Bariatric Surgery: Risks and Rewards

ECU Author/Contributor (non-ECU co-authors, if there are any, appear on document)
Walter J. Pories (Creator)
East Carolina University (ECU )
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Abstract: Context: Over 23 million Americans are afflicted with severe obesity, i.e. their body mass index (in kilograms per square meter) values exceed 35. Of even greater concern is the association of the adiposity with comorbidities such as diabetes, hypertension, cardiopulmonary failure, asthma, pseudotumor cerebri, infertility, and crippling arthritis. Objective: Diets, exercise, behavioral modification, and drugs are not effective in these individuals. This article examines the effect of surgery on the control of the weight and the comorbidities, as well as the safety of these operations. Interventions: Although the article focuses on the outcomes of the three most commonly performed operations, i.e. adjustable gastric banding, the gastric bypass, and the biliopancreatic bypass with duodenal switch, it aims for perspective with the inclusion of abandoned and current investigational procedures, a review of the complications, and an emphasis on the appropriate selection of patients. Positions: Ample evidence, including controlled randomized studies, now document that bariatric surgery produces durable weight loss exceeding 100 lb (46 kg), full and long-term remission of type 2 diabetes in over 80% with salutary effects on the other comorbidities as well with significant reductions in all-cause mortality. Although the severely obese present with serious surgical risks, bariatric surgery is performed safely with a 0.35% 90-d mortality in Centers of Excellence throughout the United Statesâ similar to the complication rates after cholecystectomy. Conclusions: Until better approaches become available, bariatric surgery is the therapy of choice for patients with severe obesity. Originally published J Clin Endocrinol Metab 93: S89â S96, 2008

Additional Information

Journal of Clinical Endocrinology and Metabolism. 93:11 Suppl 1(November, 2008) p. S89-S96.
Language: English
Date: 2008
gastric bypass, gastric banding, weight control, bariatric surgery

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