Author Affiliation: Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern Medical Center, Dallas. Dr Livingston is also Contributing Editor, JAMA.
Since the time of intestinal bypass surgery and more recently with the use of Roux-en-Y gastric bypass (RYGB) and laparoscopic gastric banding procedures, some patients who had been morbidly obese for many years seek operative interventions for treatment of obesity. Except for being obese, some of these patients are otherwise healthy without apparent diabetes, hypertension, sleep apnea, or osteoarthritis. When these patients are asked why they want to subject themselves to the considerable risks of an RYGB or other procedures, a typical response is because “I don't want to die from obesity.” Why would such patients think they are going to die from being overweight when they have been obese for many years and, despite that, appear to be healthy?
Livingston EH. Inadequacy of BMI as an Indicator for Bariatric Surgery. JAMA. 2012;307(1):88-89. doi:10.1001/jama.2011.1950