What is obesity?

Obesity results from the excess accumulation of fat that exceeds the body's skeletal and physical standards. According to the American Obesity Association, obesity is a disease. Obesity is defined as being 20% or more over ideal weight (BMI >25). Ideal weight is the weight associated with the longest life. Ideal weight tables show the ideal weight as it relates to gender and height. There are different tables and some controversy over what actually is ideal weight but a commonly used table is the 1983 Metropolitan Life Insurance Table. A rule of thumb often used by physicians to calculate ideal weight is to allow 100 lbs. for the first 5 feet of a woman's height and 5 lbs. For each inch over 5 feet. For men it is 106 lbs. For the first 5 feet and 6 lbs. For each inch thereafter.

Example: A 5 foot 6 inch woman should therefore weight 130 lbs.

Doctors need a method to determine the general healthiness of a patient, and that's where BMI comes into play. BMI stands for Body Mass Index. It's a scientific method that uses your weight and height ratio to calculate your body fat percentage.

BMI is derived by dividing your weight (in kilograms) by the square of your height in meters. Please visit your doctor for an accurate reading.

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What diet plan or pill works the best?

ObesityCare.com's mission is to provide information about severe obesity and the treatment there of. We are assuming that you are obese or morbidly obese and have tried to change your behavioral factors (diets and exercise) without success and are interested only in treatments that address the biological factors in your body that are outside your control. We suggest that you contact your doctor to get more information about any diet plans, weight loss products and specific bariatric surgical procedures such as the lap band.

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What is morbid obesity?

Morbid obesity is a much more severe form of obesity. A person who is 100 or more pounds overweight or twice the ideal body weight and has a BMI of 40 or a BMI of 35 with multiple co-morbidities is morbidly obese. Morbid obesity affects an estimated 9 million Americans.
Morbid obesity is a common condition that can have profoundly negative health and social consequences. It is considered a serious disease and has been linked to shortened life expectancy. Most morbidly obese patients are candidates for the various forms of weight loss surgery (restrictive - lap band, Roux-en-Y Gastric Bypass surgery (stomach stapling), Gastroplasty, or Malobsorbtive - biliopancreatic diversion, Duodenal Switch). According to C. Everett Koop, M.D. former Surgeon General of the United States, obesity is the second leading cause of preventable death in America! And more and more insurance companies are realizing that weight loss surgery is not a cosmetically motivated treatment but instead a life saving weight loss surgery treatment making weight loss surgeries such as gastric bypass or Lap Band financially affordable to those in need.

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What is the difference between overweight and obese?

An adult is considered "overweight" when he/she is above a healthy weight, which varies according to a person's height. An individual is overweight when their BMI is between 25–29.9. The standard used by researchers to define a person's weight according to their height is "body mass index" (BMI).

An adult with a BMI of 30 or more is considered obese. For example, for a 5'4" woman, this means that she is 30 or more pounds over her healthy weight.

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I am obese with health problems, can you help me?

ObesityCare.com is designed exactly for you. We walk you through the process of learning about yourself so that you can make informed choices about various weight loss surgery procedures. Many of us don't want to know the facts about our health but it can be a matter of life and death! So spend a little time and read these sections starting with: "Focus on yourself first", "Understanding the options", "Obtain outside support and commitment", and "Choose your path and take action".

Once you gain a better understanding about yourself and your options you need to take the initiative and go to ObesityDirectory.com and choose an obesity care facility that is best for you. You can either submit your information directly to the facility so they may contact you and make an appointment.

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Is my back pain caused by my weight?

Obesity - especially morbid obesity - greatly increases your risk of chronic musculoskeletal pain, specifically low back pain. As well as osteoarthritis and other degenerative conditions, a number of other pain and problems in the low back may be aggravated by obesity. Back pain frequently occurs as a result of the excess weight pulling the pelvis forward which strains the lower back. Fact sheets from the American Obesity Association indicate that women who are obese or who have a large waist size are especially at risk for lower back pain. To learn more about your spine and lower back pain, you can visit www.LASpineInstitute.com

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Can you do my lap band or gastric bypass surgery?

ObesityCare.com's mission is to provide information about severe obesity and the treatment there of. Our service is informational only. To find a doctor who can do your gastric bypass surgery or lap band procedure, we recommend using ObesityDirectory.com. It is a nation wide directory (United States) and all of the bariatric surgeons listed are members of the American Society for Metabolic & Bariatric Surgery (ASMBS). Simply pick a treatment facility near you and submit your information, the facility will get back to you or you may call their office directly and ask to make an appointment. They would be glad to help you.

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How can I get help in treating my obesity?

We recommend using ObesityDirectory.com. It is a nation wide (United States) directory and all of the bariatric surgeons listed are members of the American Society for Metabolic & Bariatric Surgery (ASMBS). Simply pick a treatment facility near you and submit your information, the facility will get back to you. They would be glad to help you.

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How do I find out about clinical trials?

We recommend using ObesityDirectory.com to choose a doctor, then ask your doctor about any clinical trials that you may be eligible for. They would be happy to help you.

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What are some of the reasons why a doctor might not treat me?

• BMI is too low.
  
• Failure to keep a scheduled pre-operative seminar or appointment without advance notification. The lack of commitment might identify the patient who won’t follow through with post-operative visits and instructions.
  
• Failure to comply with sample menus and diet assignments.
  
• Failure to recruit and bring along a support person.
  
• Failure to stop smoking 6 weeks before surgery (a blood test for nicotine can be checked prior to surgery).
• Failure to attend a support group meeting before surgery.
• Risk is too high due to existing co-morbidities, (health problems) adding increased risk of complications during and after the surgery.
• Perceived lack of understanding of or commitment to the life-long dietary restrictions created by this major operation.
  

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How can I find a doctor near me?

We recommend using ObesityDirectory.com. It is a nation wide directory and all of the bariatric surgeons listed are members of the American Society for Metabolic & Bariatric Surgery (ASMBS). This means they are general surgeons who specialize in bariatric surgery and are diplomats of the American Board of Surgery or Fellows of the American College of Surgeons or Royal College of Surgeons. The purpose of the Society is to advance the art and science of bariatric surgery by continued encouragement of its members to:

• Pursue investigations in both the clinic and laboratory
  Interchange ideas, information and experience pertaining to bariatric surgery
  
• Promote guidelines for ethical patient selection and care
  
• Develop educational programs for physicians, paramedical persons and lay people
  
• Promote outcome studies and quality assurance

New surgeons are added regularly, so please check back if you don't locate one near you.

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My child is obese, nothing seems to work, what should we do?

It is generally recommended that you take your child to your pediatric doctor and have a complete a physical assessment done to insure the obesity is not caused by physical problems. If there are no physical problems identified by your pediatrician, they will usually recommend the modification of external factors. Here are some very basic ways to do this:

• Set a reasonable weight-loss goal Initially, 5 to 10 lb, or a rate of 1 to 4 LB per month.
  
• Obtain a dietary management prescription specifying total number of calories per day and recommended percentage of calories from fat, protein and carbohydrates from your pediatrician.
  
• Begin physical activity according to child's fitness level, with ultimate goal of 20 to 30 minutes per day (in addition to any school activity).
  
• Support your child's behavior modification process through self-monitoring, nutritional education, stimulus control, modification of eating habits, physical activity, attitude change, reinforcements and rewards.
  
• Review your families activities and television viewing patterns; involve everyone in nutrition counseling.

There are comprehensive weight management programs for children and adolescents which should be attempted before weight loss surgery is even considered. One such facility is the Cincinnati Weight Management Center at the Children's Hospital Medical Center.

But not all children succeed in the behavior modification fight against obesity. When supervised behavioral and nutritional weight control strategies do not result in sustained success, bariatric surgery may be an option - consult your doctor.


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What is the cost of weight loss surgery?

Gastric Bypass surgery or stomach stapling usually requires a 2-4 day hospital stay and 3-6 weeks recovery time depending upon the type of work you do. The cost of bariatric operations can usually range from $17,000 to $25,000 and although many patients have had to fight for coverage, more insurers are beginning to pay, recognizing that the surgery can save them money in the long run. If

Lap band surgery is performed laparoscopically, patients typically spend less than 24 hours in the hospital. It takes most patients about a week to return to work and a month to six weeks to resume exercising. In the case of open surgery or if there are complications, recovery may take longer.

Some patients may choose to pay for the weight loss surgery themselves. There are two fees to consider, one for the bariatric surgeon and another for your hospital stay.

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Will my insurance cover weight loss surgery?

If you're lucky, the weight loss institution you choose will handle insurance matters for you. In any event, you might be surprised to learn that many insurance companies will cover the treatment of health problems caused by obesity but not obesity itself. So it is a good idea to have a basic understanding of what your insurance will cover prior to setting up a meeting with a bariatric surgeon. The Obesity Law and Advocacy Center has laid out 10 basic steps to provide some fundamental guidance to both patients and practitioners who want to get insurance claims approved the first time! (Read the article) Many health insurance companies will cover much of the cost for stomach stapling procedures. We recommend you contact your insurance company directly or find a doctor/obesity care facility and let them determine what weight loss surgery procedures and level of coverage you are eligible for.

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What if I don't have health insurance?

If you do not have insurance, don't give up! You still may have a couple options available in obtaining treatment. One is simply finding a way to pay for the surgery your self. Some doctors can work with you on their pricing or payment plans.

Another option is to look for obesity related clinical trials that you may be a candidate for; the study sponsor (whether it is the government or a pharmaceutical or biotechnology company) usually provides the new treatment at no cost and pays for special testing or extra doctor visits. Some sponsors may pay for more than this; for example, some may offer to compensate for travel time and mileage. It will still require time, effort, risk and some cost on your part.

Clinical trials - research studies with people, are needed to explore new ways to treat people. Doctors conduct a clinical trial to learn whether a new treatment is safe and effective. Even the doctors in charge of the study don't know ahead of time how things will turn out.

To learn more about clinical trials visit ClinicalTrials.gov, you will also find obesity specific clinical trials there as well.

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How safe is the lap band or gastric bypass surgery (stomach stapling)?

Like every operation, there is a risk. Because you may already have health-related problems, there is an increased risk of complications. Your doctor should thoroughly screen you to make sure that there are no surprises on the operating table.

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How long will I be in the hospital after weight loss surgery?

The average stay is three to four days.

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Can all types of bariatric surgery be performed laparoscopically?

Theoretically all kinds of surgical procedures for obesity such as laparoscopic gastric bypass, the lap band (laparoscopic adjustable banding), stomach stapling (gastric bypass), and other weight loss procedures can be performed laparoscopically (also called minimally invasive surgery), because it is performed through very small incisions and because postoperative hospital stay is shorter and recovery is quicker. However, only the lap band (adjustable gastric banding) is routinely performed using this approach.

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When can I go back to work after the weight loss surgery?

This really depends on the type of weight loss surgery you have and the type of job you do. For lap band surgery the procedures are usually done laparoscopically and don't require stapling or rearranging of your stomach anatomy, thus your hospitalization is usually less than 24 hours. And your recovery can be as little as a few days. For gastric bypass surgery, most patients can proceed with a regular activities after 6 weeks. If you work in a low-impact office, you may be able to go back to work after 3 weeks. If you are a construction worker, you may be able to go back after 6 weeks. Each patient heals on their own time, so everyone will recover on their own time.

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Will I still be able to get pregnant?

Most doctors will strongly recommend for you to not get pregnant after your first year of the operation. Most of the excess weight is lost during this time. Your fetus' health may also be endangered.

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Can I drink alcohol?

Please consult your physician regarding use of alcohol.

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What can I do about extra skin and stretch marks?

Many patients opt for plastic surgery, but we recommend you wait until you reach your ideal body weight before any plastic surgery.

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How soon can I exercise after the gastric bypass surgery (stomach stapling) or lap band operation?

After the stomach stapling surgery, most doctors recommend you exercise to help you lose the weight more quickly. Regular exercise can usually proceed after 6 weeks, but consult your doctor.

If the lap band surgery is performed laparoscopically, patients typically spend less than 24 hours in the hospital. It takes most patients about a week to return to work and a month to six weeks to resume exercising. In the case of open surgery or if there are complications, recovery may take longer.

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Do I have to take medicine after surgery?

Your body needs to receive the proper vitamins in order to survive. Your doctor will also go over with you any medicines you need to take. Most patients actually stop taking their medication from pre-surgery because they are healthy!

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What kind of foods will I be able to eat and drink?

Stomach Stapling: Usually right after the operation, you are put on a strict menu of liquid foods. You will be on a strict diet plan while you heal. The doctor will let you know what foods you will be able to eat and when you start eating them. Most patients become lactose intolerant after the operation. Your obesity treatment facility should work with you after the operation to change your diet and show you which foods are good for you and which are not. You will eat whatever you want, but in small portions. Even so, your appetite will feel satiated, and you will not feel hungry.

Lap Band Treatment: After your stomach has healed, you may eat most foods that don't cause you discomfort. However, because you can only eat a little it is important to include foods full of important vitamins and nutrients as advised by your lap band surgeon and/or dietitian. Again, your appetite will feel satiated, and you will not feel hungry. If you do eat foods that contain a lot of sugar and fat or drink liquids full of "empty" calories, such as milkshakes, the effect of the lap band may be greatly reduced or even canceled.

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How fast will I lose the weight after stomach stapling, and is it dangerous?

Most of the weight will be lost in the first six months. Some patients have even been able to loose weight for up to two years after the surgery. This surgery is a tool to help you loose weight, and exercise and diet will help you achieve your ideal body weight. Losing weight this fast is generally not a dangerous procedure if you maintain your vitamin supplements and diet. If you undergo the lap band procedure, your weight loss will be slower but you can achieve a similar result. Your doctor should support you after the operation.

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Can I get this weight loss surgery reversed?

The lap band procedure is reversible and does not modify your internal anatomy. Stomach stapling is designed to be permanent, but in general gastric bypass procedures are reversible. But ask your doctor about your specific procedure.

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How about after the lap band or stomach stapling surgery -- are there support groups?

Many treatment facilities have a network of support groups in their area and we highly recommend that you participate in them. Ask your doctor.

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I had stomach stapling surgery but have since forgotten my doctors' recommended daily nutritional requirements and I can't get in contact with him. Can you help me?

We suggest that you contact any bariatric treatment center to get more information about diet plans, weight loss products and supplements required a after specific bariatric surgical procedure. If you have forgotten who your doctor was just choose another practicing near you, they would be happy to help you.

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How do I print my current web page?

There are several ways to print the web page currently displayed in your browser. Choose any one of these methods to print the current page.

• Click the "Print" button in your Internet Explorer toolbar. Look for the icon of the printer at the top of your browser.
• From the File menu, choose Print... When the print dialog box appears, click "Print."
  
• Hold down the Control key on your keyboard and press the "p" button (Cntrl+P).
  
• Point your mouse cursor at any blank space on the web page itself and right click your mouse button. From the menu that appears, select "Print."

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