Manitoba is last province to undertake bariatric program
By Rayan Horswill-Tees
The number of Canadians who are overweight or obese has increased significantly over the past 25 years. Approximately 4.5 million Canadians age 20 to 64 are obese, with another 6.8 million overweight. The World Health Organization has declared obesity an epidemic. Achieving and maintaining a healthy weight is key to reducing the risk of chronic diseases and leading a healthy lifestyle.
Obesity is excessive fat accumulation that presents a risk to a person’s health. Someone with a body mass index (a statistical measurement that compares height and weight) greater than or equal to 30 is generally considered to be obese. Body mass index (BMI) does not measure body fat, but in most cases that number is a good indicator of obesity.
Brings on disease
Consumption of too many calories, insufficient physical activity or genetic susceptibility are the usual causes of obesity. Obesity increases the likelihood of various diseases and disorders, such as heart disease, type 2 diabetes, gallbladder or liver diseases, obstructive sleep apnea, certain types of cancers and osteoarthritis. Obesity is now a leading preventable cause of death, and its prevalence is increasing among both adults and children.
Bariatrics is a branch of medicine that deals with the causes, prevention and treatment of obesity.
Obesity treatments can take a variety of forms. Diet and physical exercise is the first step. Reducing consumption of foods high in fats and sugars, increasing intake of dietary fibre, and incorporating exercise into one’s lifestyle can make a difference. However, studies have shown diet and exercise alone are effective in the long term for less than five per cent of obese patients.
There are also anti-obesity drugs on the market that reduce appetite or inhibit fat absorption. Many people, however, do not respond to these drugs; others find the beneficial effects lessen after a few months or experience significant side-effects. In some cases, surgery is necessary to help the patient achieve and maintain a healthy weight.
Until now, Manitoba was the only province in Canada without access to a bariatric surgery program. The Victoria General Hospital began doing these procedures in 2010 and is the exclusive trial site in Manitoba for this necessary service. The Vic has already done more than 100 surgeries and currently has four surgeons available to perform them.
With the project’s development still in its first stages, the criteria for receiving the surgery is that patients must be female, under age 55 and have a bone mass index of less than 47, as well as few if any co-morbidities (the presence of one or more diseases in addition to obesity). As this referral-based program continues to grow, the criteria will expand.
Stomach size cut
Through the Victoria General Hospital, patients in Manitoba now have two new options for bariatric surgery: a laparoscopic sleeve gastrectomy or a laparoscopic gastric bypass. The former is a surgical weight-loss procedure where the stomach is reduced to about 20 per cent of its original size through removal of a large portion. The latter procedure divides the stomach into a small upper pouch and a larger lower “remnant” pouch, with the small intestine rearranged to allow both pouches to stay connected to it. This procedure leads to a marked reduction in the functional volume of the stomach, as well as a small alteration in nutrient absorption.
A physician can help an obese person determine how best to achieve and maintain a healthy body weight. The good news is obesity is a preventable cause of death, a person who is obese can take action now to bring them back to a state of good health.
Rayan Horswill-Tees is the acting director of surgery, anesthesia, and women’s health at Victoria General Hospital. To support patient care at the Vic, please contact Victoria General Hospital Foundation at (204) 477-3513 or visit online at www.thevicfoundation.ca.