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Bariatric Surgery Today
It is now common knowledge that the Centers for Disease Control and the American Medical Association consider obesity to be a high-priority medical problem. To combat the growing epidemic, bariatric surgery, which is indicated for 'severely' or 'morbidly' obese patients ' generally defined as a body mass index (BMI) over 40 (a 'normal' BMI is 19-25) ' has become increasingly popular. Surgery may also be indicated for patients with a BMI between 35 and 40, if there are significant co-morbid conditions.
Researchers have developed efficient and increasingly less invasive ways to treat severe or morbid obesity. Of these several different types, the most popular are gastric bypass and gastric banding. Gastric bypass generally produces more weight loss than gastric banding, but gastric banding is more easily reversed.
The development of gastric banding and laparoscopic gastric bypass procedures has moved bariatric surgery from a risky procedure performed at university medical centers to a more commonplace surgery. With the consequent shorter hospital stays required, health care insurers are increasingly willing to reimburse surgeons for performing the surgery. See generally, Heena, P., et al.: Trends in Bariatric Surgical Procedures. JAMA 2005; 294:1909-1917. Because of these combined factors, more surgeons are opening up 'bariatric surgery centers' and starting to advertise this still-risky procedure to the consumer public. Some observers fear that with increased reimbursement and a large potential patient population ' some estimates go as high as 61 million Americans ' some general surgeons will reinvent themselves as bariatric surgeons. Weighing Bariatric Surgery's Risks, Business Week Online, http://www.businessweek.com/bwdaily/dnflash/oct2004/nf20041028_0264_db092.htm.
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