Obesity and Health

Helping people overcome obesity

At Prisma Health Weight Management Center, we have invested in a variety of programs and services to help individuals overcome obesity.

Obesity is a life-threatening disease that currently affects 25 percent of the United States population, and South Carolina has some of the highest obesity levels in the country for children and adults. The causes of obesity are multiple and complex, and not simply a result of overeating or lack of willpower. Research has shown that in many cases a significant, underlying cause of severe obesity is genetic.

Studies have demonstrated that once the problem is established, dieting and exercise programs have a limited ability to provide effective long-term relief. However, when the disease of severe obesity is treated with an experienced surgeon and professional, multidisciplinary team, it’s possible for the patient to achieve long-term weight loss and relief from obesity-related conditions.

Causes of obesity include:
  • Genetic factors
  • Environmental factors
  • Metabolic factors
  • Behavioral factors
  • Psychological factors
  • Physiological factors
Obesity-related health conditions

Obesity causes the development of a number of serious diseases which take the lives of more than 300,000 Americans every year. These other diseases are referred to as comorbid diseases. Fortunately, significant weight loss can often lead to the complete resolution of comorbid diseases in severely obese patients.

It is important to understand that not all obesity is the same. Physicians use a calculation called a body mass index (BMI) to classify degrees of obesity and to define healthy weight.

These are the main comorbid diseases that affect the quality of and ultimately shorten the lives of the severely obese:

  • High blood pressure and heart disease
    • Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises or stays high over time, it can damage the body in many ways. The heart, brain and kidneys are especially vulnerable. Potential complications of long-term high blood pressure include heart attacks, strokes and renal failure.
    Type 2 diabetes
    • Diabetes is a disease in which the body's blood glucose, or blood sugar, level is too high. Normally, the body breaks down food into glucose and then carries it to cells throughout the body. The cells use a hormone called insulin to turn the glucose into energy.
    • In type 2 diabetes, the body's cells don't use insulin properly. At first, the body reacts by making more insulin. Over time, however, the body can't make enough insulin to control its blood sugar level.
    • Diabetes is a leading cause of early death, coronary heart disease, stroke, kidney disease and blindness. Most people who have type 2 diabetes are overweight. 
    • Being overweight or obese raises your risk for colon, breast, endometrial, and gallbladder cancers. Obesity is second to smoking as a behavioral contributing factor to cancer.
    Osteoarthritis of weight-bearing joints
    • With obesity comes added pressure on weight-bearing joints such as ankles, knees and hips. This increased “wear and tear” prematurely wears out the joints and can lead to the development of arthritis.
    Sleep apnea and other respiratory problems
    • Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. A person who has sleep apnea may have more fat stored around the neck. This can narrow the airway, making it hard to breathe. The obstruction of the flow of air can lead to dangerously low blood oxygen levels or a buildup of carbon dioxide in the blood.  Due to lack of extended sleep, patients with sleep apnea feel chronically tired.
    • Obese people also may suffer from obesity hypoventilation syndrome (OHS), in which poor breathing results in too much carbon dioxide and too little oxygen. 
  • Gastroesophageal reflux and heartburn
    • Gastroesophageal reflux (GER) happens when your stomach contents come back up into your esophagus. Stomach acid that touches the lining of your esophagus can cause heartburn (also called acid indigestion). Gastroesophageal reflux disease (GERD) is a more serious and long-lasting form of GER. You are more likely to have GERD if you are overweight or obese.
  • Depression
    • Obesity is associated with increasing rates of major depression, bipolar disorder, panic disorder and other disorders. When a patient who is depressed because of obesity experiences weight loss through bariatric surgery, it can have a positive influence on their depression.
  • Infertility
    • Many studies have highlighted the link between obesity and infertility in women and men. For example, obesity can contribute to problems with ovulation and to irregular menstrual periods. It also contributes to a lowered response to fertility treatment and to miscarriages. Sex hormone levels also can be altered due to excess adipose (fatty) tissue in the body. Research indicates that reducing obesity improves overall reproductive health.

The cost of obesity

Every year an estimated $150-170 billion is spent on the medical cost of obesity. When comparing costs of losing weight with dieting versus bariatric surgery, dieting is estimated to cost 8-10 times more per pounds lost than surgery. The table below shows the annual cost of some of the more popular diets, along with the percentage of patients completing the diet in one year.

Diet Percent of patients completing 1 year Weight loss Cost
Atkins    53% 4 lbs. $5216
Zone    65% 7 lbs. $4827
Weight Watchers    65% 6 lbs. $5025
Nutrisystem    48% 5 lbs. $5903


As you can see, the weight lost is extremely modest and only about half the patients are able to complete one year of dieting at a cost that is quite high.

Benefits of weight loss surgery

When combined with a comprehensive treatment plan, bariatric surgery has been shown to help improve or resolve many obesity-related conditions, such as type 2 diabetes, high blood pressure and heart disease. Frequently, people who lose weight find themselves taking fewer and fewer medications to treat their obesity-related conditions. With fewer social boundaries and fewer restrictions to their daily activities, patients improve their self-esteem, longevity and overall health.

Risks of weight loss surgery

Over the years bariatric surgery has progressively become safer, and outcomes continue to improve due to the implementation of Comprehensive Center criteria that is focused on quality of care provided to the patients. 

Comprehensive care

At Prisma Health Weight Management Center, we are proud to provide comprehensive care. We report our outcomes data to a national registry to ensure better patient care.

Bariatric surgery has the same or even fewer risks (bleeding, infection, accidental injury to intra-abdominal organs and even death) than any other major abdominal operation. Severely obese patients are considered to be at increased risk for other complications such as blood clot formation in the lower extremities and lungs. Even so, the percentage of serious events following bariatric surgery was less than two percent.

Malnutrition, vitamin deficiencies and anemia are possible later complications if patients do not comply with their prescribed vitamins and medications. In some cases, if patients do not address this problem promptly, diseases may occur along with permanent damage to the nervous system. Other late problems include strictures (narrowing of the sites where the intestine is joined) and hernias (part of an organ bulging through a weak area of muscle).

Bariatric surgery is not for everyone. If you wish to go down this path you must be ready to make major lifestyle changes and be compliant with all recommendations and follow up. A partnership must develop between you, your surgeon and your primary care physician in order to enjoy the success you deserve.