Sunday, 3 January 2010

Weight-loss surgery for all!

Dr. Super is loving this.

Usually reserved for the most obese people, weight-loss surgery is unlikely to be a last-ditch option much longer. Technological advancements are turning it into a one-hour, incisionless procedure -- making it more attractive to moderately overweight adults [...]; overweight and obese teenagers; and normal-weight people with difficult-to-control diabetes. Several new procedures are already in human clinical trials.

I think we're all getting a little carried away and assuming that just because a procedure is easy to accomplish, its effects are also easy to live with after the fact. As many have discovered, and as this same article notes, even though the already low morbidity rates for this type of procedure continue to decline and operation recovery times become shorter, patients still have to contend with medium- to long-term problems, including "nutritional deficiencies, diarrhea, regurgitation and bowel obstructions."

According to the Agency for Healthcare Research and Quality, 19% of patients experience dumping syndrome, which is involuntary vomiting or defecation. Complication rates involving ulcers, wound problems, hemorrhage, deep-vein thrombosis, heart attacks and strokes range from 2.4% to 0.1%.

And where do we draw the line regarding preemptive surgery? One surgeon notes that "[p]eople 50 pounds overweight are the ones we should treat, before the problem gets worse," but isn't that number quite arbitrary? Unless we ascertain that at 50 lbs overweight (as opposed to 40 or 30), people start to see marked deteriorations in their overall health (in fact, we've been told that every 10 lbs packs its own share of doom), then the benchmark at which surgery becomes an option can arguably continue to shift downwards.

I suppose weight-loss surgery is now poised to enter the realm of cosmetic procedures, where if people opt to risk their lives and health in order to try and feel better about themselves, then they have that right. The rub lies in the fact that most elective cosmetic surgery is not covered by the majority of insurance plans or universal health care systems. And so it will be interesting to see - especially in the context of the raging US health care debate - how this particular argument evolves.

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