W E I G H T - L O S S S U R G E R Y
CHANGES LIVES AND IMPROVES HEALTH
For those who are severely overweight, weight-loss surgery - also called
bariatric surgery - may be the key to leading a happier, healthier life.
According to prominent Gold
Coast weight-loss surgeon,
Dr Harald Puhalla, bariatric
surgery is a proven, well-documented
method that has the potential to
save and change lives.
Science has shown that dieting compared to
surgery is much less successful, particularly
in the long-term. In one of the longest studies
to date, initiated in July 2000 with a 12-year
follow up period, researchers compared
bariatric surgery (gastric bypass) with
conservative management in obese patients.
The Weight and Metabolic Outcomes
12 Years After Gastric Bypass study was
published in the New England Journal of
Medicine in September, 2017.
The study showed that surgery was
associated with much greater weight-loss and
a diabetes cure rate of 51 percent but only
7 percent per cent of patients who received
usual care were in diabetes remission.
Dr Puhalla said that while diet and lifestyle
measures will always be the first attempt to lose
weight, bariatric surgery is an option for patients
who are unable to lose sufficient weight with
diet and exercise to achieve their health goals.
A new study shows there are financial
benefits to losing weight in addition to the
benefits to overall health. Researchers at the
Johns Hopkins Bloomberg School of Public
Health in the US released a report in September
that states that people can save up to $A40,000
within their lifetime if they lose weight.
Maintaining a healthy weight can result in
greater productivity, lower the risk of disease
and lower medical costs.
The World Health Organisation regards
obesity as a chronic disease, linked to coronary
heart disease, diabetes, cancer and fertility.
According to Dr Puhalla, obesity is
only partly caused by lifestyle factors
“Scientists discovered that there is a genetic
predisposition to obesity,” he said. “These
genetic factors in combination with poor food
choices and reduced physical activity make
it even harder to sustain a healthy weight.
“For those who would benefit to gain control
of their weight, bariatric surgery has become
a very safe treatment option which offers a
better quality of life, improvement or cure
from illnesses associated with obesity and
potentially longer life expectancy.”
Weight-loss operations are usually
performed laparoscopically (keyhole surgery).
The expected weight-loss is difficult to
predict and varies between patients. The sleeve
gastrectomy is the most common operation
performed for obesity in Australia. Patients
can expect to lose about 75 percent of excess
weight (weight above normal range) in the first
year and roughly 60 percent after five years.
Other procedures, such as Omega Loop
gastric bypass (mini gastric bypass), achieve
an excess weight-loss of around 85 percent in
one year and about 72 percent in five years.
Those who undergo the Roux-en-Y gastric
bypass, which is considered the “Gold
Standard” in weight-loss surgery, may lose
77 percent excess weight after one year and
69 percent after five years.
Patients who undergo revisional bariatric
surgery should expect less procedure specific
weight-loss.
Despite being the most successful tool
to sustain long-term weight-loss, bariatric
surgery is often called “the easy way out” for
people who are unable to lose substantial
weight with diets and exercise.
According to Dr Puhalla, it is
important to understand that for these
people, surgery is the only option to
achieve a healthy life.
“There is also the myth that bariatric
surgery is cosmetic surgery,” he said.
“Many people who are obese suffer
from depression due to a body-dysmorphic
picture.
“By losing significant excess
weight after surgery the physical
appearance changes resulting in increased
confidence.”
In the long term, after surgery when substantial
weight-loss has been achieved and people are able
to experience an active and happier life, it is highly
recommended to continue on regular multivitamins
and have annual check-ups.
Research has shown that this gives people the
best long-term outcome.
“A holistic approach, including a careful patient
assessment and recommending the best suitable
procedure and involvement of an experienced
team, is necessary to offer patients the best long-term
outcome,” Dr Puhalla said.
Dr Harald Puhalla | General Surgeon
36 | Pindara Magazine ISSUE 12 | 2018