The effect of bariatric surgery on obesity and its complications

Abstract

Obesity has become a worldwide epidemic that is accompanied by a rise in Type 2 diabetes mellitus. Management of obesity is paramount to prevent the associated mortality and morbidity. Several randomized control trials show that bariatric surgery is an effective method for the treatment of obesity and remission of Type 2 diabetes in the short term. Long-term observational studies have further validated the improvements in weight and Type 2 diabetes as well as cardiovascular events and overall mortality. There is an improvement in microvascular outcomes, in particular retinopathy and nephropathy show promising results but further studies are needed to evaluate hard-end points for neuropathy. Bariatric surgery is cost effective with the cost of surgery being offset by future cost benefits. KEYWORDS Practice points• There is a worldwide increase in obesity and Type 2 diabetes mellitus (T2DM).• Obesity is associated with increased mortality and morbidity.• Bariatric Surgery is a cost-effective treatment for obesity and Type 2 diabetes, which in the long-term is associated with an improvement in mortality.• NICE guidelines recommend that all patients with a BMI of 35 or over who have recent-onset T2DM be assessed for bariatric surgery.• The outcome on weight of the different surgical procedures affects the remission rates of T2DM.• Microvascular outcomes show promising results postbariatric surgery, however, these need to be further evaluated particular on neuropathy.• Careful patient selection is important to achieve the best outcomes post bariatric surgery.There is a worldwide rapid increase in obesity prevalence such that it may be described as an epidemic. Obesity has more than doubled since 1980 such that in 2014 more than 1.9 billion adults were overweight and over 600 million were obese [1]. In 2013, 42 million children under the age of 5 years were overweight or obese [1]. The adverse consequences of this are emphasized when one considers that BMI is a powerful predictor of Type 2 diabetes mellitus (T2DM), cardiovascular (CV) morbidity and mortality [2,3]. There are currently 382 million people in the world with diabetes and this is estimated to reach 592 million by 2035 [4]. Indeed despite the emphasis on malnutrition in the developing world, overweight and obesity are linked to more deaths than being underweight.For reprint orders, please contact: reprints@futuremedicine.com

Determinants of Total Body Weight Loss Among Palestinian Adults Post–Bariatric Surgery

“…6 Bariatric surgery, the gastric and/or intestinal surgery performed for obese people, 7 is considered to be one of the most effective approaches for weight loss. 6 Compared with traditional methods, weight loss using bariatric surgery is generally more 42 TOPIC IN CLINICAL NUTRITION/JANUARY-MARCH 2022 cost-effective, 8 as it is more rapid, more significant, and more sustained. 2 It is also an effective method for reducing and achieving remission of obesity-related comorbidities.…”