Pharmacologic and Surgical Treatmen...

Pharmacologic and Surgical Treatment of Obesity

The Agency for Healthcare Research and Quality has released a just discovered report entitled, "Pharmacological and Surgical Treatment of Obesity." The report is available online at http://www.ahrq.gov/clinic/epcsums/obesphsum.htm.

According to the report, surgery may be more effective for weight reduction in extremely obese patients who have tried and failed to waste weight with exercise and diet. Surgery also can improve command of some obesity-related health question s such as high blood urgency and diabetes.

Extremely obese characters (those who have a visible form [i]or[/i] frame mass index [BMI] of 40 or greater) frequently have severe health problems of that kind as heart disease, musculoskeletal disorders, and slumber apnea that limit daily activities and place their lives at greater risk for adverse results An online BMI calculator can be place at http://www.nhlbisupport.com/bmi.

Roughly 60 million adults in the United States are obese, and 9 million are extremely obese. A BMI of 40 or greater is not the one criterion for selecting patients who might benefit from weight-loss surgery Of the 9 million adults who are extremely obese, barely a small fraction (about 15 percent or 140000) sustain weight-loss surgery each year in the United States.

Approximately 20 percent of those who have weight-loss surgery experience minor complications. However, any complications can be serious and include nutritional deficiencies, leaks from staple line break-down, and penetrating venous thrombosis. Laparoscopic procedures terminate in fewer wound complications and incision hernias than traditional abdominal surgery

Bariatric surgery may be more effective than pharmacologic therapy for populace with a BMI of 35 to 40 However, the evidence is not herculean enough to draw firm conclusions for this cluster Roux-en-Y gastric bypass surgery issues in greater weight loss (an average of 20 lb) than does vertical-banded gastroplasty.

There is not enough evidence to draw conclusions about differences in the safety of weight-loss surgery which include adjust-able gastric banding, vertical-banded gastroplasty, and biliopancreatic diversion proceedings Less than 1 percent of patients operated forward by experienced bariatric surgeons die as a end of the surgery or from complications, unless the rate may be higher for less-experienced surgeons

near prescription medicines, particularly orlistat (Xenical) and sibutramine (Meridia), aid moderate weight loss when prescribed along with recommendations for dieting. The amount of weight los directly attributable to these unsalable articles averages less than 11 lb on the other hand research shows that even similar a modest weight loss may decrease the accident of diabetes.

No weight-loss unsalable article appears to be superior to others and, like all medications, each has side results The drugs have not been studied sufficiently to evaluate the risk for rare side consequences nor has there been enough research to determine the optimal time to treat obesity with remedys or how this may vary through patients' age, gender, or race.

remarkably little research has been done forward either surgery or medical treatment of obesity in children and adolescents.

In December 2003 the U Preventive Services Task Force commended that physicians screen all adult patients for obesity, and give or refer obese patients for intensive counseling and behavioral interventions to encourage sustained weight loss.

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group