By M. Zakir Sabry, MD
“There was always a moment of inertia.” That was the best way that Guy could explain his every movement prior to having weight-loss surgery. As he so eloquently put it, “Every time I moved, there was a pause of a second or two and, then my large hanging skin and fat caught up with me.”
For years, this is how Guy managed his day-to-day business. Contrary to the conventional preconception, Guy was not an average couch potato who ingested large amounts of processed and fried food and watched TV all day. He was, and still is, a small business owner who runs a construction company and does well enough to feed his own family and 15 others.
How did Guy let himself go? He has a simple explanation, “I loved food.” He worked hard, earned enough, and spent most of it eating while his family helplessly watched him getting bigger and bigger. So, eventually Big Guy became the new normal.
Before Guy knew it, he was a mammoth 322 lbs. One day, he realized that something had to give, and it was his weight. After having a very poignant conversation with a friend who underwent weight-loss surgery, Guy decided that it was time to let the scalpel change his course.
Obesity is a national epidemic that is on the rise. More than one-third (35.7%) of adults are considered to be obese. More than 1 in 20 (6.3%) have extreme obesity and it affects both sexes equally, about 36% of each.
Most people with obesity are at risk for type II diabetes, heart disease, high blood pressure, fatty liver, osteoarthritis, certain types of cancer (e.g., breast, colon, endometrial, kidney), and stroke. These individuals often take multiple medications to manage the activities of daily living. The estimated annual health care cost of obesity-related illnesses is a staggering $190.2 billion, or nearly 21% of annual medical spending in our country.
The social aspect is a whole other story. Obese individuals are trapped in bodies they can’t deny and somehow adjust to the new reality. According to Dr. Paul Thodiyil, Chief of Bariatric Surgery at the Mount Sinai-Beth Israel Medical Center in New York City, many, almost 60% to 70%, consider themselves relatively healthy and without the need for any medical/surgical intervention.
The solution is multi-factorial—a combination of behavior therapy, diet, and exercise. All of these factors are essential for success but there is a subset that includes strictly surgical candidates. Post-surgery, not only do physical appearances improve, confidence levels also improve and, best of all, medical problems disappear; most are able to discontinue their pills.
However, once the heavy burden of obesity is lifted, most patients are left to deal with a new problem—the persistence of redundant wrinkly skin and the misdistribution of fat. This new problem can be addressed only with staged body contouring procedures including: abdominoplasty, lower-body lifts, thigh lifts, arm lifts, and sometimes face and neck lifts.
These procedures are not always affordable and may present complications. However, the rewards can be overwhelming. With changes in appearance comes the feeling of a new, jubilant life. In Guy’s words, “I feel incredible…like a different person. I feel [like] I’m 10 years younger. Today, I feel every part of my body, and know it’s there.”
