Safety and Efficacy of Bariatric and Metabolic Surgery
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THE OBESITY EPIDEMIC: CAUSES AND CONSEQUENCES (A CAMERON AND K BACKHOLER, SECTION EDITORS)
Safety and Efficacy of Bariatric and Metabolic Surgery Saber Ghiassi 1 & John M. Morton 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Bariatric surgery is the most effective and durable method for treating obesity. This review highlights the results and safety of bariatric surgery. Recent Findings The global prevalence of obesity and its related comorbidities including cancer are on the rise. Bariatric surgery has demonstrated more robust and durable weight loss than current medical treatment. Bariatric surgery also reduces significantly the risk of complications associated with obesity comorbidities, such as diabetes and cardiovascular disease, and the risk of mortality in comparison with medical management. Due to accreditation efforts, the safety profile of bariatric surgery is equivalent or superior to many common operations. Summary Obesity is associated with increased all cause morbidity and mortality. The current bariatric procedures produce significant and durable weight loss and reduce the morbidity and mortality associated with obesity-related diseases substantially. The risk/benefit ratio for bariatric surgery is decidedly in favor for the benefit for bariatric surgery. Keywords Obesity . Bariatric surgery . Metabolic surgery . Safety . Outcome . Type 2 diabetes mellitus . Cardiovascular disease
Introduction According the World Health Organization, global obesity has nearly tripled since 1975. More than 1.9 billion adults were overweight, of which 650 million were obese in 2016 [1]. The prevalence of obesity was 39.8% in US adults in 2016 [2]. Obesity is associated with a number of serious comorbidities, including type 2 diabetes mellitus (T2DM), cardiovascular disease, dyslipidemia, obstructive sleep apnea, nonalcoholic fatty liver disease, joint disease [3], and many common cancers such as esophageal, colorectal, endometrial, kidney, pancreas, and postmenopausal breast cancers [4]. The risk of obesity-related cancer is increasing in younger cohorts in the USA [5]. This article is part of the Topical Collection on The Obesity Epidemic: Causes and Consequences * Saber Ghiassi [email protected] 1
Department of Surgery, Division of Bariatric and Gastrointestinal Surgery, Yale School of Medicine, P.O. Box 208062, New Haven, CT 06520, USA
Bariatric surgery has demonstrated the most effective and durable treatment for severe obesity, and results in marked improvement or resolution of obesity-related comorbidities [6–9]. Bariatric surgery is safe, and complications rates are comparable with such common operations as cholecystectomy and appendectomy [10•]. According to The American Society of Metabolic and Bariatric Surgery (ASMBS), nearly 252,000 individuals underwent bariatric surgery in the USA in 2018 [11]. Sleeve gastrectomy (SG) is the common procedure followed by Rouxen-Y gastric bypass (RYGB), while adjustable gastric band (AGB) has plummeted to less t
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