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What is Bariatric Surgery mean?
Bariatric surgery (or weight loss surgery) includes a variety of procedures performed on people who are obese. Long term weight loss through standard of care procedures (Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch) is largely achieved by altering gut hormone levels that are responsible for hunger and satiety, leading to a new hormonal weight set point. Bariatric surgery is a hormonal surgery in these procedures, for which the alteration in gut hormones develops as a result of the procedure's restriction and malabsorption.
Long-term studies show the procedures cause significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a mortality reduction from 40% to 23%. The U.S. National Institutes of Health recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40, and for people with BMI of at least 35 and serious coexisting medical conditions such as diabetes. However, research is emerging that suggests bariatric surgery could be appropriate for those with a BMI of 35 to 40 with no comorbidities or a BMI of 30 to 35 with significant comorbidities. The most recent American Society for Metabolic & Bariatric Surgery guidelines suggest the position statement on consensus for BMI as an indication for bariatric surgery. The recent guidelines suggest that any patient with a BMI of more than 30 with comorbidities is a candidate for bariatric surgery.
A meta-analysis of 174772 participants published in The Lancet in 2021 found that bariatric surgery was associated with 59% and 30% reduction in all-cause mortality among obese adults with or without type 2 diabetes respectively. 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. A National Institute of Health symposium held in 2013 that summarized available evidence found a 29% mortality reduction, a 10-year remission rate of type 2 diabetes of 36%, fewer cardiovascular events, and a lower rate of diabetes-related complications in a long-term, non-randomized, matched intervention 15–20 year follow-up study, the Swedish Obese Subjects Study. The symposium also found similar results from a Utah study using more modern gastric bypass techniques, though the follow-up periods of the Utah studies are only up to seven years. While randomized controlled trials of bariatric surgery exist, they are limited by short follow-up periods.
referencePosted on 12 Sep 2024, this text provides information on Miscellaneous in Medical related to Medical. Please note that while accuracy is prioritized, the data presented might not be entirely correct or up-to-date. This information is offered for general knowledge and informational purposes only, and should not be considered as a substitute for professional advice.
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