Diabetes Complications Research Centre, Conway Institute, University College Dublin, Belfied, Ireland.
Expert Rev Endocrinol Metab. 2022 Sep;17(5):435-446. doi: 10.1080/17446651.2022.2110865. Epub 2022 Aug 10.
Obesity is a chronic disease with a complex interplay of multiple factors such as genetic, metabolic, behavioral, and environmental factors. The management of obesity includes; lifestyle modification, psychological therapy, pharmacological therapy, and bariatric surgery. To date, bariatric surgery is the most effective treatment for obesity by offering a long-term reduction in weight, remission of obesity-related complications, and improving quality of life. However, bariatric surgery is not equally effective in all patients. Thus, if we can predict who would benefit most, it will improve the risk versus benefit ratio of having surgery.
In this narrative review, we explore the question on who will benefit the most from bariatric surgery by examining the recent evidence in the literature. In addition, we investigate the predisposing predictors of bariatric surgery response. Finally, we offer the best strategies in the clinic to explain the potential benefits of bariatric surgery to patients.
Bariatric surgery is an effective obesity management approach. Despite its efficacy, considerable variation of individual response exists. Thus, it is important to recognize patients that will benefit most, but at present very few predictors are available which can be clinically useful.
肥胖是一种慢性病，其发病机制涉及多种因素的复杂相互作用，如遗传、代谢、行为和环境因素。肥胖的管理包括生活方式改变、心理治疗、药物治疗和减重手术。迄今为止，减重手术是治疗肥胖症最有效的方法，它可长期减轻体重、缓解肥胖相关并发症，并改善生活质量。然而，减重手术对所有患者的效果并不相同。因此，如果我们能够预测哪些患者受益最大，将提高手术的风险获益比。
在这篇叙述性综述中，我们通过检查文献中的最新证据，探讨了谁将从减重手术中获益最大的问题。此外，我们还研究了减重手术反应的潜在预测因素。最后，我们在临床中提供了最佳策略，向患者解释减重手术的潜在获益。
减重手术是一种有效的肥胖管理方法。尽管其疗效确切，但个体反应存在很大差异。因此，识别哪些患者受益最大非常重要，但目前可用的预测因素很少，且在临床上没有太大帮助。
