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Improvements or Resolution of Comorbidities
Depression
Excessive weight gain is often a symptom of an underlying emotional dysfunction. Depression, boredom, loneliness, chronic anger, anxiety, frustration, stress, unsatisfactory interpersonal relationships, and poor self-esteem can result in excessive eating and subsequently unwanted weight gain.
The objective of diet, exercise and behavior modification, pharmacologic therapies and weight loss surgery in morbidly obese patients is not only the reduction of their BMI, but also the improvement or resolution of the concomitant psychological and social restrictions these patients face. Overweight or obese individuals often experience social stigmatization and discrimination in employment and academic situations, as well as activities of daily living, like shopping, traveling, and restaurant dining.
Patients who have undergone Gastric Band procedure, have reported an enhanced quality of life (QOL).19,3
Laparoscopic adjustable gastric banding surgery has been found to significantly improve patient's QOL. One hundred and seventy-nine patients who had Gastric Band procedure lost a mean percent excess body weight of 45.7% (+/-17.1) during the first year and saw major improvements in their depression and a remarkable decline in their medication usage. Likewise, another study found that after 4 years, the rate of cure/improvement of self-esteem was 45%/39%. Weight loss following Gastric Band procedure was associated with significant improvements in depression, appearance evaluation and health-related QOL in a study of 50 patients with diabetes.2,3,5
InfertilityRelevant Links:
Physician Resources—DepressionStandards of Care—Depression
Resolution of co morbidities References:
1.Obesity in the U.S. American Obesity Assocation.http://www.obesity.org/subs/fastfacts/obesity_US.shtml.
2.Dixon JB, O’Brien PE. Health outcomes of severely obese type 2 diabetic subjects 1 year after laparoscopic adjustable gastric banding. Diabetes Care. 2002;25:2:358-363.Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547-559.
3.Ahroni JH, et al., Laparoscopic adjustable gastric banding: weight loss, co-morbidities, medication usage and quality of life at one year. Obes Surg. 2005;15:641-647.
4.Spivak H, et al., Weight loss and improvement of obesity-related illness in 500 U.S. patients following laparoscopic adjustable gastric banding procedure. Am J Surg. 2005;189:27-32.
5.Frigg A, Peterli R, Peters T, Ackerman C, Tondelli P. Reduction in co-morbidities 4 years after laparoscopic adjustable gastric banding. Obes Surg. 2004;14:216-223.
6.Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Management of Obesity in Diabetes, S77-80. Available at: http://www.diabetes.ca/files/cpg2008/cpg-2008.pdf.
7.Centers for Disease Control and Prevention Web site. National diabetes fact sheet: general information and national estimates on diabetes in the United States, 2005. Available at: http://www.cdc.gov/diabetes/pubs/factsheet05.htm. Accessed June 20, 2007.
8.Dixon JB, et al., Adjustable Gastric Banding and Conventional Therapy for Diabetes Type 2: A Randomized Controlled Trial, JAMA 2008;299(3):316-323
9.Ponce J, Haynes B, Paynter S, et al. Effect of Lap-Band-induced weight loss on Diabetes Type 2 mellitus and hypertension. Obes Surg. 2004;14:1335-1342.
10.Littner M, Alessi C. Obstructive sleep apnea: asleep in our consciousness no more. Chest. 2002;121: 1729-1730.
11.Fritscher LG, et al., Obesity and obstructive sleep apnea-hypopnea syndrome: the impact of bariatric surgery. Obes Surg. 2007;17:95-99.
12.Morgenthaler TI, et al., Practice parameters for the medical therapy of obstructive sleep apnea. Sleep. 2006;29:1031-1035.
13.Dixon JB, et al., Sleep disturbance and obesity: changes following surgically induced weight loss. Arch Intern Med. 2001;161:102-106.
14.Ong KL, et al., Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension. 2007;49:69-75.
15.Beuther DA, Sutherland ER. Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Respir Crit Care Med. 2007;175:661-666.
16.Dixon JB, O’Brien PE. Gastroesophageal reflux in obesity: the effect of Lap-Band placement. Obes Surg. 1999;9:527-531.
17.Clearfield MB. The national cholesterol education program adult treatment panel III guidelines. J Am Osteopath Assoc. 2003;103:S1-S5.
18.Gordon C. McCarter GC. Wrestling the beast: obesity, metabolic syndrome, diabetes, and related disorders Medscape. 2006; http://www.medscape.com/viewprogram/5352
19.American Obesity Association Web site. Health effects of obesity. Available at: http://obesity1.tempdomainname.com/subs/fastfacts/Health_Effects.shtml. Accessed April 20, 2007.
20.American Society for Reproductive Medicine Web site. Patient’s fact sheet: weight and fertility. Available at: http://www.asrm.org/Patients/FactSheets/weightfertility.pdf.
Accessed June 20, 2007.
21.Agbaje IM, et al., Insulin dependant diabetes mellitus: implications for male reproductive function. Hum Reprod. 2007;1-7 [epub ahead of print].
22.Sugerman HJ. The pathophysiology of severe obesity and the effects of surgically induced weight loss. Surgery for Obesity and Related Diseases. 2005;109-119.
23.Dixon JB, et al., Pregnancy after Lap-Band surgery: management of the band to achieve healthy weight outcomes. Obes Surg. 2001;11:59-65.
24.The American Urogynecologic Society Web site. Female urinary stress incontinence: overview. Available at http://www.augs.org/i4a/pages/index.cfm?pageid=208. Accessed on May 16, 2007.
25.Carroll JF. Lap Band gastric bypass surgery improves insulin resistance. The American Physiological Society Web site. Available at: http://www.the-aps.org/press/journal/07/29.htm. Accessed June 20, 2007.