3. WHAT ARE THE DISEASES MOST FREQUENTLY ASSOCIATED WITH MORBID OBESITY ?
Obesity is a serious public health problem due to its relation with chronic diseases. They are present in 83% of cases and may be grouped as follows:
Psychological and social problems in daily life:
Frequent discrimination when seeking a job and difficult relations with other persons. Frequent rejection of the body image entailing anxiety and depression associated to a solitary life full of complexes.
Animation:
Diseases caused by Cardiovascular Risks:
High cholesterol and/or triglycerides, arterial hypertension, diabetes, difficulty in breathing. They cause a greater risk of vascular brain damage, congestive cardiac insufficiency and coronary problems.
According to the British Medical Journal (1997; 315; 912-917), "... weight control must be an objective as important as the regulation of HTA".
The American Heart Society included obesity among the major risk factors of suffering a myocardial infarction (circulation 1998) According to the New England Journal of Medicine (1998; 338): "Those overweight are at an increased risk of death due to a cardiovascular disease as obese patients when aged between 30 and 40 years old".
Tumours: mainly of uterus, breast, colon and bladder among others.
Sudden Death Syndrome: Greater occurrences of inexplicable sudden death than in the non obese population aged less than 40 years old. (Source: New England Journal of Medicine 1998; 338: 1-7).
Sleep Apnea Syndrome (SAS): These patients are sleepy during the daytime with deterioration of intellectual capacities and a greater emotional irritability. At night they snore noisily and their lengthened breathing pauses puts them at risk.
Osteo-articular Degenerative Processes (osteoporosis, arthritis) at the lumbar level and at the extremities, causing major immobility.
All these reasons support consideration of
a resolute and efficient treatment of this disease.
We would like to add that to date there are enough works showing the inefficiency of conservative, which is non-surgical weight loss treatments. In 1991 the US National Health Institute qualified the results obtained through surgery as very positive and concluded that the outcomes and benefits of these techniques were greater than the intrinsic risks of the procedure.
Almost all the studies published upon the effects of diets, physical training and behavioural therapies and drug treatments mentioned an average loss of less than 15 kilos. This was recently described as a "yo-yo" phenomenon, meaning that the intent of those patients to lose weight was followed by a weight gain sometime even greater than the loss.
To summarise one can say that:
Morbid obesity generates a great number of processes leading the patient to progressive deterioration and a premature death. It is therefore clinically and ethically valid to introduce a surgical procedure with specific individuals provided the results of a specific given technique have proven effective and successful.
The major health costs deriving from the associated immobility makes a valuable surgical procedure of the morbid obese recommended, given its efficiency.
Obesity is a serious public health problem due to its relation with chronic diseases. They are present in 83% of cases and may be grouped as follows:
