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Query: UMLS:C0497406 (overweight)
 26,365 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

When overweight surpasses 100% of the ideal weight, morbid obesity, the obese patients is condemned to a complete inability to work, social and sexual inability, and shall suffer from an increase in its morbidity and mortality. This depends to a large degree on the additions to the obesity of insulin resistance, carbohydrates intolerance, hypertriglyceridemia, hypercholesterolemia, and arterial hypertension, all of which is enveloped in a atmosphere of neuroendocrine alterations. An efficient method of treating this syndrome is weigh loss. Medical treatments have not achieved prolonged weight losses during long periods in morbid obese patients, which is a reason for surgery to try and propose new lines of treatment for these patients. The purpose of our study is to examine the effect of weight loss in 100 patients treated with vertical gastroplasty, on the metabolic disorders (triglycerides, cholesterol, glucose) and the arterial hypertension, which are considered to be risk factors in the mortality associated with morbid obesity. Our results indicate that the weight loss modified the metabolic conditions of the patients, with there being a decrease of the levels of triglycerides, cholesterol, glucose, and arterial pressure, after 6 to 12 months after the weigh loss.
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PMID:[Endocrine metabolic and arterial pressure changes in morbidly obese patients treated with vertical gastroplasty]. 869 9

Failure of conservative treatment of obesity stimulated the development of bariatric surgery. The authors performed in 1988-1995 GB in 248 obese patients with a mean overweight of 48.2 kg and with serious comorbidity. The mortality in the group was 1.6%, the morbidity 12.5%. Within 12 months after operation the overweight of the patients declined by 70%, within 24 months by 57%. In the majority of patients the comorbidity receded, the blood sugar level reached normal levels, dyspnoea and hypertension improved as well as the psychic state and social position. The attained results confirm that this treatment of morbid obesity is justified and the authors recommend its wider use. Perspectively laparoscopic gastric banding is associated with a reduced mortality and morbidity, however it is also associated with higher costs.
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PMID:[Gastric banding in the treatment of obesity]. 876 6

Morbid obesity is related to a severe decrease in life expectancy. No medical or dietary treatment offers an alternative to control hypertension, apnea syndrome, orthopedic diseases, ..., caused by overweight. With respect to a serious preoperative evaluation and a severe selection (psychologic, dietetic, ...) Silastic Ring Vertical Gastroplasty is considered in our experience (more than 300 cases) and in the literature as the gold standard for surgical treatment of obesity. The long term follow-up (24-66 months) of 100 consecutive operated patients shows a positive response on hypertension (96%), apnea syndrome (92%), diabetes (85%), gastroesophageal reflux (76%), orthopedic diseases (74%) and cardiorespiratory insufficiency (74%). Considering our experience in the medical and surgical management of patients operated in our department or referred from other centers for complications after different procedures, we actually propose SRVG as the treatment of choice for morbid obesity.
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PMID:[The treatment of morbid obesity with gastroplasty]. 892 52

Obesity is common and its prevalence is rising. In Singapore, a national health survey in 1992 showed that 5% of the adult population were obese and 21% were overweight. Obesity causes much morbidity and mortality and treatment is desirable. The majority of obese patients have no known cause but it is essential to exclude any underlying cause before treatment. Antiobesity drugs should be used as an adjunct to an adequate programme of dietary restriction, exercise and behavior modification. Serotonergic drugs and adrenergic agents are available in the treatment of obesity. The short-term efficacy and safety of antiobesity drugs such as fenfluramine and d-fenfluramine are proven. The long-term use of antiobesity drugs used singly or in combination remains to be established. Many peptides (cholecystokinin, glucagon, bombesin, neurotensin, etc) with weight reduction properties are undergoing extensive studies: their clinical applications are experimental. The treatment of obesity is difficult and frustrating and antiobesity drugs have an established short-term role. In morbid obesity where the life of the patient is in danger, surgery such as gastric plication may be life-saving. The recent discovery of leptin (1994) and neuropeptide Y (1995) are important breakthrough in obesity research; hopefully further research may produce more effective treatment of obesity in man.
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PMID:Current management of obesity. 894 35

Dietetic treatment of overweight has its limits in cases with morbid obesity (BMI > 40 kg/m2) or with disturbed eating habits (compulsive eating). In these cases surgery and cognitive treatment may play a role. Dietetic treatment is often sufficient in patients with moderate to severe overweight (BMI > 27 to 39 kg/m3). This includes in the first place identification of bad habits by evaluation of nutritional behaviour over 3 or 7 days. The most frequent mistakes are the jumping of a meal (mostly breakfast) and nibbling of snacks rich in fat between meals and omission of hypocaloric and voluminous food like fruit and vegetables. The lacking sensation of saturation which is fostered by rapid and automatic food intake, may also contribute to the maintenance of overweight. The first dietetic rules to be observed consist in a regular schedule for meals and-if necessary-snacks in between and the selection of a lipid-poor diet with particular attention to hidden fat. The meal should be turned into an enjoyable experience whenever possible without other concurrent activities.
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PMID:[Dietary approach to obesity]. 899 76

We report the efficacy of a very low-calorie diet (VLCD)-based weight reduction program in patients with morbid obesity whose elective surgery had been postponed because of being overweight. The safety of weight loss on the immune system will also be evaluated. Thirty patients (mean age, 50 years; weight, 125 kg; BMI, 44 kg/m2) were treated. The program consisted of a 7-week to 24-week VLCD period, supported by individual sessions with a therapist, and of a refeeding period of 1 month before surgery. Two patients discontinued, and the mean weight loss of the remaining 28 patients was 19.6 kg (15% of initial weight). In 23 patients, weight loss was 10% or more of the initial weight. After weight loss, 15 patients underwent surgery, 4 patients did not need an operation, and the remaining 9 patients were not operated on for various reasons. The numbers of circulating leukocytes, neutrophils, basophils, monocytes, CD3+, CD4+, CD8+, and natural killer cells did not change significantly by the ninth week on VLCD or by the end of the program. However, there was a significant (p < 0.05) decrease in the immunoglobulinM serum concentration during the program. In conclusion, a VLCD program is suitable for preoperative weight reduction in morbid obesity and seems not to compromise the immune system.
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PMID:Use of very low-calorie diet in preoperative weight loss: efficacy and safety. 944 45

It is well established that there is a significant familial aggregation of obesity, although most of the evidence regarding the genetic basis of obesity has been derived from overweight and moderately obese cases. Less is known about the contribution of genetic factors in severely obese individuals. This paper reviews the available evidence regarding the extent of familial aggregation of morbid obesity and the contribution of specific genes. The results of available studies suggest a stronger degree of familial resemblance for morbid obesity [body mass index (BMI > 40 kg/m2)] than for more moderate levels of obesity (BMI < 40 kg/m2). Evidence from human association and linkage studies, performed with markers surrounding human homologs of the genes involved in mouse models of obesity, revealed that these genes tend to be linked more often to severe obesity than to moderate levels of obesity.
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PMID:Etiology of massive obesity: role of genetic factors. 971 15

Morbid obesity causes co-morbidity such as diabetes mellitus, hypertensive heart disease, sleep apnoea, degenerative bone diseases and increased incidence of malignancy. Life expectancy and quality of life are reduced significantly. Without adequate weight loss, treatment of co-morbidity remains symptomatic only. Surgical treatment of morbid obesity is the one therapy promising long-term success, since conservative procedures normally lead to recurrence of overweight. We performed laparoscopic gastric banding on 130 patients between 1.11.95 and 31.10.97. Mean overweight was 63 +/- 12.7 kg (SD), and mean BMI was 46.5 +/- 4.6 kg/m2. The average hospital stay was 5.5 +/- 1.5 days. 4 patients with postoperative pulmonary embolism were treated with oral anticoagulation. We performed 9 (6.9%) reoperations because of pouch dilatation or dorsal slipping with food intolerance in the first series of 70, and none in the second series of 60 patients. Median weight loss after 3 months was 14.7 +/- 4.2 kg, after six months 24.0 +/- 6.6 kg and after 12 months 33.2 +/- 8.5 kg, corresponding to excessive weight loss (EWL) of 55.9 +/- 14.8% in the first year. 14 (70%) of 20 patients with diabetes mellitus normalised and 6 patients with diabetes mellitus normalised and 6 patients showed improved blood sugar levels. All 36 patients with hypertensive heart disease had normalised blood pressure, 60% of them without further medical antihypertensive treatment after median EWL of 36%. Cholesterol levels normalised in 30 (57%) patients and improved in 20 (38%) after 6 months. Laparoscopic gastric banding is a suitable method for reducing weight in morbid obesity patients and provides a better quality of life in a group of patients who are carefully evaluated and followed. Reducing co-morbidity and improving ability to work have a positive economic impact on health care costs.
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PMID:[Morbid obesity: 130 consecutive patients with laparoscopic gastric banding]. 975 89

Surgical therapy to help the severely overweight has been performed for the past 40 years. As with every therapeutic modality, there have been changes, refinements and improvement as this therapy has evolved. Although the basic concept of gastric bypass remains intact, numerous variations are being performed at this time. Recent data compiled by the International Bariatric Surgery Registry have demonstrated that surgeons are moving from simple gastroplasty procedures, favouring the more complex gastric bypass procedures as the surgical treatment of choice for the morbidly obese patient. This review will discuss the evolution of the gastric bypass procedures, and the reasons for and results of the changes. Gastric bypass may represent the best surgical approach for the treatment of morbid obesity.
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PMID:Gastric bypass procedures. 1010 17

Morbid obesity is a serious disease that is responsible for several comorbid conditions. Body mass indices > 40 require surgical procedures if diet programs fail. Laparoscopic adjustable gastric banding (LAGB), a more recently introduced gastric restrictive procedure, was designed to be a minimally invasive and reversible operation. 184 patients (164 women, 20 men) with a mean body mass index of 47.8 kg/m2 (range 36-79) were operated on. All patients had been excessively overweight for > 5 years. Each patient was given general anesthesia, and an adjustable LAP-BAND was implanted laparoscopically. The pouch size was 15 ml in all cases; and 3-4 sutures were placed to prevent dislocation. The conversion rate was 0%. The median operating time was 65 min (range 45-190). The mortality was 0%. The mean hospital stay was 5 days (range 4-6). The mean excess weight loss was 16% in 4 weeks, 23% in 3 months, 31% in 6 months, 58% in 1 year, and 87% in 2 years. The patient satisfaction index was 97.6%. Once a surgeon has acquired the necessary laparoscopic surgical experience, LAGB is a feasible, safe, and simple procedure with excellent postoperative results. LAGB does not permanently modify the anatomy of the stomach and maintains the natural continuity of the alimentary tract, while at the same time ensuring a steady weight reduction in morbidly obese patients. The fact that the gastric band can be applied laparoscopically is a significant advantage in this group of high-risk patients, who have less pain, faster postoperative recovery, more rapid return to normal activities, fewer wound infections, fewer hernia problems, and better cosmetic results. The rate of postoperative complications is approximately 9%. In 1.1% of patients, erosion occurred, and in 2.2%, slippage of the band. The rate of port-related complications was 3.2%. Reoperations were necessary in 6.4% of the patients.
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PMID:Laparoscopic gastric banding for morbid obesity. 1019 89


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