Monday, April 27, 2015

Bariatric Surgery Continues to Show Benefits

Before bariatric surgery is considered, diet, exercise, and pharmacotherapy are most often used for weight loss and weight loss maintenance. However, bariatric surgery is gaining in popularity, usage, and broader applications. There are reasons why this is the case. The surgery does lead to weight loss success for super obese individuals. The surgery does appear to resolve a number of obesity-related comorbidities. And the surgery improves the quality of life for many persons who get the surgery.

Bariatric surgery is usually indicated for persons with a BMI greater than 40, and for persons who have a BMI greater than 35, plus obesity related comorbidities. However, in one study, experts concluded that bariatric "surgery is safe and effective at reducing weight and comorbidity" for persons with a BMI less than 35.  In the study, 1,000 subjects were studied. And it was found that most of the subjects benefited from the surgery.

But some forms of bariatric surgery are more effective than others. Roux-en-Y gastric bypass (RYBP) surgery and sleeve gastrectomy {SG) appear to be more effective at reducing weight and resolving type 2 diabetes than some other forms of the surgery. As the investigators in one study indicated, "Bariatric surgical procedures that modify the upper gastrointestinal tract anatomy (RYBP and SG) are more successful in producing weight loss and remission of T2D than those that simply restrict stomach capacity," such as LAGB (laparoscopic adjustable gastric banding).

Also, bariatric surgery has been found to substantially improve the health-related quality of life (HRQoL) for many patients "after bariatric surgery." It was also noted that  "much of the initial HRQoL improvements were maintained over the long term."

Now bariatric surgery is not always successful at improving HRQoL. Indeed, "In super-obese patients, perceived poor control over eating 2 years  after bariatric surgery was associated with lower HRQoL" But success may depend on the person's "network of social and emotional support ." Good support could improve the person's HRQoL.

At any rate, while not perfect,  bariatric surgery is an important tool for weight loss and the resolution of comorbidities associated with obesity. And the surgery can improve a person's quality of life.


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