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Obesity is not only a cosmetic problem, it is also a major health problem. Benefits of weight loss are tremendous, especially in improving life expectancy. High blood pressure, diabetes, heart disease are also greatly improved following weight loss. Patients don't always know how to go about loosing they big tummies. I often see patients who are morbidly obese, who wish to have a liposuction or a tummy tuck. I have to explain to them that the majority of the volume responsible for their protruding abdomen does not come from the fat under the skin, but rather from inside the abdominal cavity. It's the intestines, colon, stomach, liver and intraabdominal fat that is their real problem. The layer of fat on the surface that can be liposuctioned or cut out is responsible for only a small part of their large size. I thus recommend a dramatic weight loss either through diet or surgery. Surgical options for these patients include bypass procedures or restrictive procedures such as LapBand ( /). LapBand is a 45 min procedure following which you can go home. It places a band around the stomach, thus decreasing the effective size of the stomach. Patient then feel full after a small amount of food... in effect all it does is limit portion size. It doesn't cut out or bypass any part of the digestive system (unlike gastric bypass surgery) and therefore you don't need to worry about any nutritional deficits, about loosing out on any essential nutrients. (Gastric bypass surgery creates a 'bypass' of your digestive system. As the food passes through the digestive system, it skips a segment of the small intestine where certain essential nutrients are absorbed. Therefore, you need to monitor and supplement your nutrients to ensure that you do not develop a nutritional deficiency) Martin Jugenburg, MD ( )
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