Bariatric surgery (weight loss surgery) includes a variety of procedures performed on people who have obesity. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestine to a small stomach pouch (gastric bypass surgery).
Long-term studies show the procedures cause significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of 23% from 40%.However, a study in Veterans Affairs (VA) patients has found no survival benefit associated with bariatric surgery among older, severely obese people when compared with usual care, at least out to seven years.
The U.S. National Institutes of Health recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40, and for people with BMI 35 and serious coexisting medical conditions such as diabetes. However, research is emerging that suggests bariatric surgery could be appropriate for those with a BMI of 35 to 40 with no co morbidities or a BMI of 30 to 35 with significant comorbidities. The most recent ASMBS guidelines suggest the position statement on consensus for BMI as indication for bariatric surgery. The recent guidelines suggest that any patient with a BMI of more than 30 with comorbidities is a candidate for bariatric surgery.
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elsevier health sciences. "diabetes reversal after bypass surgery linked to changes in gut microorganisms: duodenum-jejunum gastric bypass surgery in diabetic mice results in changes in gut microbiota, improved metabolism, and diabetes remission." sciencedaily. sciencedaily, 11 july 2016. www.sciencedaily.com/releases/2016/07/160711092303.htm .
http://www.hindawi.com/journals/crie/2015/384526/ bhavana b. rao, benjamin click, george eid, and ronald a. codario, “management of refractory noninsulinoma pancreatogenous hypoglycemia syndrome with gastric bypass reversal: a case report and review of the literature,” case reports in endocrinology, vol. 2015, article id 384526, 4 pages, 2015. doi:10.1155/2015/384526
http://www.hindawi.com/journals/grp/2015/152852/ yingjun quan, ao huang, min ye, et al., “efficacy of laparoscopic mini gastric bypass for obesity and type 2 diabetes mellitus: a systematic review and meta-analysis,” gastroenterology research and practice, vol. 2015, article id 152852, 13 pages, 2015. doi:10.1155/2015/152852
http://www.hindawi.com/journals/grp/2013/974762/ blaire anderson, richdeep s. gill, christopher j. de gara, shahzeer karmali, and michel gagner, “biliopancreatic diversion: the effectiveness of duodenal switch and its limitations,” gastroenterology research and practice, vol. 2013, article id 974762, 8 pages, 2013. doi:10.1155/2013/974762
http://www.hindawi.com/journals/jobe/2016/4390254/ olivier f. noel, christopher d. still, george argyropoulos, michael edwards, and glenn s. gerhard, “bile acids, fxr, and metabolic effects of bariatric surgery,” journal of obesity, vol. 2016, article id 4390254, 8 pages, 2016. doi:10.1155/2016/4390254
http://www.hindawi.com/journals/srp/2016/8616581/ donevan westerveld and dennis yang, “through thick and thin: identifying barriers to bariatric surgery, weight loss maintenance, and tailoring obesity treatment for the future,” surgery research and practice, vol. 2016, article id 8616581, 7 pages, 2016. doi:10.1155/2016/8616581
http://www.hindawi.com/journals/crim/2015/593586/ megana ballal and tracey straker, “laparoscopic sleeve gastrectomy in a morbidly obese patient with myasthenia gravis: a review of the management,” case reports in medicine, vol. 2015, article id 593586, 4 pages, 2015. doi:10.1155/2015/593586
http://www.hindawi.com/journals/cris/2016/7985795/ alexandre descloux, giacinto basilicata, and antonio nocito, “omental torsion after laparoscopic roux-en-y gastric bypass mimicking appendicitis: a case report and review of the literature,” case reports in surgery, vol. 2016, article id 7985795, 2 pages, 2016. doi:10.1155/2016/7985795
http://www.hindawi.com/journals/jobe/2012/878371/ yu-feng wei and huey-dong wu, “candidates for bariatric surgery: morbidly obese patients with pulmonary dysfunction,” journal of obesity, vol. 2012, article id 878371, 6 pages, 2012. doi:10.1155/2012/878371