Diabetes Mellitus tipo 2.
Obese people develop resistance to insulin, a substance that regulates levels of sugar in the blood. Over time, the resulting high sugar content in the blood can cause serious damage to the arteries, causing blockages in the vessels of the heart, kidneys, brain and extremities.
Osteoarthritis.
The additional weight applied to the joints, especially knees, ankles, hips and spine, causing rapid wear, accompanied by pain and swelling and can cause problems with herniated discs and lower joint mobility.
Obstructive sleep apnea and respiratory problems with snoring.
Fat deposits on the tongue and neck can cause intermittent obstruction of airflow through the airways. Since this obstruction is increased when sleeping on your back, you may have to wake frequently snoring in order to rearrange yourself in bed. The resulting reduction of sleep often leads to numbness in the day and headache.
Dyslipidemia.
There are a number of disorders in fatty substances in the blood. A common form of dyslipidemia is often called "high cholesterol." However, dyslipidemia is a term that encompasses all health problems as a result of having an excess of certain lipids or scarcity of certain types of these. The danger is when the fat begins to accumulate in artery walls, along with platelets and other debris, and then they begin to cause thickening and hardening of such obstruction. Some arteries end up literally blocked; to this medical condition is called atherosclerosis. Depending on the site of obstruction a heart attack can occur on an organ where the artery supplied oxygen.
Gastroesophageal reflux and gastritis.
Acids act in the stomach and rarely cause problems if they stay in it. When there is reflux of acid in the esophagus through a weak or overloaded valve at the top of the stomach, called gastro esophageal reflux is caused whose common symptoms are "heartburn" or pain either behind the breast or in the pit of my stomach. " Approximately 10% and 15% of patients with sporadic symptoms, even benign, acidity develop a condition known as Barrett's esophagus, which is a premalignant change in the lining or coating on the inside and esophagus which is a cause of esophageal cancer. On the other hand, this acid reflux can contact the airways (bronchi) causing asthma attack or bronchospasm.
Gallbladder disease.
They occur more frequently with obesity, due in part to repeated efforts to lose weight (diet), which produce a change in metabolism, predisposing these patients to form stones (stones) vesicular. When these calculations are formed in the gall bladder, they can cause severe abdominal pain, infection and jaundice (resulting from accumulation of bilirubin in the body), which lead to the need for gallbladder removal.
Cancer.
With obesity the chances of developing certain cancers may increase by 50% more. Women can get, breast, uterus, endometrium and ovarian cancer. In men, it increases the likelihood of colon and prostate cancer.
Infertility PCOS and menstrual cycle disorders.
Morbidly obese women often experience menstrual cycle disorders, including interruption, abnormal menstrual flow and increased pain.
Stretch Marks.
Skin hygiene can be a serious problem in obese people, for the very frequent friction or rubbing of the skin and can cause small abrasions or injuries that result in fungal infections (thrush) or bacteria. On the other hand it can cause darkening and thickening of the skin on the neck, sites of friction and folds (acanthosis nigricans) and the appearance of warts and cutaneous horns.
Leg swelling and skin ulcers: inflammation of the legs is common among the obese and the causes can be decreased venous return or formation of blood clots in the veins of the legs. If left untreated, ulcers can occur in the legs extremely difficult to treat.
Stress urinary incontinence.
A large heavy abdomen, combined with the relaxation of the pelvic muscles, especially associated with the effects of childbirth, may cause the weakening of the sphincter or valve of the bladder, which can lead to urine leakage when coughing, sneezing or laughing.
Pulmonary embolism.
Pulmonary emboli are nothing but clots in the venous circulation of the lungs. Most of these clots form in the lower extremities, a condition known as Deep Vein Thrombosis (DVT). Because overweight people are more susceptible to circulatory problems, the chances of experiencing a pulmonary embolism and sudden death are higher.
Psychosocial.
No less important are the psychological, social and economic (hard to work for its limitations, disability, discrimination in the workplace, airplanes, theaters, etc..). These patients often have negative self-image, with a tendency to depression, social isolation, sexual problems, divorce and suicide POSE reach. All this makes the individual have a poor quality of life and have a high risk of severe complications that put their life expectancy. Moreover, these people with severe overweight conditions, facing constant emotional shocks, repeated failures in the diets they undertake, desperate families and friends, and mocking smiles and comments from strangers.
Focus on the problem.
Surgical treatment of obesity is major surgery that is not a cosmetic treatment. It doesn’t consist of removing fat. Bariatric surgery involves reducing the size of the stomach, associated or not, to a process that prevents the absorption of some nutrients by laparoscopy. This practice is increasingly common in treating morbid obesity and it is the result of three factors:
1.- The current understanding of the significant risks of morbid obesity for health.
2.- relatively low risk and complications of procedures, compared with the failure to perform the surgery.
3.- The inefficiency of non-surgical methods currently used to achieve effective and maintained weight loss.
Bariatric surgery is indicated in patients between 15 and 65 years of age. Patients with an index of obesity (BMI) over 40 and are candidates for surgery to improve their quality of life, prevent complications and premature death. Also, surgery is indicated in patients with a BMI between 35 and 40, with co-morbidity. The repeated failure with medical treatment and diet is an obvious reason for surgery. Some candidates for surgery are so obese and with such bad health that they have to be hospitalized and treated earlier to improve their operative risk.
The option of surgery should be offered to informed, motivated patients, that crave a change in weight, lifestyle and have an acceptable operative risk. The patient must accept inspections and monitoring after the operation, which should be for life.
In each case we must assess the risks and benefits of the surgery. Above all, the surgery should be considered as a method for alleviating a disease that debilitates the sufferer. While the cost of this surgery is not available to all patients, it is less than the risks of obesity and less than the treating medium and long term diseases and complications secondary to improved quality of life.
Effectiveness of obesity surgery.
The actual amount of weight a patient loses after the procedure, depends on several factors which are: age, weight before surgery, general health condition of the patient, the surgical procedure, the patient's ability to exercise, their commitment to continue and maintain the information about diet and other follow-up care, patient motivation and cooperation of his family, friends and relatives.
In general, success is defined as bariatric surgery, such as control or cures of co-morbidities, achieving an excess weight loss of at least 50% or more and maintains this level for at least five years. The ideal operation is one which that excess weight loss exceeds 50%, and is maintained over 5 years, benefiting at least 75% of the patients, allowing good quality of life and power, which has no long-term complications, and have a low risk of mortality (<1%) and complications (<10%). Clinical data varies according to each of the different procedures mentioned. The results can also be changed according to each surgeon.
Clinical studies show that, after surgery, most patients lose weight quickly and continue until 18 to 24 months after the procedure. In the first six months, patients may lose between 30% and 50% of overweightness, and even 70% to 80% of excess weight at 12 months after surgery.
Patients with lower initial BMI may lose a greater percentage of their excess weight and probably be closer to their ideal body weight. Patients with Type 2 Diabetes tend to show less overall reduction of weight, than patients who do not have a disease. It has been found that surgery is effective in improving and controlling many diseases or health conditions related to obesity.
A study of 500 patients showed that 96% of associated diseases studied (back pain, sleep apnea, hypertension, diabetes and depression) were improved or cured. For example, many patients with type 2 diabetes, although they showed a smaller overall reduction of overweightness, their diabetic condition was solved in an excellent way , to the extent that the need to continue with the drug, was mild or disappeared.
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