Obesity is a major problem in the United States.  Not everyone can make diet and exercise work and diet pills are not the answer.  Obese people are left with the medical and social consequences of being fat. 

In the past decade, the percentage of obese U.S. adults has nearly doubled.  But it's not just a problem in the U.S.  According to the World Health Organization (WHO) it's a global issue with more than 1 billion of the world's adults being overweight and at least 300 million of them obese. 

WHO points to profound changes in society and in behavioral patterns of communities over recent decades as the reason.  Our diet has changed to one with a higher proportion of fats, saturated fats and sugars.  And we've become sedentary with less physically demanding work, more technology at home and more passive leisure pursuits.  More people than ever have become couch potatoes and mouse potatoes. The stress of our modern-day life may also contribute to obesity.  Some people find eating to be soothing and an effective stress-reducer.  Also, scientists have proposed that stress may influence hormones in the body that promote storage of body fat.   

Most doctors agree that every other weight loss option should be exhausted before considering something as drastic as surgery.  However, both experience and medical studies have shown that traditional weight-loss methods just don't work for the severely obese.  In this group, the failure rate of dieting approaches 100 percent.  For these people shedding pounds and keeping it off is a monumental struggle.  Many have tried every diet and every weight loss pill in the book. Some even reach their weight loss goal, only to gain the weight back.

It's important to treat obesity for many reasons, not the least of which is that studies have shown that obese people have shorter life spans if untreated.  Perhaps as importantly, these people also tend to lead less satisfying lives.

Obesity puts a tremendous burden on the body. When it's severe, it's disabling in and of itself.  Plus, obesity opens the door for a whole host of serious health problems including diabetes, high blood pressure, stroke, heart disease, osteoarthritis, sudden death sleep apnea and an increased risk of death from some cancers.

Obesity carries other implications as well.  There's a stigma to being overweight. People who are not overweight judge those who are harshly.  They look at obese people as being lazy, weak-willed, less competent, less intelligent and out of control, even when the facts don't support that view.  The obese are likely to be discriminated against in school and on the job. The obese may even be stereotyped by their physicians.  Bias is never more obvious than when it comes to romance.  Just as "location, location, location" is the mantra for real estate, "appearance, appearance, appearance" is often fundamental for attracting and keeping a mate.  In many cases body image dissatisfaction prevents the obese individual from attempting intimacy. The obese tend to be at high risk for depression and anxiety, social isolation and alienation.

In the end, people who have fought with the scales for years have two choices:

• Go on another behavior modification program
• Consider a surgical alternative

Conspicuously absent from the above list is the alternative of taking diet pills.  A "magic bullet" diet pill may be invented in the not-too-distant future, but today there isn't one that will help you to lose significant amounts of weight safely and permanently.
 
When does it make sense to consider surgery?  The answer for many is when the consequences of staying at their current weight put them at higher risk than the risk of surgery.