PRAGUE, Czech Republic — As waistlines expand around the world, the demand for stomach stapling and other types of surgery to treat obesity is gradually increasing, experts said Saturday.
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About 250,000 operations to help obese people lose weight are performed every year, with 100,000 stomach staplings a year in the United States and 50,000 similar procedures in Europe, according to the International Federation for the Surgery of Obesity. In many countries, there is a shortage of surgeons skilled in the technique, the organization said.
“We haven’t got waiting lists for a year for patients, but there are more and more patients coming,” said Dr. Martin Freid, professor of surgery at the Obesity Treatment Hospital in Prague.
“The demand is increasing gradually, because people are getting fatter, because people are getting better informed and physicians are getting better informed.”
Part of the increase in demand is because current options are so unsatisfactory, said Dr. Arne Astrup, an obesity treatment expert at the Royal Veterinary and Agricultural University in Frederiksberg, Denmark.
“I think it’s a reflection of the desperation of many obese patients, that they have severe difficulties in reducing weight by diet and exercise and some of the current weight loss products,” Astrup said.
“The major problem is that out there, the possibility of getting professional help is not very good. Most doctors do not have the time to take care of this. The lack of treatment options is driving people into the gastric surgery,” Astrup said.
Surgeons and other obesity scientists held a joint symposium Saturday for the first time at the annual European Congress on Obesity, which concludes this weekend. The meeting aims to achieve better coordination between doctors and surgeons as they face the onslaught of obesity across the world.
Obesity rates soaring
About 1.7 billion people around the world are either overweight or obese — so fat that their risk of developing diseases such as diabetes, heart disease, kidney disease and cancer skyrockets.
As the Western lifestyle of abundant food and labor-saving technologies that make people more sedentary marches across the globe, obesity rates are soaring, even in the developing world. And the fat are getting fatter, so that more people are becoming fat enough to warrant surgery.
The main benefit of surgery is that patients lose weight easily and keep it off. While weight loss with diet and exercise is achievable, keeping weight down is the real problem.
There are two main types of obesity operations. One method aims to block absorption of calories by bypassing the part of the digestive tract involved in absorbing food. Staples are often used.
“Those procedures are very effective from a weight loss point of view,” Freid said. “However, they are connected with a higher rate of complications. Patients have to accept some long-term side effects — frequent diarrhea and the need to stay on vitamin and mineral supplements for the rest of their lives.”
“It’s the favorite operation in the U.S. because the patients can eat almost anything they want but will still lose their weight,” Freid said.
The second type of obesity surgery, which involves making the stomach smaller but not bypassing absorption, is the dominant choice in Europe.
That surgery involves placing a silicone band around the stomach to divide into two. The part above the band is extremely small, and can hold no more than a cup of food.
The food stays above the band, making the patient feel full on just a fraction of previous food intake. The band is tight enough for the food to remain in the upper sac for two or three hours, but loose enough for the food to gradually pass through.
The major drawback of this option is that portion sizes must be kept small at all times. If the patient overeats, the stomach stretches and hangs over the clamp, preventing food from passing through. Solving that requires another operation.
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