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Medically, the word "morbid" means causing disease or injury. Morbid Obesity is a serious disease process, in which the accumulation of fatty tissue on the body becomes excessive, and interferes with, or injures the other bodily organs, causing serious and life-threatening health problems, which are called co-morbidities.
Morbid Obesity is also called Clinically Severe Obesity, and is recognized by the consensus of medical opinion as a very serious health problem, a disease process. In most cases, the underlying cause is genetic -- you inherit the tendency to gain weight, and once the problem is established, there is very little that will power can do about it -- any more than a diabetic might control his blood sugar by will power.
How do we know it's genetic?
Numerous scientific studies have established that there is a very powerful genetic predisposition to Morbid Obesity:
- Children adopted at birth show no correlation of their body weight with that of their adoptive parents, who feed them, and teach them how to eat. They show an 80% correlation of their body weight with their genetic parents, whom they have never even met.
- Identical twins, with the same genes, show a much higher similarity of body weights, than do fraternal twins, who have different genes.
- Certain genetic populations, such as the American Indians of the Southwest, have a very high incidence of severe obesity. They also have a markedly increased incidence of diabetes and heart disease.
- Mice can be bred, which are very obese (they look like little powder puffs). This is the result of a defect in a single gene, called the ob gene, which is associated with the ability to make a hormone, called leptin. The problem in humans is much more complicated genetically, with over 100 genes involved in some aspect of obesity.
- Another hormone has recently been discovered, called ghrelin, which stimulates appetite in normal persons. Persons who lose weight by dieting have persistently elevated ghrelin levels, urging them to eat more. Persons who undergo a gastric bypass have a decrease in ghrelin levels by about 77%, indicating one mechanism of how the operation reduces appetite.
We use three criteria:
- Are you more than 100 lb over your "ideal body weight"? This is a weight established actuarially, at which you are likely to live the longest, not what you wish you could weigh - which is usually less.
- Another alternative criterion is called the Body Mass Index (BMI). If this is greater than 40, surgery should be considered. If it is greater than 35, and is accompanied by serious co-morbidity, surgery may be indicated. To find out your BMI, and visit a very informative site, visit Dr. C.Everett Koop's Shape-Up America site.
- Do you have co-morbidities of your serious overweight? We look for health effects that are known to be caused by, or aggravated by serious obesity. (See Health Effects of Serious Obesity).
- Have you tried dieting, especially medically-supervised dieting, and been unable to achieve a sustained healthy body weight. Everyone knows diets don't work in the morbidly obese, and there has actually never been a scientific study reported which shows that they do, but you should at least have tried it.
What can you do to regain your health?
- You could go on another diet. Unfortunately, although diets work for a little while, the effects seldom last, and the answer to Morbid Obesity really needs to last a lifetime. No diet program, even the drug programs such as the Phen-Fen, or Redux, programs, are sufficiently powerful, or adequately long-lasting, to produce the necessary sustained weight loss in the severely obese. There has never been a scientific study which has shown that dietary management is beneficial or effective, over the long term, in the severely obese person.
- You could look at how much your health is at risk, and consider taking some risk now, to achieve a more lasting solution: surgery to change your body's physiology, and to help you to gain control of your weight.
In our opinion, surgery is the only effective way to achieve lasting weight control, and a healthy body weight.
A person who chooses surgery can reasonably anticipate loss of at least 50% of excess body weight (average loss is 80%), as well as improved health, and the chance to live life in a normal-sized body.