The battle against the obesity epidemic: is bariatric surgery the perfect weapon?

摘要

PURPOSE: Obesity has become a major public health problem worldwide. In developed countries, 10-20% of the adult population are obese with health care costs totalling almost 117 billion dollars each year. Respectively, co-morbidities associated with excess body fat escalate this cost and contribute to social isolation, morbidity and excess mortality. Hence, organizations such as the National Institutes of Health and the Surgeon General of the U.S. are urging development of new strategies to curb this epidemic. SOURCES: A review of the up-to-date published literature reviewing obesity epidemiology, management options and outcomes was performed by two independent reviewers using a combination of hand searching, EMBASE searching and Medline searching using the Pub-Med search engine. PRINCIPAL FINDINGS: The results from conservative therapeutic tools such as dietary intervention, exercise regimens, behavioural modification and even pharmacological adjuncts remain disappointing, with most patients either failing to lose weight or, for those able to lose weight, experiencing total weight regain within a few years. Furthermore, such conservative measures do not sustain improvement in obesity-related co-morbidities. In contrast, bariatric surgery for the severely obese has resulted in an overall 61% weight reduction across all procedures and has been shown to eliminate or significantly ameliorate many of the obesity-related co-morbidities. CONCLUSION: Bariatric surgery appears to be an effective weapon in the battle against the current pandemic of obesity and its devastating complications.