The current status of bariatric surgery (original) (raw)

OBESITY AND CHALLENGES OF BARIATRIC SURGERY (Atena Editora)

OBESITY AND CHALLENGES OF BARIATRIC SURGERY (Atena Editora), 2024

Obesity is included in the group of non-communicable diseases, and its prevalence is increasing extensively, reaching epidemic proportions. more than 1 billion adults are overweight and of these more than 300 million are obese, this being the main component for chronic and limiting diseases. In developed countries, such as the United States of America (USA), 73% of the population is obese, with obesity-related mortality reaching 300 thousand cases per year. The global obesity epidemic reflects the social, economic and cultural problems currently faced by developing or recently industrialized countries, as well as by ethnic minorities in disadvantaged situations in developed countries. Obesity is a complex disease with serious social and psychological consequences, which affects all ages and social groups. METHOD: This is a narrative review of the literature, which aims to describe obesity, showing its causes and complications, and when to recommend bariatric surgery, from a theoretical point of view. DISCUSSION: Among obese patients, the female sex stands out, the predominance of patients of this sex seems to indicate that there was a greater demand for treatment among women, however, it may reflect the search for women with domestic activities, who had greater availability of time for treatment (Porto MCV et al 2002). Regarding age, the data is similar to other studies. Bariatric surgery, nowadays, is the most effective treatment for grade III obesity and has been expanding exponentially, in line with this global epidemic, and to date, of the patients undergoing this surgery, only 1% have the effects. of this therapy (weight loss) reversed. Periodic multidisciplinary monitoring in the post-operative period of bariatric surgery has a significant impact on weight loss, with clinical monitoring of the patient and psychological support. CONCLUSION: The treatment of grade III obesity, through an interdisciplinary team, results in a more effective treatment, with the entire team speaking the same language to the patient, highlighting that the success of the treatment depends mainly on the patient's commitment. Diet and physical exercise have been shown to be ineffective over a long period of treatment. More than 90% of people who have tried to lose weight regain it in specialized clinics where there is a substantial loss of weight, after stopping treatment the weight is regained.

Metabolic and bariatric surgery

Mini-invasive Surgery, 2021

Obesity is a disease causing multiple comorbid health conditions such as type 2 diabetes, hypertension, obstructive sleep apnea, back pain, and cancers. Weight loss improves overall health and quality of life. When diets, exercise, and behavioral changes are not enough, weight loss operations can help patients lose 100 pounds or more, reverse associated health problems, and increase longevity.

Bariatric surgery versus non-surgical treatment for obesity: a

Objective To quantify the overall effects of bariatric surgery compared with non-surgical treatment for obesity. Design Systematic review and meta-analysis based on a random effects model. Data sources Searches of Medline, Embase, and the Cochrane Library from their inception to December 2012 regardless of language or publication status. Eligibility criteria Eligible studies were randomised controlled trials with ≥6 months of follow-up that included individuals with a body mass index ≥30, compared current bariatric surgery techniques with non-surgical treatment, and reported on body weight, cardiovascular risk factors, quality of life, or adverse events. Results The meta-analysis included 11 studies with 796 individuals (range of mean body mass index at baseline 30-52). Individuals allocated to bariatric surgery lost more body weight (mean difference −26 kg (95% confidence interval −31 to −21)) compared with non-surgical treatment, had a higher remission rate of type 2 diabetes (relative risk 22.1 (3.2 to 154.3) in a complete case analysis; 5.3 (1.8 to 15.8) in a conservative analysis assuming diabetes remission in all non-surgically treated individuals with missing data) and metabolic syndrome (relative risk 2.4 (1.6 to 3.6) in complete case analysis; 1.5 (0.9 to 2.3) in conservative analysis), greater improvements in quality of life and reductions in medicine use (no pooled data). Plasma triglyceride concentrations decreased more (mean difference −0.7 mmol/L (−1.0 to −0.4) and high density lipoprotein cholesterol concentrations increased more (mean difference 0.21 mmol/L (0.1 to 0.3)). Changes in blood pressure and total or low density lipoprotein cholesterol concentrations were not significantly different. There were no cardiovascular events or deaths reported after bariatric surgery. The most common adverse events after bariatric surgery were iron deficiency anaemia (15% of individuals undergoing malabsorptive bariatric surgery) and reoperations (8%). Conclusions Compared with non-surgical treatment of obesity, bariatric surgery leads to greater body weight loss and higher remission rates of type 2 diabetes and metabolic syndrome. However, results are limited to two years of follow-up and based on a small number of studies and individuals. Systematic review registration PROSPERO CRD42012003317 (www. crd.york.ac.uk/PROSPERO).

Techniques, assessment, and effectiveness of bariatric surgery in combating obesity

Open Access Surgery, 2010

Obesity is an epidemic disease, and its prevalence is predicted to rise in the future. Many health and social comorbidities, such as cardiovascular disease, type 2 diabetes mellitus, cancer, nonalcoholic fatty liver disease, arthritis, infertility, eating disorders, unemployment, and low quality of life, have been associated with obesity. Nowadays, bariatric surgery is the only effective treatment for severe obesity. An increasing body of literature demonstrates significant remission of obesity-related comorbidities and an increase in life expectancy after surgical treatment. Unfortunately, serious complications can appear after surgery, and the careful preoperative assessment of patients is necessary to estimate the indications and contraindications of bariatric surgery. Recent studies report the lower complication and mortality rates when bariatric procedures are performed in high-volume centers. The purpose of this review is to describe the techniques of the currently used surgical procedures and the clinical effectiveness of bariatric surgery. Additionally, the possible complications and mortality rates after bariatric surgery are discussed.

Bariatric Surgery for Morbid Obesity

New England Journal of Medicine, 2007

This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are presented. The article ends with the author's clinical recommendations.

Bariatric surgery is an effective treatment for morbid obesity

PubMed, 2013

The global obesity epidemic is also affecting the Netherlands, paralleled by a proportional increase in the number of morbidly obese persons. Bariatric surgery has been included as a treatment for morbid obesity in the Dutch Guideline for Obesity (2008). Nonetheless, bariatric surgery is applied in only a limited number of morbidly obese subjects in the Netherlands. Based on the most recent literature and Dutch statistics, this review provides a summary of current knowledge on the impact of obesity on health and health care and highlights the effective role of bariatric surgery in reducing this threat to public health.

Bariatric Surgery - Effects on Obesity and Related co-Morbidities

Current Diabetes Reviews, 2014

Laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (SG) are the three most commonly performed bariatric procedures. Obesity responds well to bariatric surgery, with major long-lasting weight loss that is most pronounced after RYGB and SG, where the mean weight loss is about 40 kg or 15 body mass index (BMI) units. Some of the benefits after RYGB and SG are independent of weight loss, and the remission of type 2 diabetes is observed a few days after the operation; this depends on changes in insulin sensitivity and gut hormone responses, especially a 10-fold increase in glucagon-like peptide-1 (GLP-1), which improves insulin secretion. After gastric banding, the remission of diabetes depends more on weight loss. Bariatric surgery reduces cardiovascular risk factors including hypertension, lipid disturbances, non-alcoholic fatty liver, musculoskeletal pain and reduces mortality of diabetes, cardiovascular diseases and cancers. Bariatric surgery also improves quality of life. The acute complications of surgery are infection, bleeding and anastomotic leak. Long-term complications are nutritional deficiencies, including vitamins and minerals, and anemia. Some patients have dumping after meals, and a few patients will develop postprandial hypoglycemia after RYGB. About 25% of patients require plastic surgery to provide relief from excessive skin tissue.