Physical therapy can design and monitor an exercise program to help improve breathing and general strength. Some patients are so decompensated that they begin treatment on a respirator. The expense can be great and there can be recurrent admissions unless the cycle is broken by timely and appropriate surgical treatment. There are situations where insufficient communication occurs between those providing emergency care and bariatric surgeons. Instead of an operation for weight control, the patient returns home.
Recidivism leads to further emergency admissions.
This soon ends in death of the patient with no long-term benefit from the huge medical expense. It may be difficult to decide whether surgical treatment is justified. There are patients who will not benefit from an operation and this is because, after a lifetime of obesity, high output heart failure or pulmonary hypertension remains even when weight is reduced. Attempting to prepare such patients for operation is the best way to find out. Probably not, but emergency admissions to prepare patients for operation are indicated.