title: Bariatric surgery--an update for the endocrinologist.
abstract: Obesity is a major public health problem, is associated with increased rates of mortality risk and of developing several comorbidities, and lessens life expectancy. Bariatric surgery is the most effective treatment for morbidly obese patients, reducing risk of developing new comorbidities, health care utilization and mortality. The establishment of centers of excellence with interdisciplinary staff in bariatric surgery has been reducing operative mortality in the course of time, improving surgical safety and quality. The endocrinologist is part of the interdisciplinary team. The aim of this review is to provide endocrinologists, physicians and health care providers crucial elements of good clinical practice in the management of morbidly obese bariatric surgical candidates. This information includes formal indications and contraindications for bariatric operations, description of usual bariatric and metabolic operations as well as endoscopic treatments, preoperative assessments including psychological, metabolic and cardiorespiratory evaluation and postoperative dietary staged meal progression and nutritional supplementation follow-up with micronutrient deficiencies monitoring, surgical complications, suspension of medications in type 2 diabetic patients, dumping syndrome and hypoglycemia.
authors: Endocrinology & Metabolism Department, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
authors: Marcio C
authors: MC
authors: Mancini
mesh_terms: D050110:Bariatric Surgery / Q000379:methods*; D015904:Biliopancreatic Diversion / Q000379:methods; D015897:Comorbidity; D000075202:Contraindications; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000628:therapy; D004032:Diet / Q000592:standards; D019587:Dietary Supplements; D004377:Dumping Syndrome / Q000517:prevention & control; D004704:Endocrinology; D005743:Gastrectomy / Q000379:methods; D015905:Gastric Balloon; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D008488:Medical Illustration; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D010348:Patient Care Team; D011182:Postoperative Care; D011184:Postoperative Period; D017410:Practice Guidelines as Topic; D011300:Preoperative Care; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000628:therapy; D015431:Weight Loss