Obesity Surgery Perth
Suresh had obesity surgery and lost 35kg in 9 months.
Whether you are overweight or obese, there are significant lifestyle and health challenges associated with excess weight. Obesity in Australia is a complex public health issue but, closer to home, it has a tough impact on quality of life, related to both negative social outcomes as well as medical concerns.
There are a range of medical interventions for obesity, including medications, psychological support and lifestyle changes, and a choice of bariatric surgeries.
Obesity vs overweight
For most Australians, a normal BMI is 20-25. If your BMI is over 25-29, it generally means that you have excess fat and are overweight. If your BMI is over 30, this means you are obese.
Obesity simply means a disease state where an individual has more fat than is considered normal. Both conditions, overweight and obesity, are manageable conditions.
Morbid obesity is when your weight is high enough to cause medical diseases or affect your health detrimentally. Obesity is considered to be morbid when your BMI is over 40.
Some of the chronic conditions and diseases associated with being overweight or obesity include the following:
- Insulin resistance
- High blood pressure (hypertension)
- Cardiovascular disease (heart disease)
- Some cancers including breast, endometrial and colon cancer
- Type 2 diabetes (non-insulin dependent diabetes mellitus)
- Gallbladder disease
- Infertility - female and male
- Polycystic ovarian syndrome
- Musculoskeletal problems such as osteoarthritis, joint problems and back pain
- Sleep apnoea
Calculate your BMI here.
What is morbid obesity?
How does weight loss surgery reverse diabetes?
Of all the obesity treatment options, the effect of weight loss surgery on diabetes is quite remarkable. Clients often find that their diabetes has gone into remission and they no longer need any medication.
We never use the word cured, as diabetes does seem to sit in the background and may come back at a later time. However, if we can put it into remission for 10-20 years, this is a major advantage to your health.
The way this happens is not known, but theories are:
- The hormonal effect of the surgery has a major influence on insulin production and insulin sensitivity.
- Reducing weight reduces insulin resistance, and this makes the available insulin work more effectively.
- Eating less means a lower carbohydrate load with meals, so the sugar load is not as great.
Weight loss surgery performed by an experienced bariatric surgeon is most effective if done quickly after a diagnosis. If the diagnosis of diabetes was made less than two years prior to surgery, there is an 80% chance of coming off all diabetes medication. Often, we also see that diabetes is improved and medication can be reduced. This means that the progression to requiring insulin injections is far less likely.
However, the effectiveness of bariatric surgery diminishes in people that have had diabetes for longer periods of time. We (and the Australian Diabetes Foundation) recommend having weight loss surgery as soon as possible after a diagnosis of diabetes is made.
Bypasses are slightly more effective in controlling diabetes, but they also have their drawbacks.
What are the criteria to have obesity surgery?
Generally, we will offer surgery to anyone who has a BMI of 35.
However, if your BMI is 30 or above, and you are starting to experience health issues related to your weight, then you may also be eligible.
Video: Candidates for bariatric surgery
How much weight can I expect to lose after weight loss surgery?
This question is a difficult one to answer easily. The amount of weight loss depends on many factors, including dietary choices, but the most critical element is how your body responds to the surgery. Some people lose a significant amount of weight whilst others don’t lose very much.
Nonetheless, the average weight lost following a sleeve gastrectomy at the 12-month time-point is frequently 70% of excess body weight. This may even be up to 80% if you have a MiniMizer ring with your sleeve.
Interestingly, the way your body responds to the surgery depends on your genetic make-up. This means that if you have a relative who has had surgery and done well, we expect that you will have a similar weight loss outcome.
How much weight will you lose? | Perth bariatric surgeons
Obesity in Australia: a disease
Obesity in Australia places a considerable burden on individuals. Importantly, it is also a complex long-term public health issue.
Apart from the massive direct cost to the Australian taxpayer via the healthcare system, there are indirect costs such as the impact on the workforce due to absenteeism and reduction in the available workforce due to morbidity or mortality.
There are significant amounts of money being funnelled into weight management programs across Australia. Despite this, it has been predicted that the rate of obesity will continue to rise steadily in Australia, putting even greater pressure on the healthcare system.
The prediction is that 83% of males and 75% of females who are 20 years and older will be obese by 2025. That is 16.9 million Australians.
Is Obesity a Disease or a Risk Factor?
This is the source of much debate amongst doctors, and a decision has not been made. I feel that obesity is a syndrome made up of different diseases and disease processes that make you put on weight.
Figuring out what makes an individual person put on weight is hard, but important, as this is where some of the therapy needs to be targeted. The causes of obesity can be different for each person. Surgery will drop your weight but its endpoint effectiveness relies on managing these other issues as well.
So What’s the Big Deal?
There is a terrible social stigma to being overweight, which creates many other issues for people struggling with excess weight. I believe that this is the most important issue, even more than the medical impacts I will outline now.
Obesity is a risk factor for many diseases and, unfortunately, it will shorten life expectancy. It’s when you look at the numbers that the truth sinks in. With a BMI of 40 or over your chance of getting to the age of 60 is just 76%. That is a one in three chance of dying by the age of 60. This is why the government allows you to access your superannuation fund
Medical complications of obesity
Video: What are the types of bariatric surgery
There are simple things you can do to create the right environment for a weight loss programme. In fact, addressing these issues may create some weight loss all on its own or, at the very least, minimize further weight gain.
- Eat well / healthy
- Sleep well
- Avoid stress
- Psychological health / help
- Avoid medications that make you put on weight
- Avoid social behaviours that cause weight gain
- Avoid food emulsifiers
About Obesity Surgery WA: Our 6 commitments
Taking surgery seriouslyWe know that entering into an operation is a big deal and we are very serious in getting the best outcome for you. We practice what is considered to be a world class standard. Our staff regularly attend national and international conferences and bring back what is the latest research and technology.
Running on timeOur Surgeons and all of our staff try their best to run on time. Although it's not always possible, our commitment is that we do our best. Your time is valuable and we respect that.
Readily availableOur surgeons (or at least one of them) are always available in a crisis. Some of them may provide you with a direct contact, but all are available through the hospital switchboard and happy to chat any time if there is a crisis.
An obsessive attention to detailWe do our best to not miss anything. Every stitch, every staple and every clip is applied to exactly where it needs to be with the greatest care possible.
Commitment to performing the best operation possibleNot all operations are the same and there a few extras that we do to make things better. We know that our results are better with the minimiser ring so we offer it to everyone. We know that reflux can be an issue so we try to tighten every oesophageal hiatus to make reflux control as good as possibly can be.
A commitment to new technologies
- We have brought in STRETTA into Western Australia, which we believe will revolutionise reflux management. (Have a look at the Stretta page for more information).
- SJOG Murdoch has just purchased a new DaVinci robot and we believe that this will allow us to do operations with keyhole surgery that previously needed a major laparotomy incision. Lynx is on the horizon and promises to also help manage reflux, we hope to have access to this in early 2020.
Meet our team
Dr. Harsha Chandraratna
Dr. Bill Gong
General and Laparoscopic Surgeon