title: Surgical treatment of obesity: who is an appropriate candidate?
abstract: The increasing prevalence and far-reaching medical, social, and economical implications of obesity have made it a national health-care crisis in the United States. About one in every three persons is at least 20% above "ideal" body weight, and approximately 5% have direct weight-related serious health problems (morbid obesity), including hypertension, hyperlipidemia, coronary artery disease, adult-onset diabetes mellitus, degenerative osteoarthropathy, and obstructive sleep apnea. Morbidly obese patients have an estimated 6- to 12-fold increase in mortality. In addition, they have a substantially diminished quality of life, not only physically but also psychosocially due to overt and occult prejudice. Weight reduction must be aggressively pursued in these patients. Medically supervised weight-control programs have been ineffective because patients cannot maintain pronounced long-term weight loss. In contrast, current operative methods have been proved to be effective in helping patients achieve and maintain permanent weight reduction. Several operations have been designed and assessed; with these procedures, weight loss is achieved by inducing malabsorption, maldigestion, early satiety, or a combination of these outcomes. Although these operations have associated side effects and limitations, the expected benefits outweigh the risks. For optimal results, patients must be carefully selected and treated by a multidisciplinary group.
authors.affiliation: Gastroenterology Research Unit, Mayo Clinic Rochester 55905, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Balsiger
authors.forename: E
authors.initials: E
authors.lastname: Luque de Leon
authors.forename: M G
authors.initials: MG
authors.lastname: Sarr
mesh_terms: D015391:Gastroplasty / Q000379:methods; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery*; D018579:Patient Selection; D016896:Treatment Outcome; D015431:Weight Loss