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Mild obesity is defines as being 120% of the ideal weight for sex, height, and body frame as defined by the Metropolitan Life Insurance Company's weight for height tables of 1983. A more recent term that is used to describe obesity is Body Mass Index or BMI. This number is calculated from the individual's height and weight. Mild obesity is considered a BMI of greater than 25 but less than 30. Moderate obesity is defined as being greater than 140% but less than 170% of ideal weight or a BMI of 30-35. Severe or morbid obesity is defined as being greater than 225% of ideal weight or a BMI of greater than 50. A BMI Calculator has been placed on this website for your convenience.
Psychologica conditions include:
Social conditions include:
A roux-en-Y gastric bypass is a surgical procedure for achieving and maintainina healthy body weight. This procedure divides the stomach into a small gastric pouch, which will reduce the amount of food the stomach will hold. In addition, part of the small intestine is devided and attached to the small stomach pouch through a new small outlet. This rerouting causes the food to bypass the lower part of the stomach and a portion of the samll intestine where some digestive processes take place. Protein and carbohydrate digestion is not affected but the digestin of fat is affected. The net result of the surgery is to limit the capacity of the stomach for food and altering the desire to eat larger portions. Without hunger the patient reduces their quantity of food and the body must burn the extra fat for fuel. The patient will experience unpleasant "aversion" reactions if they overeat or eat the wrong types of foods.
Consuming high concentrations of fats or sugars after surgery will cause the patient to experience an unpleasant sensation called Dumping Syndrome. This consists of sweating, a feeling of nausea and sometimes vomiting, dizziness, and weakness. This sensation will last until the body has digested the fats and/or sugars. This reaction may be avoided by eating a non-fat or low-fat and non-sugar or low-sugar diet. The desire to avoid an aversion reaction usually helps the bypass patient remember to make healthy food choices, which increases their chances of achieving and maintaining a healthy body weight.
Because the part of the small intestine that is bypassed is important in the absorption of calcium, iron, vitamin B 12, and fat soluble vitamins such as vitamin A and E, the patient is required to take vitamin supplements for life. In addition, periodic blood work should be performed to assure the patient is receiving adequate nutrition and vitamin supplementation.
WLS is a major surgical process and may have short and long term complications. The mortality rate of WLS is less than 1%. In the immediae post operative period the major complications may include blood clots forming in the legs and traveling to the lungs or a leak at the junction of the new stomach and the small intestine. Other problems that may occur in the perioperative peirod may include wound infections, blockage of the outlet from the stomach, ulcers, pulmonary problems and thromophlebitis. Later complications which may develop are hair loss (which is time limited and may require additional vitamins and protein), hernia anemia and malnutrition. The benefits and risks should be determined by the patient, his physician, and the surgeon before the decision to have WLS.
Some of the criteria for gastric bypass are as follows:
Some of the contraindications to surgery are as follows:
You may call your Customer Benefits Specialist to determine if WLS is a covered benefit. After consultation with a bariatric surgeon your application will be submitted. Sometimes additional information is required to gain approval from your provider. This information may include a history of diet attempts, a letter from your primary physician and/or a letter from the patient describing the functional limitations and comorbid conditions associated with his or her obesity.
The surgery itself takes two to four hours. Most patients are discharged from the hospital on the third day after surgery. Many patients return to work two to four weeks after surgery but most all patients have returned to work six weeks after surgery.
Many woman have become pregnant and delivered healthy babies after gastric bypass. However, patients are asked to use birth control for eighteen months after surgery so they do not become pregnant during the rapid weight loass phase. In addition any woman considering pregnancy after surgery should have blood work to determine that they are nutritionally ready to support a healthy pregnancy.
Gastric bypass cn be reversed if the need should arise, however, reversal is also a major operation and the risks and benefits should be carefully considered. Reversal will almost always result in weight gain. | ||||||
