Overview of bariatric surgery for the physician

Abstract

-The worldwide pandemic of obesity carries alarming health and socioeconomic implications. Bariatric surgery is currently the only effective treatment for severe obesity. It is safe, with mortality comparable to that of cholecystectomy, and effective in producing substantial and sustainable weight loss, along with high rates of resolution of associated comorbidities, including type 2 diabetes. For this reason, indications for bariatric surgery are being widened. In addition to volume restriction and malabsorption, bariatric surgery brings about neurohormonal changes that affect satiety and glucose homeostasis. Increased understanding of these mechanisms will help realise therapeutic benefits by pharmacological means. Bariatric surgery improves long-term mortality but can cause long-term nutritional deficiencies. The safety of pregnancy after bariatric surgery is still being elucidated.

Bariatric Surgery and Exercise

“…3 Research shows that patients who became physically active postsurgery lost 8% more of their excess weight than those who remained inactive 1 year postsurgery. 4 More than 6% of patients who have had bariatric surgery are involved in physical activity that exceeds the 1-hour per day recommendation (highly active). 3 This study addresses a highly active bariatric population.…”

“…Weight loss is achieved through the creation of a stapled stomach pouch (20-30 mL) that connects to the mid small intestine, bypassing the remaining stomach cavity and duodenum. 4 Other combination procedures include the biliopancreatic diversion and the duodenal switch. 4 Substantial weight loss of up to 60% to 70% with the Roux-en-Y gastric bypass procedure can be expected following surgery.…”

“…4 Other combination procedures include the biliopancreatic diversion and the duodenal switch. 4 Substantial weight loss of up to 60% to 70% with the Roux-en-Y gastric bypass procedure can be expected following surgery. 4 To enhance weight loss, and due to less physical and mental restriction from the excess weight, 6 many patients after surgery feel more comfortable with physical activity.…”

“…Weight loss is achieved through restrictive procedures, malabsorptive procedures, or a combination of both. 4 The National Institutes of Health guidelines require that individuals who receive these procedures have a body mass index (BMI) of 40 or above or a BMI of 35 or above with comorbidities. 5 Restrictive procedures facilitate weight loss by reducing the size of the stomach pouch without decreasing absorption of nutrients.…”

Patient Experience after Gastric Banding Surgery and Need for Healthcare Communication

“…Many adults attempt to lose weight, as evidenced by the plethora of weight loss programs available, however diet therapy, with or without supports and pharmaceutical agents are ineffective in long-term treatment of obesity [7]. Bariatric surgery, as treatment for obesity, results in greater weight loss and reduction in comorbid conditions such as hyperlipidemia, diabetes, and hypertension, compared with other approaches [8,9].…”