The health risks to the morbidly plump are such that first conservative (dietary) and then belligerent (surgical) treatment must be undertaken to restore and maintain health. This paper discusses state-of-the-art aggressive treatment in which patients have an average loss of 55% of their excess weight, mortality no greater than that of normal weight population and experience both physical and psychological benefits. Patients must be carefully selected and monitored before and after surgery. By the time an individual has become morbidly obese, few would argue that the time for prevention is long past, and that treatment must be initiated to restore and to maintain health. While individuals who are seriously overweight, or 140% of ideal body weight, can concentrate on preventing further weight gain, those who are morbidly obese, or 200% and above of ideal body weight, must undergo immediate weight loss. Clearly such an effort requires participation in a multidisciplinary weight-control program at a medical facility specifically designed to treat all forms of obesity. Given the refractory nature of the disease, treatment must be long-term, with frequent visits to not only the obesity clinic but to the community medical center as well. Therapy should evolve into a partnership between the patient, the patient's family and friends, the patient's private physician and the patient's obesity treatment team. Before the details of various treatment options can be appreciated, however, morbid obesity itself must be thoroughly comprehended. (Mokdad AH, Ford ES, Bowman BA, et al (2003)
Morbid obesity is a disease. It is a chronic disease with a complex etiology, involving both the patient's genetic background and environment. Studies of twins - particularly adopted twins - suggest that genetic and environmental factors are responsible for 70% of morbid obesity in Americans today. In addition, epidemiological data indicate that if the patient has one parent with a weight problem, then the chance of the patient developing morbid obesity is 60%; if both parents have weight problems, the probability rises to 90%.............
