MORBID OBESITY Morbid obesity is the condition in which a person’s excess weight is causing or will soon cause serious health problems. Obesity is a major health issue in Australia as we enter the 21st Century, while posing a difficult therapeutic challenge for doctors. According to the recent report, the majority of Australia are overweight. Researchers and doctors are beginning to realize that obesity is a chronic condition, like hypertension or diabetes, influenced by genetic, metabolic, and environmental factors. The pathogenesis of morbid obesity involves more than just a lack of willpower or a sedentary lifestyle. Obesity contributes to the development of numerous life- threatening or disabling disorders including coronary heart disease, hypertension, Type II diabetes mellitus, hyperlipidemia, degenerative joint disease, and obstructive sleep apnea. Heavier men and women have an increased risk of premature death. In the United States, an estimated $45 billion is spent annually treating disease associated with obesity, with a total cost to society estimated at $140 billion. Annual healthcare costs are 44% higher for patients with a body mass index (BMI) > 35, compared to patients with a BMI from 20 to 24. Significant weight reduction in the morbidly obese has been demonstrated to improve or reverse co-morbid illness, and benefit psychological, social, and economic well-being. A person is considered morbidly obese when a person’s Body Mass Index (BMI) is more than 40. The formula used to calculate a person’s BMI is: BMI = weight (kg)/height (m2) weight (expressed in kilograms) divided by the square of height (expressed in meters) A BMI below 25 is normal. People with a BMI of 35-40 who also have diabetes or high blood pressure may also be considered morbidly obese. How is morbid obesity surgically treated? The Laparoscopic Adjustable Gastric Banding is one of the most commonly performed surgeries in the world and results in an excess weight loss of 60%. Attention to diet and eating habits, exercise, and long-term follow-up with your surgeon also contribute to optimal weight reduction. In addition to weight loss, many associated medical problems will resolve or improve following bariatric surgery. Adult-onset diabetes mellitus improves in over 90% of patients, with 80% becoming medicine-free, including insulin. Improvements in hypertension and high cholesterol may be expected. Obstructive sleep apnea, shortness of breath and other respiratory difficulties such as asthma, improve or go away completely in the majority of patients. Gastroesophageal reflux (GERD) is frequently cured immediately. Although permanent damage to the joints, which has already occurred, is not reversible, improvements in mobility and joint pain can be expected. Improvement is also frequently observed with leg swelling or venous stasis disease, urinary continence, and headaches.