Obesity is hard to treat

Surgery is the last resort when it comes to weight loss, well behind exercising and changing your diet. But even the National Institute for Diabetes and Digestive and Kidney Diseases, in the National Institutes of Health, says that severe obesity is a chronic condition hard to treat solely through diet and exercise.

Weight loss surgery is not approved for those under 18. And there are standards and restrictions for adults, based on guidelines set forth by the NIH in the early 1990s, according to Dr. O. Layton Alldredge, a surgeon at Alta View Hospital.

One must be twice the ideal body weight or 100 pounds over that ideal weight, or have a body mass index greater than 40. Someone who has type 2 diabetes or life-threatening heart or lung problems, such as severe sleep apnea or heart disease, could be a surgical candidate with a BMI between 35 and 40.

Alldredge and his colleague Dr. Darrin Hansen will be featured Saturday at the Deseret Morning News/Intermountain Health Care Hotline on weight loss and surgical options. From 10 a.m. to noon, the duo will answer phoned-in questions. All calls are confidential.

The list of medical problems that are related to being overweight is a lengthy one: High blood pressure, high cholesterol, joint disease, increased risk of stroke and certain types of cancers, infertility, gastroesophageal reflux, gall bladder disease and quality of life issues like depression and poor self-image are just some of them. Severely overweight people are at much greater risk of dying prematurely.

Given those illnesses and their human and financial toll, it's no surprise that studies have shown that the overall health care dollars spent on patients who have a weight-reduction operation, including the cost of the operation, are about the same as those who don't have such an operation but are severely overweight, Alldredge said.

Research has found that only 10 percent of people are able to maintain a diet after a year. For people who are morbidly obese, about 100 pounds or more overweight, most diet programs will not get them out of the high-risk category. They simply don't lose enough weight to not have the complications of obesity.

"Surgery is the last effort," Hansen added. "Any weight loss surgery is primarily for those people who have been unable to lose weight by any other means."