Obesity – Surgical and other interventions Stephen Pollard Consultant Surgeon St James’s University Hospital and Leeds Spire Hospital Cutting Edge Surgery February 2009. Classification by Body Mass Index (BMI; kg/m 2 ). <18 underweight 18-25 desirable 27-30 overweight
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Surgical and other interventions
St James’s University Hospital and Leeds Spire Hospital
Cutting Edge Surgery
1980 1993 1998 2002 2006
Recognised surgery as the only effective treatment for morbidly obese patients
Reported European data:
£6.6 – £7.4 billion per year (NICE, Dec 2006)
% of adult population with BMI>30
SE class 1 5
Male 11 16
Female 14 28
“Predictions are risky, particularly when made about the future”
Senator Dan Quayle, Former U.S. Vice President
So what has changed?
Dec 2006 – NICE consider children suitable for surgery
Weight is regulated with great precision. For example, during a lifetime, the average person consumes at least 60 million kcal. A gain or loss of 10Kg, representing approximately 90,000 kcal, involves an error of no more than 0.001%.
The results of adoption and family studies show a heritability of obesity of about 33%. Genetic influences may be more important in determining regional fat distribution than total body fat, particularly the critical visceral fat depot.
The converse of finding that genetic factors only influence a proportion of the variation in body weight means that the environment exerts an enormous influence.
2% per pound overweight for 50-62 year olds
BMI 25-30 equates to 3 years loss of life
BMI >30 equates to 7 years loss of life
BMI >40 equates to 15 years loss of life
BMI > 30 + smoking equates to 13 years loss of life