Tags: , BMI, WEIGHT LOSS
Overweight and obesity has reached epidemic proportions worldwide.) Data collected by the National Center for Health Statistics indicate that the prevalence of obesity, defined as a body mass index >30 kg/m has increased from 12.8% in 1976-1980 to 22.5% in 1988-1994 and 30% in 1999-2000. In an effort to increase public awareness of the epidemic proportion of obesity, the Surgeon General has issued a call to action to prevent and treat overweight and obesity and their associated health complications.
obesity ,particularly morbid obese (BMI 40 or more) are associated with increased risk for hypertension, diabetes, hyperlipedemia ,sleep apnoea ,coronary heart disease and stroke.The cause of obesity is complex and poorly understood, but includes genetic, behavioral, psychological and other factors. Familial suggest that hereditary may explain 67% of the population variance in BMI. Decline in physical activity and increase in consumption of energy dense food may play a role
Bariatric surgical procedures reduce caloric intake by modifying the anatomy of gastrointestinal tract.They are two types ,restrictive procedure limits intake ,malabsoptive procedure by passes the absorption area of intestine .Roux-en-y gastric bypass is a combination of restriction ad absorption procedure.This procedure accounts for 92% of the bariatric surgery
Person with BMI >40 or BMI of 35 or higher with high risk condition like severe sleep apnea, obesity related cardiomyopathy are ideal for bariatric surgery The potential benefit of surgery in BMI of 30 to 35 remains unclear .Before taking up for bariatric surgery excluding secondary cause of obesity like hypothyroid, Cushing syndrome.and medication history of antidepressant, oral pill oral hypoglycemic agents should be obtained.Medi cal assessment for obesity associated condition and a psychological evaluation should be done.
A typical weight loss of 20 to 50 kg’s occurs with bariatric procedure.In general malabsorptive procedure have higher weight loss
Bariatric surgery is associated with death in 0.5% to 1.1% and common cause are pulmonary embolism and anastomostic leak..The post operative complication can be nausea and vomiting ( common ) dumping syndrome and vitamin deficiency.
( image source :nature.com .)
