Global InformationBariatric surgery information
| Bariatric surgery | |
|---|---|
| Other names | Weight loss surgery |
| MeSH | D050110 |
| Part of a series on |
| Human body weight |
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Bariatric surgery (or metabolic surgery or weight loss surgery) is a medical term for surgical procedures used to manage obesity and obesity-related conditions.[1][2] Long term weight loss with bariatric surgery may be achieved through alteration of gut hormones, physical reduction of stomach size, reduction of nutrient absorption, or a combination of these.[2][3] Standard of care procedures include Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch, from which weight loss is largely achieved by altering gut hormone levels responsible for hunger and satiety, leading to a new hormonal weight set point.[3]
In morbidly obese people, bariatric surgery is the most effective treatment for weight loss and reducing complications.[4][5][6][7][8] A 2021 meta-analysis found that bariatric surgery was associated with reduction in all-cause mortality among obese adults with or without type 2 diabetes.[9] This meta-analysis also found that median life-expectancy was 9.3 years longer for obese adults with diabetes who received bariatric surgery as compared to routine (non-surgical) care, whereas the life expectancy gain was 5.1 years longer for obese adults without diabetes.[9] The risk of death in the period following surgery is less than 1 in 1,000.[10] A 2016 review estimated bariatric surgery could reduce all-cause mortality by 30-50% in obese people.[1] Bariatric surgery may also lower disease risk, including improvement in cardiovascular disease risk factors, fatty liver disease, and diabetes management.[11]
As of October 2022,[update] the American Society of Metabolic and Bariatric Surgery and International Federation for the Surgery of Obesity recommended consideration of bariatric surgery for adults meeting two specific criteria: people with a body mass index (BMI) of more than 35 whether or not they have an obesity-associated condition, and people with a BMI of 30–35 who have metabolic syndrome.[11][12] However, these designated BMI ranges do not hold the same meaning in particular populations, such as among Asian individuals, for whom bariatric surgery may be considered when a BMI is more than 27.5.[11] Similarly, the American Academy of Pediatrics recommends bariatric surgery for adolescents 13 and older with a BMI greater than 120% of the 95th percentile for age and sex.[13]
- ^ a b Schroeder R, Harrison TD, McGraw SL (January 2016). "Treatment of Adult Obesity with Bariatric Surgery". American Family Physician. 93 (1): 31–7. PMID 26760838.
- ^ a b Rogers AM (March 2020). "Current State of Bariatric Surgery: Procedures, Data, and Patient Management". Techniques in Vascular and Interventional Radiology. 23 (1): 100654. doi:10.1016/j.tvir.2020.100654. ISSN 1557-9808. PMID 32192634. S2CID 213191179.
- ^ a b Pucci A, Batterham RL (February 2019). "Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different". Journal of Endocrinological Investigation. 42 (2): 117–128. doi:10.1007/s40618-018-0892-2. PMC 6394763. PMID 29730732.
- ^ Müller TD, Blüher M, Tschöp MH, DiMarchi RD (March 2022). "Anti-obesity drug discovery: advances and challenges". Nature Reviews. Drug Discovery. 21 (3): 201–223. doi:10.1038/s41573-021-00337-8. PMC 8609996. PMID 34815532.
Bariatric surgery represents the most effective approach to weight loss
- ^ Bettini S, Belligoli A, Fabris R, Busetto L (September 2020). "Diet approach before and after bariatric surgery". Reviews in Endocrine & Metabolic Disorders. 21 (3): 297–306. doi:10.1007/s11154-020-09571-8. PMC 7455579. PMID 32734395.
- ^ Zarshenas N, Tapsell LC, Neale EP, Batterham M, Talbot ML (May 2020). "The Relationship Between Bariatric Surgery and Diet Quality: a Systematic Review". Obesity Surgery. 30 (5): 1768–1792. doi:10.1007/s11695-020-04392-9. PMID 31940138. S2CID 210195296.
Bariatric surgery is currently the most effective treatment for morbid obesity.
- ^ Hedjoudje A, Abu Dayyeh BK, Cheskin LJ, Adam A, Neto MG, Badurdeen D, et al. (May 2020). "Efficacy and Safety of Endoscopic Sleeve Gastroplasty: A Systematic Review and Meta-Analysis". Clinical Gastroenterology and Hepatology. 18 (5): 1043–1053.e4. doi:10.1016/j.cgh.2019.08.022. PMID 31442601. S2CID 201632114.
- ^ Snoek KM, Steegers-Theunissen RP, Hazebroek EJ, Willemsen SP, Galjaard S, Laven JS, Schoenmakers S (October 2021). "The effects of bariatric surgery on periconception maternal health: a systematic review and meta-analysis". Human Reproduction Update. 27 (6): 1030–1055. doi:10.1093/humupd/dmab022. PMC 8542997. PMID 34387675.
Worldwide, the prevalence of obesity in women of reproductive age is increasing. Bariatric surgery is currently viewed as the most effective, long-term solution for this problem
- ^ a b Syn NL, Cummings DE, Wang LZ, et al. (May 2021). "Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants". Lancet. 397 (10287): 1830–1841. doi:10.1016/S0140-6736(21)00591-2. PMID 33965067. S2CID 234345414.
- ^ Robertson AG, Wiggins T, Robertson FP, Huppler L, Doleman B, Harrison EM, et al. (August 2021). "Perioperative mortality in bariatric surgery: meta-analysis". The British Journal of Surgery. 108 (8): 892–897. doi:10.1093/bjs/znab245. hdl:20.500.11820/24849bd8-665f-406f-aac2-b8b1fc0fbb16. PMID 34297806.
- ^ a b c Cite error: The named reference
Eisenberg-2022was invoked but never defined (see the help page). - ^ "After 30 Years — New Guidelines For Weight-Loss Surgery". American Society for Metabolic and Bariatric Surgery. 2022-10-21. Retrieved 2022-11-07.
- ^ "Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity". American Academy of Pediatrics. February 2023. Retrieved July 7, 2023.