Obesity and overweightObesity is a health problem!

Different methods are used to lose weight like diets, drugs, psychoterapy or exercises. Which is the most effective methods to lose weight?


What is bariatric surgery?


Bariatric surgery or weight loss surgery!

Surgical procedures aimed at producing major weight reduction in patients with morbid obesity” is the definition of MESH term for bariatric surgery (Karolinska Institutet).

The first surgical procedure for weight loss was performed in the early 1950s in the USA, at the University of Minnesota. In 1954, the first intestinal bypass operation for severe obesity was performed by Payne and DeWinde (Guldstrand, 2007). In the 1960s, the gastric bypass (GBP) was developed by E. Mason. The procedure was improved and transformed into Roux-en-Y bypass (RYGBP), the most commonly performed operation for weight loss in the USA. In 1994, the first laparoscopic gastric bypass operation (LGBP) was performed by Wittgrove and Clark. In 1970, the first gastroplasty was performed and developed later as vertical banded gastroplasty (VGB) (The American Association for Metabolic and Bariatric Surgery, 2005).

Other surgical techniques are Biliopancreatic diversion (BPD) or Duodenal Switch (DS). These last two procedures are not so often used in Sweden (Näslund & Granström, 2007). These techniques were classified into restrictive and malabsorptive. The first reduce food intake and the patient feels satiated after eating and the second reduce the absorption of calories and/or nutrients (ibid).

The criteria for selecting the patients that will undergo weight loss surgery are well-defined; one of them is a BMI > 35 kg/m2. The candidates for surgery are selected when other previous methods for weight loss than surgery has failed. Such methods are Very Low Calorie Diets (VLCD), physical activity, cognitive behavioral therapy or pharmacology (Lindroos & Rössner, 2007).

The postoperative complications after weight loss surgery are stenosis, problems with anastomosis, sepsis or dumping syndrome. Some complications which have not occurred very frequently are hemorrhage, wound complications, pneumonia, ulcer, hernia, stroke or acute infarct (Cawley et al, 2007).

The expected outcome of bariatric surgery is not only weight loss, as the bariatric patient’s quality of life is also expected to improve; the most significant results of surgery regard obesity-related health conditions. These aspects should be a “research priority” (Dixon & O’Brien, 2002).


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