By Amir Mehran, MD, FACS, FASMBS
Co-director, Center for Weight Loss Surgery at Los Robles
Considered as the most critical threat to public health, it is estimated that by 2030, the obesity epidemic will affect more than half of the U.S. population. The number of deaths attributable to obesity among U.S. adults is approximately 280,000 each year and expected to rise. Within that group, the clinically severe or morbidly obese segment faces the fastest growth. These patients are at a higher risk of severe disability or even premature death. As a result, the American Medical Association recently categorized obesity as a disease, affirming that it is not a “condition,” but rather a chronic and progressive inflammatory disease that negatively affects not only every organ system in the body, but also impacts a significant psychological and financial burden on patients as well.
The pathophysiology of obesity is multifactorial and includes genetics, environment and personal behavior. The difficulty in overcoming obesity is in part due to inherent “wiring” inherited from the days of “famine and feast,” where evolution favored those who could survive prolonged periods of low food supplies. Whereas those days may be over for much of the world, the “wiring” has not changed. Genetics, however, does not completely account for the rising obesity epidemic. The mechanization of everyday life and the commercialization of our food supply with cheap mass-produced, high-caloric items are key factors as well. Equally important, is the concept of personal responsibility. Understanding this concept prior to any form of obesity management is vital to achieving successful and sustained weight-loss outcomes.
Diet and exercise have remained as the two primary cornerstones of obesity management. Based on the level of obesity, pharmaceutical treatments may be used as well, albeit with short-term mixed results and often with major side effects. For some, however, no amount of dieting, exercise or lifestyle modification can significantly impact severe obesity. For these patients, bariatric or weight loss surgery is the only viable solution when utilized as part of a comprehensive change in lifestyle habits. An ever-growing number of scientific publications support this notion, including treating those with mild to moderate obesity and with metabolic diseases such as diabetes.
Combating obesity begins with the patient and often requires the assistance of professionals ranging from nutritionists and psychologists to various medical specialties. Delay in action typically translates into a variety of serious health issues and a more difficult journey to reverse course.
Choice Health Associates and its members can help patients explore their various options and help them win this often difficult battle.