Bariatric/Weight Loss Surgery

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Bariatric/Weight Loss Surgery

Contemporary Bariatric/Weight loss surgery offers those suffering from morbid obesity the chance to radically transform their life and become the person they long to become. People undergoing this surgery are expected to lose on average 80% of their excess weight and significantly improve or even cure obesity related diseases such as Type II Diabetes, hypertension, joint problems, mood problems etc.

Am I a candidate for weight loss surgery?

Weight loss surgery cannot be performed on certain people such as those with extreme cases of obesity and those with very serious health problems. As a general guideline, your Body Mass index (BMI) should be between 35-60, your weight should be less than or equal to 180kg, and you should be able to walk up a flight of stairs without assistance.

It is prudent to discuss weight loss surgery with your general practitioner and also your family before arranging a specialist appointment with us.

Which operation is best for me?

The three most commonly performed weight loss operations in New Zealand:

Laparoscopic Sleeve Gasterectomy

Sleeve gastrectomy has a favourable risk profile particularly long-term. Many report superior quality of life, weight loss and improvement of obesity-related diseases is comparable to the other operations though there is a small weight loss advantage with bypasses.

Laparoscopic Gastric Bypass

Also known as the Laparoscopic Roux-en-Y Gastric bypass, this is a well-established operation, with the longest follow-up information of all the operations available. It is best for people with difficult-to-control type 2 diabetes and those with bad gastroesophageal reflux. It has a higher risk profile than either the sleeve gastrectomy or the mini bypass.

Laparoscopic Mini Gastric Bypass

This is a modification of the Roux-en-y gastric bypass whereby only one anastomosis is made rather than two (also called a one-anastomosis gastric byass). The advantage is shorter operating time and fewer complications than the roux-en-y gastric bypass, with similar health benefits. It has an additional risk to the roux-en-y gastric bypass of bile reflux, it has also had the least time to study the long-term effects than the other two operations.

What is obesity?

Obesity is the term for when a person is significantly overweight. Body mass index (BMI) is a simple measure of weight-for-height that is commonly used to classify weight and obesity in adults. Medical professionals use the following definitions:

  • A BMI greater than or equal to 25 is overweight
  • A BMI greater than or equal to 30 is obesity
  • A BMI greater than or equal to 40 is morbid obesity
  • Morbid obesity is a term that reflects the serious health implications of being very overweight.

BMI does not differentiate between body fat and muscle mass, therefore body builders and people who have a lot of muscle bulk will have a high BMI but are not overweight or obese.

The simplest explanation for why someone becomes obese is that their body receives more energy from food than their body uses. The excess energy is stored as fat. Why this occurs is usually due to a combination of factors including the following:

  • The genes you inherited from your parents
  • How well your body turns food into energy
  • Your eating and exercise habits
  • Your surroundings
  • Psychological factors

The Ministry of Health 2012/2013 health survey reported continuing growth in New Zealand obesity rates:

  • 31% of New Zealand adults were obese
  • 21% of 15-24 year olds were obese
  • 39% of 65-74 year olds were obese
  • 48% of Maori adults were obese
  • 68% of Pacific adults were obese

Adults living in deprived areas are 1.5 times as likely to be obese as those living in least deprived areas (adjusted for age, sex, and ethnic differences).

Obesity is the second leading cause of preventable death following smoking. It is a major risk factor for diseases such as:

  • Cardiovascular diseases (mainly heart disease and stroke), which were the leading cause of death in 2012
  • Diabetes
  • Musculoskeletal disorders (especially osteoarthritis; a highly disabling degenerative disease of the joints)
  • Some cancers (endometrial, breast, and colon)
  • The risk for these diseases increases, with the increase in BMI.

Childhood obesity is associated with a higher chance of adult obesity, premature death and disability in adulthood. But in addition to increased future risks, obese children experience breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance and psychological effects.

Unfortunately most patients with morbid obesity will not achieve significant and sustainable weight loss with diet and exercise alone and currently, available medicines to aid weight loss, only provide modest benefit.

By the time a person considers surgery to help them lose weight they have usually extensively tried and failed alternative forms of weight loss such as diet and exercise. Continuing to view their obesity as a lifestyle issue ignores the true health consequences of their condition.

Surgery comes with some risks but to these people it is a real chance at improving both their health and their quality of life.