Bariatric Surgery Can be Useful for Morbid Obesity

Q:  I am a 53-year-old pre-menopausal white female, 5 feet 4 inches tall and 240 pounds. I have acid reflux and have been taking Prevacid for three years.

I have a cough, which may be due either to the acid reflux (this is what my doctor thinks) or to mild asthma (my pulmonary test was positive).

Wouldn't a gastric bypass help all these problems?

A:  You do have "morbid obesity," meaning obesity that causes medical problems such as acid reflux or lung problems.

Sometimes the best treatment for obesity-related problems is indeed bariatric surgery such as a gastric bypass or stomach stapling. Bariatric surgery is a useful treatment for obesity in people unable to maintain a normal weight by changing their food intake and increasing their activity.

Bariatric surgeries promote weight loss by restricting food intake and, in some operations, interrupting the digestive process.

Operations that only reduce stomach size are known as "restrictive operations" because they restrict the amount of food the stomach can hold.

"Malabsorptive operations" combine stomach restriction with a partial bypass of the small intestine. These procedures create a direct connection from the stomach to the lower segment of the small intestine, literally bypassing portions of the digestive tract that absorb calories and nutrients.

As in other treatments for obesity, the best results are achieved with healthy eating behaviors and regular physical activity.

Because it sometimes has serious complications, the National Institutes of Health recommends bariatric surgery only for people with a body mass index greater than 40 or those with a BMI greater than 35 and a serious medical condition such as diabetes, high blood pressure and sleep apnea. (Your BMI is 41.2; you can determine your BMI using the HealthLink BMI Calculator.)

To find out more about whether bariatric surgery is right for you, you should ask your doctor to refer you to an obesity clinic where experienced bariatric surgeons practice.

For information on the Medical College of Wisconsin Bariatric Surgery Program, see the HealthLink article When Nothing Else Works: Surgical Treatment of Obesity.

Julie L. Mitchell, MD, MS, is an Assistant Professor of Medicine at the Medical College of Wisconsin. She practices internal medicine at the Froedtert & Medical College General Internal Medicine Clinic - East. Her column appears in the Milwaukee Journal-Sentinel.