On medical issues, there are different ways of interpreting events. Go back ten years and the question of surgery for weight loss — the so-called bariatric surgery — was viewed as an extreme response to the problem. In some senses this represented caution on the part of surgeons who wanted to ensure the procedures were safe. But it also reflected a desire to encourage people, wherever possible, to achieve weight loss through their own efforts. The concern was that, if people had proved incapable of controlling their intake of food before eating, they might continue to eat unwisely and undo the surgeon’s good work. For this reason, access to surgery was limited to cases where individuals were more than 40 BMI or more than 35 BMI if their health was adversely affected. More importantly, people had to demonstrate a genuine effort at weight loss before surgery would be authorized. This always involves dieting, an exercise routine and use of one of the anti-obesity drugs.

Today, surgery is increasingly common with thousands of patients treated every year. This is perhaps a commentary on the number of people who now qualify with a BMI of 35 or higher. It may also reflect the increasing availability of funding through health insurance. Whatever the reason, there is urgent research to determine the effectiveness of the surgery and the extent to which the patients experience an improvement in their quality of life. The picture emerging is mixed. Up to 40% of people going through surgery require follow-up treatment for complications. Significantly, real psychological problems have been identified with people requiring treatment for sometimes severe depressive disorders. These people find the physical effects of surgically restricting the amount they can eat very disruptive.

However, on the good news side, more women are able to produce children safely. Between 2003 and 2005, more than 50,000 women of child-bearing age had the surgery. Following this group has found that, when pregnant, they have fewer problems with high blood pressure, diabetes and premature birth than obese women who have not had surgery. Their babies were more consistently born at a healthy weight. Note that pregnancy is not recommended during the first year while your body is adjusting to the new physical limitations. Equally important is the need to get guidance on eating a healthy diet. It may be necessary to take vitamins and other supplements following surgery to ensure the baby is born healthy.

Surgery actually has a more dramatic effect on the body than most people realize. They are unable to eat solid food for some time, and the diet has to change to ensure they get all the nutrients required for good health. Under such circumstances, people do not need to rely on acomplia or any of the other anti-obesity drugs. Eating is significantly less pleasurable and people do not need appetite suppression. But before surgery, the use of acomplia can be appropriate as part of a real effort to lose weight naturally. The only issue to ask your doctor about is mood. As already indicated, many people become depressed after surgery. Before surgery, it is very important to stay positive and to maintain a reasonably happy mood. If not, this may not be a good indicator for them after surgery. It may also make it inappropriate to use acomplia. Always take advice and follow your doctor’s instructions before going through with surgery.