Klinger R
Minerva Med. 1978 Nov 17;69(56):3821-4.
Reference is made to 96 grossly obese subjects classed as "resistant" to medical treatment and examined as possible candidates for surgery. 31 were eventually subjected to jejunal-ileal bypass. The main difference between these patients and those with slight or average spontaneous obesity was not so much their weight, but its self-maintenance. Weight patterns did not reflect calorie intake, though they pointed to a change in the energy balance when taken as a whole. In some cases that proved resistant both to severe hypocalorific treatment and the by-pass, no reason could be found for the discrepancy between calorie intake and the maintenance of weight. Some correlations between weight and certain endocrine, biohumoral and genetic features offer an idea of the metabolic orientation in gross obesity, but they fail to provide a satisfactory pathogenetic explanation.
有96名严重肥胖患者被归类为对药物治疗“耐药”，并作为手术的潜在候选人接受检查。最终，31人接受了空肠回肠分流术。这些患者与轻度或中度自发性肥胖患者的主要区别与其说是体重，不如说是体重的自我维持。体重模式并不反映卡路里摄入量，尽管从整体来看，它们表明能量平衡发生了变化。在某些对严格低热量治疗和分流术均耐药的病例中，无法找到卡路里摄入量与体重维持之间存在差异的原因。体重与某些内分泌、生物体液和遗传特征之间的一些相关性为严重肥胖的代谢方向提供了一些线索，但它们未能提供令人满意的发病机制解释。
