Obesity, Gastric Bypass: A Rock Or A Hard Place...

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• 1. In 2006, 24 per cent of adults (aged 16 or over) in England were classified as obese. This represents an overall increase of 15 per cent since 1993.
• 2. In 2006, 16 per cent of children aged 2 to 15 were classed as obese. This represents an overall increase of 11 per cent since 1995.
• 3. In 2006, 1.06 million prescription items were dispensed for the treatment of obesity. Overall, the number of prescriptions in 2006 was more than eight times the number prescribed in 1999.
• 4. The number of patients opting to undergo surgery to achieve weight loss has soared. The UK’s second biggest private hospital group conducted 72 per cent more weight-loss operations in the six months to March 2008 than a year earlier. The National Health Service (NHS) reported that it performed 2,724 weight-loss operations in 2008 – a 36 per cent increase since 2007.

“Britain we have a problem!”

Obesity can pose significant health risks by potentially increasing the likelihood of diabetes, high blood pressure, heart diseases and stroke. Research has also shown the rise in obesity in Britain is fuelling an increase in cases of type-2 diabetes.

In addition to increasing the risk of ill health, obesity also increases the risk of mortality. Young adults with a Body Mass Index (BMI) of 35 or more have double the risk of death compared to those with a normal BMI. The National Audit Office (NAO) estimated that in 1998 over 30,000 deaths in England were attributable to obesity, approximately 6 per cent of all deaths in that year. In 2004, research by a House of Commons Select Committee, estimated that 34,100 deaths were attributable to obesity. This equates to 6.8 per cent of all deaths in England.

Short supply in options

Clearly, Britain’s obesity is a major concern. Another concern is the soaring number of weight-loss operations conducted to curb this problem, because these operations have their own health risks.

A US government report showed that 4 out of 10 gastric bypass patients experience complications. Abdominal hernias, infections and digestive problems such as acid reflux, vomiting, and diarrhoea are typical setbacks.

Another US study from the University of Arkansas (UA) shows that neurological difficulties may also arise after gastric bypass. The most frequent and disabling condition was myelopathy, a spinal column disorder that causes loss of sensation and even mobility. Symptoms of myelopathy generally begin about 10 years after surgery. The UA team also linked other neurological conditions to bariatric surgery:

• Encephalopathy – progressive cognitive decline, memory loss, inability to concentrate and loss of consciousness.
• Optic neuropathy – progressive vision loss.
• Polyneuropathy – movement loss due to inflammation.

And the common denominator to all these conditions is nutritional deficiencies but correction of these deficiencies usually do not correct the problem... Which says to me, if you mess with an essential part of the body’s function you are bound to have nutritional and absorption difficulties.

• Deep vein thrombosis (DVT). A condition in which a blood clot can form in the lower part of the body such as the leg. If left untreated it can be potentially fatal. Often caused by a long period of inactivity.
• Infection. The staple lines or incisions can become infected.
• Pulmonary embolus. This is the formation of blood clots in the lungs.
• Leakage. Fluids can leak around the site joining the intestine to the stomach or at the lower point or ‘Y’ section of the intestine. * Marginal ulcers.
• Stenosis. This is caused by a narrowing of the loop of the intestine or one of the openings.
• Adverse reaction to anaesthesia and medications. This can happen in a few rare cases.
• ‘Dumping syndrome’. This is the name given to a collection of symptoms which refer to an unpleasant condition. It is caused by the rapid intake of sugary foods from the stomach to the intestine. In effect, they are ‘dumped’ too quickly from the stomach and as a result of this they cause a large amount of fluid to enter the stomach. This then causes nausea, vomiting, bloating, diarrhoea, dizziness and heart palpitations. There are two types of dumping – ‘early’, which can happen directly after a meal and ‘late’ which occurs a couple of hours after a meal.

Then there is the mortality rate. US researchers from the University of Washington examined medical records of more than 16, 000 gastric bypass patients. Results showed that 5 per cent of men and 3 per cent of women in the 35-44 age group died within a year of surgery. In the 65-74 age group about 6 per cent of women and 13 per cent of men died within the first year of surgery.

Where do we go from here?

Some may argue that the benefits of weight-loss operations out-weigh the dangers and I am sure that this kind of procedure has changed some peoples’ lives.

For example, a recent study revealed that severely obese patients who chose bypass surgery, reduced their risk of premature death by up to 89 per cent, compared to equally overweight patients who did not get surgical treatment.

However, about 10-20 per cent of patients undergoing stomach bypass require follow-up operations to correct complications, the most common complaints being abdominal hernias.

So, if you look at the situation in which Britain finds itself, my question is: With people lining up in their thousands to receive weight-loss surgery and with obesity escalating annually, are we really doing enough to promote good healthy eating and lifestyle habits. Or are we simply feeding a monster, widening the range of a vicious cycle, year after year?

‘Statistics on Obesity, Physical Activity and Diet: England, January 2008’ published online by the NHS Information Centre, .ic.nhs.uk

‘Private hospitals and the NHS report surge in patients having weight loss surgery’ by Tom Bawden, published 06/04/09, The Times

‘What are the risks of gastric bypass?’ published online, hda-online.org.uk

‘Health Dangers of Gastric Bypass Surgery’ published online, annecollins.com