Article/Ju Yan Image courtesy of NTU Hospital
According to the National Health Service's 2013 statistics, 42.3% of Taiwanese are overweight (BMI > 24), and 17.1% are obese (BMI > 27); according to NTU Hospital's statistics, the proportion of patients with severe obesity (BMI > 35) or morbid obesity (BMI > 40) is also increasing. The percentage of patients with severe obesity (BMI > 35) or morbid obesity (BMI > 40) is also increasing year by year.
Obesity is a new national disease! The higher the BMI, the higher the risk of death!
Taiwan has the highest prevalence of obesity in Asia, and obesity is a new national disease! The higher the body mass index (BMI), the greater the health risk! Obesity can cause many related diseases, such as some cancers, cardiovascular disease, hypertensive disorders, diabetes, stroke, etc., are not related to "obesity", and more than half of the obese people also have sleep apnea problems. In other words, the risk of death increases with increasing BMI.
In view of the health hazards of obesity, NTU Hospital has combined the Departments of Surgery, Internal Medicine, Family Medicine, Nutrition, Psychiatry, Rehabilitation, Physical Therapy, and the Sleep Center to formally establish an integrated Weight Loss and Metabolic Surgery Center in September of this year to provide multidisciplinary and integrated medical care for moderately and severely obese patients with concurrent metabolic diseases. The center will also develop cross-disciplinary basic and clinical academic research, integrating the existing research platforms of NTU Hospital and National Taiwan University to enhance industry-academia collaboration and research effectiveness.
Surgery effectively solves morbid obesity and improves type 2 diabetes
Dr. Yang Bo-jen, Deputy Executive Director of the Center for Weight Loss and Metabolic Surgery at National Taiwan University Hospital, pointed out that in addition to surgical treatment of morbid obesity, the center also provides treatments that include weight-loss diets, exercise, and medications for weight-loss, which provide a full range of services for patients who need to lose weight and improve their metabolic disorders (such as type 2 diabetes). The case manager's guidance and arrangements can reduce the need for patients to travel back and forth between departments to register, which can be difficult and time-consuming, saving time and avoiding the waste of medical resources.
For patients with severe obesity, bariatric surgery is currently the only method of long-term effective weight control and can improve the health problems caused by obesity.
Currently, weight loss surgery is mainly performed by gastric bypass and gastric sleeve resection. According to the statistics of National Taiwan University Hospital, one year after the gastric bypass surgery, 32% of the body weight can be lost, and one year after the gastric sleeve resection, 29% of the body weight can be lost, and at the same time, it can also greatly improve the metabolic problems associated with obesity, such as type 2 diabetes, high blood pressure, high blood fat, sleep apnea, etc., especially for the treatment of type 2 diabetes, which has an even more pronounced effect.
Yang Boren said, about half of the obese patients, combined with the problem of type 2 diabetes, in the application of weight loss surgery, blood glucose problems are also improved.
The weight loss surgery team at National Taiwan University Hospital has made it possible to improve the health of many high-risk patients who are severely obese and have a combination of three highs or cardiorespiratory problems, and at the same time, combined with diet and exercise-related treatment, and by the hands of a plastic surgeon, it has also made a lot of postoperative successful weight loss patients more perfect.
Beware!
Whether it's weight loss surgery or metabolic surgery, Dr. Yang reminds us that some patients need to pay special attention to whether they have a tendency to be depressed. The first step in the process is to make sure that you have a good understanding of how to use the data to make sure that you have a good idea of what you're doing and how to use it.
The first step in the process is to find a way to make sure that the patient has a good understanding of what is happening in the world, and how to make it happen.
However, people in China are not used to dealing with psychiatrists, and the willingness of patients and their families to agree to a psychiatric consultation before surgery is mostly low.
Mastering the 5 elements of weight loss without surgery is also easy to lose
For the assessment of patients who do not need or are not suitable for weight loss surgery, Yang Boren pointed out that the center will refer patients to the Department of Internal Medicine, Department of Family Medicine or Department of Nutrition, the use of LEARN (LEARN) by means of Lifestyle, Exercise, Attitudes, Interpersonal skills, and the ability to learn and learn from each other, as well as the ability to learn and learn from each other, Lifestyle, Exercise, Attitudes, Relationships, and Nutrition. After treatment, patients can lose an average of about 10 kilograms of weight, and the BMI value can also be reduced by about 3.6.
In recent years, NTUH has identified a number of obesity-related genes and biomarkers, which are expected to reduce the health risks associated with obesity and its complications. In the future, the Center for Weight Loss and Metabolic Surgery at NTUH will not only focus on the evaluation and treatment of patients with severe obesity, but will also establish a local database to develop the most suitable treatment for Asian patients.
Bariatric Surgery Benefits
Currently, health insurance benefits for bariatric surgery are based on the 1991 National Institutes of Health (NIH) standards, and must meet the following six conditions:
1. BMI>40 (morbid obesity), or BMI>35 with obesity-related complications (severe obesity). (severe obesity).
2. Age between 18 and 55 years.
3. Failure of medical weight loss treatment for more than six months.
4. No endocrine system abnormalities or other diseases that can cause obesity.
5. No substance abuse or mental illness.
6. No major organ dysfunction and acceptance of surgical risk.
If the patient is eligible for Medicare coverage, the patient is responsible for the cost of the laparoscopic supplies, the difference between the hospital room and the Medicare portion of the cost, which can range from tens of thousands of dollars to over a hundred thousand dollars.
Yang Boren pointed out that, if the current Asia-Pacific region in accordance with the newer norms, BMI>35 or even BMI>30 and at the same time combined with obesity-related complications, can also be assessed for bariatric surgery; in the metabolic surgery for type 2 diabetes as the main object of the current recommendations around the world, as long as BMI>32.5 or BMI>27.5 and poorly controlled diabetes or cardiovascular problems, metabolic surgery can also be considered to improve the condition.
Definition of obesity
The World Health Organization (WHO) recommends that body mass index (BMI) be used as a criterion for overweight and obesity. The Ministry of Health and Welfare of Taiwan defines the weight standard for Taiwanese people according to the health condition of the nation as shown in the table below. BMI Calculation: Weight (kg) / Height (m2)
BMI Value Weight Standard
BMI <18.5 Underweight
18.5 ≦ BMI <24 Ideal Weight
24 ≦ BMI <27 Overweight
27 ≦ BMI <30 Mild Obesity
30≦BMI＜35 Moderate obesity
35≦BMI＜40 Severe obesity
BMI ≧40 Morbid obesity
Common 2 major weight loss surgeries
Nowadays, weight loss surgeries are performed to change the structure of the gastrointestinal tract to achieve the purpose of weight loss, and there are commonly 2 types of surgeries: gastric bypass and gastric sleeve resection.
◆Gastric bypass surgery
Gastric bypass surgery is the most effective for weight loss. The surgery is divided into 2 parts. The first part divides the stomach into a small stomach and a large stomach, so that only the small stomach passes through the stomach and the patient gets full when he eats a little bit; the second part changes the structure and direction of the small intestine, so that the small intestine does not have a normal digestive and absorptive role, and so the patient not only eats less, but also has poor digestion and absorption.
◆Gastric Sleeve Resection