In Spain, according to a study by the Spanish Society of Cardiology, the ratio of people with morbid obesity soared by 200%, increasing from 1.8 people of every 1,000 inhabitants in 1993, to 6.1 people in 2006. This is a serious public health problem that surely will increase if effective interventions are not made. In most cases morbid obesity is due to a lack of education and social culture, where food is very poor in quality. According to many specialists, health authorities should go for a strong intervention at national level to raise awareness in considering this problem as a disease. Among the health consequences, morbid obesity not only leads to cardiovascular disease, diabetes, joint problems or respiratory apnoea but also has an impact on social exclusion. One of the most effective solutions for this disease is the gastric bypass surgery. It is a procedure to treat morbid obesity that first divides the stomach into a small upper pouch and a much larger lower “remnant” pouch and then re-arranges the small intestine to connect to both. “From my 124 Kg I managed several times to drop to 100-105 Kg, but I never managed to remain at that weight”. This is the reason why Sandra, a 31 year old Spaniard, decided to go for this long and tough process. One year waiting in the public health system going through nutritional group sessions, psychiatrist interviews and different medical exams and of course the deal to lose at least 10 Kg before the surgery. When I asked Sandra why she did it, she told me that she didn’t want to have health problems in the future and also because she wanted to be accepted by society”. The first signs of obesity began to emerge when Sandra was twelve years old and then consolidated at the age twenty when she overtook 100Kg. At twenty-nine years of age she was already 124kg. “I’ve never had a complex of aesthetics, but I have always been aware of health problems.” When Sandra found out about the possibility of surgery, she began to realize that her goal could be achieved. It was a hard decision for her, but at the end she decided to be enrolled at the Hospital del Mar’s program. Despite having several people in the family who disagreed with her decision, she got the unconditional support of her mother. Sandra succeeded to achieve her goal as she lose almost 55 kg in less than two years and now she is on her way to a new life, though she is still on the process. The program was launched at the Hospital del Mar in 2004 and in the first eight years 350 patients underwent surgery. Even if not all of them managed to reduce significantly their weight, the entire number of patients got much better in terms of health problems like diabetes, cholesterol, cardiovascular disease. According to the experience accumulated during the first eight years at the Hospital del Mar, 70-80% of the patients are women with an average of age of 43 years and within a range between 18 and 60 years of age. Beside there are many different typologies of patients, normally morbid obesity in the western world is associated with lower socioeconomic and educational levels.
