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Overview of Obesity
Overview of Obesity  
The message sounds simple: To lose weight, you must eat less and exercise more. However, for many morbidly overweight individuals, losing weight is not as easy as it sounds. After diets and exercise fail, some people turn to bariatric surgery for obesity. Gastric bypass surgery and adjustable gastric banding are two bariatric procedures performed at Cleveland Clinic. Both obesity treatments have excellent long-term track records for weight loss. Also known as gastric bypass surgery, banding or weight loss surgery, bariatric surgery for obesity has an excellent long-term track record for helping sufferers lose weight.

Morbid obesity is a chronic debilitating condition that requires long-term lifestyle changes. Anyone considering obesity surgery for weight loss needs to anticipate maintaining these changes, as well as the risks and benefits of morbid obesity surgery. This web site is designed to help you understand each bariatric surgery procedure offered at Cleveland Clinic and the intensive evaluation process involved in making a surgical weight loss choice.

Obesity and Morbid Obesity
Obesity is a common problem in the United States. Current research suggests that obesity affects one in three Americans. In this country alone, about 300,000 deaths per year can be linked to obesity.

Obesity is defined as weighing at least 100 pounds over ideal body weight or having a body mass index (BMI) greater than or equal to 35. The BMI is a mathematical formula that factors a person’s height and weight in determining obesity. A person is considered to have morbid obesity with a BMI of 40 or greater. Persons with a BMI of 40 or more or those with a BMI of 35 or more with serious health conditions may be candidates for obesity surgery such as adjustable gastric banding.

What Causes Obesity

Causes of Obesity Involve Many Factors
In scientific terms, obesity occurs when a person’s calorie intake exceeds the amount of energy he or she burns. Many factors may contribute to this obesity-generating imbalance, including genetic, environmental, psychological and other factors.

Genetic factors
Obesity tends to run in families, suggesting that it may have a genetic cause. However, family members share not only genes, but also diet and lifestyle habits that may contribute to obesity. Separating these lifestyle factors from genetic ones is often difficult. Still, growing evidence points to heredity as a strong determining factor of obesity. In one study of adults who were adopted as children, researchers found that the weight of the adult subjects was closer to the weight of their biological parents than the weight of their adoptive parents. The environment provided by the adoptive family apparently had less influence on the development of obesity than the person’s genetic makeup.

Nevertheless, people who feel that their genes have doomed them to a lifetime of obesity should take heart. Many people genetically predisposed to obesity do not lapse into obesity or are able to lose weight and keep it off.

Environmental factors
Although genes are an important factor in many cases of obesity, a person’s environment also plays a significant part. Environment includes lifestyle behaviors such as what a person eats and how active he or she is.  Americans tend to have high-fat diets, often putting taste and convenience ahead of nutritional content when choosing meals. Sedentary lifestyles are second to none in contributing to obesity.

People can't change their genetic makeup, of course, but they can change what they eat and how active they are. Some people are able to lose weight and fend obesity off by:
  • Learning how to choose more nutritious meals.
  • Replacing refined foods with whole foods.
  • Learning to recognize environmental cues (such as enticing smells) that may make them want to eat when they are not hungry.
  • Becoming more physically active.
  • Cutting down on portion sizes.
Psychological factors
Many people eat in response to negative emotions such as boredom, sadness or anger. While most overweight people have no more psychological disturbances than people at their normal weight, about 30 percent of the people who seek treatments for serious weight problems have difficulties with binge eating. During a binge-eating episode, people eat large amounts of food while feeling they can’t control how much they are eating. Those with the most severe binge-eating problems are considered to have what is called binge-eating disorder. These people may have more difficulty losing weight and keeping the weight off than people without binge-eating problems. Some individuals will need special help, such as counseling or medication, to control their binge eating before they can successfully manage their weight.

Other causes of obesity
In some instances, there are rare illnesses that can cause obesity. These include hypothyroidism, Cushing’s syndrome, and certain neurological problems that can lead to overeating. Certain drugs, such as steroids and some antidepressants, may cause excessive weight gain. A doctor can determine if a patient has any of these conditions, which are believed to be responsible for only about 1 percent of all cases of obesity.

Complications of Obesity
Obesity is directly harmful to a person’s health, which is why obesity surgery is a serious option for some individuals and the best of all available obesity treatments for morbid obesity. Someone who is 40 percent overweight is twice as likely to die prematurely than an average-weight person. (This effect is seen in people after living with obesity for 10 to 30 years.) Obesity is a risk factor for many serious, life-threatening diseases, including:
Many people consider obesity weight loss surgery in order to improve their overall health and lessen the risks of these conditions. Studies show that the risk of death from these conditions returns to normal after weight loss resulting from the most effective of obesity surgery. In addition, obesity contributes to numerous other medical conditions, including:
Click here to view Co-morbidity Reductions after Surgery.

After Weight Loss Surgery
Most patients recover from weight loss surgery procedures without complications. Although you will have some discomfort from the laparoscopic weight loss surgery, you will need to get out of bed and start walking the next day. This activity is crucial in preventing surgical complications, such as blood clots.

If you have been diagnosed with sleep apnea through a sleep study, you will remain on breathing monitors in a monitored bed overnight or until you are breathing well on your own after weight loss surgery.

The hospital stay for patients who undergo the Roux-en-Y procedure is usually two to four days. Patients who have the LAP-BAND® procedure will stay one to two nights. Before you are discharged, you will receive full instructions for your care at home. Patients are usually scheduled to see their bariatric surgeon about one week after laparoscopic weight loss surgery procedures.
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