RedWine
05-07-2007, 04:00 AM
Bariatrics is the branch of medicine that deals with the causes, prevention, and treatment of obesity.The term bariatrics was created around 1965, from the Greek root baro ("weight," as in barometer) and suffix -iatrics ("a branch of medicine," as in pediatrics). Besides the pharmacotherapy of obesity, it is concerned with obesity surgery.
Overweight and obesity are rising medical problems of pandemic proportions.There are many detrimental health effects of obesity,heart disease, diabetes, many types of cancer, asthma, obstructive sleep apnea, chronic musculoskeletal problems, etc. There is also a clear effect of obesity on mortality, though this is not so clear for overweight.
Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment,medical therapy for severe obesity has limited short-term success and almost nonexistent long-term success.Therefore, obesity surgery (or bariatric surgery) has been a popular treatment in the war against obesity. Weight loss surgery generally results in greater weight loss than conventional treatment, and leads to improvements in quality of life and obesity related diseases such as hypertension and diabetes.
Before someone can become eligible for bariatric surgery, certain criteria must be met.The basic criteria are an understanding of the operation and the lifestyle changes the patient will need to make, and either:
a body mass index (BMI) of 40 or more, which is about 45 kg (100 pounds) overweight for men and 35 kg (80 pounds) for women; or
a BMI between 35 and 39.9 and a serious obesity-related health problem such as type 2 diabetes, heart disease, or severe sleep apnea (when breathing stops for short periods during sleep)
Past studies found that 10 percent to 20 percent of bariatric surgery patients had complications while they were in the hospital. In 2006, federal researchers found that 39.6 percent of patients had complications within 180 days of surgery. The most common complications are
a composite of gastrointestinal symptoms including vomiting, diarrhea,
dysphagia, and reflux (20%)
anastomotic leaking (at the surgical connections between the stomach and the intestine) (12%)
abdominal hernia (7%)
and "infections" (6%).
About 7% of patients were readmitted to the hospital within 6 months to treat complications specific to the bariatric procedure.
There were 212 in-hospital deaths out of an estimated 104,702 adults who underwent obesity surgery in 2003, or a rate of 0.2 per cent.
The prevalence of extreme obesity (body mass index > or = 40 kg/m²) in the United States in 2003-2004 was 2.8% in men and 6.9% in women.This suggests millions of people are in the weight range for potential therapy with bariatric surgery. Laparoscopic surgery has become an important addition to this field of surgery, and demand soars, amidst scientific and ethical questions.The number of Americans having weight-loss surgery more than quadrupled between 1998 and 2002—from 13,386 to 71,733—according to a study by the Agency for Healthcare Research and Quality.
If diet and exercise are ineffective alone, anti-obesity drugs are a choice for some patients. Orlistat (Xenical®) reduces intestinal fat absorption by inhibiting pancreatic lipase. In January, 2006, a US Food and Drug Administration (FDA) panel of doctors and scientists recommended that the regulatory agency approve over-the-counter sales of orlistat, but GlaxoSmithKline Consumer health care still needs final FDA approval before it can sell the non-prescription version.Sibutramine (Reductil® or Meridia®) is an anorectic or appetite suppressant, reducing the desire to eat. Both drugs have side effects. Sibutramine may increase blood pressure and may cause dry mouth, constipation, headache, and insomnia. Orlistat may cause frequent, oily bowel movements, but if fat in the diet is reduced, symptoms often improve.
In diabetic persons, the drug metformin (Glucophage®) can reduce weight.
Other weight loss drugs have also been associated with medical complications, such as fatal pulmonary hypertension and heart valve damage due to Redux® and Fen-phen, and hemmorhagic stroke due phenylpropanolamine.Many of these substances are related to amphetamine.
Prescription weight loss drugs are recommended only for short-term use, and thus are of limited usefulness for extremely obese patients, who may need to reduce weight over months or years.
The discovery of cannabinoid receptors in the brain and other organs has stimulated research in a new class of drugs, namely cannabinoid receptor (CB1) antagonists, such as Rimonabant.
Unresearched nonprescription products or programs for weight loss are heavily promoted by mail and print advertising and on the internet. The US Food and Drug Administration recommends caution with use of these products, since many of the claims of safety and effectiveness are unsubstantiated.Individuals with anorexia nervosa and some athletes try to control body weight with laxatives, diet pills or diuretic drugs, although these generally have no impact on body fat.Products that work as a laxative can cause the blood's potassium level to drop, which may cause heart and/or muscle problems. Pyruvate is a popular product that may result in a small amount of weight loss. However, pyruvate, which is found in red apples, cheese, and red wine, has not been thoroughly studied and its weight loss potential has not been scientifically established.
Overweight and obesity are rising medical problems of pandemic proportions.There are many detrimental health effects of obesity,heart disease, diabetes, many types of cancer, asthma, obstructive sleep apnea, chronic musculoskeletal problems, etc. There is also a clear effect of obesity on mortality, though this is not so clear for overweight.
Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment,medical therapy for severe obesity has limited short-term success and almost nonexistent long-term success.Therefore, obesity surgery (or bariatric surgery) has been a popular treatment in the war against obesity. Weight loss surgery generally results in greater weight loss than conventional treatment, and leads to improvements in quality of life and obesity related diseases such as hypertension and diabetes.
Before someone can become eligible for bariatric surgery, certain criteria must be met.The basic criteria are an understanding of the operation and the lifestyle changes the patient will need to make, and either:
a body mass index (BMI) of 40 or more, which is about 45 kg (100 pounds) overweight for men and 35 kg (80 pounds) for women; or
a BMI between 35 and 39.9 and a serious obesity-related health problem such as type 2 diabetes, heart disease, or severe sleep apnea (when breathing stops for short periods during sleep)
Past studies found that 10 percent to 20 percent of bariatric surgery patients had complications while they were in the hospital. In 2006, federal researchers found that 39.6 percent of patients had complications within 180 days of surgery. The most common complications are
a composite of gastrointestinal symptoms including vomiting, diarrhea,
dysphagia, and reflux (20%)
anastomotic leaking (at the surgical connections between the stomach and the intestine) (12%)
abdominal hernia (7%)
and "infections" (6%).
About 7% of patients were readmitted to the hospital within 6 months to treat complications specific to the bariatric procedure.
There were 212 in-hospital deaths out of an estimated 104,702 adults who underwent obesity surgery in 2003, or a rate of 0.2 per cent.
The prevalence of extreme obesity (body mass index > or = 40 kg/m²) in the United States in 2003-2004 was 2.8% in men and 6.9% in women.This suggests millions of people are in the weight range for potential therapy with bariatric surgery. Laparoscopic surgery has become an important addition to this field of surgery, and demand soars, amidst scientific and ethical questions.The number of Americans having weight-loss surgery more than quadrupled between 1998 and 2002—from 13,386 to 71,733—according to a study by the Agency for Healthcare Research and Quality.
If diet and exercise are ineffective alone, anti-obesity drugs are a choice for some patients. Orlistat (Xenical®) reduces intestinal fat absorption by inhibiting pancreatic lipase. In January, 2006, a US Food and Drug Administration (FDA) panel of doctors and scientists recommended that the regulatory agency approve over-the-counter sales of orlistat, but GlaxoSmithKline Consumer health care still needs final FDA approval before it can sell the non-prescription version.Sibutramine (Reductil® or Meridia®) is an anorectic or appetite suppressant, reducing the desire to eat. Both drugs have side effects. Sibutramine may increase blood pressure and may cause dry mouth, constipation, headache, and insomnia. Orlistat may cause frequent, oily bowel movements, but if fat in the diet is reduced, symptoms often improve.
In diabetic persons, the drug metformin (Glucophage®) can reduce weight.
Other weight loss drugs have also been associated with medical complications, such as fatal pulmonary hypertension and heart valve damage due to Redux® and Fen-phen, and hemmorhagic stroke due phenylpropanolamine.Many of these substances are related to amphetamine.
Prescription weight loss drugs are recommended only for short-term use, and thus are of limited usefulness for extremely obese patients, who may need to reduce weight over months or years.
The discovery of cannabinoid receptors in the brain and other organs has stimulated research in a new class of drugs, namely cannabinoid receptor (CB1) antagonists, such as Rimonabant.
Unresearched nonprescription products or programs for weight loss are heavily promoted by mail and print advertising and on the internet. The US Food and Drug Administration recommends caution with use of these products, since many of the claims of safety and effectiveness are unsubstantiated.Individuals with anorexia nervosa and some athletes try to control body weight with laxatives, diet pills or diuretic drugs, although these generally have no impact on body fat.Products that work as a laxative can cause the blood's potassium level to drop, which may cause heart and/or muscle problems. Pyruvate is a popular product that may result in a small amount of weight loss. However, pyruvate, which is found in red apples, cheese, and red wine, has not been thoroughly studied and its weight loss potential has not been scientifically established.