Weight Loss Surgery & BMI - The Surgical Weight Loss Centre

1. Weight Loss Surgery… It’s not just about the Surgery Obesity has overtaken smoking as the leading cause of premature death and illness in Australia. Obesity has become the single biggest threat to public health in Australia. The obesity crisis is not on its way – it is already here. Obesity is no longer considered just a cosmetic issue, brought on by a lack of self- discipline. It is a complex condition with biological, genetic, behavioural, social, cultural, and environmental influences. The human body is made to survive in situations where food is scarce and high physical activity is the norm. However, in this day and age much of humanity is faced with just the opposite. Food is overabundant and physical activity is actually a break from the normal daily

2. routine. As a society, we experience high levels of stress, anxiety, and depression, fewer opportunities for physical activity and greater exposure to marketing of obesity-promoting products. Why BMI is Used as a Starting Point in the Surgical Management of Obesity Obesity has overtaken smoking as the leading cause of preventable disease and premature death in Australia. It is therefore important to be able to easily identify people who are most likely to have obesity. Once identified, people in this group can be further assessed to determine if and how they would benefit from having their obesity treated.

3. The World Health Organisation (WHO) defines obesity by the percentage body fat, over 25% for men and over 35% for women. What does that mean in laymans terms? If more than a quarter of a man‟s body if made up of fat, then he has obesity. If more than a third (roughly) of a women‟s body is made up of fat, then she has obesity. How do we identify people with obesity? A good screening tool to identify people with obesity would be Quick Easy Non-invasive Free Based on information that most people already know or can easily find out without needing difficult or expensive equipment A reliable indicator of actually having obesity to maintains public trust in the result oThat is, it would be best if most of the people identified by the screening tool would turn out to actually have obesity on further testing and relatively few people are incorrectly categorised as having obesity. BMI meets all of these criteria. BMI = weight in kilograms Height in metres x height in metres Take home message: BMI is not used because it is perfect or the most accurate measurement for every person in the population. BMI is not a diagnostic tool. BMI is a good starting point to identify people with obesity so they can be further assessed to determine if and how they would benefit from having their obesity treated.

4. KEY THINGS TO LOOK FOR WHEN CHOOSING A SURGICAL WEIGHT LOSS CENTRE: EXPERIENCED SURGEON: Studies show that surgeries performed by an experienced surgeon result in fewer complications. Your surgeon should have extensive experience operating on the upper gastrointestinal tract and performing the specific procedure you are undertaking. No single weight loss surgery procedure is best for everyone. If a surgeon only performs one procedure, ask why. Weight loss surgery procedures evolve with technology. Your surgeon should actively participate in continuing education specific to bariatric surgery and groups such as the International Federation for the Surgery of Obesity (IFSO). Anaesthetic and perioperative care also contribute to an un-complicated recovery from bariatric surgery. It is essential that the whole team has substantial training and experience specific to the treatment of bariatric surgery patients. THOROUGH MEDICAL ASSESSMENT BEFORE SURGERY: All surgeries have risks and benefits, including bariatric surgery. Obesity related health complications can put people with obesity into a higher risk category for surgery. Pre-operative assessment is key to maximising safety. Your surgeon should rigorously assess and investigate your health. This includes arranging reviews and investigations by other specialists, such as cardiologists or gastroenterologists, to manage any existing conditions before, during and after the operation to ensure your safety. What often surprises people is that more than a third of candidates for bariatric surgery have „high calorie malnutrition‟, with vitamin and mineral deficiencies present before surgery. A detailed nutritional screening is required before surgery. SPECIALISED BARIATRIC DIETITIAN: Bariatric surgery reduces the volume of food that can be eaten. The quality of the food consumed and compliance with recommended supplements remains the choice of the patient, making nutritional care and food choice important lifelong. Specialised dietetic advice is essential at each phase: Before surgery: to identify factors that may impact on your long-term success, such as your dietary beliefs and behaviours, cultural background.

5. After surgery: to support and troubleshoot your transition from liquids to puree and then back onto solids to ensure your nutrient requirements match your appetite within the texture permitted. Over the long-term they monitoring and prevent nutrient deficiencies and maximise weight loss. Symptoms of vitamin and mineral deficiency are commonly non-specific, and most characteristic physical findings are seen late in the course of nutrient deficiency. Dr Jacobus (Jorrie) Jordaan MB ChB MMed Surg (Pret) (Hons) FCS(SA) FRACS is a Specialist Upper Gastrointestinal and Endocrine surgeon with 25 years of experience. Having performed many thousands of advanced and complicated surgical operations, he is among Australia‟s most experienced specialists in minimally invasive weight loss (bariatric) surgery. Dr Jordaan is professionally known for his meticulous surgical technique and attention to detail, his exceptionally low complication rate, his ethical conduct and remarkable overall patient care.

6. CLINICAL PSYCHOLOGIST: Emotional support is vital. Most people in society have developed their eating patterns over time to meet more than just their physical needs but also for comfort, for socialisation, to combat boredom or to overcome fatigue. Sometimes, obesity has psychological causes that need to be addressed. A psychologist can assist patients to identify and overcome potential barriers that may hinder their weight loss success. BARIATRIC NURSE COORDINATOR: It is important that the whole treatment process runs smoothly. A bariatric nurse can case manage each patient to coordinate the appointments and information streams involved and ensure nothing is forgotten. LONG-TERM FOLLOW-UP: Ongoing coordinated care that links with the bariatric dietitian and others involved in the weight management team maximises the health benefits for the patient by preventing nutrient deficiencies and maximising long term weight loss. “It is important to take the time to get to know your patients so you can understand their struggles, determine what they need to succeed and make a commitment to supporting them to successful, long-term weight loss.” Says Dr Jordaan. “We ensure our patients have accesses to lifelong support through wellness workshops, psychology support groups, dietetic reviews and follow-ups with bariatric nurses to monitor nutrition profiles.” “With the right dedication and support, people can turn their life around and achieve permanent weight control for a healthy future.” For more information, contact us here or call (07) 5556 8888.