What is bariatric medicine?
Bariatric medicine is the field of medicine dedicated to treating and preventing obesity and obesity-related diseases.
The term bariatrics can also be used as an adjective to describe products and services relating to the overweight and obese, such as a bariatric wheelchair.
In this article, we’ll delve into the field of bariatric medicine and learn more about its medical applications.
What does “bariatrics” mean?
The word bariatrics is rooted in the Greek word for weight, baros. In the most general sense, bariatrics involves the study, treatment, and prevention of obesity and its related problems.
It wasn’t until the 1960s that the field of bariatrics become widely known. It was during this time that bariatric physicians began developing various surgeries for weight loss–first the gastric bypass, and later the intestinal bypass.
Some doctors and professional groups specializing in obesity have moved away from the term bariatrics due to its strong associations with weight loss surgery. In fact, one of the leading organizations formed to further the study of obesity, the American Society Of Bariatric Physicians (ASBP), recently changed their name to the Obesity Medicine Association (OMA).
This new name, they believe, encompasses a multi-faceted approach to fighting obesity that includes environmental, genetic, nutritional, physiological, and psychosocial factors.
While bariatric surgery is still very much a part of obesity treatment, it is just one component of a larger field.
Why would somebody need bariatric medicine?
For people living with obesity, it can be difficult to develop and adhere to a plan for weight loss.
They might not have adequate information for developing weight loss strategies. They may feel overwhelmed or discouraged by the challenge. They may even have an underlying condition preventing weight loss that a professional will need to diagnose.
A bariatric doctor can provide the guidance, information, and support necessary to help an overweight person achieve real change.
The health problems associated with chronic obesity are numerous and can be very severe. Here are just a few examples:
Reduced life span
People with chronic obesity can expect a reduction in life expectancy of 10 to 15 years. This figure will vary depending on a number of factors, but the bottom line is that overweight people don’t live as long.
Increased risk of diseases and health complications
Susceptibility to conditions such as coronary heart disease, high blood pressure, stroke, type 2 diabetes, and metabolic syndrome will increase. Obesity can also increase instances of sleep apnea, reproductive issues, gallstones, cancer, and arthritis.
Loss of mobility
The increased stress on joints and bones can make movement difficult and can lead to dependence on walkers, wheelchairs, canes, and scooters for normal movement.
Who qualifies as a bariatric patient?
We’ve established that bariatric medicine focuses on obese people, but how do you define obesity?
A common way to determine obesity is body mass index (BMI). This simple calculation provides a rough estimate of a person’s body fat levels and is the metric of choice for the World Health Organization (WHO) and the National Institute of Health (NIH).
According to these organizations, those with a BMI greater than 30 are obese and greater than 40 are severely obese. Individuals in these categories are candidates for bariatric treatment.
It’s important to note that BMI is simply a screening tool and does not a medical diagnosis. Many factors can skew a person’s BMI, so it’s always best to see a doctor if you’re concerned about your weight.
While BMI is the most common guide for obesity classification, some organizations use criteria based upon body fat deposits and waist circumference.
Some medical publications indicate that a person who is more than 100 pounds overweight, or who has a total body weight exceeding 300 pounds should undergo some bariatric procedures.
Bariatric Surgery (Weight Loss Surgery)
While a large segment of bariatric medicine is devoted to diet and lifestyle changes, many people think of weight loss surgery when they hear the word “bariatrics.”
There are several types of bariatric surgeries designed to control weight. The most common include the adjustable gastric band, gastric bypass, vertical sleeve gastrectomy.
A full discussion of weight loss surgery is a topic for another post, but this article from the Mayo Clinic is a good start.
A Bariatric Doctor’s Approach to Discussing Obesity
A person’s weight is a sensitive subject, so most bariatric health care providers approach the discussion with care and respect.
One common method involves the 5 A’s Of Obesity Management:
- Ask for permission to discuss body weight
- Explore readiness for change
- Determine body mass index, waist circumference, and obesity stage
- Explore drivers and complications of excess weight
- Inform the patient about the risks of obesity, the reasons for weight loss, and the need for a strategy
- Agree on realistic expectations, goals, behavioral changes, and details
- Identify barriers to success
- Provide resources
- Arrange regular follow-up
Bariatric Services and Equipment
In addition to the specialized knowledge required to treat obesity, special equipment and procedures may be necessary.
Facilities specializing in bariatric medicine are often designed to accommodate larger individuals. They will also have the specialized equipment and staff training needed to help patients move and exercise.
Here are some of the things you might find at an obesity treatment center:
- Extra large hospital beds with pressure reducing mattresses
- Beds with built-in lift systems
- Full body slings and lifts
- Specialty wheelchairs and walkers
- Heavy duty stretchers
- Showers and restrooms designed to accommodate large individuals
- Plus-size hospital garments
Additionally, health care workers trained in bariatrics have educated themselves on providing attentive care to patients.
These staff members know the protocol for assisting patients in employing safe techniques. They can help patients avoid injuries when attempting physical activity. They can also provide information and insight at the request of patients regarding treatments and procedures.
American Board of Obesity Medicine
How Are Overweight and Obesity Treated? (NIH Article)
What is Bariatric Surgery? (News-Medical.net)