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Morbid Obesity - The Disease Morbid obesity is a chronic disease which is multifactorial including genetic predisposition, environmental factors, socioeconomic factors, cultural influences, hormonal influences and digestive abnormalities. In the United States over 300,000 related deaths are noted per year and has quickly become the second leading cause of preventable death in our country. 25% of our children under the age of 16 are approaching morbid obesity. In the United States the morbid obesity represents 5.7% of all our health expenditures or a hundred billion dollars a year. Current trends in our country recognize morbid obesity as becoming an epidemic and leading to major crisis in our near future. The lack of public awareness, uninformed healthcare providers and prejudice toward the morbidly obese severely cripple our ability to effectively treat patients for morbid obesity. Why is morbid obesity treated by surgery? Unfortunately, conventional methods toward weight loss that include exercise, behavioral modification, and weight loss programs have proven to be ineffective. Less than 5% of patients who embark on any combination of conventional measures toward weight loss are successful. The surgery is the only proven treatment with adequate long-term outcome for morbid obesity. Moreover, it is recognized as the only effective treatment for morbid obesity that reduces comorbid diseases that seriously decrease a patient's life span These include diabetes, hypertension, coronary artery disease, sleep apnea, stroke, pulmonary embolism and depression. There are many comorbid diseases that are associated with morbid obesity that include all of the above mentioned. Other comorbid diseases include asthma, arthritis, gastroesophageal reflux disease/heartburn, gallbladder disease, hypercholesterolemia, stress urinary incontinence, and chronic fatigue, depression. Orthopedic problems are very commonly associated with morbid obesity with increase in frequency and severity over time and over relative weight. Early arthritis in the weight bearing joints, chronic hip, knee, ankle and foot pain, and herniated disc disease. Other associated comorbid problems include infertility, breast cancer, uterine cancer, prostate cancer and colorectal cancer and cirrhosis. Medical treatments including diets, exercise, behavior modification and pharmacological treatments have all been proven to fail. Diets results in short-term results with modest loss. Long-term results at one year reveal no significant change in over 90% of patients. Exercise programs are good for maintenance and well-being, however there is a minimal response in weight loss without diet modification. Unfortunately, the combination of diet and exercise once again have poor long-term results. Behavioral modification is also a good adjunct to the maintenance of weight loss, however produces very poor results on its own. Various pharmacological approaches have surfaced over the last decade. Unfortunately, these are often associated with undesirable side effects and poor long-term results without continuance of medication. The long limb Roux-en-Y gastric bypass procedure has shown to be an effective method of weight loss with significant long-term results and a high probability of maintenance of weight loss and decrease in comorbid problems.  Back to Top
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