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Bariatric surgery can be a lifesaving procedure, but there are many factors to weigh. If you or a loved one are considering the procedure, Dr. Warner presents this informative program. She reviews the criteria and commitment required to undergo this type of surgery, the surgical options, as well as the potential outcomes and health benefits.
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Bariatrics & Beyond
Elizabeth A. Warner, MDGeneral & Bariatric Surgery
www.SpringfieldClinic.com/DoctorIsIn
Outline• What is Obesity? (Calculate your BMI)
• Obesity Trends in U.S.
• Obesity Comorbidities
• Cause of Obesity
• Bariatric Surgery Options and Benefits
• Candidates for Bariatric Surgery
• Bariatric Surgery Program Components
What is Obesity?• Body Mass Index (BMI) = • Weight Categories:
• Underweight- BMI <18.5• Normal weight- BMI ≥18.5-24.9• Overweight- BMI 25-29.9• Obese- BMI ≥30
• Class I- BMI 30-34.9• Class II- BMI 35-39.9• Class III- BMI ≥40
• Super obese- BMI >50
Weight (kg)Height (m)2
BMI Real Life Example
5’4”
120lbs: BMI 20.6
140lbs: BMI 24 160lbs: BMI 27.4
180lbs: BMI 30.9 200lbs: BMI 34.3
220lbs: BMI 37.7 240lbs: BMI 41.1
260lbs: BMI 44.6
280lbs: BMI 48
5’9½”
120lbs: BMI 17.4
140lbs: BMI 20.4
160lbs: BMI 23.3
180lbs: BMI 26.2
200lbs: BMI 29.1
220lbs: BMI 32
240lbs: BMI 34.9
260lbs: BMI 37.8
280lbs: BMI 40.7
Underweight <18.5Normal weight ≥18.5-24.9Overweight 25-29.9Obese- ≥30
Class I- 30-34.9Class II- 35-39.9Class III- ≥40
Super obese- >50
Obesity Trends Among U.S. Adults
1985
http://www.cdc.gov/obesity/data/adult.html
Obesity Trends Among U.S. Adults
1990
http://www.cdc.gov/obesity/data/adult.html
Obesity Trends Among U.S. Adults
1995
http://www.cdc.gov/obesity/data/adult.html
Obesity Trends Among U.S. Adults
2000
http://www.cdc.gov/obesity/data/adult.html
Obesity Trends Among U.S. Adults
2005
http://www.cdc.gov/obesity/data/adult.html
Obesity Trends Among U.S. Adults
2010
http://www.cdc.gov/obesity/data/adult.html
Why do physicians care about obesity? • Hypertension• Diabetes• Coronary artery disease• Heart failure• Atrial fibrillation• Kidney disease• Obstructive sleep apnea• Osteoarthritis• Cholelithiasis• Infection• GERD• PCOS, Infertility
• Sexual dysfunction• Urinary incontinence• Hepatic steatosis (“fatty liver”)• Stroke• Cancer: Esophagus, stomach,
colon, rectum, liver, gallbladder, pancreas, kidney, breast, prostate, uterus, cervix, ovarian, lymphoma, multiple myeloma
• Death (all-cause and cardiac)
What causes obesity?
• Calories In• Calories Out• Metabolism
• Muscle mass• Genetics• Microbiome• Stress• Sleep
Calories In (Eating)
• Hyperpalatable foods
• Salt-Sugar-Fat
• Bliss point
• Standard American Diet (S.A.D.)
• Convenient, Low cost
• Highly processed
• Devoid of micronutrients and fiber
Sugar4g of sugar = 1 tsp of sugar
12oz coke: 38.5g of sugar8oz grape juice: 40g of sugar8oz apple juice: 28g of sugar8oz orange juice: 26g of sugar
Calories Out (Activity)• Calorie Expenditure
• Aerobics (low impact) 272kcal
• Bicycling (10mph) 327kcal
• Bowling 163kcal
• Housework 163kcal
• Jogging (6mph) 544kcal
• Stair climbing 435kcal
• Vacuuming 191kcal
• Walking (3mph) 180kcal
• Washing the car 163kcal
• Sleeping 49kcal
• Watching television 54kcal
• Driving 109kcal
• Standing 65kcal
• Grocery shopping 125kcal
www.caloriesperhour.com
Prevention Is Key
• Establish healthy eating habits early for children
• The majority of meals should be made at home
• Be mindful of gradual weight gain and make adjustments before the problem feels overwhelming
– Once a week weigh in
– Clamp down on diet and increase activity
• Consistency (diet & exercise) is mandatory
Dr. Warner’s Quick Tips• No soda or juice (Liquid calories = NEVER foods)
• Increase your fruit & vegetable consumption
• Decrease your processed food consumption
• Eat at least one green thing per day
• Keep a food journal
• Start to read labels and educate yourself
• Get the ‘bad for you food’ out of the house
Bariatric Surgery Options
Gastric Bypass Sleeve Gastrectomy Gastric Band
Bariatric Surgery Benefits• Rapid weight loss
– 70% EBW Gastric Bypass (~1 year)
– 60% EBW Sleeve Gastrectomy (~1 year)
– 50% EBW Gastric Band (~2 years)
• Improvement in comorbidities
– Diabetes
– Hypertension
– Obstructive Sleep Apnea
– GERD
– Infertility
MMC Bariatric Surgery Benefits at 5 Years
Bariatric Surgery- Who is a candidate?
• Body Mass Index (BMI) = • Weight Categories:
• Underweight- BMI <18.5• Normal weight- BMI ≥18.5-24.9• Overweight- BMI 25-29.9• Obese- BMI ≥30
• Class I- BMI 30-34.9• Class II- BMI 35-39.9• Class III- BMI ≥40
• Super obese- BMI >50
Weight (kg)Height (m)2
Memorial Bariatric Surgery Program• Springfield Clinic partnership with Memorial Hospital• Multidisciplinary Program:
• Medical evaluation and education• Medical candidacy• Procedure choice
• Nutritional evaluation and education• Physical therapy evaluation and education
• Fitness assessment• Personalized exercise program
• Psychological evaluation and support• Monthly support groups• Long-term follow-up
More Information
www.MemorialBariatricServices.com
www.SpringfieldClinic.com