By: Isaias Irgau MD FACS FRCS(Ed), President, Christiana Institute of Advanced Surgery

Obesity is a disease characterized by the accumulation of excessive body fat. The degree of obesity depends on the weight of the person. One of the commonly used methods to define obesity is to calculate the Body Mass Index or BMI. The BMI is a number derived by taking into account the height and the weight of the person. A normal BMI is between 18 and 25; obesity is defined as a BMI greater than 30 and morbid obesity or clinically severe obesity is defined as a BMI of 40 or above. This also corresponds roughly to a body weight about 100lb in excess of the ideal body weight.

Many studies have shown that leaner people tend to live longer than heavy individuals. Many dangerous illnesses occur much more commonly when obesity is present. Reducing weight with bariatric surgery or weight loss surgery has been shown to improve or even cure many of these illnesses. The list of illnesses related to obesity is very long and continues to grow; the most commonly recognized include diabetes, high blood pressure, sleep apnea, joint pain, depression and many types of cancer.

Unfortunately the number of people that suffer from obesity in the US continues to increase. The most dramatic increase has occurred in the last 20 years. Currently a third of the US population is said to be obese and about 9 million individuals qualify for the definition of morbid obesity.

Once the level of obesity reaches the morbid obesity stage the risk of contracting dangerous illnesses like diabetes and sleep apnea increases dramatically and the prospects of living to the expected lifespan fade significantly. Currently the only effective method of treatment for morbid obesity is weight loss or bariatric surgery. With weight loss surgery, specially trained surgeons known as bariatric surgeons, operate on the digestive tract of the morbidly obese and reduce the size of the stomach that receives the food and/or change the routing of nutrients in the intestines. The two most commonly undertaken operations in the US are gastric bypass and adjustable gastric banding.

Gastric bypass entails the cutting of the stomach into two pieces, a very small portion still attached to the food pipe and the rest of the stomach which becomes excluded from the passage of food. The small portion which is the size of an egg will then be connected to the intestines to restore continuity. Weight loss happens because the small stomach causes fullness with small portions of food and the rerouting of intestines leads to changes in the processing of the foods consumed.

Adjustable gastric banding involves the placement of a silicone belt around the upper part of the stomach to create a narrowing that will slow down the passage of food between the small portion of the stomach above the belt and the rest of the stomach. This in turn will result in early fullness and longer fullness with each meal. Weight loss happens because of control of portions and control of hunger.

Each procedure has its own advantages and drawbacks. The best way to determine if one is a candidate for weight loss surgery, which procedure is appropriate and what is the expected commitment for a successful outcome, is in consultation with a bari-atric surgeon.

At the Christiana Insti-tute of Advanced Surgery (Chrias) we offer bariatric surgery as part of a comprehensive weight loss surgery program. Our surgeons have performed more than 2000 operations with excellent results. The Chrias surgeons were the first surgeons to make laparoscopic Gastric Bypass the standard operation in Delaware, and the first laparoscopic adjustable gastric band in Delaware was performed by the Chrias surgeons. Chrias surgeons started and established laparoscopic bariatric surgery in the areas two leading hospitals, Christiana Hospital and St Francis Hospital, and helped both institutions earn the prestigious designation of Center of Excellence for Bariatric Surgery.

For more information or to schedule a consultation, please contact the Christiana Institute of Advanced Surgery at 302-892-9900.

Christiana Institute of Advanced Surgery performs Laparoscopic Gastric Bypass and Laparoscopic Adjustable Gastric Banding surgery for the treatment of Morbid Obesity. Please call our office or visit our web site at www.chrias.com for a schedule of our free seminars.