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EOSS: Evaluating Need for Surgical Management of Obesity
Dr. Arya Sharma, an obesity expert from the University of Alberta, has
developed a new classification system to help doctors assess and treat obese
patients (published on 16 Aug 2011/medicalnewstoday.com). If proven successful,
this system
would be used in tandem with the
BMI measurement to help identify the health differences between people with
similar BMIs.
The doctors will rank people with Class 1, 2 or 3 BMIs — where Class 3 is the
heaviest, but not necessarily the worst — they would also use five new stage
rankings.
According to Dr Sharma "Edmonton Obesity Staging System (EOSS), is a five-stage
scale (0-4) that considers BMI, other illnesses and functional status of people
who are obese to rank
the consequences of excess
weight. "
The stages to be used for evaluation:
-
Stage 0 would be someone with no health problems.
-
Stage 1 would be someone with risk factors, such as snoring or
borderline
hypertension.
-
Stage 2 and 3 would be someone whose condition is worsening, causing a
heart attack, liver cirrhosis, sleep apnea or need for hip and knee
replacement.
-
Stage 4 patients have so many problems they have to be treated extremely
aggressively or need palliative care because losing the weight would be so
difficult.
Using the two systems together would mean someone could have a Class 3 BMI,
but only be at Stage 0. Doctors would encourage that person to
lose weightt, but not
suggest stomach
surgery or prescription drugs since that person is otherwise healthy.
Medical advice would become much more urgent for someone at Class 3, Stage 3,
where bariatric surgery may be necessary.
Currently, the EOSS is being studied at
Alberta Health Services’ adult Weight Wise clinic in Edmonton, Alberta for both
its accuracy and usefulness to doctors.
Is weight loss surgery right for you?
For clinically severe obesity, surgery may be an element of treatment. Many
people, wrongly believe that obese people merely need to stop eating so much and
they will lose weight. In reality, severe obesity is a potentially deadly
disease that sometimes requires a treatment as dramatic as surgery.
There are two types of obesity surgery — restrictive
and combined restrictive/mal-absorptive. Different ways of performing
each surgery have been developed. Each type of surgery has its own risks and
side effects. Your physician can help you decide which is best for you.
Wiring the
jaws together to prevent eating has been used to treat those who have found it
impossible to adhere to
low-energy diet. These can help patients to achieve remarkable
weight loss, but most patients regain weight when the
procedure is reversed. Another major surgery involves the reduction in size of
the stomach for example by stapling which can be undone. Small intestine bypass
aimed at inducing mal-absorption, has been undertaken in some centers for
treatment of severe "morbid" obesity but complications can be severe and
sometimes fatal. Surgery should be considered only for those with gross,
intractable obesity. To know more about the various surgical procedures log on
to
http://www.medscape.com.
These are the kind of questions you will be asked, before surgery:
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Are you 100 pounds or more overweight?
-
With a Body Mass Index (BMI) of 40 or higher
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Are you 80 pounds overweight with related health problems?
-
With a BMI of 35 or higher, plus conditions such as
diabetes, high blood pressure or
sleep apnea
-
Do you have a history of obesity?
-
Have you made multiple attempts to lose weight without long-term
success?
-
Are you willing to make lifelong changes in your
diet? And follow other
lifestyle changes recommended by our weight loss team?
In addition, while on a weight loss program the patient needs medically
supervised weight management. Non-surgical bariatric weight loss services range
from dietary and diabetes counseling to seminars and community education.
- WF Team
Dated 16 August 2011
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