METAMORPHOSIS

Alessandro Vincenzi

A study by the Spanish Society of Cardiology has found that the proportion of people in Spain with morbid obesity has tripled, soaring from 1.8 of 1,000 inhabitants in 1993 to 6.1 people in 2006. It is a serious public health problem that is sure to increase unless there are effective interventions. In most cases morbid obesity is due to inadequate education and social attitudes, where food is very poor in quality. According to many specialists, health authorities should launch a strong national campaign to make more people realise that this problem as a disease. Among the health consequences, morbid obesity not only leads to cardiovascular disease, diabetes, joint problems or respiratory apnea, it can also fuel social exclusion. One of the most effective solutions for this disease is gastric bypass surgery. It is a procedure that first divides the stomach into a small upper pouch and a much larger lower “remnant” pouch and then re-arranges the small intestine to connect to both. “From my 124 kg I managed several times to drop to 100-105 kg, but I never managed to remain at that weight”. That is why Sandra, a 31-year-old Spaniard, decided to go for this long and tough process. She spent a year in the public health system going through nutritional group sessions, psychiatric interviews and different medical exams and had to promise to lose at least 10 kg before the surgery. When I asked Sandra why she did it, she said she didn’t want to have health problems in the future and also because she didn’t want to be socially isolated. The first signs of obesity came when Sandra was 12 years old and by the age of 20 she had passed 100 kg. By her 29th birthday she was 124 kg. ”I’ve never had a complex of aesthetics, but I have always been aware of health problems.” When Sandra found out about the possibility of surgery she began to realize that her goal could be achieved. It was a hard decision but in the end she decided to enrol in the Hospital del Mar’s program. Despite having several people in her family who disagreed with her decision, she had the unconditional support of her mother. Sandra succeeded in achieving her goal as she lost almost 55 kg in less than two years and she is now on her way to a new life. The program was launched at the Hospital del Mar in 2004 and in its first eight years 350 patients underwent surgery. Not all patients managed to significantly reduce their weight but every one of them made important progress with problems like diabetes, cholesterol and cardiovascular disease. So far at the Hospital del Mar, 70-80 percent of the patients have been women with an average of age of 43. While there are many different types of patients, morbid obesity in the Western world is normally associated with lower socioeconomic and educational levels.

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