Morbid obesity is treated by surgery due to the serious risks posed by associated diseases, the low risk of surgical intervention, and the low effectiveness of medical and dietary treatments with this degree of obesity.
This surgery is indicated in patients with morbid obesity (BMI>40) and in patients with severe obesity (BMI 35-40) with comorbidities. However, these criteria were established in 1995 in the USA and adopted in 2003 in Spain. More than 20 years later, with a GLOBESITY EPIDEMIC underway, with the greater safety and less aggressiveness of Laparoscopic Surgery, and the best results of surgical techniques, the indications have also been expanded to PATIENTS WITH BMI 30-35 and COMORBILITIES , especially DIABETES, since we know that the risk/benefit ratio in these patients is VERY FAVORABLE.
To indicate surgical treatment, as a general rule, previous serious and controlled attempts at weight loss, age between 18 and 65 years, and absence of psychiatric pathology or severe addictions that contraindicate the intervention are necessary.
Surgery can be considered in less overweight patients if from a medical point of view there is sufficient reason for weight reduction and surgical intervention seems to be the only way to achieve it. Adolescent patients between 14 and 18 years old may also be candidates for surgical treatment in the setting of ADOLESCENT BARIATRIC SURGERY UNITS like ours. Patients over 65 years of age, even up to 70 or 75 years of age, would benefit from the disappearance of comorbidities, greatly improving quality of life and reducing dependency, since the average life expectancy in Spain reaches 87 years in the women.
It is a major surgery, it is not cosmetic surgery, and the final objective is not to reach the ideal weight but a HEALTHY WEIGHT, which is what allows us to live a life without physical or mental limitations (self-esteem and depression-isolation) and with the control of comorbidities to improve quality of life, reducing the risk of mortality.
In general, we consider that final success depends on both the operation and the subsequent follow-up.
The goal of surgery is to control obesity by changing the energy balance in two ways: reducing the amount of food we eat, and causing food not to be fully digested and absorbed (partial malabsorption).
