Surgical Treatment of Obesity

This chapter provides an overview of bariatric surgery as a treatment for obesity and its associated health benefits. Bariatric surgery, also known as obesity or metabolic surgery, has evolved beyond weight loss to improve overall health. The surgery has been shown to result in improved glycaemic control, reduced morbidity and mortality from cardiovascular disease and cancer, and improved quality of life. The eligibility criteria for bariatric surgery are discussed, emphasising the importance of patient compliance with lifelong lifestyle changes and regular follow-up. However, careful assessment of comorbidities and frailty is necessary for older patients. It also highlights the role of a multidisciplinary team, including a registered dietitian and mental health provider, in the preoperative assessment process. The different mechanisms of bariatric surgery are described, such as malabsorption, restriction, or a combination of both. A brief explanation of commonly performed procedures is provided, including sleeve gastrectomy, Roux-en-Y gastric bypass, gastric banding, and biliopancreatic diversion. The effects of each procedure on weight loss, comorbidities, and endocrine changes are also discussed. Long-term complications of bariatric surgery are procedure-specific, but nutritional deficiencies are a concern. Regular monitoring of vitamins and minerals, along with supplementation, is necessary. Overall, bariatric surgery has proven to be an effective treatment for obesity and its associated health conditions. Careful evaluation and long-term follow-up are crucial for optimal outcomes.