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Millions of individuals in the United States and around the world are overweight or obese (severely overweight). When weight increases to an extreme level, it is called morbid obesity. Obesity is associated with diabetes, heart disease, high blood pressure, some types of cancer, and other medical problems. Bariatrics is the field of medicine that specializes in treating obesity. Bariatric surgery is the term for operations to help promote weight loss. Bariatric surgical procedures are only considered for people with severe obesity (about 100 pounds overweight or a body mass index greater than 40) and not for individuals with a mild weight problem. The February 10, 2010, issue of JAMA includes an article about laparoscopic (surgery performed through tubes) adjustable gastric banding for severely obese adolescents. This Patient Page is based on one previously published in the October 19, 2005, issue of JAMA.
The body mass index (BMI) is a standard way to define overweight, obesity, and morbid obesity. The BMI is calculated based on a person's height and weight—weight in kilograms (2.2 pounds per kilogram) divided by the square of height in meters (39.37 inches per meter). A BMI of 25 or more is considered overweight; 30 or more, obese; and 40 or more, morbidly obese. Bariatric surgery may be offered to patients with severe obesity when medical treatments, including lifestyle changes of healthful eating and regular exercise, have not been effective.
Considerations for bariatric surgery
Individuals considering bariatric surgery must discuss risks and possible benefits with their doctor. Bariatric surgery has associated risks and long-term consequences and should be considered only one part of an approach to treating obesity. Most bariatric surgeons think that the operations work best when they help promote lifelong behavioral and dietary changes. Long-term follow-up with doctors experienced in the care of patients having these procedures, as well as lifelong vitamin supplementation, is essential to avoid life-threatening complications.
For more information
American Society for Metabolic & Bariatric Surgeryhttp://www.asmbs.org
Centers for Disease Control and Prevention, BMI Calculator http://www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm
To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: American Society of Bariatric Physicians, American Society for Metabolic & Bariatric Surgery, National Institute of Diabetes and Digestive and Kidney Diseases, American Obesity Organization, Centers for Disease Control and Prevention
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
Torpy JM, Lynm C, Glass RM. Bariatric Surgery. JAMA. 2010;303(6):576. doi:10.1001/jama.303.6.576
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