American Society for Metabolic & Bariatric Surgery

The overall chemical and emotional/psychological balance of the body is changed following any surgery and there are definite changes after weight loss surgery, including possible increased self esteem. This may make it easier for a patient to follow a diet. Mental health and diet/nutritional support should be provided long-term, however. Surgery is not an easy way out, but can be a new beginning for the severely obese person suffering cardiovascular disorders/risk, sleep apnea, diabetic complications or obesity-related depression to achieve better health.

The qualified patient should be at BMI of 35 or above and exhibit cardiovascular compromise or elevated cardiovascular risk, and/or complications of Type 2 Diabetes and/or severe sleep apnea, which can be fatal. The qualified patient may also show marked obesity-related dysfunction in daily activities, such as an inability to walk, an inability to maintain employment, and/or other physical problems or the manifestation of clinical depression or other Severe Mental Disorders (SMDs). The patient should also be willing to consent to Hyperbaric Oxygen Treatments that not only induce quicker surgical healing, but also more efficient metabolism that will aid the patient’s diet regimen post surgery. The patient must agree to and sign a behavioral contract with the treatment team and family physician to a prescribed exercise and nutritional/diet plan and regular related medical follow-up, including mental health support.

I would choose the least invasive and totally reversible strategy for gastro-surgery, which is the Laparoscopic Gastric Banding. It involves minimal incision and the band is adjustable, providing more individual control with a doctor’s help and a greater feeling of patient autonomy that can boost patient compliance. The band can also be removed at a later date, with a return to normal for the stomach.

Health and medical insurance should pay for these procedures and follow-up in order to combat the conditions of life-threatening cardiopulmonary conditions/risk, potentially deadly levels of sleep apnea, and obesity-related diabetes, along with related clinical depression. Insurance payment for gastro-surgery should be a one-time-per-lifetime payment, because the patient should learn correct nutrition and dietary procedures and comply with follow-up regimens and treatment. This is because repeated gastro-surgery of these types can be costly and dangerous to the individual in repetition. Insurance should not pay for cosmetic surgery that entails these treatments, because elective medicine for vanity’s sake is a luxury and should be an out-of-pocket expense. If a severe mental health problem is related to obesity’s resultant poor appearance, this might be a special case of payment allowed.

References

American Society for Metabolic & Bariatric Surgery. Bariatric surgery: postoperative concerns.

Retrieved January 4, 2008 from http://www.asbs.org/html/pdf/asbs_bspc.pdf

American Society for Metabolic & Bariatric Surgery. Suggestions for the pre-surgical

psychological assessment of bariatric surgery candidates. Retrieved January 4, 2008 from

http://www.asbs.org/html/pdf/PsychPreSurgicalAssessment.pdf

Jones, W.G. The Canada Free Press. Hbot to treat chronic conditions. Retrieved January 4, 2008

from http://www.canadafreepress.com/medical/medicine071205.htm

The Cleveland Clinic. Surgical options for severe obesity. Retrieved January 4, 2008 from

http://www.clevelandclinic.org/health/health-info/docs/2400/2451.asp?index=9472