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Treatment of Obesity: Weight Loss and Bariatric Surgery

Bariatric surgery includes a variety of procedures performed on people with obesity. The loss is achieved by reducing the size of the stomach with a gastric band or by removing part of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by removing and restoring the small intestine to the small pouch (gastric bypass surgery).

The main basis for bariatric surgery for the purpose of weight loss is the determination that obesity is a disease associated with many negative health effects that can be reversed or improved by losing weight. effective weight loss in patients who have not been able to lose weight. non-surgical method. Helps reduce cardiovascular disease (CVD) and other benefits expected from this intervention. The ultimate benefit of weight loss is related to reduced co-morbidity, quality of life and all-cause mortality.

Specific criteria established by the NIH consensus panel indicated that bariatric surgery is appropriate for all patients with a BMI (kg/m2) > 40 and for patients with a BMI of 35-40 with comorbid conditions. These standards have been maintained for many years, although specific indications for bariatric/metabolic surgery have been identified for people with obesity, such as people with a BMI of 30-35 with type 2 diabetes. Indications for bariatric surgery are rapidly evolving to consider the presence or absence of comorbid conditions as well as the severity of obesity, as indicated by BMI.

Special Bariatric surgery methods are Roux-en-Y Gastric Bypass (RYGB), Sleeve Gastrectomy, Biliopancreatic diversion with duodenal switch, Implantation of Devices (includes Adjustable Gastric Banding, Intermittent vagal blockade, Gastrointestinal Endoscopic Devices).

The bariatric surgery community has made several changes to make this safety record possible. This includes identifying the importance of surgeon and center experience, establishing pathways, care protocols, and quality initiatives and integrating all aspects of care. those in the accreditation program of centers. Changes in laparoscopic procedures occurred during the same period and helped to improve safety.

Weight loss after bariatric surgery has been evaluated and reported in the short and long term after all surgeries performed, as weight loss is the primary goal of bariatric surgery. Reports of weight loss are similar. It is important to recognize, however, the variability of weight loss following standard procedures such as RYGB or Laparoscopic Adjustable Gastric Banding (LAGB).

The ultimate benefit of weight loss, whether medical or surgical, relates to reductions in co-morbidity, quality of life and all-cause mortality. Despite the importance of assessing these risks and taking measures to implement effective medical management with variable success, surgery has been shown to be more effective.

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