The management of obese patients requires a pluridisciplinary approach due to the multiple co-morbidities associated with this disease. Furthermore, health insurers will only cover costs under the condition that patients are treated by a multidisciplinary medical team. For several months, the Hôpital de La Tour worked on setting up a team of this type to meet the needs of the growing number of obese patients. Thus was born the Pluridisciplinary Group for Obesity treatment (GPO). This group is composed of doctors; internists, endocrinologists, lung specialists, intensive care specialists, surgeons and anaesthetists, psychiatrists and psychologists, and, of course, dieticians.
The determination of excess weight is done via an index of body weight or BMI (Body Mass Index) which is calculated as the weight (in kg) divided by the height squared (in metres). A score between 18.5 and 25 reflects a normal BMI ratio. Between 25 and 30, one speaks of excess weight, from 30 to 40, obesity. Above 40, it is called morbid obesity, because there are always one or more co-morbidities. These co-morbidities are multiple and of varying severities ranging from diabetes to heart failure to hypertension, sleep apnoea, osteoarthritis and precocious skin changes, to list only the main ones. In addition, affected women often suffer from menstrual disorders and all patients have psychological issues and/or psychiatric problems.
In no way does the GPO replace the physician but seeks to create a relationship of privileged doctor/patient partnership. Multiple skills are needed to provide optimal care to obese patients. Patients under the care of the group will have a single medical record which will be completed by each specialist as and when difficulties arise, in order to provide the primary physician with an appropriate therapeutic analysis as well as an effective follow-up.
This alternative therapy includes three types of surgical procedures:
- purely restrictive procedures aimed at reducing gastric capacity (a typical example is the gastric ring);
- malabsorptive processes which include diversion of the small intestine that absorbs food (biliary-pancreatic diversion, duodenal switch); and combined procedures (restrictive and malabsorptive) such as the gastric bypass.
The Hôpital de La Tour and its medical team provide a highly sophisticated holistic structure since all medical and surgical specialties are available, as well the most advanced technical services (continuing care, intensive care, physiotherapy and dietary services). The operating theatre of the hospital has recently acquired an operating table for obese patients and the housing service has several beds suitable for such patients.
Last modified on December 18th, 2015.
Unless specified otherwise, this text has been written by the editorial team.