Bariatrics (Description)
Pathological obesity is a growing medical problem in highly developed countries. This results in many other health problems for society as a whole. Hand in hand with obesity is the increasing incidence of metabolic syndrome, leading to severe complications and disability. The health consequences of obesity are greater than those of smoking and drinking alcohol. It is believed that people with a high BMI (Body Mass Index - body mass index expressed in kg / m2) live on average 10 years shorter than people with a normal BMI. According to WHO obesity is the fifth most common cause of death depending on risk factors and wealth. Obesity is associated with an increased incidence of various disorders and diseases, such as hypertension, type 2 diabetes, hyperlipidemia, chronic hypoventilation and insomnia, hypertrophic cardiomyopathy and many others.
According to WOBASZ research from 2005 in Poland there are over 6,000,000 people with BMI -> 30 and almost 450,000 with BMI -> 40. As a result, obesity has become one of the most important public health problems. Conservative obesity treatment is ineffective and very burdensome for patients. The only effective method with documented long-term weight reduction in morbid obesity is bariatric surgery. In distant observations, it leads not only to weight loss but also to normalization of blood triglycerides in 65% of cases, HDL - 79% of cases, arterial hypertension - 69.9% of cases. and 90% recovery or improvement in diabetes control. Therefore, it leads to a reduction in the intake of anti-diabetic, high-pressure or lipid-lowering drugs.
The costs of treating patients with pathological obesity are also huge. It is believed that the number of obese Poles will increase to 33% of the population by 2035, and therefore the population of patients with type 2 diabetes will increase to 12%. Effective, i.e. surgical, obesity treatment can reduce the costs of treatment of complications, reduce the percentage of sickness absenteeism, disability pensions and minimize social damage resulting from seeking help by obese people in places offering unconventional or inconsistent with the current knowledge methods of obesity treatment.
An extremely important aspect is also changing the perception of obesity by society - obesity is not a defect in appearance, but a disease with specific complications and significantly shortening life.
The indications for surgical treatment are:
1. BMI -> 40
2. BMI -> 35 with at least one obesity-related disease (hypertension, type 2 diabetes, sleep apnea, dyslipidemia, musculoskeletal disorders limiting motor activity)
The most frequently performed bariatric surgeries:
1. Restrictive - limiting the volume of consumed food: Sleeve gastrectomy - one of the most frequently performed operations today
2.restrictive-exclusion - containing elements of both above: Gastrointestinal bypass (Roux-en-Y gastric bypass, MGB - mini gastric bypass
Properly performed operations are safe and give good long-term results. However, they should be performed in centers with properly trained staff.
Doctors working in our clinic have been dealing with the surgical treatment of obesity for many years. In addition, we provide support from a psychologist, dietitian and many years of postoperative control.