With over 22,000 weight loss operations performed in Australia alone in 2014-15, compared to 9300 in 2005-6, laparoscopic weight loss surgery has become an increasingly common method for managing excess weight and its health related complications. Over 90% of weight loss surgery, also known as bariatric surgery, is performed in the private hospital system. Due to an increasing number of patients now requiring surgery to effectively treat obesity and its consequences, research and development surrounding the different surgical techniques has received global attention with focus to continually improve outcomes in terms of excess weight loss, minimisation of weight regain, and reduction in morbidity.
Currently the most highly effective bariatric operations include the laparoscopic gastric band, the sleeve gastrectomy, and the gastric bypass. These operations allow patients to eat smaller meals that satisfy them like larger meals. These surgical interventions are generally recommended when adequate attempts at eating a healthier diet and exercise have not resulted in sufficient weight loss. Like all major surgery, laparoscopic weight loss operations have risks but are much safer and less invasive as they once were.
Why have non-surgical methods failed to address the widespread growth of obesity?
Nearly two-thirds of Australian adults are overweight or obese, over 70% of male and 50% of female adults. A similarly alarming trend is being seen in adolescents and children. Of great concern is that these adults are more likely to be from a lower socio-economic background with much less access to weight loss surgical options. Numerous studies have shown that although diet and exercise are good at improving health and function they only given rise to small amounts of sustained weight loss in the majority of people and rarely last in people with morbid obesity. The resulting “yo-yo syndrome” where a patient continually gains and loses weight can lead to serious psychological and health consequences.
Coupled with a lack of weight loss drugs available on the PBS and poor access to bariatric surgery in public hospitals it is no surprise that obesity is on the rise in Australia. Although many question the cost effectiveness of bariatric surgery as a solution for the majority of society, to date surgery is the still the single most effective intervention in managing obesity and metabolic syndrome when other interventions have failed.
When is bariatric surgery recommended?
If patients have a great deal of weight to lose and a great deal of health to gain then weight loss surgery may be an option. It must be highlighted that bariatric surgery is not cosmetic surgery but an intervention aimed at rapidly correcting metabolic abnormalities in the body which in turn restore health. Being obese increases a patient’s risk of diabetes, sleep apnoea, asthma, high blood pressure, arthritis, infertility, depression, varicose veins, skin problems, and premature death. The Royal Australasian College of Surgeons (RACS) and Australia & New Zealand Metabolic and Obesity Surgery Society (ANZMOSS) guidelines have the following widely accepted criteria which make a patient suitable for bariatric surgery:
- Weight greater than 45kg above ideal body weight for gender and height
- BMI > 40 by itself or > 35 if there is an associated obesity illness such as diabetes or sleep apnea
- Reasonable attempts are other weight loss methods
- Age 18-65
- Obesity related health problems
- No psychiatric or drug dependence problems
- A capacity to understand the risks and commitments associated with surgery
Why does Dr Ozmen perform bariatric surgery?
This type of surgery is not cosmetic or functional alone but life saving surgery. Once weight exceeds a certain level patients are more likely to develop metabolic syndrome (diabetes, sleep apnoea, hypertension, etc) and have a much greater risk of cancer, cardiovascular and cerebrovascular events leading to premature death. Obesity affects employment prospects, mobility and social acceptance with many patients suffering from depression as a consequence. Bariatric surgery aims to reduce the excess weight to a safer level improving the patient’s health in many ways.
Dr Ozmen has had a special interest in weight loss surgery since his extensive post-fellowship training in bariatric surgery in two centres of excellence, one in Australia and one at AZ Sint Jan Hospital in Bruges Belgium under world famous bariatric surgeon Dr Bruno Dillemans. He is dedicated to his patients and good outcomes with the help of his multi-disciplinary team. This is achieved through a minimum of two years follow-up post-operatively on a quarterly basis.
