The people of Montana face a health crisis: the crisis of obesity. Across our state, the number of overweight and obese individuals is rapidly increasing. In the Treasure State alone almost 59% of the population is overweight or obese. It’s killing us -- nationwide, obesity is the second leading cause of preventable death -- and it may lead to life-threatening illnesses called co-morbidities, such as Type II diabetes, cancer, heart conditions and hypertension, among those who have it.

Obesity is expensive, too. In Montana, obesity-related expenditures account for nearly five percent of all state government health spending.

There is no royal road to instant weight loss. The only way to lose excess weight is to reduce the body’s daily caloric intake below its daily caloric needs. When this happens, the body begins to draw upon stored energy – that is, fat – to stay functional, and weight loss occurs. Given this fact, successfully treating the disease of obesity requires medical care, based upon a complete change in lifestyle and eating habits.

Facing the Crisis

An individual is categorized as obese if he or she is significantly above a healthy weight. Healthy weight is not calculated in terms of pounds, but instead in terms of individual body mass index (BMI). And, BMI is calculated by a person’s weight in pounds x 703 / (height in inches)2.

Those with a BMI of at least 25 are considered overweight; those with a BMI of 30 or above are clinically obese.

Since there’s obviously no way to change a person’s height, the only way to realize a lower BMI is by reducing the patient’s weight. For some of us, education, counseling, support and willpower are enough to accomplish this. For the rest, weight loss surgery stands as a weapon of last resort.

Weight loss surgery is a medical procedure intended to address a patient’s obesity by limiting the amount of food – and thus calories – that her or she can consume. Common procedures, such as the Lap-band and gastric bypass surgery, are performed under general anesthesia, and most (though not all) are performed laparoscopically. The three main types of weight loss surgery are: malabsorptive (which alters the patient’s intestinal tract), restrictive (which involves the creation of a smaller stomach pouch that limits the amount of food needed for the patient to feel full), and combination (which involves both creating a small stomach pouch and altering the patient’s intestinal tract). Each procedure entails different risks and benefits.

Considering Surgical Weight Loss

Weight loss surgery can be a true lifesaver. However, patients who fail to follow their doctor’s guidelines for diet and physical activity postoperatively may regain their excess weight or reach a weight-loss plateau over time.

Those considering bariatric surgery as an option for the management of obesity should carefully weigh the risks and possible outcomes of these procedures in consultation with their physician.

Montanans can face this crisis, but only as a team. It is going to take time, money, and leadership. But, by working together – and by keeping the goal of a healthier Montana in mind – we can overcome the problems caused by widespread obesity in our great state.