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Bariatrics is the medical discipline that focuses on the causes, prevention, and treatment of obesity. Obesity has reached epidemic portions in the United States, with an estimated 55% of the adult population either overweight or obese. Obesity also continues to rise in the rest of the developed world, and is beginning to become an issue in poorer nations as incomes rise. Bariatrics has received a great deal of attention in the United States over the last decade because of the proliferation of surgical procedures that have become increasingly common to help patients lose weight. The first step that a patient typically completes with a bariatrics specialist is a body mass index measurement to determine whether there is a problem with their weight. The body mass index is a statistical measurement that compares a individual’s weight and height against what has been determined by medical research as a healthy weight. The measurement is meant to by used as a diagnostic tool, although it is not fool-proof. A very muscular person can be assessed as obese, and a person with a low weight can have a high body fat percentage due to low bone density and/or low muscle mass. Because of this, bariatric specialists may use other markers including waist circumference and a direct measure of body fat percentage to determine whether a patient needs treatment. Bariatric specialists also look at risk factors such as heart disease, diabetes, and other medical conditions associated with obesity when determining whether a patient needs treatment. Once a bariatric specialist has determined that a patient needs treatment for obesity, the first step is typically dietary counseling. This counseling usually involves a diet plan for the patient that directs the patient on the type and amount of foods to be consumed in order control caloric intake and lose weight. Coupled with this counseling, the bariatric specialist will also recommend an exercise regimen to raise the patient’s metabolic rate and improve the patient’s overall health. Should this approach not achieve the desired weight loss, the physician can then prescribe a number of anti-obesity drugs that are currently approved for use in the United States by the Food and Drug Administration. Typically these drugs are recommended for short-term use, and because of this they are not usually prescribed to extremely obese patients who need therapy over months or years. As a last resort if none of the above treatments are effective, a bariatrics specialist may decide that a surgical procedure may be the best alternative for a patient to lose weight. This is a decision that neither the patient or physician takes lightly; past studies have shown that up to 20 percent of the patients that have these procedures done have complications withing 180 days of the surgery. While there are a variety of different surgical procedures that have been approved in the United States, the most common current procedures involve either malabsorption, restricting stomach size, or a combination of both procedures.
