Our Summary

In recent years, obesity rates in Western countries have grown, leading to an increased demand for weight loss surgeries. Currently, many public hospitals prioritize these surgeries based on how long a patient has been waiting, rather than how severe their obesity is. This study proposes a new system, called the Obesity Surgery Score (OSS), which considers both wait time and obesity severity.

The OSS uses three factors: body mass index (a measurement of body fat based on height and weight), obesity-related health problems, and functional limitations (how much obesity affects a person’s ability to function in daily life). The study found that patients with a higher OSS score have a higher average body mass index, more severe health problems related to their obesity, and a greater impact on their social and work life. Currently, many patients with a high OSS score have been waiting for surgery for over a year.

The researchers argue that because severe obesity and long wait times can lead to more health problems and a higher risk of death, it’s important to prioritize patients with a higher risk. This not only improves patient outcomes, but also makes better use of hospital resources and can reduce costs.

FAQs

  1. What is the Obesity Surgery Score (OSS) and what factors does it consider?
  2. How does the current prioritization system for obesity surgeries in public hospitals work?
  3. Why do the researchers believe that prioritizing patients with a higher OSS score can lead to better patient outcomes and use of hospital resources?

Doctor’s Tip

One tip a doctor might tell a patient about obesity surgery is to make sure to follow the pre-operative and post-operative instructions provided by their healthcare team. This can include things like maintaining a healthy diet, staying hydrated, getting regular exercise, and attending follow-up appointments. It’s important to take these instructions seriously in order to ensure the best possible outcome from the surgery and to reduce the risk of complications.

Suitable For

Overall, patients who are typically recommended for obesity surgery are those who have a high body mass index (usually above 40), have obesity-related health problems such as type 2 diabetes, high blood pressure, sleep apnea, or joint pain, and have functional limitations that significantly impact their quality of life. These patients have often tried other weight loss methods without success and are at a high risk for developing serious health complications due to their obesity.

It is important for healthcare providers to carefully evaluate each patient’s individual situation and determine if they are a good candidate for obesity surgery. This decision should be made based on a combination of factors, including the patient’s overall health, willingness to make necessary lifestyle changes, and potential risks and benefits of the surgery. Ultimately, obesity surgery is recommended for patients who have a high likelihood of benefiting from the procedure and improving their overall health and quality of life.

Timeline

Before obesity surgery:

  1. Patient meets with their healthcare provider to discuss weight loss options and determine if surgery is the best option.
  2. Patient undergoes a series of tests and evaluations to assess their overall health and suitability for surgery.
  3. Patient attends counseling sessions to prepare mentally and emotionally for the surgery and post-operative lifestyle changes.
  4. Patient follows a pre-surgery diet and exercise plan to help reduce the size of their liver and improve surgical outcomes.

After obesity surgery:

  1. Patient undergoes the surgery, which can vary from minimally invasive procedures to more extensive surgeries like gastric bypass or sleeve gastrectomy.
  2. Patient stays in the hospital for a few days to recover and receive post-operative care.
  3. Patient follows a strict diet and exercise plan to aid in weight loss and prevent complications.
  4. Patient attends regular follow-up appointments with their healthcare provider to monitor progress and address any issues.
  5. Patient experiences significant weight loss, improved health outcomes, and a better quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about obesity surgery include:

  1. How severe is my obesity and what is my Obesity Surgery Score (OSS)?
  2. What are the potential risks and benefits of weight loss surgery for someone with my level of obesity?
  3. What type of weight loss surgery would be most appropriate for me and why?
  4. What lifestyle changes will I need to make before and after the surgery to be successful?
  5. What is the expected recovery time and potential complications of the surgery?
  6. How will my obesity-related health problems be managed before and after the surgery?
  7. Will I have access to a support team, such as a nutritionist or counselor, to help me through the weight loss journey?
  8. What is the success rate of weight loss surgery for patients with similar obesity severity as mine?
  9. How will the OSS score affect my placement on the waiting list for surgery?
  10. Are there any alternative treatments or therapies I should consider before opting for weight loss surgery?

Reference

Authors: Casimiro Pérez JA, Fernández Quesada C, Del Val Groba Marco M, Arteaga González I, Cruz Benavides F, Ponce J, de Pablos Velasco P, Marchena Gómez J. Journal: Obes Surg. 2018 Apr;28(4):1175-1184. doi: 10.1007/s11695-017-3107-6. PMID: 29383562