Fast Five Quiz: Weight Loss

Romesh Khardori, MD, PhD; Evelyn S. Marienberg, MD

Disclosures

November 08, 2022

Well-performed bariatric surgery, in carefully selected patients with a good multidisciplinary support team, has been shown to ameliorate morbidities associated with severe obesity. Bariatric surgery guidelines state that laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy, laparoscopic Roux-en-Y gastric bypass, and laparoscopic biliopancreatic diversion without/with duodenal switch, or related procedures, should be considered as primary bariatric and metabolic procedures performed in patients requiring weight loss and/or amelioration of obesity-related complications.

Patients should be considered candidates for bariatric procedures if they have a BMI > 40 kg/m2 and/or > 45 kg above the age- and sex-defined ideal weight. For persons with BMIs of 35-40 kg/m2, at least one major comorbidity (eg, type 2 diabetes, hypertension, NAFLD or nonalcoholic steatohepatitis, obstructive sleep apnea, osteoarthritis of the knee or hip, urinary stress incontinence) must be present to justify these procedures. The presence of comorbidities is not a contraindication to bariatric surgical procedures; however, the patient's condition must be stabilized and adequately treated before surgery.

A recent meta-analysis showed 48.9% excess weight loss and 22.2% total weight loss at 20 years following bariatric surgery.

Tobacco use should ideally be discontinued for 1 year prior to bariatric procedures. At a minimum, guidelines recommend cessation at 6 weeks prior, particularly among those who smoke cigarettes.

Learn more about bariatric surgery.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....