Obesity is a serious health condition defined by an excess of body fat. It’s a growing issue in the U.S. and can lead to various life-threatening conditions such as heart disease, diabetes, and high blood pressure. According to the Centers for Disease Control and Prevention, one in five adults is obese, making it an alarming health problem. While a healthy diet and exercise can provide relief in some cases, it might not be enough in extreme cases.
For many individuals, standard weight loss methods, such as diet and exercise, are not enough to combat severe obesity, particularly when dealing with morbid obesity, where the body mass index (BMI) is significantly higher than normal.
In order to assess whether a person has a healthy weight, we often rely on a tool called Body Mass Index (BMI), which measures body fat based on height and weight. A normal BMI typically ranges between 18.5 and 24.9. Once a person’s BMI reaches 25 or higher, a person is considered overweight. Obesity begins at a BMI of 30, with more severe classifications, such as morbid obesity, starting at a BMI of 40 or more.
When a person is classified with morbid obesity, surgery may be considered as a treatment option. Bariatric surgery, which includes various types of procedures, can help reduce the amount of food a person can eat and/or alter the digestive process to support weight loss. These surgeries are often recommended when other methods have failed and the patient’s health is at risk.
It is essential to understand the options available to better guide patients through complex decisions and provide appropriate support before and after surgery. In this Fast CE For Less guide, we will give you a quick overview of morbid obesity, its risks, and the surgical procedures to help you provide better patient education, support, and care.
Understanding Body Mass Index (BMI)
Body Mass Index (BMI) is a simple yet effective way to determine the healthy ratio of fat in a person’s body based on their weight and height. The BMI helps healthcare providers identify whether a person’s weight falls within a healthy range or if they may be classified as overweight or obese. While BMI is widely used, it’s important to understand its calculation and the different classifications it provides.
How BMI is Calculated
Experts determine a person’s BMI by dividing their weight by their height. While the formula is simple, it provides valuable insight into a patient’s overall health. This calculation doesn’t require any special equipment and is often used during routine health assessments.
BMI Classifications
A BMI score helps classify weight ranges. For instance:
- 5 to 24.9: Considered a normal, healthy weight.
- 25 to 29.9: Classified as overweight, indicating a risk of future health problems.
- 30 or higher: Classified as obese. At this stage, patients are at a higher risk for conditions like heart disease and diabetes.
- 40 or higher: Often referred to as morbid obesity or severe obesity. Patients in this category are at significant risk of serious health complications and may benefit from surgical interventions.
Limitations of BMI
Although BMI is a helpful tool, it doesn’t account for muscle mass or the distribution of fat. For example, athletes with higher muscle mass may have a high BMI without having excess body fat. As nurses, it’s important to consider BMI alongside other health indicators for a complete assessment of a patient’s weight and health.
Types of Bariatric Surgery Procedures to Treat Morbid Obesity
Bariatric surgery offers several options for treating morbid obesity, especially when other methods, such as diet and exercise, have not worked. These surgeries aim to reduce the amount of food a person can consume or change how the body absorbs nutrients. Understanding the different types of bariatric surgery will help you better educate your patients about which option may suit their specific needs. Below are the three most common types of bariatric surgery.
Vertical Sleeve Gastrectomy (Gastric Sleeve Procedure)
The vertical sleeve gastrectomy, often called the “gastric sleeve,” is one of the most popular bariatric surgeries. During this procedure, a large portion of the stomach is removed, leaving a small tube or “sleeve”-shaped stomach. The smaller stomach limits the amount of food the patient can eat, making them feel full after eating less.
The gastric sleeve procedure also helps reduce hunger because part of the stomach that produces a hormone responsible for stimulating appetite (ghrelin) is removed. The benefits of gastric sleeve surgery include significant weight loss and improved health outcomes for many patients. However, it is not reversible, so patients must understand the long-term commitment to lifestyle changes that will follow.
Gastric Bypass
Gastric bypass surgery is another common procedure that involves creating a small pouch at the top of the stomach. This pouch is directly connected to the small intestine, bypassing most of the stomach and the first part of the intestine. As a result, patients eat less and absorb fewer calories.
Gastric bypass is known for its effectiveness in producing rapid weight loss. It is particularly helpful for patients who have severe health conditions related to obesity, such as type 2 diabetes or heart disease. However, it is a more complex surgery compared to the gastric sleeve and comes with a higher risk of complications. Patients will also need to take vitamin supplements for life due to reduced nutrient absorption.
Gastric Band
The gastric band procedure involves placing an adjustable band around the top portion of the stomach, creating a smaller stomach pouch. Unlike the other surgeries, the gastric band does not involve cutting or removing parts of the stomach. Instead, the band limits how much food the stomach can hold, making the patient feel full sooner.
One of the advantages of this procedure is that it is adjustable and reversible. The gastric band can be tightened or loosened based on the patient’s weight loss progress or any discomfort. However, it requires regular follow-up appointments for adjustments, and weight loss tends to be slower compared to other bariatric procedures.
Each of these procedures has its own benefits and risks, so as a nurse, it’s essential to help patients understand their options and what they can expect from surgery. This guidance is vital in ensuring patients make informed decisions about their health.
The Benefits of Surgical Procedures for Obesity
Bariatric surgery provides more than just weight loss benefits for patients with gross obesity. The positive effects extend to the management of several obesity-related conditions, improving both physical health and quality of life. Understanding these benefits will help you better support your patients as they navigate their surgical journey.
Diabetes Management
Bariatric surgery has been shown to be particularly effective in managing type 2 diabetes. Weight loss improves insulin sensitivity and reduces blood sugar levels, often allowing patients to reduce or stop their diabetes medications. Some patients even experience remission of diabetes after surgery. This is a critical benefit, as diabetes is a leading cause of complications like heart disease, kidney failure, and vision loss.
Fatty Liver Disease Improvement
Obesity is one of the primary causes of fatty liver disease, a condition where fat builds up in the liver and can lead to inflammation or liver failure over time. After bariatric surgery, as patients lose weight, the fat deposits in their liver decrease, improving liver function and reducing the risk of long-term liver damage.
Reduced Hypertension
Hypertension, or high blood pressure, is a common issue in patients with obesity. Bariatric surgery helps lower blood pressure by reducing the strain excess weight puts on the cardiovascular system. Many patients see significant drops in their blood pressure after surgery, which reduces the need for medications and lowers the risk of stroke and heart attack.
Improved Mobility and Joint Health
Carrying excess weight puts a tremendous strain on joints, especially on the knees and hips. Over time, this can lead to chronic pain, arthritis, and reduced mobility. After bariatric surgery, as patients lose weight, they often report less joint pain and better mobility. This improvement allows them to engage in more physical activities, which further enhances their overall health.
These health improvements, alongside weight loss, make bariatric surgery a life-changing option for patients with morbid obesity. As a nurse, understanding these benefits will allow you to guide patients effectively, helping them see the long-term value of the surgery.
Risks and Considerations for Bariatric Surgery
While bariatric surgery can be highly effective for patients with morbid obesity, it is important to understand that there are risks involved. As with any major surgery, there is a chance of complications such as infections, bleeding, and blood clots. Nutritional deficiencies can also occur after surgery, especially with procedures like gastric bypass, where the body absorbs fewer nutrients.
Patients may need to take vitamin and mineral supplements for the rest of their lives. Other potential side effects include nausea, vomiting, and gastrointestinal issues. As a nurse, it’s crucial to ensure that patients understand these risks before surgery so they can make an informed decision and be prepared for the challenges they may face during recovery.
Nurse’s Role in Patient Education and Care for Morbid Obesity Procedures
You play a critical role in supporting patients through the process of bariatric surgery. One of your key responsibilities is to educate patients about their surgical options, helping them understand the benefits and risks of each procedure.
Providing clear, accurate information about post-surgery recovery is equally important. After surgery, patients need guidance on diet, exercise, and follow-up care to ensure they stay on track. You can also help by monitoring patients for any potential complications and offering emotional support as they adjust to lifestyle changes.
Your ongoing involvement ensures patients receive the comprehensive care they need to achieve the best possible outcomes.
If you have not completed your nursing continuing education requirements to renew your license and want to learn more, online nursing CEUs offered by Fast CE For Less can help.
To access flexible and affordable nursing continuing education courses and state bundles, visit www.fastceforless.com.
