Morbid obesity: surgical and non-surgicel treatment

Morbid Obesity is a serious disease that is usually overlooked. Morbid obesity has a huge impact on all aspects of health condition.

Cardiovascular diseases, endocrine disorders and psychiatric problems are general expressions of complications associated with morbid obesity. In detail endocrine disorders alone cause a complete hormonal imbalance which result in diabetes, osteoporosis, infertility, feminine character in men and much more.

While patients are struggling to do their daily simple tasks they are offended by lack of respect. Most people around them don’t even think that is a disease. Doctors don’t spend enough time to consult them for appropriate treatment.

The only really effective treatment is bariatric surgery, which improves patient’s health and quality of life enormously. Due to lack of consultation most of patients are hesitant about surgery and they are afraid of surgical complications which compared to the complications of morbid obesity is nothing.

There are two options for surgery; the first one is gastric bypass or Roux –en – Y method. This procedure can be done either conventionally or by laparoscopy. This technique provides a small pouch stomach for early satiety and shorter intestine for less absorption.

The newer technique is Lap- band adjustable or adjustable gastric banding and usually is done laparoscopic which is less invasive. A silicon adjustable band splits stomach to a small pouch reservoir. Lap – Band has less complication because does not affect absorption and also is an adjustable and reversible procedure.

And bottom line for those patients who are scared of surgery: there is exciting news about a very new non surgical procedure. In this procedure an endobarrier is placed in stomach and upper intestine through an endoscopic instrument. This procedure takes half an hour and works like gastric bypass. Link

Is hormone replacement therapy for you?

For women who are in menopause or about to experience this period of their life, hormone replacement therapy (HRT), estrogen with or without progesterone, could be a big question mark.

They usually opt for HRT to relieve menopause symptoms. However, many other health related consideration are also included in decision making.

One should know that hormone replacement therapy is not for everyone. Just for your information, it is better to be aware of some conditions that prohibit using hormone replacement therapy.

You should NOT even think about hormone replacement therapy if you have any of these conditions:

• Acute liver disease
• Undiagnosed vaginal bleeding
• Known or suspected uterine/breast cancer
• Acute vascular thrombosis or history of severe thrombophlebitis of thromboembolic diseases

If you have any of the following condition you should be extra cautious and most probably choose any of alternative to hormone replacement therapy:

• Uncontrolled hypertension
• Uterine fibroids or endometriosis
• Familial hyperlipidemia
• Migraine headache
• Family history of estrogen-dependent cancer
• Chronic thrombophlebitis
• Diabetes mellitus
• Gallbladder diseases
• Impaired liver function
• Fibrocystic disease of the breast

The take home message is that hormone replacement therapy is not a simple answer to a simple condition. Menopuase should be dealt with very carefully and delicately. Always consult your doctor and let your doctor know about any change in your condition/health as soon as it happens.