Obese and in Danger

Obese and in Danger. When a person is 100 pounds (45.3 kg) or more over his or her ideal body weight, the condition is referred to as morbidobesity. This is a serious disease. Morbid obesity may also be defined as a BMI of 40 or greater, or as a BMI between 35 and 40 if accompanied by a serious medical problem, such as heart disease, diabetes, or joint pain. A BMI between 45 and 50 is severe morbid obesity. A BMI between 50 and 60 is super-morbid obesity. A BMI greater than 60 is super-super morbid obesity.

People with morbid obesity are at great risk of medical problems and disease if they do not lose weight. If they cannot reduce their weight by any other means, they are often eligible for bariatric surgery. This is weight-loss surgery in which the stomach and intestines are permanently modified. Gastric bypass is one type of bariatric surgery. First, a small pouch is created at the top of the stomach by stapling it off from the rest of the stomach. Then the small intestine is cut so that its first section is no longer connected to the rest of the digestive system. The second section of the small intestine is sewn directly to the stomach pouch.

The pouch is tiny—about the size of a walnut—and can hold only about 1 ounce (28 grams) of food. Calorie absorption also is limited by disconnecting, or bypassing, the first part of the small intestine. Many people experience drastic weight loss with gastric bypass surgery andvastly improve their health, but the risk of malnutrition is high. People take dietary supplements for life and learn a special diet that emphasizes proteins first.

Another bariatric procedure is called lap-band adjustable gastric banding. In this procedure, the doctor partitions the stomach into two parts with a flexible band or belt that creates only a tiny opening between the two parts of the stomach. This can make people feel full after very small meals. It is a simpler procedure than gastric bypass, but weight loss is not as extreme. In both cases, people who are not completely committed to the weight-loss program can overcome the procedures, gradually stretch their new stomachs, and regain weight. Neither procedure is a miracle cure for obesity, and people have to change their lifestyles permanently to achieve lasting good health and prevent disease.

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