Surgery can cure litany of obesity woes.

Byline: FOCUS ON HEALTH By Thomas Umbach For The Register-Guard

At 357 pounds, Kim Goulart knew she had to make a change. The 39-year-old Springfield resident was taking about 10 different medications for a range of health problems including diabetes, high blood pressure, high cholesterol, severe heartburn and pain in her back and feet.

Back then, in November of 2006, Kim was among an estimated 60 million adults in the United States who are categorized as obese, a condition that substantially raises their risk for high blood pressure, type 2 diabetes, coronary artery disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, along with cancer of the breast, prostate and colon. Obese individuals may also suffer from social stigmatization and discrimination.

Like many obese people, Kim attempted multiple diets over the years without much success. In November, she decided it was time to look at other options, including weight loss surgery.

Contrary to what some might believe, when patients like Kim walk into a weight loss surgeon's office, they are not focused on simply looking better. Sure, that's an added benefit of any successful weight loss program. But the majority of people who are considering weight loss surgery (known in the medical community as bariatric surgery) have one common goal: to become healthier. What most patients don't realize is just how much healthier they will become once they shed the excess weight.

As the second leading cause of preventable death in the United States today, obesity poses a major public health challenge. Health care costs associated with obesity amount to about $100 billion in the United States. Plus, higher body weights are associated with increases in mortality from all causes.

There is hope for people who are obese. If they can lose the excess weight, either through diet and exercise or surgical methods, the body's ability to recover often surprises them. For obese patients, dropping down to a healthy weight can improve cholesterol levels and decrease blood pressure, while also wiping out symptoms of severe heartburn and urinary incontinence. On occasion, obese women who initially report problems with infertility become pregnant after weight loss surgery. But these improvements to health and quality of life are just the beginning.

At the Oregon Bariatric Center, approximately 60 percent of patients are suffering from sleep apnea, a disorder in which patients regularly stop breathing for 10 seconds or longer during sleep. Episodes may occur from five to 50 times an hour, which not only makes for a rough night's sleep, but can become dangerous. When you stop breathing or breathe very slowly during your sleep, it may result in less oxygen in your blood. Over time, this lack of oxygen can lead to serious health problems; however, once patients lose their first 20 to 30 pounds, they see a great improvement in their sleep quality and, in many cases, the sleep apnea goes away for good. In fact, one type of weight loss surgery, known as gastric bypass, has an 85 percent cure rate for sleep apnea.

Type 2 diabetes, which is directly linked to obesity, also tends to disappear after a substantial weight loss. For a surgeon, seeing a person cured of a disease as life threatening as diabetes is the ultimate reward for our work. About 75 percent of patients who seek weight loss surgery are cured of diabetes. Kim no longer has to rely on diabetes medication; in fact, the only pills she regularly takes now are vitamins. The other conditions, including the severe heartburn, high blood pressure and back pain are gone.

According to the National Center for Health Statistics, 64.5 percent of adult Americans are overweight or obese. The Oregon Bariatric Center finds that most obese patients are suffering from at least one, if not many, of the disorders and diseases mentioned in this article. While this is a severe problem for adults, it is even more startling to see the number of children who are starting down the path to a life of battling obesity, and all the health problems that come with it.

For Kim, going through weight loss surgery herself has changed the way her entire family thinks about food. After losing nearly 100 pounds, she is happy to report her family has cut back on processed food and now reads nutrition labels.

With these changes, the entire family has lost weight together. Just the other day, Kim says her son left her a note that said: `I'm proud of you mom, and I'm impressed by your weight loss.' That's all the motivation she needs to keep losing the weight.

Thomas Umbach, M.D., is a board-certified general surgeon and surgical director of the Oregon Bariatric Center at Sacred Heart Medical Center.

DO YOU HAVE A SLEEP DISORDER?

Many obese people suffer from sleep apnea. Here are some of the signs of sleep apnea (for a complete list, visit www.peacehealth .org/sleepdisorders):

I have been told that I snore, gasp or quit breathing during my sleep, even though I do not remember.

I have high blood pressure.

I have woken up with my heart pounding or having skipped a beat during the night.

I frequently feel sleepy during the day, even though I sleep well at night.

I often awaken with a dry mouth.

I frequently awaken with headaches.

I have almost fallen asleep while driving or at work.