Morbid obesity (MO) is a type of obesity rebellious to medical treatment of any kind, which compromises health and predisposes to serious diseases. Despite being a chronic and incurable disease, it is a pathology that can be controlled, although in the worst cases it can even cost patients their lives. The best way to quantify the degree of obesity is the Body Mass Index (BMI). We speak of morbid obesity when the BMI ≧ 40.
Many diseases are associated with morbid obesity, and can worsen the prognosis and decrease the patient’s life expectancy (up to 10 years in the most extreme cases). In addition to suffering from associated pathologies such as diabetes, dyslipidemia or hypertension, morbidly obese people suffer from problems of self-esteem, mobility or social, occupational and sexual relationships.
USA, ‘leaders
The incidence of the number of people affected by obesity has increased exponentially in the USA, including children. With an estimated 350,000 deaths per year due to the disease.
According to the Spanish Society for the Study of Obesity, 14% of our children are obese (0.6% of them morbid), and it foresees a considerable increase in the next 10 years. The economic impact of obesity is strong in Spain, since it accounts for 6.9% of health expenditure, slightly below the forecasts that place the economic cost of the disease in the USA at between 7% and 8%.
A complex treatment
The treatment of obesity is generally medical. It includes aspects such as dietary measures and drugs, psychological support to create new eating habits and physical activity. In patients with a lower degree of obesity, medical treatment has an acceptable success rate. This is exceptional in OM. The surgery of the OM or Bariatric Surgery is currently the only resource in a very high percentage of patients (more than 85%) to achieve important losses of excess weight (more than 40%) and maintained (more than 10 years). For these reasons it appears as the only effective treatment for morbid obesity in the long term.
Bariatric Surgery comprises a series of procedures whose purpose is the search for the reduction of body weight. There are three types of surgical techniques: restrictive techniques such as vertical gastrectomy, malabsorptive techniques and mixed techniques such as gastric bypass. The criteria for the inclusion of patients in OM surgery programs are well established with a wide consensus of different Scientific Bodies and Societies.
The postoperative period after vertical gastrectomy or gastric bypass is similar and relatively placid. You will usually remain in the hospital for 2 to 3 days. A few hours after the operation, you will be asked to get up with help and sit in a chair so that you can progressively begin to walk. You will be given pain medication, which should usually be mild. On the first day you will start drinking small sips of liquids and/or milkshakes. You will continue with a liquid/puree diet upon arrival at home, according to the dietician’s instructions, for up to 3-4 weeks. We advise a gradual return to normal life from the first moment, which is usually achieved between the second and third week, sports activities and heavy exertion should be avoided during the first two months after surgery.