Surgery vs. Dieting for weight loss; which is more effective Essay Example

Surgery vs. Dieting for weight loss; which is more effective Essay Dieting is usually advised for the milder or moderate versions of obesity or being overweight.   The individual may be recommended dieting if the BMI is greater than 25 (suggesting overweight) or greater than 20 (suggesting obesity).   Studies have demonstrated that in such a situation, even a 10 % reduction in the body weight would help to remove the obesity-related risk factors (AOA, 2005).   The patient is given advice on the manner in which the diet should be modified to reduce the calorie consumption.   The individual has to moderate the consumption of calories (AOA, 2005).   It should be brought down within the 1000 to the 1400 Kcal limit in a day (Merck, 2005).   A calorie consumption of less than 1200 Kcal per day may be required for a short, especially before a surgery.   A diet below the 800 Kcal mark is usually not advised as it may be potentially harmful to the body (Merck, 2005).   The individual should consume larger amounts of fruits and fibers instead of calories, fats and carbohydrates.Further, the risk of CVS disease may get reduced if fish oils and certain monosaturate oils are consumed in moderated amounts (Merck, 2005).   The individual has to become calorie conscience and be able to read and understand the amount of calories present and the type of food from the labels.   The individual should adopt certain dietary patterns and habits to ensure that the weight loss is enabled.   The daily calorie consumption should be recorded in a diary.   The individual should stop keeping foods containing high calories in the house (AOA, 2005).   They should also reward themselves when they are able to achieve certain milestones or are able to exercise for longer periods or eat reduced quantities of food.   They should be able to set realistic targets of body weight loss and consumption of calories.   The individual is also advised to perform physical activity of moderate intensity for at least 30 minutes or longer everyday (AOA, 2005).Studies have demonstrated that through dieting a weight loss of about 5 Kilograms of body weight was possible.   Through an appropriate diet, the individual is able to reduce about 0.5 to I kilogram a week (Truswell, 1996).   An obese individual can tolerate a diet of up to 1000 Kcal a day without gaining body weight, and an obese individual who performs some physical activity can tolerate a body weight of 1000 to 1200 Kcal per day (Truswell, 1996).Gastric bypass (is also known as ‘bariatric surgery’ or â€Å"Roux-en-Y gastric bypass†) is a surgery meant for weight-loss and involves making a small pouch in the stomach so that the food consumption is reduced and a bypass is made so that it escapes being absorbed by the mucosa of the duodenum.   It can be performed by two means, namely conventional surgery and laparoscopic method (involves using a specialized tubular instrument that can be placed into the abdominal cavity to take snapshots of the structures and also perform maneuvers).   The procedure involves stapling a portion of the stomach to (containing a smaller pouch) to the jejunum (second portion of the small intestines).   The surgery involves creation of a smaller pouch for the stomach and hence, lower quantities of food are consumed.   As the duodenum is bypassed, the chance of it being absorbed is reduced and hence it is emitted into the large intestines (Trowers Jr., 2005).   The results of gastric bypass have been really magnificent (LAPSF, 2007).There has been an epidemic of obesity in the US, and more than 35 % are in fact overweight.   These individuals are at risk of developing several health problems such as heart disease, hypertension, diabetes, hypercholesterolemia, etc.   In the US non-invasive methods to cut down on body weight has been hugely unsuccessful and ineffective (Simpfendorfer, 2005).The trend for undergoing gastric bypass has increased significantly in the US.   The procedure was first introduced in the US by Mason in 1967, and was later modified by Alden in 1977.   In 2002, about 80, 000 such surgeries were performed and in 2003 this figure crossed the 100, 000 mark (Simpfendorfer, 2005).   Several reasons have been attributed for this trend.   Firstly, laparoscopy has simplified the procedure and has reduced the risk of developing several unfavorable outcomes.   The healing period and the hospitalization has been significantly reduced, and presently physicians are looking at the possibility of conducting it on an outpatient basis.   The media are popularizing gastric bypass by suggesting it as an effective means to reduce obesity (Townsend, 2002).There are several limitations to gastric bypass surgery.   The individual should be completely evaluated including mental status examination performed so that their ability to cope up with the problems that develop during and after surgery is determined.   Only if the individual is physically an d mentally prepared to undergo surgery, should it be performed.   Besides, pre-surgically and post-surgically, the individual should be able to follow certain nutritional measures, fluid intake, daily activities, physical exercises, smoking and medication consumption (Mayo, 2006).   The conventional bypass surgery is performed in two stages.   In the first stage, the large stomach is converted into a small pouch, which is the size of a walnut to hold about an ounce of food.   The small intestines are then cut at a point slightly beyond the duodenum, and the mucosa of the newly created functional stomach and the small intestines are sutured together (Mayo, 2006).   The disconnected end of the small intestines (Containing the old stomach which secretes gastric HCl and important enzymes) is then connected to a point slightly beyond the duodenum, bypassing three to four feet of the small intestines.This creates a ‘Roux limb’ or a ‘Y-shaped connection’ (LAPSF, 2007).   Another problem closely related to the gastric bypass operation is that vital nutrients that are required by the body may not be properly absorbed by the intestinal mucosa, and may create a deficiency or a disturbance in the body.   Hence, the individual should be closely monitored to observe if such problems do develop (Trowers Jr., 2005).   Gastric bypass has utilizes a special tip present in the laparoscope to visualize and incise the mucosa and perform the maneuvers that are performed in the conventional operation.   The advantage of such a procedure is that as the incision performed over the skin is much smaller and the trauma that can develop from the operation is minimal, thus ensuring that the healing period is reduced and the patient can recover within a rather short period of time.   However, the limitation associated with this procedure is that in extreme cases laparoscopic surgery has to be avoided as the chances of risk are realistically high er.   Besides, the surgeon should have a high level of competence, knowledge and skill to perform laparoscopic surgery (Mayo, 2006).Gastric bypass is also known to bring about weight loss as digestive tract increases release of certain substances that control the appetite encourages weight reduction.   Neurotensin is substance that reduces gastric and intestinal motility and also lowers gastric secretions.   Gastric bypass was more effective than any other weight losing surgery such as gastric banding (placing a band around the stomach so that the a smaller pouch is created) (Christ-Crain, 2006).Although gastric bypass is very effective in helping to reduce obesity, it cannot be performed in all cases, as the chances of complications and risks are very high.   Frequently, the surgeon should weight the risks along with the benefits, and only if a clear benefit exits, should it be performed.   Some of the complications that can develop include bleeding, gallstone formation, gastritis, infections, nausea, vomiting, nutritional deficiency, bloating, surgical hernia, intolerance to food, excessive scar formation, diarrhea, dizziness, tiredness, fatigue, loss of hair, feeling cold, etc.   Only if the individual has a severe and resistant form of obesity that has shown resistance to exercises and diet therapy, should it be performed.   It can be performed only if the BMI has crossed 40 and in case of individual with certain generalized diseases such as diabetes has crossed 35.   The individual has to follow certain dietary precautions, be physically active and adapt to a new lifestyle, following gastric bypass so that the outcome or the result is successful (Trowers Jr., 2005).Elders who have undergone gastric bypass surgery may not be able to tolerate the procedure and are at a higher risk of fatal outcomes.   Clots can form in the veins of the legs leading to pain and swelling.   These clots may dislodge and get deposited into the lungs causing ‘pulmonary embolism’.   Chest pain, breathlessness, difficulty in breathing, etc, may develop.   At the site of surgery, a leakage may occur resulting in infection and may also require corrective surgery.   Leakage is more common in gastric surgery compared to conventional (Townsend, 2002).   The newly created pathway of the digestive tract may also get obstructed (Mayo, 2006).Individuals whom undergo gastric bypass surgery have to follow several precautions.   They may have to consume a liquid or a semi-liquid diet for several weeks after the procedure.   Initially, they should consume lower amounts of foods, as the stomach can accommodate only lower quantities.   Over a period of time, they can increase their consumption.   The individual should also avoid consuming too much of alcohol, fat and sugars, along with staying away from junk and fried foods (Trowers Jr., 2005).The results of gastric bypass are quite amazing.   An individual can lose up to 10 pounds a month, and the most important part is lost during the first few months after the procedure (Trowers Jr., 2005).   Studies have demonstrated that the individual is capable of losing 50 to 70 % of their excessive body weight within the first 2 years after the surgery.   Weight may be lost on two mechanism, one is that the stomach feels full faster with lower quantities of food and the nutrients consumed in the diet are lost as the duodenum is bypassed (LAPSF, 2007).A study was conducted to determine the effects of surgical and non-surgical methods in treating obesity.   It was observed that surgery was only slightly effective in reducing obesity compared to dieting.   The risks associated with surgery were also higher compared to dieting (HSTAT, 2003).   Another study was conducted to determine the effect of dieting when performed alone or in combination with surgery.   After a 2 year interval, their weight losses were compared, and it was observed that those i ndividuals, who underwent surgery, benefited the most when dieting was followed.   In a Swedish trial that underwent surgery or dieting to reduce obesity, it was found that thaws treated with surgery lost more than 20 kilograms of weight in comparison to a smaller amount by dieting.   The difference between surgical and non-surgical benefits was a 10 kilogram loss of body weight (HSTAT, 2003).   Fatalities following gastric bypass is fairly common (0.3 to 1 %) and may occur due to anatomical leakage, embolism, cardiac problems, etc.   Individuals above the age of 50 years are at a higher risk of developing fatalities and complications.   Severe complications occur 15 to 24 % of all cases (HSTAT, 2003). Wernicke’s encephalopathy can be frequently related to chronic vomiting.   This could result in associated depression which could result in a further weight loss.   Overall failure rate of gastric bypass is about 10 % (Townsend, 2002).From the current literature a vailable, it can be seen that surgery is only slightly more effective in reducing obesity compared to dieting.   Besides, dieting is also required along with surgery to lose body weight in a more efficient manner.   Surgery is more helpful in losing body weight over a long-term period compared to dieting.   As surgery is more effective in losing body weight, it is frequently suggested for treating severe and resistant versions of obesity.   However, the risk factors associated with surgery are higher and may even be life-threatening.   Hence, it can be suggested only in cases in which the risk is completely evaluated.   It may have to be avoided in individuals who are very old or who are mentally not able to tolerate the procedure.   For surgery to be more effective, it should be performed along with diet therapy.   This goes on to show the importance of dieting.   Further research needs to be conducted to determine the benefits and risks of surgery and dieting in treating obesity.