Faculty of Medicine, Department of General Surgery, Gazi University, Besevler, Ankara, Turkey.
Mustafa Kemal Mah. 2137. Sok. 8/14, 06520, Cankaya, Ankara, Turkey.
Adv Exp Med Biol. 2024;1460:697-726. doi: 10.1007/978-3-031-63657-8_24.
Obesity is a constantly growing health problem which reduces quality of life and life expectancy. Bariatric surgery (BS) for obesity is considered when all other conservative treatment modalities have failed. Comparison of the multidisciplinary programs with BS regarding to the weight loss showed that substantial and durable weight reduction have been achieved only with bariatric surgical treatments. Although laparoscopic sleeve gastrectomy is the most popular BS, it has high long-term failure rates, and it is claimed that one of every three patients will undergo another bariatric procedure within a 10-year period. Although BS provides weight loss and improvement of metabolic comorbidities, in long-term follow-up, weight gain is observed in half of the patients, while decrease in bone mass and nutritional deficiencies occur in up to 90%. Moreover, despite significant weight loss, several psychological aspects of patients are worsened in comparison to preoperative levels. Nearly one-fifth of postoperative patients with "Loss-of-eating control" meet food addiction criteria. Therefore, the benefits of weight loss following bariatric procedures alone are still debated in terms of the proinflammatory and metabolic profile of obesity.
肥胖是一个不断增长的健康问题，它降低了生活质量和预期寿命。当所有其他保守治疗方法都失败时，才会考虑肥胖的减重手术（BS）。对 BS 与多学科项目进行减肥效果比较的研究表明，只有通过减重手术治疗才能实现显著和持久的体重减轻。尽管腹腔镜袖状胃切除术是最受欢迎的 BS，但它的长期失败率很高，有人声称每三个患者中就有一个会在 10 年内再次接受另一种减重手术。虽然 BS 可以减轻体重并改善代谢合并症，但在长期随访中，一半的患者会出现体重增加，而高达 90%的患者会出现骨量减少和营养缺乏。此外，尽管体重明显减轻，但与术前相比，患者的一些心理方面仍会恶化。近五分之一的术后“失去饮食控制”患者符合食物成瘾标准。因此，仅从肥胖的促炎和代谢特征来看，BS 后减肥的益处仍存在争议。
