Surgery as the best way of treating morbid obesity

Such procedures reverse the effects of obesity and improve the quality of patients’ lives. In 90% of cases, it is possible to abate diabetes, prolong patients’ lifespans and cure depression, which is often associated with morbid obesity. The treatment brings about positive changes in the organism, such as improved heart capacity. The heart is not so strained and undergoes spontaneous reconstruction. Also the gastrointestinal hormones, which decide when and what to eat, are then secreted differently.

What is the efficacy of such a procedure?

The efficacy of bariatric surgery is unparalleled. It can help up to 80-90% of morbidly obese people, while conservative treatment consisting in observing an appropriate diet and increasing the volume of physical activity yields long-lasting effects only in 5% of patients.

According to Prof. Mariusz Wyleżoł, Head of the Surgery Department at the Military Institute of Aviation Medicine in Warsaw, treating morbidly obese people by only changing their lifestyles and prescribing drugs can be compared to treating cancer with herbs.

Indeed, there have been cases where those weighing 120 kg succeeded in reducing their weight to 90 kg using only conservative methods. However, weight loss is not always permanent. Such people gain weight, often becoming more obese than before treatment. After a year or two they again reach the level of 120 kg, and then become even more obese, weighing 130 kg and more.

“And then it turns out that a surgical procedure has become a necessity, but the problem is the higher the weight, the riskier it becomes," highlighted Prof. Wyleżoł.

Prof. Krzysztof Paśnik, Head of the General, Metabolic and Cardiothoracic Surgery and Surgical Oncology Department at the Military Institute of Aviation Medicine in Warsaw assures us that the risks associated with bariatric surgery are small. Only 1% of patients die due to complications. This is usually not caused by the operation itself, but by numerous complications associated with obesity.

Who can qualify?

Bariatric surgery consists in employing measures aimed at the reduction of food intake (by reducing the stomach capacity) or at the exclusion of a part of the gastrointestinal tract from food absorption and assimilation (e.g. by the excision of a part of the stomach or reducing the way food has to go in the intestine).

Such treatment is recommended for people aged 18-60 with BMI exceeding 40 (so-called class III obesity). Bariatric surgeons suggest that it is also beneficial for those with BMI equal to 35 (that is with class II obesity). This is because such people are also in danger of developing such complications associated with obesity as diabetes and cardiovascular disease. It is rather rare for those people not to suffer from any comorbidities.

There are 300-600 thousand people in Poland with BMI exceeding 40, and as many as 1.5 million with their BMI of at least 35. Even if we were to assume that only those with class III obesity are in need of bariatric surgery, this would give us a staggering number of at least 300 thousand who should undergo an operation.

According to US data, in the second year following a bariatric surgery on a diabetic patient with BMI of 35, the costs of his or her treatment decrease by 34%, and in the third year – by 70%. “We can make a similar observation in Europe," stated Prof. Rafał Paluszkiewicz from the General, Transplantation and Liver Surgery Department at the Medical University of Warsaw.