The concept of gastric surgery to control obesity grew out of results of operations for cancer or severe ulcers that removed large portions of the stomach or small intestine. The idea was that patients could eat large amounts of food, which would be poorly digested or passed along too fast for the body to absorb many calories. The problem with this surgery was that it caused a loss of essential nutrients (malnutrition) and its side effects were unpredictable and sometimes fatal. The original form of the intestinal bypass operation is no longer used. Surgeons now use other techniques that produce weight loss primarily by limiting how much the stomach can hold.
I received an e-mail message from Dr. Justine Davies, the editor of The Lancet Diabetes & Endocrinology, announcing a series of review articles on bariatric surgery for treatment of obesity.
Bariatric surgery, she says,
is the most effective treatment for both obesity and type 2 diabetes. In many people with type 2 diabetes, bariatric surgery not only limits disease progression, but also reverses complications.
She asks: So why is this procedure not being used more often to treat
patients with obesity?
Bariatric surgery has substantial benefits in terms of weight loss, metabolic status, and quality of life. It is safe and effective, and the future savings made through prevention of comorbid diseases could counterbalance its high cost. The surgery should, therefore, be available as an option to use when appropriate, and not only when all other options have been eliminated. Bariatric surgery offers a real opportunity for preventing comorbid diseases and complications of obesity. If it is only used as a final …