One Tool in Our Arsenal to Combat Obesity
Obesity is a complex disease with a web of interlocking causes that are unique to each patient, including genetics, nutrition, hormones, medication, environment, and sleep. As healthcare professionals, it is our responsibility to understand every treatment option available for patients with obesity and help them navigate which choice is right for their unique circumstances.
Bariatric Surgery Types
Surgical treatments for obesity should be combined with permanent healthy changes in nutrition, physical activity, and behavior to be effective. Combining surgery with anti-obesity medications can also achieve greater weight loss and prevent weight regain. Patients considering bariatric surgery should review the benefits and risks of every option with an experienced bariatric surgeon. Bariatric surgery options include:
- Roux en Y Gastric Bypass or “gastric bypass” results in reducing both the amount of food that can be eaten at one time and the calories that can be absorbed.
- Sleeve Gastrectomy involves permanently removing a large portion of the stomach, decreasing it to about 25% of its original size, thus reducing the amount of food that can be eaten at one time.
- Adjustable Gastric Banding involves placing an inflatable silicone band around the stomach to create a small pouch, thereby limiting the amount of food that can be consumed at one time. Follow-up visits are required to inflate or deflate the band.
- Biliopancreatic Diversion With Duodenal Switch is a combination of sleeve gastrectomy and gastric bypass and the most complicated and aggressive surgical treatment.
- Endoscopic Sleeve Gastroplasty is offered to patients with a BMI over 30 and involves using an endoscopic suturing device to reduce the size of the stomach.
- Gastric Balloon is a procedure in which one to three deflated balloons are swallowed and then inflated in the stomach, resulting in an earlier feeling of fullness. After six months, the balloons are removed endoscopically.
Bariatric Surgery Stigma & Myths
As a primary care provider, I hear many myths and misconceptions about bariatric surgery. Some patients have been told they just need to “eat less and exercise more,” and that they are “lazy.” Some say they feel that bariatric surgery is taking the “easy way out” and report being told this by other HCPs, friends, and their own family. Besides the stigma around bariatric surgery, popular misconceptions include:
- Never being able to eat normal or previously enjoyable food again.
- Never eating at a restaurant or having dinner with family as done before.
- Postop chronic nutritional deficiencies.
- Bariatric surgery is just a “quick fix.”
Bariatric surgery is far from a quick fix; it is the most challenging choice for a patient. Obesity involves a multitude of complex factors, such as behavior change, genetics, socioeconomics, and psychological conditions. Living and eating 30-50 years a certain way can be incredibly difficult to unlearn and reverse.
As healthcare professional facing a growing obesity pandemic, bariatric surgery knowledge is a tool in our arsenal. It is our duty to educate patients about bariatric surgery, correct potential misconceptions, and help guide them to determine if it’s the right choice. Our knowledge of obesity continues to evolve. The OMA offers a variety of digital tools, webinars, and educational resources to educate and empower healthcare professionals with advanced obesity medicine knowledge. To learn more about OMA or become a member, visit https://obesitymedicine.org/join.