Obesity Microchapters |
Diagnosis |
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Treatment |
Lifestyle Intervention and Counseling (Comprehensive Lifestyle Intervention) |
Case Studies |
USPSTF Recommendations and Guidelines on Management of Obesity |
2017 Guidelines for Screening of Obesity in Children and Adolescents |
AHA/ACC/TOS Guidelines on Management of Overweight and Obesity |
2013 AHA/ACC/TOS Guidelines on Management of Overweight and Obesity |
Obesity surgery On the Web |
American Roentgen Ray Society Images of Obesity surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Bariatric surgery (or "weight loss surgery") is the use of surgical interventions in the treatment of obesity. As every surgical intervention may lead to complications, it is regarded as a last resort when dietary modification and pharmacological treatment have proven to be unsuccessful. Weight loss surgery relies on various principles; the most common approaches are reducing the volume of the stomach, producing an earlier sense of satiation (e.g. by adjustable gastric banding and vertical banded gastroplasty) while others also reduce the length of bowel that food will be in contact with, directly reducing absorption (gastric bypass surgery). Band surgery is reversible, while bowel shortening operations are not. Some procedures can be performed laparoscopically. Complications from weight loss surgery are frequent.[1]
Two large studies have demonstrated a mortality benefit from bariatric surgery. A marked decrease in the risk of diabetes mellitus, cardiovascular disease and cancer.[2][3] Weight loss was most marked in the first few months after surgery, but the benefit was sustained in the longer term. In one study there was an unexplained increase in deaths from accidents and suicide that did not outweigh the benefit in terms of disease prevention. Gastric bypass surgery was about twice as effective as banding procedures.[3]
Class IIa |
"1.Electronically delivered weight loss programs (including by telephone) that include personalized feedback from a trained interventionist† can be prescribed for weight loss but may result in smaller weight loss than face-to-face interventions.(Level of Evidence: A)" |
Class IIb |
"1.Advise patients that choice of a specific bariatric surgical procedure may be affected by patient factors, including age, severity of obesity/BMI, obesity-related comorbid conditions, other operative risk factors, risk of short- and long-term complications, behavioral and psychosocial factors, and patient tolerance for risk, as well as provider factors (surgeon and facility)(Level of Evidence: A)" |