Highlights
- •Weight loss surgery is an effective intervention for obesity and related disorders.
- •Roux-en-Y gastric bypass and sleeve gastrectomy are the most common surgeries.
- •Two recent trials suggest they are comparably safe and effective.
- •Novel therapies, including endoscopic interventions, are under active investigation.
- •Weight loss surgery is under-utilized; we should improve access and delivery.
Abstract
Weight loss surgery is the most effective intervention for addressing obesity and
related metabolic disorders such as diabetes. We describe common surgical procedures
as well as emerging and investigational procedures in terms of their capacity to induce
weight reduction and their risk profiles. We then discuss the impact of weight loss
surgery on important obesity related disorders including diabetes, cardiovascular
disease, and non-alcoholic fatty liver disease. The question of operative choice is
discussed with respect to benefits and risks of common procedures. Reoperative weight
loss surgery, an increasingly common element of weight loss surgical practice, is
reviewed. We briefly discuss the metabolic mechanism of action of weight loss surgery.
Lack of access to and under-utilization of weight loss surgery represent important
challenges to adequate obesity treatment, and we review these topics as well.
Abbreviations:
ASMBS (American Society for Metabolic and Bariatric Surgery), BMI (body mass index), CT (computed tomography), GB (gastric banding), GERD (gastroesophageal reflux disease), MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program), NAFLD (non-alcoholic fatty liver disease), NASH (non-alcoholic steatohepatitis), NSAID (non-steroidal anti-inflammatory drug), OSA (obstructive sleep apnea), SG (sleeve gastrectomy), RYGB (Roux-en-Y gastric bypass), VTE (venous thromboembolism), WLS (weight loss surgery)Keywords
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Article info
Publication history
Published online: December 18, 2018
Accepted:
December 14,
2018
Received in revised form:
December 12,
2018
Received:
September 14,
2018
Identification
Copyright
© 2018 Published by Elsevier Inc.
