By Rodrigo Diaz Guerrero
According to the World Health Organization, since 1975 obesity has nearly tripled worldwide. In 2016, more than 1.9 billion adults were overweight, of whom more than 650 million were obese. In our country, according to the National Health and Nutrition Survey (ENSANUT 2018), of all adults over 20 years of age, 39.1% are overweight and 36.1% obese, giving a worrying total of 75.2% of the population with abnormal accumulation of fat that can be harmful to health.
The main cause of this rise is lifestyle: the imbalance between energy consumption and expenditure. On the one hand, the sedentary lifestyle, the lack of physical activity; and on the other, the great supply of food products with high caloric density at low prices, among other factors. Fortunately, there are now effective ways to treat morbid obesity in people where traditional measures such as diet, medication, and exercise have not worked. We are talking about bariatric or obesity surgery, which contributes to solving comorbidities and improving the quality of life, since patients obtain several benefits, such as the reduction of blood pressure, blood glucose, cholesterol levels, and the elimination of sleep apnea.
What is obesity surgery? It is any procedure aimed at weight loss and the correction of comorbidities associated with it. There are currently two standardized procedures worldwide: the gastric sleeve and the gastric bypass. The first is a restrictive procedure, in which 80% of the stomach is removed, thereby ensuring that the patient eats less and is not hungry. The second is a malabsorptive procedure (which changes the way the digestive system works), in which the size of the stomach is also considerably reduced, creating a stomach approximately 4 cm in length, which is attached to a portion of the intestine.
Any person with a body mass above 35kg/m2 with some associated comorbidity, such as diabetes, hypertension, or sleep apnea, or any patient with a body mass index of 40kg/m2 or more is a candidate. These procedures are done through minimally invasive surgeries (with incisions of a maximum of 1 cm in length) with which there is a quick recovery, with a short hospital stay, with less pain and less bleeding.
The contrasted study of the upper digestive tract (esophagogram) is useful in postoperative bariatric surgery patients to determine the anatomy and volume of the gastric remnant in the early postoperative period (zero time), as well as to detect possible complications. Today in San Miguel de Allende there is a hospital team and top-level doctors, such as Dr. Armando Joya, with more than 20 years of experience in obesity surgery, together with Dr. Jaime González, specialist in surgery gastrointestinal and laparoscopy—specialists who are working at La Joya Hospital.
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