Bariatrics

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Bariatrics2017-07-30T22:38:11+00:00

Bariatrics

bariatrics obesity conditions Image from New Medical Terms

conditions linked to obesity

The paucity of food throughout most of human history led to the belief that corpulence was a sign of good health, as reflected in art, literature, and medical opinion of yesteryear. Despite obesity seeing the earliest frowns for aesthetics in the late 19th centuries, the first fat men’s club was launched in 1903, a holdover from the broader belief that flab was fab. Probably the paunchiest of the period was Queen Victoria who, after the death of Albert, ate her way to 50-inch bloomers, making her wider than tall. With improved data collection, insurance actuaries and doctors started weighing in (no pun intended) against overweight in the 1920s and 1930s. Well-known hold-overs of tubbier times were Oliver Hardy (of Laurel and Hardy), WC Fields, Babe Ruth, and Al Capone, muffling the message that greater girth meant more morbidity and mortality. 

The public health pendulum finally began to swing in earnest in the stout is out and thin is in direction in the 20th century with the increasing recognition of the association of overweight and obesity with death and disease. Beginning in the 1930s, life insurance companies started using weight to determine premiums. By the 1960s, there was a small but noticeable upward tick in Americans’ weight. What is now called an epidemic began in the 1990s and is attributed to two main factors: (1) change of the average American’s diet towards convenience and fast foods which are high in fat (especially saturated fats) and sugar and (2) adoption of a sedentary lifestyle (30+ hours of “screen time” and virtually no vigorous exercise. 

bariatrics surgery image from New Medical Terms

bariatric surgery

Statistics In 1990, 9 US States had < 10% obesity; 20% to 25% of those in Mississippi were obese. In 2000, 2 States had 10% to 15% obesity; 21 States had 20% to 25% obesity. By 2015 > 35% of the  population in 4 States were obese, and 4 States had 20% to 25% obesity. Extreme obesity (BMI > 40), a unheard of phenomenon 50 years ago, now affects 6% of Americans. Obesity is one of America’s largest exports; other countries have yet to catch up to the US waistline; 66% of the world’s overweight and obese are American. Fatter countries include many of the islands of Oceania and the Caribbean and Arab countries. Developed countries not far behind the Americans include New Zealand, Canada, Australia and the UK. 

Cons, obesity Diseases linked to obesity include cardiovascular disease (coronary artery disease, congestive heart failure, stroke, and hypertension), marked reduction in lifespan (sumo wrestlers live 15 years less than the average Japanese male), type 2 diabetes, cancer (breast, colorectal, endometrial, renal, esophageal, and possibly also cancer of the gallbladder, ovaries, and pancreas), cirrhosis, fatty liver, gallbladder disease and gallstones, osteoarthritis, gout, and breathing problems in the form of sleep apnea, hypoventilation and asthmatiform episodes.

Pros, obesity Eligible for a handicapped sticker, retirement won’t be too long, can substitute a piano crate for a coffin (much cheaper).

Also known as bariatric medicine, obesity medicine or, pejoratively, fat people medicine, bariatrics* is a new field meant to manage the obesity, a major epidemic of the 21st century. Bariatrics is less than 50 years old and probably best regarded as a surgical specialty, given the dismal efficacy of medical management which consists of diet–patients underestimate their food consumption (by a large margarine), exercise–patients overestimate their workout, behavior therapy, and anti-obesity drugs–which patients rarely take. About 80% of those who undergo surgery lose the desired amount of weight and keep it off. Accumulating data indicate that the duodenal switch is the most effective procedure with a 95% success rate. At the opposite end of the surgical spectrum is the lap band procedure, for which 47% success rate is the norm. 

*The term was coined in the 1960s and cobbled together from the Greek roots, bar– weight, –iatr– medicine or therapy and –ics referring to. 

Reference

bariatrics scale Image from New Medical Terms

scale groaning under the weight

https://www.ncbi.nlm.nih.gov/pubmed/17045228

http://www.npr.org/sections/thesalt/2016/03/07/469571114/the-forgotten-history-of-fat-men-s-clubs

http://www.livestrong.com/article/359624-obesity-history-in-america/

http://www.webmd.com/diet/obesity/obesity-health-risks#1

http://obesity.procon.org/view.resource.php?resourceID=006026#us-obesity-maps

http://www.medscape.com/viewarticle/876411

http://www.obesitycoverage.com/the-complete-patients-guide-to-bariatric-surgery/

 http://en.wikipedia.org/wiki/Bariatrics