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Bariatrics

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Bariatrics is a discipline that deals with the causes, prevention, and treatment of obesity,[1] encompassing both obesity medicine and bariatric surgery.

Terminology

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The term bariatrics was coined around 1965,[2] from the Greek root bar- ("weight" as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). The field encompasses dieting, exercise and behavioral therapy approaches to weight loss, as well as pharmacotherapy and surgery. The term is also used in the medical field as somewhat of a euphemism to refer to people of larger sizes without regard to their participation in any treatment specific to weight loss, such as medical supply catalogs featuring larger hospital gowns and hospital beds referred to as "bariatric".

Bariatric patients

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Being overweight or obese are both rising medical problems.[3][4] There are many detrimental health effects of obesity:[5][6] Individuals with a BMI (Body Mass Index) exceeding a healthy range have a much greater risk of medical issues.[7] These include heart disease, diabetes mellitus, many types of cancer, asthma, obstructive sleep apnea, and chronic musculoskeletal problems. There is also a focus on the correlation between obesity and mortality.[8]

Overweight and obese people, including children, may find it difficult to lose weight on their own.[9] It is common for dieters to have tried fad diets only to find that they gain weight, or return to their original weight, after ceasing the diet.[10] Some improvement in patient psychological health is noted after bariatric surgery.[11] 51% of bariatric surgery candidates report a history of mental illness, specifically depression, as well as being prescribed at least one psychotropic medication at the time of their surgery candidacy.[12][13]

Methods of treatment

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Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment,[14] medical therapy for severe obesity has limited short-term success and very poor long-term success.[15] 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 mellitus.[16] A meta-analysis of 174772 participants published in The Lancet in 2021 found that bariatric surgery was associated with 59% and 30% reduction in all-cause mortality among obese adults with or without type 2 diabetes respectively.[17] This meta-analysis also found that median life-expectancy was 9.3 years longer for obese adults with diabetes who received bariatric surgery as compared to routine (non-surgical) care, whereas the life expectancy gain was 5.1 years longer for obese adults without diabetes.[17]

The combination of approaches used may be tailored to each patient.[18] Bariatric treatments in youth must be considered with great caution and with other conditions that may not have to be considered in adults.

Techniques used in bariatrics include bioelectrical impedance analysis, a method to measure body fat percentage.

See also

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Physiology

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References

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  1. ^ Torpy JM (2005). "Bariatric Surgery". JAMA. 294 (15): 1986. doi:10.1001/jama.294.15.1986. PMID 16234505. Retrieved 10 Sep 2020.
  2. ^ Dictionary.com, based on Random House Unabridged Dictionary, Random House (2006): [1] Retrieved 15 April 2006
  3. ^ Reynolds K, He J (2005). "Epidemiology of the metabolic syndrome". Am J Med Sci. 330 (6): 273–9. doi:10.1097/00000441-200512000-00004. PMID 16355011. S2CID 10074071.
  4. ^ Hedley AA, Ogden CL, Johnson CL, et al. (2004). "Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002". JAMA. 291 (23): 2847–50. doi:10.1001/jama.291.23.2847. PMID 15199035.
  5. ^ WHO factsheet on obesity Archived May 18, 2006, at the Wayback Machine
  6. ^ Bray, George A. (2004), "Medical Consequences of Obesity", Journal of Clinical Endocrinology & Metabolism, 89 (6): 2583–2589, doi:10.1210/jc.2004-0535, PMID 15181027
  7. ^ Gregg, Edward W.; Cheng, Yiling J.; Cadwell, Betsy L.; Imperatore, Ciuseppina; Williams, Desmond E.; Flegal, Katherine M.; Narayan, K. M. Venkat; Williamson, David F. (2005), "Secular Trends in Cardiovascular Disease Risk Factors According to Body Mass Index in U.S. Adults", Obstetrical & Gynecological Survey, 60 (10): 660–661, doi:10.1097/01.ogx.0000180862.46088.0d
  8. ^ Flegal KM, Graubard BI, Williamson DF, Gail MH (2005). "Excess deaths associated with underweight, overweight, and obesity". JAMA. 293 (15): 1861–7. doi:10.1001/jama.293.15.1861. PMID 15840860.
  9. ^ Bagozzi, Richard P.; Moore, David J.; Leone, Luigi (2004), "Self-Control and the Self-Regulation of Dieting Decisions: the Role of Prefactual Attitudes, Subjective Norms, and Resistance to Temptation", Basic and Applied Social Psychology, 26 (2–3): 199–213, doi:10.1207/s15324834basp2602&3_7
  10. ^ Ikeda, J.; Hayes, D; Satter, E; Parham, ES; Kratina, K; Woolsey, M; Lowey, M; Tribole, E (1999), "A Commentary on the New Obesity Guidelines from NIH", Journal of the American Dietetic Association, 99 (8): 918–9, doi:10.1016/S0002-8223(99)00218-7, PMID 10450304
  11. ^ Kubik, Jeremy F.; Gill, Richdeep S.; Laffin, Michael; Karmali, Shahzeer (2013). "The Impact of Bariatric Surgery on Psychological Health". Journal of Obesity. 2013: 1–5. doi:10.1155/2013/837989. PMC 3625597. PMID 23606952.
  12. ^ Hensel J, Selvadurai M, Anvari M, et al. Mental illnessand psychotropic medication use among people assessedfor bariatric surgery in Ontario, Canada. Obes Surg.2016;26:1531–1536.
  13. ^ Ward H.B., Yudkoff B.L., Fromson J.A. Lurasidone malabsorption following bariatric surgery: A case report. J. Psychiatr. Pract.. 2019;25(4):313-317. doi:10.1097/PRA.0000000000000402
  14. ^ Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, The Evidence Report. NIH Publication NO. 98-4083, September 1998. NATIONAL INSTITUTES OF HEALTH National Heart, Lung, and Blood Institute in cooperation with The National Institute of Diabetes and Digestive and Kidney diseases. Archived June 12, 2006, at the Wayback Machine
  15. ^ "Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement". Am J Clin Nutr. 55 (S2): 615S–619S. 1992. doi:10.1093/ajcn/55.2.615s. PMID 1733140.
  16. ^ Colquitt J, Clegg A, Sidhu M, Royle P (2003). "Surgery for morbid obesity". Cochrane Database Syst Rev. 2 (2): CD003641. doi:10.1002/14651858.CD003641. PMID 12804481.
  17. ^ a b Syn, Nicholas L.; Cummings, David E.; Wang, Louis Z.; Lin, Daryl J.; Zhao, Joseph J.; Loh, Marie; Koh, Zong Jie; Chew, Claire Alexandra; Loo, Ying Ern; Tai, Bee Choo; Kim, Guowei (2021-05-15). "Association of metabolic-bariatric surgery with long-term survival in adults with and without diabetes: a one-stage meta-analysis of matched cohort and prospective controlled studies with 174 772 participants". Lancet. 397 (10287): 1830–1841. doi:10.1016/S0140-6736(21)00591-2. ISSN 1474-547X. PMID 33965067. S2CID 234345414.
  18. ^ Gerwecka, C.A.; Krenkela, J.; Molinia, M.; Frattingera, S.; Plodkowskia, R.; Jeora, S. St (2007), "Tailoring Information to the Needs of the Individual Patient Sustains Interest in the Weight Loss Program and Increases Compliance: A Pilot Project", Journal of the American Dietetic Association, 107 (8): A83, doi:10.1016/j.jada.2007.05.212
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