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Causes :: BMI :: Treatment
Causes of Obesity
Health Risks of Morbid Obesity
According to the NSW Department of Health, overweight and obesity is a
serious, chronic medical condition.
 Morbid obesity brings with it an increased risk for a
shorter life expectancy. For individuals whose weight exceeds 50% above their
ideal body weight, the risk of an early death is doubled compared to non-obese
individuals. (3)
Causes of Overweight and Obesity
The following have been identified as important contributing factors
in becoming overweight or obese (4)
- Energy intake from food exceeds energy expenditure, but obesity is not
simply a result of overeating.
- Biological factors such as age, sex, hormonal and genetics.
- Behavioural influences such as learnt habits, emotions, attitudes, beliefs
and thought process.
- Environmental/societal influences such as social, political and economic
environment.
- Metabolism and the potential effects of a 'set point'. (7)
- Some medical conditions such as hypothyroidism. (16)
It is very important to understand that all current medical interventions,
including weight loss surgery, should not be considered medical cures. Rather
they are attempts to reduce the effects of excessive weight and alleviate the
serious physical, emotional and social consequences of morbid obesity.
Contributing Factors of Morbid Obesity
There are many factors that contribute to the development of obesity
including genetic, hereditary, environmental, metabolic and eating disorders.
There are also certain medical conditions that may result in obesity like
intake of steroids and hypothyroidism.
We have included additional information for the following contributing
factors:
Treatment Options
Non-Surgical Treatment
For anyone who has considered a weight loss program, there is certainly no shortage of choices. Most non-surgical weight loss programs are based on some combination of diet/behavior modification and regular exercise. Unfortunately, even the most effective interventions have proven to be effective for only a small percentage of patients. Research has shown that non-operative methods alone have not been effective in achieving significant long-term weight loss in severely obese adults . (3)
The main non-surgical treatment options are:
- Diet and behaviour modification
- Exercise
- Over-the-counter & prescription drugs
In 2002, Australian researchers reviewed the effectiveness of treatments available for severe or 'morbid' obesity and concluded that surgery was the only effective option available at the time of the report. (8)
Diet & Behaviour Modification
There are literally hundreds of weight loss diets available. Doctors who prescribe and supervise diets for their patients usually create a customized program with the goal of greatly restricting calorie intake while maintaining nutrition.
These diets fall into two basic categories:
Low-Calorie Diets (LCDs) are individually planned so that the patient takes in 500 to 1,000 fewer calories a day than he or she burns.
Very-Low-Calorie Diets (VLCDs) typically limit caloric intake to 400 to 800 a day and feature high-protein, low-fat liquids. Studies show that the long-term results of Very-Low-Calorie Diets (VLCDs) vary widely, but weight regain is common. (9)
Behavior modification uses therapy to help patients change their eating and exercise habits. Combining a Very-Low-Calorie Diet (VLCD) with behavior therapy and physical activity may help increase weight loss and slow weight regain. In the long term, however, Very-Low-Calorie Diets (VLCDs) are no more effective than more modest dietary restrictions. (9)
If diet and behavior modifications have failed you and surgery is your next option, it is important to understand that diet and behavior modification will be instrumental to sustained weight loss after your surgery. The surgery itself is only a tool to get your body started losing weight - complying with diet and behavior modifications required by most surgeons would determine your ultimate success.
Surgical Treatment options
:: Laparoscopic Adjustable Gastric Banding :: Tube Gastrectomy
:: Bilio Pancreatic Diversion (BPD) :: Gastric Bypass
Laparoscopic Adjustable Gastric Banding
Adjustable gastric banding. In this procedure, a hollow band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The band is then inflated with a salt solution. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution.
Find out more about Laparoscopic Adjustable Gastric Banding with the following links.
Interactive Movie |
Text version |
Patient Info handout |
Tube Gastrectomy
This is a relatively new approach. It is the first component of the duodenal switch operation and involves removing the lateral 2/3rds of the stomach with a stapling device. It can be done laparoscopically ( keyhole surgery) but is not reversible. It basically leaves a stomach tube instead of a stomach sack.
Find out more about Tube Gastrectomy with the following links.
Interactive Movie |
Text version |
Patient Info handout |
Bilio Pancreatic Diversion
These operations combines removal or exclusion of 2/3rds of the stomach along with a long intestinal bypass which significantly reduces the absorption of fat. The capacity to eat is greater than with the other operations, and the eventual weight loss is the best of all the operations but if fatty foods are overeaten e.g. a hamburger and fries then diarrhoea and foul flatus will result.
Find out more about Bilio Pancreatic Diversion with the following links.
Interactive Movie |
Text version |
Patient Info handout |
Gastric Bypass
Here a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This bypass reduces the absorption of nutrients and thereby reduces the calorie intake.
Find out more about Gastric Bypass with the following links.
Interactive Movie |
Text version |
Patient Info handout |
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