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Morbid Obesity : Recommendations

There is still hope however for the morbidly obese. There is an effective, durable (long lasting effects), and safe (when performed by a trained/experienced bariatric surgeon) treatment option, and that's bariatric or weight loss surgery. The following are what some medical and scientific societies have said about bariatric surgery:

According to the National Institutes of Health (NIH), in their National Institutes of Health Consensus Development Conference (1991),

"The surgical procedures currently in use [such as Roux-en-Y gastric bypass and vertical banded gastroplasty] are capable of inducing significant weight loss in severely obese patients, which in turn, has been associated with amelioration of most of the co-morbid conditions that have been studied… while limited success has been achieved by a variety of techniques that include medically supervised weight loss and intensive behavior modification, … a major drawback of the non-surgical approach is failure to maintain reduced body weight in the vast majority of patients."

According to the American Obesity Association in their Shape-Up America/American Obesity Association: Guidances for the Treatment of Adult Obesity (1996),

"Surgical treatment for obesity should be considered for patients with a BMI above 40 or a BMI above 35 with co-morbidities or other risk factors."

According to the American Heart Association in their Science Advisory and Coordinating Committee: Obesity and Heart Disease (1997),

"When the BMI is above 35 and co-morbidities exist, gastrointestinal surgery becomes a consideration. When the BMI is >40, surgery is the treatment of choice. The experience of the surgeon and type of operation chosen predict outcome. In general, a Roux-en-Y gastric bypass is superior to gastric plication (stomach stapling)."

According to the American Dietetic Association in their Position Paper on Weight Management (1997)

"Surgical treatment of obesity should be limited to patients with a BMI over 40 or BMI over 35 and severe co-morbid conditions related to the obesity. Roux-en-Y gastric bypass and vertical banded gastroplasty are the most commonly performed and widely accepted procedures currently in use.

Seventy percent of patients maintain a loss of 50 percent of their initial excess weight for 5 years. Improvements in cardiovascular functioning, lipid profile, sleep apnea, physical activity, and work abilities have been reported."

According to the World Health Organization (WHO) in their Obesity: Preventing and Managing the Global Epidemic (1998),

"Surgery is now considered to be the most effective way of reducing weight, and maintaining weight loss, in severely (BMI above 35) and very severely obese (BMI above 40) subjects. On a kg/weight loss basis, surgical treatment has been estimated after four years to be less expensive than any other treatment."

The National Institutes of Health (NIH) reiterated in their, NIH, National Heart Lung and Blood Institute: Clinical Guidelines on the Identification, Evaluation and Treatment of Overweight and Obesity in Adults – The Evidence Report (1998),

"Gastrointestinal surgery can result in substantial weight loss, and therefore is an available weight loss option for well-informed and motivated patients with BMI above 40 or BMI above 35, who have co-morbid conditions and acceptable operative risks."
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