Affiliation:
1. Centre for Obesity Research and Education, Monash University, The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Victoria, Australia
Abstract
Abstract
Background
There are many controversies related to bariatric surgery. This review explores selected areas.
Methods
A combination of randomized clinical trials (RCTs), systematic reviews and expert opinion have been brought together to highlight areas of importance or conflict.
Results and Conclusion
Metabolic surgery is an increasingly preferred term rather than bariatric or obesity surgery. Reporting should be standardized to include appropriate weight measures, valid disease measures and data on loss to follow-up. There are many putative mechanisms of effect of key bariatric procedures, but satiety and early satiation appear central. Weight loss must be durable. Long-term outcome studies (more than 10-year follow-up) show that biliopancreatic diversion is most effective, with 72 per cent excess weight loss (EWL). Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding (LAGB) are equally effective, with 54 per cent EWL. There are no long-term data on vertical sleeve gastrectomy. Type II diabetes is a common and serious disease, usually associated with increased weight. Multiple RCTs have shown that bariatric surgery provides clear benefits over continuing with non-surgical therapies. The earlier the treatment, the more likely and durable will be the remission. Bariatric surgery should be available to all who are obese (body mass index over 30 kg/m2). LAGB, a safe, effective, reversible outpatient procedure, is the author's preferred primary option.
Publisher
Oxford University Press (OUP)
Reference51 articles.
1. Metabolic/bariatric surgery worldwide 2011;Buchwald;Obes Surg,2013
2. 1983 metropolitan height and weight tables;Metropolitan Life Insurance Company;Stat Bull,1983
3. Bariatric analysis and reporting outcome system (BAROS);Oria;Obes Surg,1998
4. Mechanisms underlying weight loss after bariatric surgery;Miras;Nat Rev Gastroenterol Hepatol,2013
Cited by
22 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献