Expert Commentary: Rami E. Lufti, M.D., FACS 12/15/2009
Obesity has become an epidemic crisis in United States! The problem is further aggravated by the serious threat obesity has on our society. This was evident by a study published by the Journal of the American Medical Association (JAMA) in 2004. Researchers found, looking at the top 10 causes of preventable death in the US, that obesity came a close second to smoking, causing 400,000 deaths yearly! The projection is that obesity will soon surpass smoking as the number one killer in our country! Medical, behavioral, and nutritional interventions are many; and while they are the way to go for the overweight individuals, it has become clear that for the morbidly obese patients (>80 pounds over IBW, Ideal Body Weight), these interventions alone, fail to provide a long term meaningful weight loss.
In this group of patients (morbidly obese), which now is 5% of the population, surgery to date has been the only effective treatment to provide a significant long term weight loss.
Surgical procedures for obesity have gone through a long maturing process reaching a high level of safety and efficacy. Using cutting edge technology, we can perform the most complex procedures through tiny incisions (Minimally Invasive Surgery), and in many times do the surgery in an outpatient setting!
Despite the proven safety, surgery remains a drastic solution; going under general anesthesia, and having abdominal surgery is a major decision that we take very seriously; complications could happen, such as a leakage from suture lines, or Band slippage after placement of an adjustable gastric band.
So how should we determine the way to go?
As in taking any decision in life, we should have the proper education, then weigh the risks and the benefits to be able to make the right decision. Despite continuous scrutiny, the data has been clear for the long term effect of weight loss surgery.
A Utah study¹ compared about 10,000 individuals who had weight loss surgery with a matched 10,000 morbidly obese patients who did not have surgery. After a long term follow up of 18 years (1984 to 2002) a significant 40% reduction of death was found in the morbidly obese group who underwent bariatric surgery.
Similar results were found in a large European study² that followed prospectively morbidly obese patients who underwent surgical treatment, and compared them to a morbidly obese group who underwent intense behavioral and dietary management (over 2000 patients in each group). Follow up was over 10 years span. A clear survival advantage was demonstrated in the surgical group with about 25% decreased in the risk of death in the surgical group.
We do recognize that surgery is not the real solution, but instead it is preventive therapy; however, for morbidly obese individuals who missed the chance of prevention, who suffer from many diseases caused or aggravated by obesity such as diabetes, heart disease, high blood pressure, back and joints pain, surgical therapy when done in a technologically advanced center by fellowship trained surgeons is the only way for cure!!
¹ Adams TD, Gress RE, Smith SC, Halverson RC, et al. Long-Term Mortality after Gastric Bypass Surgery. NEJM 2007; 357-8, pp.753-761.
² Sjostrom L, Narbro K, Sjostrom D, Karason K, et al. Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects. NEJM 2007; 357-8, pp.741-752.
Rami E. Lutfi, MD, FACS
Disclaimer
Featured Doctors
GI Specialist Downtown Chicago, Illinois
Andrew Albert, MD, MPH
945 W. George Street
Chicago, IL 60657
Call: 773-368-3164
Diagnostic Laboratory Services Bronxville, Eastchester, New York
Outpatient Services | Laboratory & Pathology Services
Lawrence Hospital Center | Outpatient Services
55 Palmer Avenue
Bronxville, NY 10708
Call: (888) 281-4612
Foot Surgeon Dunning Chicago Illinois
Jeffrey J. Betman
Board Certifed in Podiatric Medicine and Podiatric Surgery
6039 W. Belmont Ave.
Chicago, Illinois 60634
Call: 773-745-1919
Weight Loss Surgery NYC, New York
Columbia University Medical Center for Metabolic and Weight Loss Surgery
Center for Metabolic & Weight Loss Surgery
Herbert Irving Pavilion,161 Fort Washington Ave, 6th Fl., Room 620
NYC, NY 10032
Call: 888-838-9148
Obesity Surgery Manhattan, NYC
Columbia University Medical Center for Metabolic and Weight Loss Surgery
Center for Metabolic & Weight Loss Surgery
Herbert Irving Pavilion,161 Fort Washington Ave, 6th Fl., Room 620
New York City, NY 10032
Call: 888-838-9148
Body Lift Near North Side Chicago, IL
Rodger Wade Pielet, MD, FACS
One East Erie Street.
Chicago, IL 60611
Call: 312-440-3100
Weight Loss Surgeon Upper West Side Manhattan
Marc Bessler, M.D.
Center for Metabolic & Weight Loss Surgery
Herbert Irving Pavilion,161 Fort Washington Ave, 6th Fl., Room 620
Manhattan, NY 10032
Call: 888-838-9148
Tummy Tuck Near North Side Chicago, IL
Peter Geldner, MD
680 N. Lake Shore Drive, Suite 1325
Chicago, Illinois 60611
Call: 312-981-4440
Lumineers Hyde Park Chicago Illinois
Louis R. Kaufman
1525 E. 53rd Street
Chicago, Illinois 60615
Call: 773-643-6006
Brow Lift Near North Side Chicago
John Q. Cook
737 North Michigan Avenue Suite 760
Chicago, Illinois 60611
Call: 312-751-2112
Facial Plastic Surgery Near North Side Chicago, IL
Stacie McClane, MD, FACS
Stacie McClane, MD, FACS
680 North Lake Shore Drive, Ste. 930
Chicago, IL 60611
Call: 312-867-9500
Diagnostic Laboratory Services Bronxville, Eastchester, New York
Outpatient Services | Laboratory & Pathology Services
Lawrence Hospital Center | Outpatient Services
55 Palmer Avenue
Bronxville, NY 10708
Call: (888) 281-4612
Joint Replacement Wheaton Chicago, Illinois
Stephen Baker, MD
2001 Gary Ave Ste. 110
Wheaton, Illinois 60187
Call: 630-665-9155
Obesity Surgery Specialist Westchester, New York
The Columbia University Center for Obesity Surgery at Lawrence Hospital
Lawrence Hospital Center for Advanced Surgery
55 Palmer Avenue, First Floor
Bronxville, NY 10708
Call: 888-468-9351
Gastric Bypass Manhattan, New York City
Columbia University Medical Center for Metabolic and Weight Loss Surgery
Center for Metabolic & Weight Loss Surgery
Herbert Irving Pavilion,161 Fort Washington Ave, 6th Fl., Room 620
New York City, NY 10032
Call: 888-838-9148
Diagnostic Testing Services Bronxville, Eastchester, New York
Outpatient Services | Laboratory & Pathology Services
Lawrence Hospital Center | Outpatient Services
55 Palmer Avenue
Bronxville, NY 10708
Call: (888) 281-4612
Diagnostic Testing Services Bronxville, Eastchester, New York
Outpatient Services | Laboratory & Pathology Services
Lawrence Hospital Center | Outpatient Services
55 Palmer Avenue
Bronxville, NY 10708
Call: (888) 281-4612
Metabolic Surgery
Elliot Goodman
Beth Israel Medical Center
6th Floor 1st Ave & 16th St
New York City, New York 10003
Call: 888-351-8607
Bariatric Surgery/ Obesity Surgery Brooklyn, NYC
John L Holup, DO
Beth Israel Medical Center - PACC
10 E Union Square Ste., 2N
New York, NY 10003
Call: (888) 762-2167
Lasik in Skokie Chicago, IL
Stuart Sondheimer, M.D.
9150 Crawford Ave. Suite 201
Skokie, IL 60076
Call: (847)-677-2794
OBGYN Lincoln Park Chicago, IL
Sayeed Iqbal
1920 N. Lincoln Avenue
Chicago, Illinois 60614
Call: 312-787-3444
Specialities
- Acupuncture
- Alternative Medicine
- Bariatric Surgery
- Breast Cancer
- Breast Surgery
- Cancer Treatment
- Cardiology
- Chiropractic
- Cosmetic Dentistry
- Cosmetic Surgery
- Dentistry
- Dermatology
- Endocrinology
- Facial Enhancement
- Fertility Treatment
- Foot Specialist
- Foot Surgery
- Gastroenterology
- General Surgery
- Geriatrics
- Hair Replacement
- Hematology
- Infectious Diseases
- Infertility Treatment
- Integrative Medicine
- Internal Medicine
- LASIK
- Laser Hair Removal
- Medical Editorial Board
- Medical Spa
- Medical Testing
- Neurology
- Neuropathy
- Nursing Home Services
- Nutrition and Diet
- Obstetrician & Gynecology
- Oncology & Cancer
- Oncology Center
- Ophthalmology
- Orthopedic Surgery
- Orthopedics
- Pain Management
- Physical Therapy
- Plastic Surgery
- Podiatry
- Spinal Decompression
- Spine Surgery
- Sports Medicine
- Stem Cell Therapy
- Thoracic Surgery
- Vascular Surgery
- Vein Surgery
- Weight Loss