Obesity and weight loss surgery

By Joshua Clark, M.D. Feb. 23, 2009

In lay terms, obesity could simply be defined as too much body fat. The human body is made up of water, fat, protein, carbohydrates and various other vitamins and minerals. Too much fat puts individuals at much higher risk for diseases such as insulin resistance, type 2 diabetes, high blood pressure, high cholesterol, liver disease and degenerative joint disease to name a few. While genetics and underlying medical conditions can cause and contribute to obesity, obesity typically is caused by consuming more calories than are used up in physical activity and our busy daily lives.

How much fat is too much?

There are two common ways to measure body fat - waist circumference and body mass index (BMI). A high-risk waistline is 35 inches or higher for women, and 40 inches or higher for men.

The BMI formula measures body weight relative to height. It can be a useful measure of body composition, because in most people it correlates highly with body fat. When using a standard BMI formula:

• BMI values less than 18.5 are considered underweight.

• BMI values from 18.5 to 25 are normal.

• Overweight is defined as a BMI of 25 to 30.

• Obesity is defined as a BMI of 30-35.

• Severe obesity is defined as a BMI of 35-40.

• Morbid obesity is defined as a BMI of 40 or greater.

For those who are morbidly obese, research shows conventional diets including weight-loss medications, result in less than 10-percent reduction in body weight with less than a 1-percent chance of keeping the weight off long term. For someone weighing 300 pounds, this means losing 30 pounds. However, roughly only one out of 100 people are able to maintain that 30-pound weight loss. For the morbidly obese, even the best diet and exercise programs usually are not effective. Weight loss surgery (bariatric surgery) typically is the most effective treatment for these individuals. And recent scientific research suggests this may be equally true for severely obese individuals as well.

The argument in favor of weight loss surgery has been strengthened by recent scientific studies and articles, which demonstrate weight loss surgery in qualified individuals may improve or cure certain diseases such as type 2 diabetes.

Weight loss surgery is major surgery, not to be taken lightly. It is not a "magic bullet" but is considered a tool to be coupled with dietary and lifestyle modifications. Flagstaff Medical Center’s Bariatric Surgical Weight Loss Center helps patients prepare well in advance of their surgery. The team at FMC guides patients to make behavioral changes before and after surgery such as exercise, eating habits, and fluid and vitamin intake. Surgery also is not a guarantee. The success of each patient’s surgery always depends on the commitment of the patient to a lifetime change in eating and exercise behaviors.

If you are considering weight loss surgery, you are invited to attend one of our free information sessions prior to making an appointment with our surgical staff. Information sessions are from 6 - 7 p.m. on the second Tuesday of each month at the Radisson Woodlands Hotel. These sessions include a presentation by our surgical staff on causes and complications of morbid obesity and the types of surgeries available, with time for questions and answers following the presentation. No registration is required for this session.

For more information on weight loss surgery, call 928 214-3737 or visit