Magazine article Clinical Psychiatry News

Rising Obesity Fuels Demand for Bariatric Surgery: Preoperative Psychological Testing Done

Magazine article Clinical Psychiatry News

Rising Obesity Fuels Demand for Bariatric Surgery: Preoperative Psychological Testing Done

Article excerpt

SAN DIEGO -- The demand for bariatric surgery is so great that the next open slot in Dr. Noel Williams' appointment book is March of 2004.

"The demand is unbelievable," said Dr Williams, director of the bariatric surgery program for the University of Pennsylvania Health System in Philadelphia "It's happening because of the Internet, celebrity patients, and TV coverage. At least every month, there's a television news program on bariatric surgery," he said at the annual meeting of the American Association of Clinical Endocrinologists

The chief reason for the boom is the fact that 97 million Americans are obese, which the National Institutes of Health defines as having a body mass index (BMI) of at least 30 kg/m[sup 2]. Obesity causes 300,000 deaths annually and accounts for 9.1% of the nation's annual medical costs. "Obesity is at the highest level ever," he commented.

The NIH defines class I obesity as 30-34.9 kg/m[sup 2], class II as 35.0-39.9 kg/m[sup 2], and class, III as at least 40 kg/m2. Obese patients typically fail medical therapy, which leads them to consider bariatric surgery, said Dr. Williams, who performs about 450 bariatric procedures per year.

The two most common bariatric procedures are Roux-en-Y gastric bypass (which he called the gold standard) and vertical banded gastroplasty. A third procedure, biliopancreatic diversion, is a "drastic" operation that he does not recommend. "'There are probably two to three surgeons in this country who are doing this operation, but I don't do it," he said. "The procedure bypasses the small bowel, which can create metabolic problems. Some of these patients have to be reversed because of severe malnutrition."

NIH guidelines state that patients are eligible for bariatric surgery if they have a BMI of 35-40 kg/m[sup 2] with comorbidities such as hypertension, diabetes, severe sleep apnea, and musculoskeletal disease. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.