Obesity is defined as having a Body Mass Index greater than 30. The Body Mass Index is a calculation based on a person’s height and weight. Recent statistics of obesity in the United States are staggering. Obesity is the No. 2 cause of preventable death. About 78 million Americans 20 years and older are obese, and 12.5 million children 6-19 years are overweight or obese (both according to the Centers for Disease Control).

Being overweight or obese increases the risk of many adverse health conditions and diseases: cancer, heart disease, type 2 diabetes, hypertension, sleep apnea and many others.
What is so alarming is that diabetes, hypertension, sleep apnea and other obesity-related disease states that are prevalent in adults are now becoming common in our adolescent population. Endocrinologists and pediatricians are seeing a dramatic increase in Type 2 diabetes in children and adolescents where it did not exist in previous decades.
The reported reasons for the increased incidence of obesity in children include poor dietary habits and inactivity. A focus on a high simple carbohydrate diet is a large contributor to obesity.

Looking for answers
So, what is the answer? What can we do to hopefully reverse this trend?
The No. 1 answer is prevention. At a very young age, children should be taught and guided to eat a healthy, well-rounded diet. Physical activity should be a part of their everyday lives. These measures, if followed, will prevent the development of obesity. But how do we address the population that has already developed obesity or morbid obesity?
Conventional diet and exercise should always be the first course of action. The problem with this approach is this: Statistics show that only 1%-3% of the obese or morbidly obese population will be successful in significant sustained weight loss. The reasons for the limited success include: weight loss with dieting is very slow, so those who have 50 plus pounds to lose may become frustrated with the slow process; the person dieting creates a state of continued hunger, maybe controlling certain cravings which both become overwhelming and often cause these persons to regain their weight plus more. This phenomenon is simply due to that person satisfying that hunger created during the dieting phase. Also, many people, because of their size, cannot exercise effectively, which also will affect the rate of success.
Most obese or morbidly obese persons have failed many attempts at diet and exercise, whether on their own or using structured medically supervised diet plans. There can be a strong sense of failure because of the inability to succeed. Most individuals do not realize the internal turmoil, depression, social prejudice and poor self-esteem that the obese individual experiences. Those who do not struggle with being overweight may feel that the obese are just lazy and unable to control eating habits or just do not care about themselves and their well being.
They could not be farther from the truth. The only way one could truly understand what the obese or morbidly obese person experiences is to walk a day in their shoes. If one could, there would be a much better understanding, and I think, much less prejudice. Obesity and morbid obesity are disease states, not a choice. These individuals do not make a choice to become obese. The disease allows those to become obese due to many factors including hormonal and genetic factors. Abnormal hormonal levels decrease the sensation of fullness and increase the sensation of hunger so that it is very difficult to satisfy that hunger.
As mentioned earlier, a very small percentage of the obese population will be successful with diet and exercise. Most of the obese or morbidly obese face an insurmountable task of losing a significant amount of weight and then sustaining that weight loss.

Bariatric surgery
So, what is the next option? Bariatric (weight loss) surgery. Bariatric surgery is a safe and effective treatment option for the obese or morbidly obese person.
There are four recognized Bariatric procedures being performed in the United Sates: the adjustable gastric band, the gastric bypass, the duodenal switch and the laparoscopic vertical sleeve gastrectomy.
The procedure that is rapidly growing in popularity is the laparoscopic vertical sleeve gastrectomy. This procedure involves removal of 85%-90% of the stomach. It is considered a restrictive operation, which means it will physically restrict or limit the amount one can eat.
A dramatic benefit this operation offers over some of the other procedures is that in most cases the person experiences a significant reduction in hunger. Many have a decreased interest in food, decrease in cravings and a changed perception of food. This has been described to me by a former patient as a removal of food as a priority. One can imagine, if their doctor could give them a magic pill that would remove their interest in food, that dieting would be so successful.
This is the situation that most people experience following the sleeve gastrectomy. For those who also have developed hypertension, diabetes and/or sleep apnea, the sleeve gastrectomy will significantly improve or resolve these conditions in 75%-80% of patients. In many instances, I have seen my diabetic patients experience normalizing of the blood glucose in two to three days after surgery. Even some who required insulin therapy have had complete resolution. These results can not be achieved in any other manner.

Recent advances
Technological advances in laparoscopic surgery now allow the sleeve gastrectomy to be performed with a less invasive approach. The Spider device, made by TransEnterix, is a robotic laparoscopic instrument that allows for three separate working instruments through one small incision. The procedure is performed with fewer incisions than the standard approach, and the incisions are placed in the belly button creases so that they are hidden.
The result is a better cosmetic outcome, less postoperative pain, and possibly quicker recovery. Many of my patients are interested in minimal scarring and therefore choose to have the Spider approach.
Some patients have been accused of taking the easy way out by opting for bariatric surgery. There is nothing easy about this decision, and for many it is not the easy way out but possibly the only way out. With weight loss surgery, people who have struggled with their weight and medical issues have an opportunity to live a happy, healthy and active life. It is truly a life-changing experience.

ANDREW G. HARGRODER, M.D.
Dr. Hargroder is a board-certified surgeon who specializes in minimally invasive weight loss surgical techniques and has successfully performed more than 2,500 laparoscopic weight loss procedures with proven success in the resolution of diabetes, high blood pressure and long-term weight loss management.
Dr. Hargroder is the only surgeon in the  state currently performing minimal incision weight loss surgery using the latest technology, the Spider® Surgical System. This innovative new technology allows for fewer incisions; therefore, the patient experiences less pain, a shorter recovery time and a more desirable cosmetic outcome.

Contact us:

Andrew G. Hargroder, MD

(225) 388-5380

www.andrewhargrodermd.com