obesity Facts (2018, August). Retrieved from URL https://www.cdc.gov/obesity/data/adult.html.
  2. Linda Searing. (2018, January). The Big Number: 45 Million Americans Go on a Diet Each Year.  Retrieved from URL https://www.washingtonpost.com/national/health-science/the-big-number-45-million-americans-go-on-a-diet-each-year/2017/12/29/04089aec-ebdd-11e7-b698-91d4e35920a3_story.html
  3. Tuah NA, Amiel C, Qureshi S, Car J, Kaur B, Majeed A. Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults.  Cochrane Database Syst Rev 2011; (10)CD008066.
  4. Singla P, Bardoloi A, Parkash AA. Metabolic effects of obesity: A review. World J Diabetes 2010 July 15; 1(3): 76-88.

Why Bariatric Surgery is NOT a Crutch!

ABOUT THE AUTHOR

Nikhilesh Sekhar MD, FACS, FASMBS currently practices at New York Bariatric Group and has performed hundreds of bariatric procedures including Laparoscopic Gastric Bypass, Laparoscopic Sleeve Gastrectomy and Laparoscopic Adjustable Gastric Banding. He also has background performing laparoscopic Nissen for reflux, laparoscopic inguinal and ventral hernia repair, laparoscopic colectomy and laparoscopic lymphadenectomy.

Read more articles from Dr. Sekhar